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7 Psychological Factors Affecting Pain Perception

Why do people experience pain differently?

Key points

  • Not everyone hurts the same way; pain tolerance varies greatly among individuals.
  • Our expectations, mood and perspective on pain powerfully influence our sensitivity to pain.
  • Our mental state can dramatically affect pain perception.

Pain has a protective role. A primary role of acute pain is to protect us from further harm. For example, a painful blister on your foot can motivate you to stop walking or to wear more comfortable shoes.

People might experience pain differently depending on various emotional and cognitive factors (belief, anxiety, and expectations) (Lumley, 2011). These factors can substantially shape the experience of pain. They function as a kind of volume control for pain, and they play a major role in any pain management (Corns, 2017).

1. Attention

Pain disrupts the person’s attention and forces them to focus on their body. The pain is then judged as a threat, which makes them more aware and urges them toward addressing the injury. Paying close attention to the pain sensations may increase pain intensity. Attention distraction from pain is one of the most used strategies for managing pain. Because you can only attend to only one thing at a time. This explains why athletes can continue to play and soldiers can continue to fight when injured. They often don’t notice their injury until the action stops.

2. Interpretation

Some people may perceive a pain problem as devastating to one’s well-being whereas others may perceive the same pain problem as an inconvenience that can be tolerated and managed. It is the meaning of how pain influences life activities and the future that fuels much of the pain-related emotions (i.e., suffering). For example, the emotional aspect of cancer pain is quite different from labor pain. The positive emotional consequences of labor pain may offset, to some degree, the unpleasantness of pain.

3. Attitudes toward pain

Cultural factors influence beliefs, perceptions, and emotions. Culture can influence how an individual communicates pain, pain tolerance, and pain catastrophizing. Some cultural groups expect an excessive display of emotion in the presence of pain, while others value stoicism, restraint, and playing down the pain, or accepting pain as a natural part of life. For example, in some Asian cultures, there is a tendency to avoid talking about one’s own pain.

4. Catastrophic thinking

Catastrophic thinking can be defined as imagining the worst possible result that could happen. Catastrophizing may worsen pain by making a person focus and attach additional emotion to it. Catastrophic thinking can also be viewed as a coping strategy used to draw support from others, such as showing an excessive display of pain in the hope of gaining better support. The social reinforcements of exaggerated illness behavior can serve to sustain it.

5. Sense of agency

Having control over an unpleasant stimulus can make it feel less painful. Evidence has shown that patient-controlled analgesia allows a patient experiencing pain to self-administer analgesics to be effective for acute pain management. Patients clearly feel better as their sense of control increases. Pain is no longer a threat when we know we are not entirely at its mercy.

6. Expectations

The subjective experience of pain is largely shaped by our expectations. When people expect to have more pain, they have more pain, and vice versa. Expectations are a fundamental component of the placebo effect. The placebo effect means that when someone expects that a treatment will work, it tends to work better than if the person expects that it will not work. The placebos are effective because people believe in them. In fact, a placebo is an effective pain therapy without any side effects.

7. Anxiety

Anxiety is well known to increase pain. Anxious people seem to have a lower pain threshold. Some people (mostly men) even shy away from seeing doctors because they fear receiving bad news. Some deny their pain through pills, narcotics, alcohol, etc. In contrast to the effects of anxiety in intensifying pain, positive emotional states (such as could arise when listening to pleasant music), generally, reduce pain. For example, research shows that pain is reduced when partners hold hands.

In sum, psychological factors play a huge role in pain perception. The mind and emotions can powerfully exaggerate or dimmish the perception of pain. Pain is not a purely sensory experience reflecting underlying tissue damage. Emotions, beliefs, and actions are vital parts of the human pain experience (Morris, 1991).


Corns, J. (ED) (2017). The Routledge Handbook of Philosophy of Pain. London; New York: Routledge.

Lumley, M.A., Cohen, J.L., Borszcz, G.S., Cano, A., Radcliffe, A., Porter, L., Schubiner, H., & Keefe, F.J. (2011). Pain and emotion: A biopsychosocial review of recent research. Journal of Clinical Psychology, 67, 1-27.

Morris, David B. (1991). The Culture of Pain. Berkeley: University of California Press.

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