Condition
Chronic Pain — therapy online across the UK
Psychological support to help you live well alongside persistent pain, working alongside your medical care.
1 in 5
adults live with chronic pain
Recommended
CBT and ACT alongside medical care per NICE
High
overlap between chronic pain and depression/anxiety
Improved
quality of life with acceptance-based approaches, per research
Understanding it
About Chronic Pain
Chronic pain is pain that persists beyond normal healing time, often for three months or more, and can affect mood, sleep, relationships and daily functioning as much as it affects the body. Psychological therapy doesn't suggest the pain is 'in your head' — it addresses the very real toll pain takes on mental health and helps build strategies for managing flare-ups, pacing activity, and reducing the distress that can amplify pain's impact.
Chronic pain and the nervous system are closely linked: prolonged pain can sensitise the nervous system, meaning pain signals persist or intensify even without ongoing tissue damage. This is a recognised physiological process, not a sign that the pain isn't real.
Fear of pain often leads to avoidance of activity, which can cause deconditioning, low mood and increased focus on the body — which in turn can increase perceived pain. Breaking this cycle through gradual, paced activity is a core part of psychological pain management.
Living with chronic pain frequently brings grief — for the body, activities, identity or future you expected — alongside frustration with a healthcare system that can feel slow or dismissive. Processing this alongside practical pain management tends to improve outcomes.
Mood, stress and pain interact in both directions: low mood and anxiety can amplify the experience of pain, and persistent pain understandably affects mood — which is why addressing both together, rather than treating them as separate issues, is usually more effective.
How it shows up
You might recognise some of this
Nobody has all of it. Most people recognise a handful — and that's enough to start.
How it shows up
- Pain persisting beyond three months, with or without a clear ongoing cause
- Increased low mood, anxiety or irritability linked to pain
- Avoiding activities for fear of triggering or worsening pain
- Sleep disruption due to pain
- Frustration or grief about changes to capacity or identity
What sessions involve
- Understanding the relationship between pain, stress and mood
- Pacing strategies to build activity without triggering flare-ups
- Managing pain-related fear and avoidance
- Acceptance-based approaches to living well alongside ongoing pain
- Processing grief and identity changes related to chronic pain
What changes
- Reduced pain-related distress and catastrophising
- More consistent activity levels through pacing
- Improved mood and sleep
- A renewed sense of identity and purpose alongside pain
Signals
When this helps
- Pain-related distress, anxiety and low mood
- Avoidance and fear around movement or activity
- Sleep difficulty linked to pain
- Grief around changes in capacity or identity
- Building a sustainable, paced daily routine
The work
How therapy helps here
Addresses the psychological impact of persistent pain directly
Builds practical pacing and flare-up management strategies
Supports a renewed sense of identity and purpose alongside pain
The evidence
What the research actually says
Plain-English summaries of the guidance our therapists work from.
CBT and ACT are recommended alongside medical care
NICE guidance for chronic pain recommends psychological therapies, including CBT and ACT, as part of a combined approach alongside physical and medical management, rather than pain treatment being purely pharmacological.
Pacing reduces the boom-and-bust cycle
Research on activity pacing shows it reduces the pattern of overdoing it on good days and being incapacitated afterwards, supporting more stable functioning over time.
Acceptance-based approaches improve quality of life
Studies on ACT for chronic pain show it can improve quality of life and reduce pain-related disability, even when pain intensity itself doesn't change — by changing the relationship to the pain.
What to expect
How a course of therapy usually unfolds
A guide, not a script — your therapist shapes this around you.
- 1
Understanding your pain and its impact
Mapping how pain interacts with mood, activity, sleep and relationships in your specific situation.
- 2
Pacing and activity planning
Building a sustainable, consistent activity level rather than a cycle of overexertion and crash.
- 3
Addressing pain-related fear and avoidance
Gradually rebuilding confidence in movement and activity where medically appropriate.
- 4
Acceptance and values work
Shifting focus toward what matters to you, alongside pain, rather than solely fighting to eliminate it.
- 5
Maintenance and flare-up planning
Preparing specific strategies for managing pain flare-ups without losing overall progress.
Worth saying
Common worries, honestly answered
“Seeing a therapist means the pain isn't real or is 'in my head'.”
Chronic pain is physiologically real. Therapy addresses its real psychological impact and helps manage the nervous system's role in pain, alongside — not instead of — medical care.
“Resting completely is the best way to manage pain.”
Complete rest often leads to deconditioning and can increase pain sensitivity over time; paced, appropriate activity is usually more helpful.
“You have to eliminate the pain before you can live well.”
Many people significantly improve their quality of life by changing their relationship with pain, even when the pain itself doesn't fully resolve.
Between sessions
Small things that genuinely help
None of these replace therapy — but they're a gentle place to begin today.
- Track pain alongside activity to spot your personal boom-and-bust pattern
- Break activities into smaller, paced chunks rather than pushing through
- Practise a brief relaxation or breathing technique during flare-ups
- Notice catastrophic thoughts about pain and gently question them
- Stay connected to people and activities that matter, even in adapted form
FAQs
Frequently asked
Find the therapist who fits
Answer 10 short questions and we'll match you within 48 hours — no card needed to start.