Chronic Pain and Self-Blame: Understanding the Role of Self-Compassion

This article considers self-blame and a lack of self-compassion as one of several factors that may be associated with the persistence of chronic pain. Chronic pain is influenced by a range of interacting medical, neurological, psychological, and environmental factors, and experiences vary between individuals.

Living with chronic pain often means carrying more than physical discomfort. In addition to the ongoing physical sensations, many people also bear the invisible weight of self-blame. Thoughts such as “If I had taken better care of myself,” “If I were stronger,” or “I should be coping better than this” can quietly establish themselves, turning pain into a moral failing rather than a human experience. Over time, this internalized blame can become as exhausting and harmful as the pain itself.

Self-blame is not a personal flaw; it's a common psychological response to long-term suffering. When pain persists without clear answers or cures, the mind searches for reasons. Blaming oneself can feel like regaining a sense of control; if the pain is my fault, then perhaps I can fix it. Yet this belief often backfires. Instead of empowering change, self-blame amplifies stress, shame, and emotional distress, all of which can intensify pain through the nervous system.

In many cases, cultural narratives that highly value productivity, resilience, and personal responsibility contribute to the reinforcement of self-blame. People in pain may absorb messages (subtle or explicit), that they are not trying hard enough, that recovery is a matter of willpower, or that suffering reflects weakness. For those with histories of trauma or attachment wounds, self-blame may feel even more familiar. It can reflect earlier experiences of needing to take responsibility for circumstances beyond one’s control in order to feel safe or acceptable.

From a mind–body perspective, self-blame keeps the nervous system in a state of threat. The body interprets harsh self-criticism as danger, activating stress responses that increase muscle tension, inflammation, and pain sensitivity. In this way, self-blame does not merely coexist with chronic pain; it can actively maintain it. The body is asked to heal while simultaneously being attacked from within.

This is where self-compassion becomes a therapeutic necessity. Self-compassion involves responding to suffering with kindness rather than judgment, recognizing pain as part of the shared human experience, and offering oneself the same care one might extend to a loved one. Importantly, self-compassion is not about resignation or giving up, it's about creating the internal conditions in which healing, both emotional and physical, becomes more possible.

Practicing self-compassion in the context of chronic pain often begins by gently questioning self-blaming narratives. Instead of “What did I do wrong?” the question becomes “What has my body been carrying?” or “What do I need right now?” This shift moves the focus from fault to understanding, from judgment to curiosity. It acknowledges that chronic pain arises from complex interactions between biology, stress, trauma, environment, and chance; factors no single person can fully control.

Self-compassion also supports nervous system regulation. When individuals speak to themselves with warmth and patience, the body receives cues of safety. Over time, this can help reduce hypervigilance and allow the nervous system to move out of constant fight-or-flight into a parasympathetic phase. While self-compassion does not eliminate the underlying source of pain, it can reduce both secondary suffering and pain intensity by calming the nervous system, lowering threat responses, and decreasing pain amplification.

Learning self-compassion is often challenging, especially for those who have relied on self-criticism as a survival strategy. It may initially feel unfamiliar, uncomfortable, or even undeserved. This, too, deserves compassion. Developing a kinder inner relationship is a gradual process, one that may be supported through trauma-informed therapy, mindful practices, or compassionate body-based approaches that emphasize safety and choice. I have written more about different ways to apply self-compassion here.

Ultimately, releasing self-blame does not mean denying the desire for improvement or relief. It means recognizing that healing does not come from punishment. Chronic pain already asks enough of the body and mind. Self-compassion offers a different path; one that honours the reality of suffering while reducing its emotional weight. By softening the inner response to pain, individuals can begin to relate to their bodies not as enemies to be fixed, but as allies deserving of care, patience, and respect.

If this is something you’ve been affected by, please leave a comment below. If there’s something important you’d like to add, please do so. I'd love to hear from you.

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Dr. Ingela Thuné-Boyle is a licensed Practitioner Health Psychologist and a Doctor in Behavioural Medicine who specializes in improving the quality of life of people struggling with long-term health problems, chronic pain and trauma. She runs a private online (telehealth) practice at www.ingelathuneboyle.com. You can find out more about her background [here], and more about her approach to therapy [here].

📩 Contact: For therapy or other enquiries, you can contact her at info@ingelathuneboyle.com.

Please note: Advice given in this blog is not meant to take the place of therapy or any other professional advice. The opinions and views offered by the author is not intended to treat or diagnose, nor is it intended to replace the treatment and care that you may be receiving from a licensed physician or mental health provider. The author is not responsible for the outcome or results following their information and advice on this blog.