There’s a New Way to Conquer Chronic Pain

The experience of pain is often a fact of everyday life. You’ve strained a muscle, stubbed a toe, or wrenched your back. Now you are faced with days, weeks, or possibly months with this nuisance interfering with your ability to enjoy life.

No one can escape even temporary pain, but chronic pain can be a different matter altogether. People with diseases such as arthritis, for example, have to find a way to cope so that they can put the pain on the back burner. Although it’s natural to believe that the fix must come from physical treatment, there is new evidence that personality plays a strong role in influencing outcomes.

Alexithymia: The Hidden Culprit in Pain

According to a new study by Johns Hopkins University’s Rachel Aaron and colleagues (2026), there is solid evidence to support the role of alexithymia in chronic pain. Defining alexithymia as “a cluster of emotion processing deficits, including difficulty identifying and describing one’s own emotions," this personality trait is elevated in pain sufferers.

The risk of alexithymia may be associated with the experience of distress, the authors suggest. If you’re not aware of your emotions, you can’t use psychological strategies to regulate them. Further, you might try to shove the pain out of awareness by turning to problematic substance use. Then there are your relationships. Being in pain on a chronic basis takes the edge off your pleasure, and not being able to regulate your emotions means that other people might not want to be with you that much, even the people you care about.

Testing Alexithymia’s Role in Pain via Distress

Aaron and her research team used data from a large follow-up study of more than 1,500 people in the United States living with chronic pain (average age 41 years). To measure alexithymia, they used a standard 20-item questionnaire consisting of three subscales: difficulty identifying feelings, difficulty describing feelings, and externally oriented thinking (not attending to feelings). A simple measure of chronic pain asked participants to rate their worst, least, and average pain (on an 11-point scale) within the past day. Finally, psychological distress was assessed with a symptom rating of depression and anxiety.

Across a 24-month period, the authors plotted out the pathways linking alexithymia at the beginning, middle, and end points of the study to emotional distress and pain severity at each time point.

Turning to the findings, alexithymia showed a continuous effect on pain levels through the intermediate effects of distress. To understand this pattern of relationships, the authors suggest that it is indeed failure to engage in emotion regulation strategies that can exacerbate the experience of pain. What’s more, due to the structure of the study (i.e., measuring pathways over time), there is little possibility that the pathways go in the opposite direction. In other words, if you can’t regulate your emotions, you can’t regulate your pain.

Making the Pain Go Away

The Johns Hopkins study provides concrete support to help you through the long and the short of your experiences with pain. Think about the experience of stubbing your toe. It’s annoying that this mishap is going to ruin your day, week, or month. The aching toe prevents you from wearing your favorite shoes, perhaps, or going on the hike you’ve planned with your friends. These emotions rival the sensations you feel from your aching foot. If you don’t confront and try to manage these emotions, you’ll never be able to set the pain aside and take it all in stride. Yes, it hurts, but at least you didn’t break anything, or there’s nothing you can do to change what happened. These are both standard emotion-regulating strategies.

Another angle to the alexithymia-distress-pain relationship is that this personality trait can directly increase pain on its own through such thought processes as catastrophizing (“This is the worst thing to happen!”) and pain-related fear (“Did I break it?”).

Unfortunately, alexithymia is regarded as a stable trait. This means that individuals high in this quality could be fated to a life of chronic pain when something physically goes wrong. The authors suggest that this outcome can be averted through “a staged treatment approach” in which the methods of cognitive behavioral therapy are applied to help individuals identify their emotions as the first step to reducing their impact on the experience of pain. Not as helpful, they maintain, would be mindfulness treatments in which people are encouraged to focus on the pain as a way to reduce its interference in their lives. People high in alexithymia need more help in bringing their emotions to the forefront so they can learn to neutralize them.

To sum up, because you can never completely avoid pain, identifying the personality risk factors at work can provide you with relief. Once you can get your emotional awareness to work for you, pain can become just another challenge in your life that you can successfully manage.

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