My Story: Eeeeek… pain behaviors!

My Story: Eeeeek… pain behaviors!

What do you do and say when you hurt? How do you react to chronic pain?

You may moan or groan. You may make a face and grimace or wince. You may touch or rub the area that hurts. You may stop what you are doing and limit activity. You may even say a few choice words.

The body’s natural vocal, verbal, physical, emotional, and social reactions to pain are called pain behaviors. They are our ways of expressing we are hurting.

While fine for acute pain like touching a hot stove, these pain behavior reactions place undue focus on chronic pain and reinforce the pain – causing emotional distress and anxiety. Which can lead to reduced coping skills, intensified perceived pain, disability, and increased use of the healthcare system.

But, wait, Tom. Are you reinforcing the pain by the sheer fact of talking about it in this article?

No. Not really.

It is okay to talk about chronic pain in a general or educational sense just like we do any other topic in a conversation. Our emotions stay in check. What is not okay is “stinking thinking” – verbally expressing pain, complaining about it, wallowing in it, or placing blame for it.

Pain is a learned response not just a physical problem

Research has shown as pain conditions become chronic, the relationship between pain severity and pain behavior weakens. In other words, pain behaviors can become over-exaggerated responses to the pain.

Rubbing the spot where it hurts may help you feel better. But what does rubbing and other pain behaviors tell your brain? They tell your brain how to react the next time you have pain. You not only learn the pain; you learn the reaction.

And what do pain behaviors tell others around you? How do they react to your demonstrations of pain? They may become confused, over helpful, over cautious, or over critical. They may even stop interacting with you.

Change how we react to chronic pain

We know what to expect from our pain by the very nature of it being chronic. It is not like twisting an ankle or getting stung by a bee.

Below are a few tips to reduce pain behavior:

  • Challenge any negative thoughts or feelings about chronic pain – it does not always mean continued damage to your body

While easier said than done, these tips can work with practice.

Tom Bowen oversees the Facebook group Chronic Pain Champions — No Whining Allowed. Check it out for information, resources, suggestions, and support.

sample pain behaviors: what to watch out for
vocalizations Cry, gasp, groan, grunt, moan, say ouch, swear (%$@#!), whimper


Facial expressions


Distressed look, frown, grimace, squint, wrinkled face


Physical Expressions


Clinch fists, bracing, hold breath, restlessness, rubbing, slow movement, tears, tense muscles, turn red or pale


Emotions Anger, anxiousness, fear, irritability


Suffering talk


Darn doctors can’t solve my pain, I hurt, I am sick and tired of this, My day is ruined, My life will never be the same, Not again, This is killing me, This is torture, This sucks, What did I do to deserve this, Why me


Social behavior


Asking for help, excessive sleep, frequent use of healthcare system, guarding, not getting out of house, not grooming, withdrawing from activity


Tom Bowen lives in Iowa and is a chronic pain patient. Hi Facebook group Chronic Pain Champions – No Whining Allowed has information, resources, suggestions and support.

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Authored by: Tom Bowen

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Tom, I see you’ve received some very constructive criticism here. I think that I might understand you though. As a fellow chronic pain patient I understand that we have a choice. Vocalizing or verbalizing our experience often alienated people from our lives as they simply have no frame of reference for our experience and literally do not know what to say or how to support us. We have to support us - our community. Secondly - yes anything I focus my mind and intent on tends to manifest itself in my life. I focus on painting and do the painting and a canvas with a picture appears. I have a choice to focus on the pain ( it’s there 24/7 - no denying it ) or I can use some distraction techniques so as not to heighten my awareness. It’s there, but now it’s in the background vs. the foreground. I think if you explained your rationale and your position with more empathy perhaps it would have been taken more seriously. Overall - a decent read though. Thanks for submitting.

Katherine Douglas

Tom, although I think? I understand what you are attempting to say, I feel your article is very problematic and to me, comes across as shaming and victim blaming. Many of us don’t feel we can talk or “complain” about what we are dealing with, which is extremely isolating. So we don’t. Many of us do the opposite of what you’ve suggested we do in your article, which is minimising body language to hide our pain. Because I carry on regardless and often do not act like I’m in pain, I’ve had doctors (as well as friends) think I must be exaggerating in the few instances I will talk about what’s truly happening for me. Most people suffering from pain use other management techniques like breathing. Despite all of it, sometimes it does get too much, and it’s ok to admit that.
I do understand why catastrophising how we feel about our lives and our futures can be a problem; but there’s also research out there that shows that shows that bottling it up is damaging and “complaining” to others who understand can be therapeutic. “Venting” can also allow us to deal with our emotions. I’m not wallowing, I’m being real. I don’t do it 24 hours a day but websites like this are a place we can for once be honest and say how bad it gets. Venting can make us feel heard, and in turn we can listen and extend our empathy to others in our situation. We are allowed to be angry and frustrated and sad. Nothing wrong with asking for help. Excessive sleep is because pain is very fatiguing regardless of how I pace myself.
If you want people to actually understand and make use what you are trying to say, you might want to communicate this a little differently. You come across to me as completely lacking compassion and empathy, and I would presume that can’t be the actual case since you’ve written something “ trying” to help others.
I found this interesting and more useful to me than what you’ve said here.

Don Prue

I agree with the other people who don’t subscribe to comparing pain, so I don’t…until someone like Tom does it to me.
Tom, get off your pompous pulpit and put your writing skills to good use. Write a novel about how tough people never react to chronic (look the word up Tom) pain. Only crybabies do. Include how pain meds get you high (really?!). Oh, wait a minute, you already did. Maybe your next novel could be “How to Survive Life on Mars.”
Sounds to me like YOU’RE THE CRYBABY!
I did conclude one fact from your sermon on the mount, you don’t know what the hell you are talking about.

Theresa L. Negrete

Oh, I’m not supposed to react to the endless pain? What a joke! Since being cut off my medication that’s an impossibility! Just [edit]!!!!!!!!

Don Prue

In response to Jill’s post; yes Tom. I’ve been ‘sucking up” my pain and going about my life acting like I’m not in pain and not letting it become an obstacle for me for over 20 years (not including a lifetime of pain from scoliosis). That’s why I continued injuring my back. My 7th surgery was compromised of 5 procedures and in recovery I told my surgeon that the pain was ‘inhumane’. He told me “there’s not a drug on the market that will touch this. We’re going to have to make our own cocktail.” It caused me to lose about a week of memory. And when it wore off I was in incredible pain. That was 4 years ago and I’m still in pain.
My pain wakes me up 2-3 times a night in spite of muscle relaxers and sleeping aids. Haven’t figured out how to ‘ignore’ that yet.
My pain doctor of 17 years said he never saw anyone with a tolerance for pain like I have.
The only thing I get by acting like I’m not in pain is disbelief. “How can you do ‘that’ if you’re in so much pain? Can’t win Tom!
If you have chronic pain you are discriminated against. When the pain becomes so freaking severe you react people think you’re a crybaby. Everything and everyone has a breaking point. Even animals react to severe pain.
Veteran suicides are up not because they’re whining and can’t handle pain. It’s because they can’t get the treatment required to deal with chronic pain that finally takes them to their breaking point.
Tom’s advice wouldn’t work for someone trapped in a burning car. Tom’s advice is good for people who have a low tolerance for pain, I guess.


Dear Tom, a positive attitude is helpful guiding you though a difficult time with an ending. Chronic pain experienced by most of the posters has no end with no positive component. No silver lining, no sun behind the clouds waiting to shine again. We all push through our pain, are quite experienced at it, and don’t need condesending advice on how to do that. Facial and verbal expressions that you consider acceptable with acute pain are just as acceptable with chronic. They both hurt!! Pain is pain! Distraction helps sometimes,not at all other times. My pain has been part of my life for over 30yrs. No amount of stoicism or CBT takes it away because it doesn’t come from my mind. The pain will never go away., Please go preach elsewhere. Your article is offensive.

….And I should add Gabapentin was given first!!!

We have two, 14 year old dogs both have arthritis and enlarged livers. Due to possible side effects neither were being treated for their pain UNTIL both dogs walking abilities deteriorated and visible rapid breathing became daily and one developed a worsening daily coughing. After blood work, x rays and ultra sounds it was determined one dog they believe has cancer and the other who has had multiple ultra sounds done by a veterinarian cardiologist he is convinced (dogs regular vet agrees) that the rapid breathing and trachea collapse (that was caused by the stress of pain), daily limping and great decrease in activity is ALL due to untreated pain. Now they have both been put on Tramadol and the rapid breathing has returned to normal most of the time and their activity has increased.They have been now been given medication to control much of their pain and have enough quality of life to want to eat, move and interact. Constant pain was causing physical and psychological damage to both dogs and they are NOT addicts.
I had a stent and a triple bypass in 2017, 5 months after healing my pain medications were cut due to the crisis of people using drugs without medical issues and my blood pressure has yet to go back to normal (which it was controlled on a single low dose of ONE beta blocker before and after surgery until medications were cut). I have been back on the same dosage of pain medication I maintained on for 11 years and now on 3 beta blockers and blood pressure is still high leaving me at risk of a heart attack or stroke every day for 2 years now and my chronic pain issues have deteriorated.
Since the powers that be think every pain patient is an addict and undeserving of relief because of others abuse due to a need to escape life, they should be consulting and learning from veterinarians that animals don
t try to escape life and if fact because of instinct try to hide pain.

Ann Sable

Tom, I kindly thank you for your response. I have undergone all the above since 1996 to present. It hasn’t taken me hostage, it has literally ran me into the ground 365 days since past. I am not new to any of this by any means. Take no offense in what the others and myself has dished out on this topic.
If your mind is saying one thing, but your body, another. There isn’t anything in the world that you can do to change that. You can meditate on that all your days and it still will not make any difference. Of course, depending on what exactly is going on with said illnesses. Happy to hear that you have overcome your obstacles, but do keep in mind that you cannot speak for all. It doesn’t work that way. Those who are able to do so…many kudos to them, sincerely! And, like Linda said below, pain does cause stress on the body and stress in large sums does and WILL cause damage. Much, much more damage internally and externally. I am proof of this. I have had 5 organs removed because of being left untreated. Yet, still, I’m only deteriorating. You cannot retrain your brain for things such as that. Also, I’m only 42 y/o and many years of this to go.
True, your brain is a computer and your gut is your second brain. But when you have all of this working against one another, including all of the other ailments/diseases and such, every single thing that you do and not do, can and will tire and drain you beyond your imagination. To all the CCPs, my heart goes out to each and every one of you and truly hope that you find peace and relief; if only for a moment.

Krista Battrick

Tom, I understand the concept you are going for I think it is the way you have presented it that most people have a problem with. You write that not complaining will help reduce pain levels. But then in the comment section you wrote that it is very helpful to have a positive attitude. I think that if you had written about the benefits of a positive attitude instead of not complaining that would be more well received. Also, there are many conditions/diseases that cause intractable daily pain 24/7/365. I have one of them, its called Trigeminal Neuralgia Type 2. there are no known treatments and no cure. I have tried every treatment that exists - including tying to ignore the pain. So far, the only treatment that helps my pain is opioid pain medications.

Linda Olds

Being in pain is stressful to the body.
The methods mentioned have their place, but they do not get rid of the pain, and patients should not have to grin and bear it.


Oh Tom, Tom, Tom
Reading your article made me want to scream!
The old “now honey you’ve got to think positive” or “focusing on your pain is causing your pain to be worse!!” or “toughen up, stop whining!!” All the things being said by people who know nothing about chronic pain!! Yet you, a supposed chronic pain patient, felt you should write this insulting nonsense for those of us suffering due to uneducated morons supposing to know how we feel.
Each of us have one or more diagnosese or serious injuries! My pain is ever present, severe most of the time, and does include the extreme fatigue. Thinking positive thoughts might work well for a broken arm that soon will heal but not two autoimmune diseases running my body down 24 hours a day, 365 days a year, with unspeakable pain ranging from bad to unbearable! Sorry but the “speaking positive” thing may be great for you but is rather insulting to people who need change from government NOW in order to survive this attack on chronic pain patients!


This kind of talk has no place in the pain community. I’m sorry but pain is not in our heads it is not a behavior of mental health issue. You can no longer think yourself less pain than you can more pain. This kind of article leads to us being labeled headcases in dismissed instead of our pain being taken seriously here.

Bill Viverito

Tom- When I first read your post, while thinking it almost impossible to adhere to, I went to your Facebook page on this post, and simply posted “guilty”. I have personally tried to reduce “pain behavior” as you call it. And have been successful in one area. Getting out of the recliner. I know my knees and back are going to hurt, but I’ve stifled it. And my wife is happy about that. However, after trying to apply this to the rest of my life is near impossible. I see pm doc every month for a morphine pump refill. I need to go to pt 3x/year to keep ambulatory. As I think about it, there’s no way to reduce my dependence on the health care system no matter how hard I might try not to moan, grimace or wince at the pain. Prior to the pump I was a candidate for non cancer palliative car. They’re not required to follow cdc and nih guidelines for opiates. There mission is to keep you comfortable. IE, doped up. No complaints there. But where’s my quality of life go. Down the toilet! After reading all 42 responses. None that I found support your findings, I’m jumping on the I call BS to this philosophy. I’ve earned my right to moan and grimace. And it sure beats the alternative. Thanks for trying, but you seem to be on the lower side of chronic intractable pain. Might want to give some more thought before writing and back it up with some valid and verifiable sources. Think it’s time to leave the No Whining Facebook page. Thanks to all y’all for helping me see the light I was temporarily blocked from.

Continued (part 4)
• Max, when I wrote shorten your breaths, I meant shorten the number of breaths you breathe each minute. Deep breaths are good!

Continued (part 3)
• Alan, no whining doesn’t mean not talking to your doctor, therapist or loved ones about pain. Those are necessary conversations. What isn’t necessary is responding to pain in a negative fashion.
• Ann, I don’t understand how changing our response to pain to better cope with it adds distress. In no way, do I mean to undermine more focus on the chronic pain problem in our country and around the world. More research needs to be spent on chronic pain to develop new treatments and hopefully, someday a cure. Until then, I refuse to let pain take me hostage.
• Robert, great question. You ask for proof about the article’s premise. I don’t have proof but can share a couple of pieces of research that help explain it: The persistence of pain behaviors in patients with chronic back pain is independent of pain and psychological factors ( and Learning and Unlearning of Pain (file:///D:/biomedicines-06-00067.pdf).
• NRJ, the article is incredibly supportive. It provides another tool in your pain toolbox.
• Maureen, the article is comparing acute pain to chronic pain. While pain behaviors are natural reactions to acute pain, they aren’t helpful with chronic pain.
• Angel, I am sorry to har about your diagnosis. It is the first time I heard of this so did some reading. Have you ever tried Cognitive Behavioral therapy to help with the emotional part of pain? Check out Adhesive Arachnoiditis: A Continuing Challenge ( The author recommended CBT as a treatment option.
• Kay, I have a handicapped parking placard and have rode the store scooters, when needed. And yes, I have been hassled before for doing both. We hurt. But that doesn’t mean we can’t find tools to help us live.
• Rosalind, it can’t hurt!


Continued (part 2)

• Pain can become consuming. It is easy to become our pain by giving it to it. It becomes learned behavior just like a kid screaming for candy at the store. If we always buy the child (in this case, pain) candy when they scream, they will continue to scream each time we take them to the store.
• If you expect something will happen, it has a greater chance of happening. Pro golfers envision the ball going straight down the fairway where they want it to land.
• I never mentioned pain medicines, opioids, or the CDC in the article…why the need to shift focus? There is no pill that will magically solve pain (at least, not yet).
• Patients cope differently to chronic pain. But no matter where we are. We can all get better at doing it. Myself included!
• Change is hard. But, as an old boss of mine used to say, “If you always do what you always did, you’ll always get what you always got.”
• Elyce, you can hurt without complaining. Changing how we think about pain and react to it doesn’t diminish the facts pain hurts. It simply recognizes negative thoughts can make stress and pain worse.
• Margie, chronic pain can occur in the absence of tissue damage and long after the body heals – changing how our nerves and brain process the pain. The conclusion of the position paper you cited says, “ Physicians and other health care professionals will have to consider the behavioral and physical health of the patient if they are to be treated as a “whole person.” It makes sense to both the physical and emotional components. Why not try safer therapies, if they are available?
• TerryOtt, I didn’t have a “miraculous recovery from the 3 week Mayo Clinic” program. I still hurt. Always will. Not all chronic pain has an underlying cause or tissue damage. Rather than focus on the pain and the cause, focus on improving function and quality of life.


Hello. I am the author of the article. Thank you for your comments. I appreciate constructive feedback and discussion.

It is hard to write about a topic like pain behavior in a 500-word article. I am just trying to get the conversation started.

Please let me add some flavor and clarify some items based on the comments I have read. Most of the bullets below are general in nature to cover several comments. Some are in direct response to specific comments and mention people by name.

• I live with “real” chronic pain from fibromyalgia, costochondritis, tinnitus, IBS, post-concussion syndrome, neuropathy, chronic fatigue, anxiety, and depression. Rephrase that, I do my best to live despite chronic pain.
• I wouldn’t trivialize anyone’s pain condition. Pain isn’t fun. I, too, would like to be pain-free again. It is not fair to compare my pain to your or anyone else’s pain.
• I am not a trained clinician. Nor do I know it all. I share my experience as a pain patient. Which may or may not be right for everyone else. Treatment is a decision between patient and doctor.
• I didn’t mean to sound preachy, confrontational, or condescending. I was just trying to present content in a straight-forward and easy-to-read format (6.2 grade level).
• I hope the article didn’t come across as victim blaming – telling chronic pain patients to shut up and suck it up. We are not to blame. I know better, pain hurts!
• The article isn’t about being positive and wishing away pain or keeping emotions bottled in (that is what therapists are for). That is unreal. Unfortunately, many pain patients will never be pain-free again. But being positive doesn’t hurt. Research has shown optimistic people are less likely to suffer from chronic diseases and live longer.



Ironically all of these suggestions you have given would be mute if our government wasn’t practicing medicine without a license! Our government/DEA dictating how many MME’s per person per day is discrimination to those patients who are fast metabolizes of Rx opioids, ppl taking other meds that interfere w how well Rx opioids work, & several other factors that would/could cause a person to need a higher dose of Rx opioids then the next.
So yes if cpps who have tried the alternative treatments w/in their financial means w no significant pain relief and Rx pain meds are what work for them then WHY would that patient be denied their life saving meds & offered your suggestion in its place??
This seems to me as CRUEL AND UNUSUAL TREATMENT! Being punished for the actions of someone else needs to stop before no one has any rights left in this country!!

If your not complaining , you must not hurt that bad. We hurt!! And we are not keeping quiet.

I’ve tried Not talking & thinking about pain. No good. I swear complain & cry constantly. I get mad at the Government not the doctors. Why does the CDC get to have a say so over what I do with my doctor for pain he went to school for ,for 10 years.! The Governmement needs to keep out of the medical business and get back to taking care of other messes in the US.

3rd reply. Mr.Bowen thanks for heads up “no pun intended” chronic pain will now be treated as a mental/ behavioral issue.
Look up integration of annals.Org
Annals of internal medicine 18 August 2015. Article titled
( The integration of care for mental illness, substance abuse, and other Behavioral Health conditions into Primary Care: executive summary of a American College of Physicians position paper. Please read all but for short read conclusions. Says 68% of all adults w/ mental illness also have at least 1 chronic physical illness. This is where r chronic pain treatment being treated as a mental illness, substance abuse disorder. It includes sedentary & social isolation equals physical illness & mental illness that increases cost. They r overlooking the pain that causes these things. Chronic pain = mental illness. What!! That when we react / talk about pain it’s a behavioral ( learned response.) I called it bull. This is why we are not getting pain control or very little BC now being treated as in our heads. So medical records will now have us as mentally ill? The healthcare system won’t have to worry about overuse of Medical Care BC we will not see them as often BC we refuse to be lumped in as being mentally ill. Why have they taking a human response to pain that was built into our body our nervous system, turned it into a mental illness? Physicians r being trained pain equals substance use disorder / mental illness. The irrevocable damage they’re doing to CCP. Be aware / afraid CCP.


The great majority of replies to Mr Bowen are clear, correct, and empathetic. One in particular from Cindy says: “While I really don’t believe in one CPP comparing his/her pain to that of another CPP, given your miraculous recovery from the 3 week Mayo Clinic that you wrote about recently, plus that in that same column, you described opioids which you gave up easily as ‘feel good’ pills or some similar phrase, I do have to wonder if your pain was all that bad to begin with.”

Right on, Cindy. And I’d wager that Mr. Bowen’s experience is/was very unlike in nature, causality, and intensity what I saw for years as a caregiver for my wife. We visited Mayo full of hope about learning about the CAUSE of her pain. That was never even discussed by the staff there, except in dismissive terms; they were interested in having us come back for a long $tay in the program to which Mr. Bowen refers, and we never even found out if during that $tay the $taff would have bothered to $pend time and resources to identify the likely cause of her.

My wife and I came to this pain issue from different backgrounds, hers a doctorate in a scientific field, mine as an executive and then co-owner of a large consulting business. Away from home we inhabited different worlds, but agreed on this: When one seeks the best solution for a serious problem, one should first do all possible to determine the nature and cause and only then evaluate and choose among potential responses. Anything else smacks of desperation and/or being overly influenced by some vested interest in one or another of the possible solutions.

FOOTNOTE: Later on, we had the good fortune to be seen (after waiting months) by a world-class neuro specialist and researcher in the CRPS field. She’d worked at Mayo for several years. When told of our experience there, she was dismayed and said “If I’d have been the doctor you encountered at Mayo, I can absolutely assure you things would have gone differently for you”.

Alan Edwards

No whining allowed is double speak for don’t tell your doctor about the Cancer pain in your lower back or under the thigh. Suck up the lower back pain when the steel you lift at work can no longer be lifted and your job is lost. Say nothing about chronic neuropathic pain which attacks your ears, skin and any bodypart touched by your down pillow.
And yes, physical therapy after 50 years has failed. Moaning, screaming, and crying are allowed until the police decide to give fines. The Mayo Clinic, and JAMA are in the FDA budget. Pain is a vital sign. Verbalization is autonomic and tells your dog and those who can hear that something is afoot and should be dealt with. Have you ever had intractable pain for 50 years day and night with nausea? Cerebral palsy with spasticular pain? NPR has to cover both sides. But Chronic, Intractable pain with multiple comorbdities is the most tortuous condition known. Screaming and moaning allowed.

“We know what to expect from our pain by the very nature of it being chronic. It is not like twisting an ankle or getting stung by a bee.” — When you suffer from Dercum’s Disease, Ehlers-Danlos Syndrome and other comorbidities: yes it does (chronically) “feel” like that. There is no predicting other than daily torture. I’ve been a long time patient at Mayo Clinic and other renowned facilities. I‘ve submitted my case to the TV show “Chasing the Cure” for more help because I can’t seem to stop “distracting my mind” in the meantime.


That’s right, you just got hit with a baseball bat to your eufhr knee. Don’t wince don’t gasp don’t stumble don’t cry out just don’t. Every time I stand, almost every time. My right knee will lock in place and no matter which way I try
It has to unlock usually with a loud pop. Shooting pain through the knee joint radiating up and down my leg. It’s brief and sharp and always takes me by surprise. Strange that a 1998 reconstruction surgery that was deemed a success could cause such ramdon pain. For the most part ihave ignored it cause it’s not operable. I still have stainless steel staples in the bone above and below the knee joint. Do I wince, grab my knee, call out, say a choice word. Sure I do! Oh yeah when I stand one a few minutes without walking it like a coffee grinder. My knee . painfully? Sure is. A learned response to pain? Not sure denial is the right answer to being in pain. Acceptance may be a start. But I know what pain feels like and it’s not pretty. Am I looking for sympathy. Nope. Understanding, compassion anything from anybody. Not. Really. But my doctor, my politicians who would be doctors, the CDC and the DEA.. YES, THEY NEED TO BE AWARE THAT PAIN IS AN UGLY WAY TO HAVE TO LIVE. NNO JUSY EXIST.. Happy faces and smiles all around. Have a nice day everyone. Sarcasm is another way to deal with pain

Ann Sable

And…this is the FINAL answer after all that ‘we chronic pain patients’ have gone through and fought and even have been speaking out, all along. Wasted words, wasted tears, pleading and begging to be heard and treated -properly; if at all. And now, something this obsurd to be printed out for the whole world to see just set us all back even further. Tsk-tsk! As to, what I have said above, a total lost cause and have seen it coming all along. Keep your heads down, your mouths shut and show no emotion…just to please and put at ease of others that do not want to hear nor see the likes of us. Very disappointed with this article. Very contradictory to everything that we have been told to do. But, for those of us that know better, this speaker and all that was said, is already out there now. All I can say is…thanks a million for nothing but more distress on all of us that had some hope. So sad…


The Copd video Telephone health Coaching is rediculas.As a cpp and Copd patient I think it’s a dangerous game to turn to some stranger on the phone to help Coach us.When someone is in the Red Zone, the place to be is the ER not the phone.Each person should be treated on an individual basis.Time is essence and should be left to the specialist.I am not a smoker and know many who aren’t and have died of this disease.While I can see pulmonary Rehabilitation offered after being discharged from the Hospital which I have done .I personally think the Mayo Clinic should not be offering a phone coach.Just my personal opinion.Showed this to my Pulmonary Specialist yesterday and she looked at me and said it’s rediculas and our care should be left in the Hands of of Drs. So now what? Are we at the point we will all have Telephone Coaches for every illness out there,rather than an actual Physician.


I started to chime in with the rest of the objections but I thought I would at least ask for what proof the writer has for his underlying premise; “these pain behavior reactions place undue focus on chronic pain and reinforce the pain – causing emotional distress and anxiety. Which can lead to reduced coping skills, intensified perceived pain, disability, and increased use of the healthcare system”. If his premise is true we would be better served to give consideration to the advice. So… what studies are involved and are they reliable?


The Author once again sounds like The Poster boy for Mayo Clinic.I also see the Mayo Clinic must of taken some quotes out of the AA Books.Stinking Thinking,Wallowing,blaming others complaing about it.I know because 20 years ago I was asked to show my support to a Friend who admitted she needed help and to go to a meeting with her.I did.No im not an Alcoholic nor do I drink.I was showing my support.she still sober. Just stop already! What worked for you does not work for us all.In your mind I am whining right? Sorry but not sorry I can’t think my damn pain away.I won’t get into my many problems that prevent me from doing things I once loved because it seems you have no empathy for the CPP community.You can’t fix the world so stop acting like you got this.I know these are suggestions but I don’t think they are yours alone.I believe they are the Mayo Clinics and have to wonder if the Mayo Clinic pays you to try and recruit us over to them. Glad it worked for you but please stop pushing this on us.It is people like you who are making matters way worse than they already are.Margie said it well.I think you drink way to much Kool -Aid.

This is what your article sounds like follow the movement of the watch ,are you feeling sleepy, do you hear my voice. LOL
What do you do when you are hungry ignore the will to eat. imagine there is no food for you and you have gone without food for several days, do you rub your stomach and think about all I wish I had something to eat even a bag of chips would be nice. No don’t do that because you wouldn’t want to tell your brain and reinforce that your stomach is growling then it’s telling you that you want food but then you’re giving into a behavior that is natural to the body. Even when dogs fight or cats they let out some horrific noises especially when flesh is torn are scratched and when you go to work on this animals flesh they even flinch or trying to bite. so is the animal reinforcing it’s pain Behavior in the brain because you’re trying to treat the scratch or wound? Or when a animal has arthritis you will see it licking an area until it is raw because it is comforting , is the animal reinforcing its pain Behavior ? We are not the only animal that reacts to pain or goes off by itself to lick its affliction or to die. Animals kill the weak or chase away the old and afflicted heard. Some Humans animals do the same. I think you need to spend some time in a very small box for about a week then come out and then make those statements. I think you drink too much Kool-Aid. LOL

Alan Edwards

A CDC approved article. Informative, does not apply to severe intractable pain patients. Frequent use of a healthcare system? As an intractable pain patient, farmed out to specialists, who do nothing for the entire 5 minute visit. Ludicrous. If I could legally self administer pain and disease treatment I would
be back in the workforce in months. There is no healthcare system in the USA. Medicare is in complete shambles and bankrupt.
Sick patients need not observe etiquette when in severe pain caused by the CDC, police overreach, and threat of civil forfeiture or legalized theft.


Go have enough bone removed from your spine to loose 1 1/2 inches in height, the come back and tell me about how the pain is all in my mind !!

Thomas Kidd

Not funny at all. Maybe we could just strain really hard and all our pain would go poof. Makes about as much sense.

Thomas Kidd

Not possible to change how we react to chronic daily pain


Very disappointed this is posted on this site, which is normally extremely supportive! How did I take this advice… it made me angry. First initial thoughts were “are you freaking kidding me?! I have anxiety from how much I try to hide my pain. Why do I try to hide it? To try follow your advice that is already common sense to me. I can’t hide my grimacing forehead though… if I did I think I would burst, because I had no release from the pain.”
This is the problem with lumping every CPP, addict, personality type, history etc… into one bucket. It’s not a one size fit all. Yes, I’m angry with the way CPP’s are being treated, hence, very defensive.


I do my best to be open-minded about different approaches to dealing with ongoing, incurable pain, although I must admit that I’m not a big fan of the “it’s your fault” approach. Somehow, it seems like I’m not doing something “right” or I wouldn’t be in serious pain(?).

I’d like to take a look at the author’s “No Whining Allowed” website but I’m required to join the group first-which I’m not sure I want to do sight unseen. I did some brief research on Mr. Bowen and, as I rather anticipated from his earlier post, he appears to be a healthy-looking gentleman in his 40s. He has an impressive background in finance, marketing and sales. I do not know much about his chronic pain experience.

I try very hard not to be a whiner and to carry on with my life as best I can as I approach 83 Y/O. I also try not to “show” pain-who wants to look like an OLD person in a society that does not value us? However, when I can barely turn my head to due to degenerative disc disease and osteoarthritis, I’d really like to understand how to “take note of the pain, accept it and let it go”!


While this information may be useful, not exhibiting pain behaviors can work against chronic pain patients interacting with health care professionals. “Oh she must be faking her pain because she dormant seem to be in pain”.


Are you serious?? This article is describing ACUTE, not CHRONIC, pain. Do you think someone who is in continual pain walks around grimacing, groaning and clutching their hands all the time? Next time you have the flu try, “mindfulness” all day long and see if that helps. Chronic pain is just that: CHRONIC, like diabetes, high blood pressure, etc. Who has got you in their pocket?

Cindy R

Pain behaviors definitely scream “victim” to onlookers, but I hadn’t thought how they might reinforce pain in the brain.

As for your FB group, What a great idea! I was involved in some very helpful online groups many years ago on Compuserve, but my experiences on Facebook have run the gamut from disappointing to depressing, to hilarious (pointing out an experimental blood test for fibro was neither “FDA approved”, nor “proof of disability for SSA”, as the moderator claimed, and being kicked from the group for my assertion)
I hope you also discourage the people who insist on pushing their religion on others?

Kris Aaron

Accept the pain and then let it go?
Distract myself?
Relax and take short breaths?
How about our elected officials lean HARD on the Drug Enforcement Administration and force them to stop prosecuting physicians who write what agents (with no medical training) decide are “too many” opioid prescriptions for chronic pain patients?
Perhaps the families whose much-loved members accidentally overdosed on illegal fentanyl could stop blaming physicians who prescribed Grandma the opioids that “disappeared” out of her medicine cabinet. Maybe they could admit their son or daughter knowingly took several narcotics at once (poly-drug intoxication) and washed them down with high-proof alcohol, which helped depress their central nervous system and stopped their breathing.
Can we please see an end to politicians campaigning on a “law and order” platform that includes blaming prescription opioids for overdose deaths, even when it helps get them elected? How many of those deaths were caused by stolen drugs NOT prescribed to the victims?
Physicians for Responsible Opioid Prescribing (PROP) recommends denying prescription opioids to everyone but end-stage cancer patients. That approach certainly helps fill beds at pricey – and unregulated — drug “rehabilitation” centers that profit off frequent flyers – patients who return time and time again because the earlier rehab efforts failed. Perhaps it should be acknowledged that the founder of PROP was an investor in a chain of those clinics.
The vast majority of drug overdose deaths are caused by illegal fentanyl mixed with heroin, poly-drug intoxication combined with alcohol, and illegally obtained prescription opioids.
Why should pain patients pay the agonizing price for other people’s bad judgement? Why should we be forced to suffer and rely on idiotic solutions like “pain acceptance”, distraction and deep breathing?

Angel Soulet Porche

I can’t believe what I just read! Having Arachnoiditis is not something you can just move on and suck it up buttercup! I’m so disappointed in this article. Until you walk a mile in someone else’s shoes…. Take short breaths, that’s all I can take because the pain is unbearable. I feel demeaned because I have chronic pain. Believe me, I didn’t need to hear that! I’m demeaned enough by my own family because” She’s not who she used to be….She never hangs out anymore….She doesn’t cook like she used to every Wednesday and Saturday! REALLY! Thanks for such fantastic advise!

Judie Plumley

I didn’t like this at all. There have been times I cried my heart out over not the pain, but the sorrow of it, the sheer fact other human beings can allow such agony.
I cry in my sleep when I don’t even know it. God gave us pain for a reason, and many ways to voice it. And though I am ashamed of my tears, and I hate my family to see me in such pain, I am thankful I can express it.
Expressing pain does not make a person weak.


Yes, I agree with Patricia. And sometimes these are the only coping mechanisms we have. I suffer from severe FM, osteoarthritis, chronic migraines, neuropathy, severe, chostochondritis, and many digestive issues including ulcerative colitis, and pancreatitis. I sometimes have pain so severe it makes me get dry heaves. I have vomited on occasion too. You can try to relax all you want, but until you yourself experience this kind of pain you just have no idea. When you feel as though you’ve been hit in the chest with a hammer or it feels like you’re being stabbed with a knife, or your skin feels like its on fire you’re going to grimace! I can guarantee all of us are trying to distract ourselves and cope as best as we possibly can. Many of us are masters at it from living with these issues for so long. I will never know what its like to wake up and feel good again. Somedays are so bad it litetally feels like torture. I know many can relate. It’s definitely
not healthy to keep this bottled up. While I agree that constant whining, crying, and focusing on the pain (giving pain the power) is not good, but one definitely needs to have a good cry or vent at times to release all the stress and anxiety that builds up from living with chronic pain.


I can’t tell you how maddening this article is but one thought: I was told during childbirth prep to yell good and loud when I needed to, it was better for me than holding my breath and caused me to inhale sooner, keeping oxygen up. You’re not going to convert this crowd. We know better! Maybe better than the Mayo Clinic.

Oh please, these suggestions are well known by everyone who has crossed the 3 month chronic pain threshold and beyond. As we all know, the one-size-fits-all does not apply to those who suffer from various forms of complex neuropathic conditions. To think otherwise is ludicrous and unfair. Taking a cold hearted and callus approach to chronic pain, suggesting that the patient should Shut-Up & Man-Up or Get-Lost may work in some cases, may even help reduce SOME forms or pain by rewiring the CNS through positive thought. But in my opinion, that only applies to those who feel that a warm consoling sympathetic heart contradicts that ethos, and may even worsen their own pain. Another words, its selfishly cruel IMO. Therefore no thanks, you can keep your Facebook Group.

Kay Sodowsky

“Stiff upper lip” is an interesting philosophy, and yet, how many of us with hidden disabilities have been hassled for using our handicapped parking placards because we “don’t look disabled?” I feel the judgement of invisible eyes every time I park and I hope they DO see me wince and scowl in pain! After reading this piece, I can’t help but feel, “Damned if I do, and damned if I don’t.”

Katie Olmstead

I have mixed feelings about this. Having been in pain daily for 21 years, I have learned a lot of coping skills. I have taught myself to look “normal” and act “normal” in order to function in the world. I have learned to report on pain rather than whine about pain. That’s an important distinction for me. If someone asks how I am, I might just say “fine” or I might really tell them what is going on but rarely with emotion. On the one hand, I think this is healthy for being in the world. On the other hand, I don’t know if I am actually causing more pain by invisibly gritting my teeth. I even have TMJ now. So, quite literally gritting my teeth. I don’t want to be seen as that person in pain. I want to be seen as the vivacious person I am but I also want some people to really know what a struggle my life is. One thing I require is time alone, often lying on an ice pack, or like now, sitting with a purring cat in my lap. I need time when no one sees how i am reacting. I am still not interested in acting the victim. I am passed that but the balancing act of appearing normal vs being more truthful is tricky. I will dance robustly for 3 hours tonight but I will pay for it tomorrow and require solitude.

Rosalind Rivera

I am torn between accepting what the writes says, realizing that he is absolutely correct in his descriptive assessment of how we feel and react to pain and how he over simplified how we feel and react to our pain. I’m actually shocked to admit that he is most definitely correct in his discovery. I believe that I will endeavor to try his solution. It can’t hurt, right?

Take note of the pain, accept it, then let it go. Really? Ever heard of atypical Trigeminal Neuralgia ? I have pain 24/7. When it flares there is no way to “let it go”. Am I supposed to make others feel comfortable when I’m in pain? Sorry, can’t do it. Is that why you say no whining allowed in your group? Most TN groups are so you have others you can “whine” to who understand the pain. It helps to have people who understand. I don’t think I’ll be joining your group.