How to Talk to Family & Friends About Your Chronic Pain

You cancel plans again. Your friend sounds annoyed.

You try to explain why you can't help with something. Your family member rolls their eyes.

You mention your pain. Someone suggests you just need to exercise more or think positively.

Living with chronic pain is hard enough on its own. But talking about it with the people closest to you can feel impossible.

You want them to understand. But you're tired of explaining. And you're tired of not being believed.

Chronic pain therapy can help with many aspects of pain. Including how to communicate about it in ways that feel less exhausting and more effective.

Why is chronic pain so hard for others to understand?

Pain is invisible. People can't see what you're feeling. They can't measure it or understand it from the outside.

When you say you're in pain, they have to take your word for it. And if you look fine, it's hard for them to believe you.

This isn't always their fault. Most people understand pain from their own experience. A headache that goes away. A sore muscle after exercise. Pain that has a clear cause and a clear end.

Chronic pain is different. It doesn't go away. It doesn't always have a visible cause. And it varies day to day in ways that don't make sense to people who haven't experienced it.

So when you can do something one day but not the next, they get confused. They think you're being inconsistent. Or that you're exaggerating when you don't want to do something.

They also don't understand how exhausting pain is. How much energy it takes to manage. How it affects your mood, your sleep, your ability to focus.

They see you functioning sometimes and assume you're fine. They don't see the cost of that functioning.

All of this creates a gap. Between what you're experiencing and what they can understand.

And that gap makes communication really hard.

What are good scripts for talking about invisible pain?

Sometimes it helps to have specific words. Especially when you're too tired to figure out what to say in the moment.

When someone suggests a simple fix: "I appreciate that you want to help. I've tried a lot of things. Right now I'm working with my doctor and therapist on approaches that fit my situation."

When someone doesn't believe your pain: "I know it's hard to understand because you can't see it. But the pain is real and it affects what I can do."

When you need to cancel plans: "I'm dealing with a pain flare and I need to rest. I know this is frustrating. It's frustrating for me too. I want to be there."

When someone compares your pain to something they experienced: "I'm glad your back pain got better with physical therapy. Chronic pain is different from acute pain. What worked for you might not work for my situation."

When you need accommodation: "I need to sit down for this. It's not optional for me. My pain gets worse when I stand for too long."

When someone tells you it's all in your head: "Pain involves the brain, but that doesn't make it imaginary. The pain I feel is real and it affects my daily life."

These scripts give you starting points. You can adjust them to fit your situation and your relationships.

The key is to be clear and firm without apologizing for your needs.

What do I say when people think I'm exaggerating?

This is one of the hardest things about chronic pain. People doubt you. They think you're making it worse than it is.

Sometimes they say it directly. Sometimes you just feel it in their tone or their body language.

When this happens, you have a few options.

Option 1: State your reality simply. "This is my experience. I'm not exaggerating. I'm telling you what's happening in my body."

Option 2: Set a boundary. "I need you to believe me when I tell you about my pain. If you can't do that, I can't keep talking about this with you."

Option 3: Redirect to impact. "Whether or not you think it's 'that bad,' it's affecting my life. I need support, not judgment."

Option 4: End the conversation. "I can see this conversation isn't helpful. I'm going to step away now."

You don't owe anyone proof. You don't have to convince them. And you don't have to keep subjecting yourself to disbelief.

The part of you that's angry about not being believed makes sense. That anger is protective. It's standing up for you.

In therapy, we work with that part. We help it feel heard without it having to get louder and louder to be noticed.

We also talk about how to speak up about chronic pain in different contexts—with providers, employers, and loved ones. The strategies vary depending on the relationship and what you need from it.

How do I set boundaries when I need rest or accommodation?

Setting boundaries with chronic pain means saying no. A lot.

This is hard. Especially if you're used to being the reliable person. The helpful person. The person who shows up.

But saying yes when you need to say no makes everything worse. Your pain gets worse. Your resentment builds. And you end up canceling anyway, just later and with more guilt.

Here's how to set boundaries:

Be direct about what you need. "I can come for an hour, but then I need to leave." "I can help, but I need to sit down while I do it." "I can't commit to that right now. My pain is unpredictable."

Don't over-explain. You don't need to justify your limitations. "I need to rest" is a complete sentence.

Expect pushback and plan for it. Some people won't like your boundaries. That's okay. You're not responsible for their disappointment.

Practice saying no. It gets easier with practice. Start with small things. Work up to bigger ones.

Remember that boundaries protect your relationships. When you push past your limits to please others, you end up resentful. Boundaries prevent that resentment.

People who care about you want you to take care of yourself. Even if it's inconvenient for them.

And people who don't respect your boundaries are showing you something important about the relationship.

How can therapy help me communicate about pain?

Therapy helps in a few ways.

First, it helps you get clear on what you need. When you're exhausted and in pain, it's hard to think clearly about boundaries and communication.

Therapy gives you space to figure out what actually works for you. What you can realistically commit to. What you need from others.

Second, therapy helps you practice. You can try out different scripts in session. Figure out what feels authentic to you. Get feedback on what's working and what's not.

Third, therapy addresses the emotional side of communication. The guilt you feel about canceling. The anger you feel when people don't believe you. The fear of being too much.

All of these emotions make communication harder. When they're addressed, communication gets easier.

Fourth, therapy helps you work with the different parts of you that show up around communication.

The part that wants to protect others from disappointment. The part that's furious about not being believed. The part that just wants to withdraw and stop trying.

When all these parts feel heard, they don't have to fight each other. And you can communicate from a clearer, calmer place.

Finally, therapy helps you navigate the grief that comes with these communication challenges. The grief of being misunderstood. The grief of relationships that change or end because of your pain.

That grief is real. And it deserves attention.

Finding support for communication challenges in Lee's Summit or Missouri

If talking about your chronic pain feels impossible, you're not alone.

At Aspire Counseling, we help people with chronic pain navigate these exact communication challenges. We offer therapy both in person at our Lee's Summit office and through telehealth throughout Missouri.

We understand that chronic pain affects every relationship in your life. And we have tools that can help you communicate more effectively without exhausting yourself in the process.

You can reach out online or call us at (573) 328-2288. We'll talk about what's going on and how therapy might help.

You don't have to keep feeling dismissed and misunderstood. There are ways to communicate that feel better for you and work better with the people in your life.

Related reading:

• Living With Chronic Pain: Therapy for the Emotional Toll and Daily Challenges

• How to Speak Up About Chronic Pain—Even When You Feel Doubt or Shame

• When Pain and Emotion Collide: How Chronic Pain Affects Mood, Sleep, and Mental Health

About the Author: This post was written by Jessica (Tappana) Oliver, LCSW, founder of Aspire Counseling. Years ago, Jessica worked with many clients who felt completely alone in their pain because the people around them didn't understand. She saw how much energy people spent trying to make others believe them—energy they didn't have to spare. These days, she focuses her clinical work on offering trauma therapy intensives at Aspire, but she remains passionate about helping people find their voice around chronic pain. After countless conversations with Adam White, LPC, one of Aspire's chronic pain specialists, she's convinced he's the go-to expert in the Kansas City metro area for treating chronic pain through therapy. This post reflects Adam's clinical wisdom about validating all the parts that show up around communication—including the angry part that's tired of not being believed. Adam practices at our Lee's Summit, Missouri location and also offers online therapy throughout Missouri.