Living a Meaningful Life Despite Chronic Pain: An ACT Perspective
One of the most painful losses people describe when living with chronic pain is not only the pain itself, but the life that feels as though it has been put on hold.
“I’ll do that when my pain is better.”
“I’ll start again once this flare settles.”
“I can’t live properly until this is fixed.”
Over time, days become organised around pain levels rather than purpose. And while this makes sense — pain is exhausting and demanding — it often leaves people feeling stuck, disconnected, and grieving the life they once imagined.
Acceptance and Commitment Therapy (ACT) offers a different way forward: a life guided by meaning, not by pain.
When Pain Becomes the Decision-Maker
Chronic pain has a way of taking over decision-making.
Plans are cancelled. Activities are postponed. Relationships narrow. Life becomes smaller — not because people don’t care, but because pain and fear start calling the shots.
Many people tell me:
“I don’t know who I am anymore without my old life.”
“Everything I do depends on how much pain I’m in.”
“I feel like my life is on pause.”
ACT recognises this pattern as understandable — and changeable.
Values vs Goals: An Important Distinction
ACT places a strong emphasis on values, and this is where many people experience a shift in how they relate to pain.
Goals are outcomes (e.g. “I want my pain to be gone”).
Values are directions (e.g. “I want to be a caring parent,” “I want to stay connected,” “I want to contribute in some way”).
Pain can interfere with goals.
Values, however, remain available — even on difficult days.
You may not be able to control pain, but you can choose how you show up in your life.
Living Despite Pain Does Not Mean Ignoring It
Living a meaningful life despite chronic pain does not mean:
Pushing through pain at all costs
Denying physical limits
Invalidating your experience
ACT is not about forcing yourself to “be positive” or pretending pain doesn’t matter. It is about making room for pain while refusing to let it erase what matters to you.
This often involves learning how to pace, adapt, and take smaller steps — not fewer steps.
Reconnecting With What Matters
One of the first questions ACT invites is simple, yet powerful:
If pain were not in charge, what would you want your life to stand for?
For some people, this may be:
Being present with loved ones
Expressing creativity
Helping others
Living with integrity and compassion
Staying engaged with the world in meaningful ways
ACT helps people take values-based actions — small, intentional steps that honour these priorities, even when pain is present.
Why Meaning Can Reduce Suffering
Pain often demands centre stage. When life becomes narrow and restricted, pain has more room to dominate attention and identity.
When life expands — even gently — people often notice:
Less emotional suffering
A greater sense of agency
Improved mood and resilience
A feeling of “being themselves again,” even in a new way
Meaning does not cure pain. But it can profoundly change how much power pain has over your life.
ACT in Practice: What This Looks Like in Therapy
In ACT-based therapy for chronic pain, this work may include:
Clarifying personal values
Grieving losses while making room for a new life chapter
Learning how to take flexible, values-driven steps
Reducing the impact of fear and avoidance
Developing compassion toward yourself and your body
This approach works alongside medical care, not instead of it.
You Are Allowed to Live Now
One of the hardest ideas to let go of is the belief that life must wait until pain improves.
ACT gently challenges this — not by minimising pain, but by asking whether waiting has come at too high a cost.
You are allowed to live a meaningful life now, even if pain remains part of the picture.
I offer ACT-informed psychological treatment for people living with chronic pain, both individually and in groups. If this perspective resonates, you’re welcome to contact me to explore whether this approach may be helpful for you.
By Dr Michelle Beukes-King
