Pain behaviors: what are they and how do they affect well-being?

When we feel pain we emit a series of behaviors that, without realizing it, can harm us in the long term. Find out how they affect us and what to do about it.

Pain behaviors: what are they and how do they affect well-being?
Elena Sanz

Written and verified by the psychologist Elena Sanz.

Last update: 28 October, 2022

Pain is a physical event. Of course, when there is an injury or any type of organic damage, it is necessary to intervene to treat it. But, Did you know that your mind also plays an important role in increasing or reducing your suffering? One of the most curious phenomena are the so-called pain behaviors or disease behaviors.

are those reactions, acts or behaviors that we perform as a result of pain or discomfort. For example, putting pressure on the painful area with your hand, adopting certain postures to mitigate the sensation, or avoiding certain activities while you feel bad. This kind of behavior seems very logical; and, in fact, in the beginning they can be of help to us. However, in the long run, they can make the discomfort last longer.

Pain behaviors can maintain long-term discomfort.

What are pain behaviors?

Normally, we tend to think of pain as something purely physiological: stitches, a burning or itching sensation, pressure or tension in the area… However, the reality is that it has several other components:

cognitive aspect

It refers to the thoughts, ideas and beliefs that are generated and maintained around pain and illness. And these are not the same in all people.

There are those who adopt a catastrophic attitude that accentuates the negative vision that almost all of us already have of pain, to constantly ruminate about it And you can’t get it out of your mind. They pay a lot of attention to it and this generates a greater sensitivity to pain as well as a more intense perception of it.

emotional or affective aspect

It is related to the emotions generated by pain. Obviously, it is not pleasant for anyone, but there are those who develop excessively negative affects. For example, they feel helpless and unable to control the ailment, they exaggerate the threatening properties of the painful stimulus and they feel that they cannot do anything to influence their situation.

These associated emotions amplify the pain and also add a component of psychological suffering.

behavioral aspect

Finally, all pain has a component related to conduct, acts and behavior. It is reflected in the actions we take in this regard.

As we said, this can range from touching the area that hurts, verbalizing how sick or sore we feel, visiting the doctor, taking medication or limiting our movements or daily activities. These are all so-called pain behaviors.

What role do pain behaviors play?

All of these actions occur naturally when we are in pain. It is normal for us to do them and they can help us feel better, obtain comfort or find solutions. Nevertheless, if we over-commit to them, they can become a problem.

Those who emit this type of disease behavior the most are more likely to adopt the “sick role”, to settle in that conception of themselves and, therefore, to suffer the consequences of seeing themselves in this way. Although, in the face of specific pain, they may not have great relevance, if we talk about a chronic condition, these behaviors can aggravate the situation and disability.

Those who are more involved with these behaviors and settle in the “sick role” tend to suffer more pain, experience more symptoms of anxiety and depression, higher degrees of disability and inactivity and worse employment status. These results have been found when analyzing patients with pathologies such as low back pain, rheumatoid arthritis, fibromyalgia or migraine.

In view of these findings, psychotherapeutic strategies have been designed to reduce or eliminate these pain behaviors in order to reduce discomfort and improve the quality of life of patients.

Those who emit more behaviors of pain tend to adopt more the role of sick.

psychotherapeutic interventions

This behavioral approach to pain focuses on modifying these behaviors associated with discomfort. Thus, the person is urged to progressively get rid of those reactions that he has developed.

These procedures are known as operant techniques, since they are based on the principles of instrumental conditioning (that is, all behavior that is repeated and maintained does so because it is reinforced in some way).

From this point of view, we note that by performing pain behaviors, we often receive some kind of secondary benefit. For example, we get attention, affection and comfort from our loved ones. Or we can free ourselves from unpleasant activities (like working or doing housework). Although unconsciously, we understand that this “sick role” provides us with advantages, and we continue to embody it.

Thus, a conscious commitment and work is sought to reverse this situationn. For example:

  • Stopping verbalizations of discomfort
  • Eliminating facial and body gestures of pain
  • Stopping avoiding situations “welcoming” the disease. Resuming and restoring all those daily activities that are limited (always as far as possible).
  • Introducing physical exercise

Through gradual programs, each advance is reinforced and the objective is thus achieved. Although a comprehensive approach that does not neglect the physical and physiological aspects of pain is always necessary, working in the rest of the areas (and, specifically, in the behavioral one) can favor a better quality of life.

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