Tug of war with the pain monster

Radically Accepting Chronic Pain | Psychology Today United Kingdom


This is a very good article from a psychologist and a chronic pain sufferers explaining how to apply Acceptance and Commitment Therapy.

There is a focus on letting go of the struggle in your life, and reflects on the ACT metaphor, “Tug of War with the Pain Monster”.


The article says,

  • “Radically accepting chronic pain involves fully acknowledging the present moment without fighting it.
  • Practicing radical acceptance helps us “drop the rope” in the game of tug-of-war with chronic pain and frees up energy.
  • We can then put our focus on things we can control, are grateful for, or are meaningful to us.

It is natural to fight against chronic pain. It is physically unpleasant and uncomfortable, making certain activities more difficult or less enjoyable. And, the more we fight against pain, the stronger it gets and the more depleted and exhausted we feel.

Radical acceptance is defined as being willing to fully accept the present moment as it is. Radically accepting chronic pain does not mean you like it or are resigned to it. You can practice tools to improve your quality of life even with pain. Radically accepting chronic pain simply means you completely acknowledge what is happening in the moment without struggling against it.

This can feel like a tall order. I have been living with a physical disability for over 40 years and I continue to fight against my chronic pain. Often this fight comes from wanting the pain to go away. My body hurts and it can feel like a slog to get through the day. And, by fighting my pain, I am ultimately fighting myself and increasing my distress. Deep down, I know spending my mental and physical energy in a tug-of-war with my pain is futile. It does not make the pain better.

Living with chronic pain is tiring and can make us feel physically and emotionally stuck. Radically accepting pain frees up energy as we are not using energy fighting pain and helps create options. You could spend your time and energy struggling against pain. Or, you could take a few slow, deep breaths. Or, you could go for a walk outside. Or, you could call a loved one. There is power in or, in knowing there are options and that you have the power to choose how you respond to pain.

So, how do we “drop the rope” and stop playing tug-of-war with pain?

Acknowledge How You Are Feeling

Ignoring, or trying to suppress, our emotions and physical sensations just make them stronger. If your lower back is killing you, for example, and you feel frustrated and tired, acknowledge this. You may simply say, “My lower back is hurting right now and I feel exhausted.”

Pause and Breathe

Next, pause for a few moments and take some slow, deep breaths, focusing on lengthening the exhale portion of the breath. For example, you may inhale to a count of 3 and exhale to a count of 5. Living with chronic pain is stressful and is often associated with muscle tension. Taking some slow breaths eases physical and emotional tension and may make it a bit easier to practice other coping skills.

Practice a Radical Acceptance Coping Statement

Use a coping statement. These statements are meant to remind you that there are things you cannot control and that it is unhelpful to fight against what is outside of your control. Here are some examples:

  • This moment is what it is even if I don’t like it.
  • I accept this moment as it is.
  • Fighting my current reality only increases my distress.
  • Although this moment is unpleasant, I can cope with it as it is.
  • Although my pain is unpleasant, the intensity ebbs and flows. This specific sensation will not last forever.

Shift Your Focus

When I notice that I am caught in a tug-of-war with my pain, I practice pausing and reminding myself that I have a choice in where I put my attention and energy by asking myself, “Jen, how do you want to be spending your mental and physical energy right now?” Then, I aim to focus on things I can control, am grateful for, or are meaningful to me.

For example, maybe I put in a load of laundry as this is a specific task that I can control. Or, I remind myself that I am grateful that I can go for a walk even if my legs hurt. Or, I make a plan to go out to eat with my partner as I value taking time to nurture my relationships.

So, pause and ask yourself, “What is something I can focus on right now that is under my control, I am grateful for, or is meaningful to me?” and do your best to let the answers guide your behavior.

Your pain will still be there. And, by dropping the rope and not playing an endless game of tug-of-war with it, you will create more space to live your life.”


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