Why Avoiding Pain Shrinks Your Life (and What ACT Does Differently)
When you live with chronic pain, avoidance can slowly become a way of life.
You stop moving in certain ways.
You cancel plans “just in case.”
You rest more than you used to — not always because you need to, but because it feels safer.
Avoidance is rarely a conscious choice. It is a natural response to pain and fear, driven by a nervous system trying to protect you from harm. And yet, over time, it can quietly shrink your world.
Acceptance and Commitment Therapy (ACT) offers a different approach — one that helps people step out of the fear–avoidance cycle without pushing through pain or ignoring limits.
The Fear–Avoidance Cycle
Research into chronic pain consistently shows that fear of pain is often more disabling than pain itself.
When pain is interpreted as dangerous, the brain learns to avoid anything that might trigger it. This leads to:
Reduced activity
Loss of confidence in the body
Physical deconditioning
Increased attention to symptoms
Heightened pain sensitivity
Ironically, the strategies meant to protect the body can end up reinforcing pain.
This fear–avoidance cycle often looks like:
pain → fear → avoidance → reduced function → increased pain.
Why Avoidance Makes Sense — and Why It Backfires
Avoidance is not a sign of weakness. It is a sign that the nervous system is in threat mode.
In the short term, avoiding painful activities can bring relief. But when avoidance becomes the primary way of coping, it sends a powerful message to the brain: this is dangerous.
Over time, the brain responds by increasing vigilance and pain signals, keeping the threat system switched on.
Avoidance Is Not the Same as Pacing
Many people worry that challenging avoidance means pushing through pain. ACT makes an important distinction.
Avoidance is driven by fear and control.
Pacing is guided by values, flexibility, and self-compassion.
ACT supports graded, values-based engagement — taking small, intentional steps toward meaningful activities, rather than forcing or withdrawing.
What ACT Does Differently
ACT does not aim to eliminate pain or fear before life resumes.
Instead, it helps people:
Notice fear-based urges without obeying them automatically
Make room for discomfort while staying connected to what matters
Rebuild trust in the body through gentle, flexible action
Expand life without demanding certainty or control
Rather than asking, “How do I avoid pain?”
ACT asks, “What kind of life do I want to live — even with pain present?”
Re-Expanding Life, One Step at a Time
In ACT, progress is not measured by pain reduction alone, but by life expansion.
This might look like:
Attending a social event for a short time
Returning to a valued hobby in an adapted way
Moving the body gently and consistently
Saying yes to life in small, manageable doses
These steps are chosen deliberately — not in defiance of pain, but in service of meaning.
Avoidance Shrinks Life. Values Expand It.
When pain dictates choices, life often becomes smaller.
ACT offers a way to acknowledge pain while refusing to let it be the sole decision-maker. With support, people can learn to live a fuller life — not because pain has disappeared, but because it no longer defines everything.
I offer ACT-informed therapy for people living with chronic pain, both individually and in groups. If this approach resonates, you’re welcome to contact me to explore whether it may be helpful for you.
By Dr Michelle Beukes-King
