Understanding Chronic Pain: The Biopsychosocial Model

Let’s be honest—if you’ve been living with chronic pain, you’ve probably heard it all. “Have you tried yoga? It took my mom's migraines away!” “Maybe you should drink more water - you might just be dehydrated.” “It’s probably just stress.”

Chronic pain is exhausting enough without having to decode confusing advice or defend your experience. That’s why I want to introduce you to a gentler, science-backed way of understanding what’s going on in your body. It’s called the biopsychosocial model.

What is the Biopsychosocial Model?

At its heart, this model says: pain isn’t just physical—it’s personal. Everyone experiences it differently depending on their body, their mind, and their world. Here’s a quick breakdown:

Bio – What’s Happening in Your Body

This is the part most people are familiar with. It includes:

• Injuries or illnesses

• Inflammation or immune responses

• Structural issues (like a disc bulge or joint damage)

• Hormonal shifts

• Sensitization of the nervous system (when your nerves become extra reactive over time)

  
  

In chronic pain, the nervous system often becomes more sensitive. The same signal that wouldn’t have caused pain before now does. This is called central sensitization (aka amplified pain syndrome, fibromyalgia, complex regional pain syndrome and other pain syndromes), and it’s a big part of why chronic pain can persist even after the original injury has healed.

It doesn’t mean you’re imagining your pain. It means your nervous system has gotten into the habit of reacting as if you’re in danger—even when you’re safe.

Psycho – What’s Happening in Your Mind

Your brain is always interpreting signals from your body—like a translator. Its translations are heavily influenced by:

• Your emotions (stress, anxiety, fear, grief)

• Your beliefs (about your body, your future, or your pain)

• Past experiences with trauma, injury, or being dismissed by others

• Mental habits (like catastrophizing, or always expecting the worst)

• Your fear when pain starts to escalate

  
  

Let’s say you bend over to tie your shoe and your back twinges. If you’ve had a scary injury in the past, your brain might panic. That fear response alone can make your pain worse. Why? Because your brain is wired to protect you. If it thinks you’re in danger, it may amplify the pain signal.

This doesn’t mean pain is “in your head.” It means your head (your brain) plays a key role in how your body feels—and that’s something we can work with, not against.

Social – What’s Happening in Your Life

We don’t live in a vacuum. Everything from your daily environment to your cultural background to your relationships can influence pain, including:

• Feeling isolated or misunderstood

• Navigating work, school, or financial stress

• Lacking access to healthcare or validation

• Receiving unhelpful messages from doctors, teachers, or family

• Cultural beliefs about illness and strength

  
  

Stressful environments can activate your body's fight-or-flight system. This keeps your nervous system in a heightened, reactive state. On the flip side, connection, safety, and support can help dial pain down.

All of this weaves together to shape your experience of pain. And—here’s the hopeful part—because pain is influenced by many things, there are many ways to support your healing, too.

Your Pain is Real. Period.

This isn’t about saying “it’s all in your head.” Your pain is real. It’s your nervous system trying to protect you—even if it’s a little overprotective, like a smoke alarm that goes off when you toast a bagel.

Sometimes our pain system gets stuck in the “on” position. It can keep shouting danger! even when there’s no fire. The good news? With the right tools and support, we can help it settle down. Not by ignoring the pain, but by getting curious about what it’s trying to say.

What Does Healing Actually Look Like?

Not a bootcamp. Not a magic pill. Not “just think positive.” Healing through a biopsychosocial lens often looks more like this:

• Learning how your nervous system works—so pain feels less scary and mysterious.

• Slowly and incrementally increasing your capacity to function in life - in a way that doesn't overwhelm your nervous system)

• Pacing your activity—not doing nothing, not doing everything, but finding that sweet spot in between and then slowly growing your capacity to do a little more.

• Calming your nervous system—through breathing, movement, connection, and sometimes just watching cat videos guilt-free.

• Shifting unhelpful thoughts (gently!)—especially those ones that say, “I’ll never get better.”

• Doing things that bring joy, not just relief—because life isn’t just about avoiding pain; it’s about actually living.

  
  

And yes, it’s a slow road sometimes. Healing isn’t linear. But over time, small steps can add up to big changes.

You’re Not Broken—and You’re Definitely Not Alone

If you take one thing from this, let it be this: you’re not broken. You’re not faking, imagining, or failing. Your body is trying to protect you. In fact, it is doing too good a job of protecting you and has become overprotective. We just need to re-teach it that the world around you is safe and that it doesn't need to increase your pain in order to keep you safe.

Incorporating the biopsychosocial model into your understanding of pain can be empowering. It opens up new avenues for healing and support. Remember, your journey is unique, and it’s okay to seek help along the way.

~ Carla

Registered Clinical Counsellor (RCC)

Chronic Pain Coach