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Emotion-Focused Therapy for Chronic Pain : Impact of Emotions on Perception & Coping

Understanding Emotion-Focused Therapy in the Context of Chronic Pain

Emotion-Focused Therapy (EFT) is not just another therapeutic model; it represents a profound intersection of emotion and healing, which is especially pertinent for those grappling with chronic pain. Pioneered in the 1980s by Leslie S. Greenberg, PhD, EFT is rooted in the rich soils of humanistic therapy or humanistic psychology, which emphasizes the holistic understanding of individuals, valuing them as whole beings rather than mere conglomerates of symptoms or dysfunctions.(1,2)

At the heart of Emotion-Focused Therapy (EFT) lies a potent realization: emotions aren’t just ephemeral feelings but crucial drivers that shape our perception, decision-making, and overall well-being. They act as compasses, guiding us through the terrain of life, helping us interpret our surroundings, chart our goals, define our needs, and crystallize our values. This understanding is particularly critical when considering the experience of chronic pain, where emotional states can dramatically influence pain perception and coping mechanisms.

EFT is premised on the transformative power of emotions. By delving deep into this emotional realm, the therapy not only seeks to highlight the emotional contributors and responses to physical pain but also to equip individuals with the insights and tools necessary for fostering self-awareness, emotional regulation, and, most importantly, effective pain management.(3)

Emotion-Focused Therapy (EFT) therapists, in their pursuit to bridge the emotional and physical experiences, cultivate an atmosphere of collaboration, safety, and non-judgment. Here, emotions tied to pain, often masked or misunderstood, are unearthed, processed, and rechanneled. This therapeutic journey touches upon past emotional scars, promotes healthier emotional expression tied to pain experiences, and champions self-compassion and acceptance, making it an invaluable approach for those seeking respite from the relentless grip of chronic pain.

What Can Emotion-Focused Therapy Be Used For?

Emotion-Focused Therapy (EFT) is best used for addressing emotional difficulties and fostering emotional regulation in individuals. It is particularly effective in various contexts, including:

  • Relationship Issues. Emotion-Focused Therapy (EFT) is often used in couples therapy to help partners express and understand their emotions, improve communication, and build stronger emotional bonds.(4)
  • Depression. Emotion-Focused Therapy (EFT) can be beneficial for individuals experiencing depression by helping them explore and process underlying emotions, develop coping strategies, and build a more positive emotional experience.(5)
  • Anxiety. Emotion-Focused Therapy can assist individuals in understanding and managing anxiety by exploring the emotions contributing to their anxious feelings and developing healthier ways to cope with stressors.(6)
  • Trauma and Post-Traumatic Stress Disorder (PTSD). Emotion-Focused Therapy can be utilized in trauma therapy to help individuals process and make sense of traumatic emotions, fostering healing and resilience.(7)
  • Grief and Loss. Emotion-Focused Therapy is effective in helping individuals navigate the complex emotions associated with grief and loss, supporting them in the mourning process.
  • Self-Exploration and Personal Growth. Emotion-Focused Therapy can be valuable for individuals seeking to better understand themselves, improve emotional intelligence, and develop healthier ways of coping with life’s challenges.
  • Emotional Regulation. EFT is helpful for individuals who struggle with regulating their emotions, assisting them in identifying and understanding their emotional responses and finding constructive ways to manage them.

Emotion-Focused Therapy for Chronic Pain Management

Emotion-Focused Therapy (EFT) can be beneficial in chronic pain management as it helps address the emotional aspects that often accompany persistent pain. Chronic pain can lead to a wide range of emotional responses, including frustration, anger, sadness, anxiety, and even depression. Emotion-Focused Therapy aims to help individuals understand and process these emotions, ultimately reducing their suffering and improving their ability to cope with the pain.(8,9,10)

Here’s how Emotion-Focused Therapy helps in chronic pain management:

  • Emotional Exploration: Emotion-Focused Therapy provides a safe and supportive space for individuals to explore and express their emotions related to chronic pain. This emotional exploration allows clients to gain insight into how their feelings contribute to their pain experience and how emotions may be influencing their thoughts and behaviors around pain.
  • Coping Strategies: Through Emotion-Focused Therapy, individuals can learn healthier ways of coping with the emotional challenges of chronic pain. This includes developing effective strategies for managing stress, anxiety, and other negative emotions that can exacerbate pain.
  • Changing Emotional Responses: EFT helps individuals modify emotional responses to pain, allowing them to become more accepting and adaptive. By reframing how they perceive pain and their emotional reactions to it, individuals can reduce feelings of helplessness and increase their sense of control.
  • Enhancing Emotional Regulation: Chronic pain can disrupt emotional regulation, leading to increased distress and difficulty managing emotions. Emotion-Focused Therapy assists individuals in developing skills to regulate their emotions effectively, leading to improved emotional well-being and pain management.
  • Addressing Underlying Emotions: Chronic pain can sometimes be connected to unresolved emotional issues or trauma. Emotion-Focused Therapy facilitates the exploration and processing of these underlying emotions, enabling individuals to work through past emotional wounds and potentially reducing the intensity of pain.
  • Improving Quality of Life: By focusing on emotional well-being, Emotion-Focused Therapy aims to enhance overall quality of life for individuals living with chronic pain. As emotional distress is addressed, individuals may experience a reduction in pain-related disability and improved engagement in daily activities.

However, it is important to note that Emotion-Focused Therapy does not aim to eliminate physical pain directly, but rather it helps improve emotional responses to pain and enhances coping strategies. Integrating Emotion-Focused Therapy into a comprehensive chronic pain management approach that includes medical, physical, and psychological interventions can lead to a more holistic and effective approach to managing chronic pain. As with any therapeutic intervention, the effectiveness of Emotion-Focused Therapy may vary for different individuals.

What to Expect During an Emotion-Focused Therapy Session?

In an Emotion-Focused Therapy (EFT) session, your therapist will create a safe and empathetic environment where you can comfortably explore your emotions. The focus is on identifying, experiencing, and understanding your emotions, rather than suppressing or controlling them.

During the session, your therapist will help you in the following ways using the principles of emotional intervention:

  1. Awareness: You will be encouraged to identify and label your feelings, gaining a deeper understanding of your emotional experiences.
  2. Expression: Your therapist will assist you in overcoming emotional avoidance, allowing you to express your emotions freely and authentically.
  3. Regulation: You will learn distress tolerance skills to better manage intense emotions, such as pain or anxiety.
  4. Reflection: The therapist will guide you in making sense of your emotional experiences and the situations that triggered them.
  5. Transformation: Maladaptive emotions, like fear and shame, will be explored and transformed into adaptive and positive feelings.
  6. Corrective Experience: Through support and guidance, the therapist will help you have new, positive experiences that can modify old emotional patterns.

Limitations of Emotion-Focused Therapy (EFT)

EFT is deeply rooted in the active engagement and acceptance of an individual’s present emotional landscape. It operates on the core principle that emotions have adaptive potential, and personal transformation is possible when these emotions are thoroughly explored and processed. However, some barriers to its effectiveness include: 

  • Resistance to Emotional Exploration: Not all individuals are open to delving deep into their emotional experiences. Those hesitant or resistant to confronting emotional distress might not reap the full benefits of EFT.
  • Specific Mental Health Conditions: While EFT is beneficial for many, it might not be the optimal choice for those with certain chronic mental health conditions, such as schizophrenia or bipolar disorder. Such conditions often have unique therapeutic needs that may be more effectively addressed by other specialized treatments.
  • Relevance to Chronic Pain: EFT focuses on emotional exploration and regulation. For individuals dealing with chronic pain, the source of pain might be both physical and emotional. While EFT can address the emotional dimensions of pain, it doesn’t directly target the physical aspects. Those expecting a direct reduction in physical pain might feel that the therapy falls short. It’s crucial for patients and therapists to set clear expectations and understand that while EFT can improve emotional responses to pain and enhance coping mechanisms, it doesn’t replace medical interventions targeting the physical sources of pain.


Emotion-Focused Therapy (EFT) stands as a beacon for those seeking emotional healing and personal growth. Recognizing emotions not as impediments, but as adaptive forces, EFT champions the cause of self-awareness and emotional resilience. The therapy’s efficacy hinges on the individual’s commitment to actively engage and face emotional challenges head-on. While it might not be the go-to solution for specific, chronic mental health issues, EFT paves the way for enhanced emotional comprehension and robust coping mechanisms. Under the adept guidance of trained therapists, those who embark on this therapeutic journey find themselves in a nurturing space, geared towards emotional exploration and a richer life experience.


  1. Greenberg, L.S., 2004. Emotion–focused therapy. Clinical Psychology & Psychotherapy: An International Journal of Theory & Practice, 11(1), pp.3-16.
  2. Greenberg, L.S., 2011. Emotion-focused therapy. American Psychological Association.
  3. Elliott, R. and Greenberg, L.S., 2007. The essence of process-experiential/emotion-focused therapy. American Journal of Psychotherapy, 61(3), pp.241-254.
  4. Wiebe, S.A. and Johnson, S.M., 2016. A review of the research in emotionally focused therapy for couples. Family Process, 55(3), pp.390-407.
  5. Greenberg, L.S. and Watson, J.C., 2006. Emotion-focused therapy for depression. American Psychological Association.
  6. Timulak, L. and McElvaney, J., 2016. Emotion-focused therapy for generalized anxiety disorder: An overview of the model. Journal of Contemporary Psychotherapy, 46, pp.41-52.
  7. Mlotek, A.E. and Paivio, S.C., 2017. Emotion-focused therapy for complex trauma. Person-Centered & Experiential Psychotherapies, 16(3), pp.198-214.
  8. Dysvik, E., Natvig, G.K., Eikeland, O.J. and Lindstrøm, T.C., 2005. Coping with chronic pain. International journal of nursing studies, 42(3), pp.297-305.
  9. Boersma, K., Södermark, M., Hesser, H., Flink, I.K., Gerdle, B. and Linton, S.J., 2019. Efficacy of a transdiagnostic emotion–focused exposure treatment for chronic pain patients with comorbid anxiety and depression: a randomized controlled trial. Pain, 160(8), p.1708.
  10. Linton, S.J. and Fruzzetti, A.E., 2014. A hybrid emotion-focused exposure treatment for chronic pain: a feasibility study. Scandinavian Journal of Pain, 5(3), pp.151-158.

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Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:August 9, 2023

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