The Biopsychosocial Model of Chronic Pain & Supporting the Sensory/Emotional Experience of Pain

Source: Training Development Resources/Chronic Pain — webinar notes doc (biopsychosocial model of chronic pain)

Core beliefs behind this model:

• All pain is real and is a biopsychosocial experience — pain perception happens in the brain, not "just in your head."
• Hurt ≠ harm: feeling pain doesn't necessarily mean injury or tissue damage is occurring.
• Pain = protection: pain is a signal from the brain meant to protect the person.
• Recovery is possible.

Factors that influence chronic pain, relevant to a coach working with a young person managing pain alongside mental health: anxiety/depression/stress (very high overlap — ~60% of people with chronic pain have significant anxiety, ~20% have depression; stress increases inflammation and pain-receptor activity); fear of pain and catastrophizing; sleep disturbance (bidirectional with pain); trauma exposure; health behaviors (smoking/alcohol increase inflammation; exercise is protective); and altered body perception (guarding behaviors, disliking a body part).

What actually helps (coaching-relevant takeaways):

• Support the young person in working with their medical team rather than around it — keeping notes between appointments, being honest about what's realistic, helping them identify short- and long-term goals tied to what matters to them (not just "less pain" but "what do I want to be able to do").
• Goal-setting and self-efficacy matter: SMART goals plus checking in on personal values increases follow-through.
• Gentle movement/stretching (not necessarily formal exercise) can reduce pain over time — the "boom and bust" pattern (overdoing it on a good day, crashing after) is common and worth naming; consistent, gradual pacing (activity–rest–activity–rest) helps the nervous system learn that movement is safe.
• Mindfulness and relaxation approaches (MBSR, ACT, DBT) are associated with improved affective pain and quality of life, more so than reducing sensory pain itself.
• How much attention a person gives their pain, and how they interpret it, shapes how much it affects them — this is a place where a coach can help broaden someone's field of awareness without dismissing what they're feeling.
• Coaching stance: don't over-accommodate (can remove agency) or under-accommodate (can leave someone feeling isolated and increase pain through unaddressed distress) — aim to empower while showing empathy.