Counselling for Chronic Pain (In My Practice)

If you live with chronic pain, you may have encountered moments where your pain was minimized, misunderstood, or dismissed. These experiences often come from broader stigma surrounding chronic pain and can occur in everyday conversations, workplaces, healthcare settings, or within social relationships.

Over time, being exposed to messages like “it’s all in your head” or “just think positively” can understandably make the idea of counselling feel confusing, frustrating, or even unsafe.

Because not every counsellor or therapist approaches chronic pain the same way, I think it is important to be clear about what counselling for chronic pain looks like in my practice and what my role is when working with people who live with ongoing pain or chronic illness.

Understanding Chronic Pain

Chronic pain is generally understood as pain that lasts beyond normal healing time, typically longer than three months, or pain that continues without a clear, ongoing injury. In Canada, chronic pain is often described as falling into two broad categories.

Some people live with chronic primary pain, where pain continues even after the body has healed or where there is no single identifiable cause. This can include conditions such as fibromyalgia, persistent low back pain, pelvic pain, or other widespread musculoskeletal pain.

Others experience chronic secondary pain, which occurs alongside an underlying condition or medical issue, such as arthritis, autoimmune disorders, Long COVID, post-surgical pain, cancer-related pain, or pain associated with chronic illness.

While causes and diagnoses may differ, what these experiences share is that pain becomes an ongoing part of daily life rather than a short-term symptom.

General definitions and categories of chronic pain are informed by public health information from the Government of Canada.

Living With Chronic Pain Is More Than a Physical Experience

Pain is a deeply personal experience and can vary widely from person to person. Chronic pain is influenced by many factors, including the body and nervous system, emotions, mental health, stress, social context, and life experiences.

In my counselling work, I often see how chronic pain affects far more than the physical body. It can impact:

• Mental and emotional wellbeing

• Sense of identity and self-worth

• Relationships and social connection

• Work, finances, and job security

• Participation in everyday activities

• Meaning, values, and future planning

This is one of the reasons chronic pain can feel so overwhelming. It touches nearly every area of life.

The Social Impact of Chronic Pain

Because chronic pain is often invisible, many people encounter misunderstanding or disbelief from others. Friends, family members, employers, and even professionals may not fully understand the pain or may question whether it is real.

Over time, this can lead to isolation, reduced support, difficulty accessing services, and

hesitation to seek help at all. These social barriers can add another layer of stress on top of the pain itself.

In counselling, these experiences matter just as much as physical symptoms.

First, Let’s Be Clear: Your Pain Is Real

In my counselling practice, the reality of your pain is not doubted. Chronic pain is real. It is not imagined, exaggerated, or a personal failure. Feeling emotionally affected by pain does not make the pain less legitimate. It reflects the reality of living in a body that hurts. My role is not to convince you otherwise, but to acknowledge your experience and support you within it.

What Counselling for Chronic Pain Is in My Practice

In my work, counselling for chronic pain is not about "fixing" your body. It is about supporting you as a whole person living with pain.

This may include:

• Making space for grief related to losses that often come with chronic pain, such as changes to identity, independence, work, or future plans

• Support with anxiety, low mood, frustration, or burnout related to ongoing symptoms

• Navigating unpredictability, flare-ups, and fluctuating capacity

• Learning pacing, boundaries, and energy management that respect your limits

• Processing medical or healthcare experiences that may have felt invalidating or overwhelming

• Rebuilding a sense of meaning and quality of life alongside pain

The focus is not on pushing through pain. It is on learning how to live in a way that feels more supported, sustainable, and compassionate.

Why This Work Still Matters Even When Pain Persists

A common and very understandable question is: If counselling cannot take my pain away, why does it matter?

Chronic pain often affects identity, relationships, emotional wellbeing, and the ability to engage in daily life. Counselling can help reduce the emotional weight of carrying pain alone and provide space to process what living with pain has taken and continues to take.

Over time, many people find they feel less overwhelmed, more supported, and more able to engage with life in ways that align with their values, even when pain remains present. The goal is not perfection. It is support, understanding, and improved quality of life.

My Approach as a Social Worker

My approach is grounded in a whole-person perspective that considers not only the individual, but also their environment, relationships, and the systems they move within. I work collaboratively and flexibly, recognizing that capacity can change from day to day. Sessions are adapted to what you are able to bring in that moment.

When appropriate, I draw from therapeutic approaches such as Acceptance and Commitment Therapy (ACT), Cognitive Behavioural Therapy (CBT), and Narrative Therapy, always adapting these approaches to the realities of living with chronic pain or chronic illness. These approaches are not used to suggest that pain is imagined or to eliminate pain. Instead, they support emotional wellbeing, help reduce the additional suffering that often accompanies chronic pain, and focus on building a meaningful life alongside pain rather than fighting against it.

I also work from a person-in-environment and systemic perspective, recognizing that chronic pain does not exist in isolation. Alongside personal experiences, we explore how social, financial, cultural, workplace, and healthcare systems influence the experience of pain. Challenges related to work, relationships, disability supports, or access to care are understood as real external pressures, not personal failures.

I also bring specialized training in chronic pain and chronic illness, along with personal lived experience. This shapes how I listen, how I pace sessions, and how I support clients without minimizing what they are going through.

There is no single right way to cope with chronic pain. Different approaches work for different people, and part of this work is figuring out what fits you.

Who This Approach May Be a Good Fit For

This approach may be helpful if you:

• Want counselling that validates your pain rather than challenges its existence

• Are grieving changes to your life, identity, or future due to chronic pain or illness

• Feel emotionally exhausted or overwhelmed by ongoing symptoms

• Are struggling with everyday tasks, relationships, or changing roles because of pain

• Have had difficult or traumatic experiences within healthcare systems or feel worn down by barriers to care

• Want support in building a meaningful, sustainable life alongside pain

• Need flexibility and understanding around fluctuating capacity

You do not need to be in crisis to seek support.

Moving Forward, At Your Own Pace

There is no timeline for when someone should seek counselling. If and when you choose to explore support, it is important that it feels respectful, collaborative, and aligned with your needs. My goal is to offer counselling that honours the reality of chronic pain while supporting emotional wellbeing and working toward a better quality of life.

If you are curious about whether this approach might be a good fit, I offer a free 15-minute consultation where you can ask questions and explore next steps without pressure.

Book a free consultation

References

Government of Canada. About chronic pain.https://www.canada.ca/en/public-health/services/diseases/chronic-pain/about-chronic-pain.html