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Pain: what does guilt have to do with it?

by Hayzell

Feelings of guilt are familiar to people who suffer from chronic pain. In this post I hope to update you on what science has to say about this all too common feeling.

What is guilt exactly?

Guilt is a complex emotion, and scientists have many views of it, depending their area of expertise. Researchers Hochwarter and Byrne state that “guilt represents an unpleasant feeling with accompanying beliefs that one should have felt, thought, or acted differently.” In other words, guilt makes you regret past behavior. For example, you may feel guilt if you get a flareup because of something you could have avoided, like pushing yourself too hard.

Psychologists say that guilt arises from our interactions with others, because guilt can be “socially learned.” People learn early on what is expected of them or “ways to behave” from their interactions with others. When our behavior does not meet social expectations, we feel guilty.

A recent article in the Personality and Social Psychology Bulletin suggested that guilt is an emotion where individuals focus on some type of past action they considered “controllable and malleable.” This perception of control leads people to feel the need to have to do something to repair what has¬†been done in the past. It creates the need to make amends or reparations in order to get rid of the guilty feelings. For someone in pain, it may be the feeling that urges you to double up on your physical therapy exercises because you feel guilty skipping them the day before.

Guilt and pain

Guilt may have a huge impact on people who feel pain on a daily basis. It can cause emotional stress, impact your relationships, and interfere with your daily life.

Recently, Hochwarter and Byrne found that guilt can also affect job satisfaction and the level of tension at work. People with chronic pain who had the need to be perfect and felt guilty about accommodations that were required to alleviate pain felt worse than other workers. The researchers explained that the need to feel perfect and having to work differently because of pain caused guilt and the need to “make up for” it . Consequently, people in pain chose “to become more involved in aspects of the work that extend beyond what is contained on the formal job description.” In my opinion, this may lead into a vicious cycle where guilt fueled by perfectionism and having to work differently cause people to set up unattainable goals in order to make up for the guilt. Raising one’s bar is probably not the best thing to do when you need to listen to your body and allow time for healing.

Handing guilt

In addition to having pain-related guilt, I also have heaps of natural guilt that comes along with being raised by a Catholic mother. I found that becoming more aware of the “should have, could have” statements that come into my mind has been helpful in lowering my guilt levels. Using mindfulness meditation and techniques from cognitive behavioral therapy have helped me gain awareness into my feelings. I also whole-heartedly recommend reading Full Catastrophe Living by Jon Kabat-Zinn that provides a step-by-step guide on mindfulness meditation for pain.

Another thing that has helped me tackle guilt has been the support of my husband, family and close friends. Just like guilt can be socially learned, ways to handle it can be learned with the help of the people around you. Sometimes you just need someone to understand and remind you that it’s okay to let go of the guilt.

Can you relate to feelings of guilt? Let me know in the comments what has helped you.

[This post was included in the PFAM blog carnival on guilt.  Kudos to Rachael at Glass of Win for hosting this great carnival]


  • Baumeister, R., Stillwell, A., & Heatherton, T. (1994). Guilt: An interpersonal approach. Psychological Bulletin, 115 (2), 243-267 DOI: 10.1037/0033-2909.115.2.243
  • Hochwarter, W., & Byrne, Z. (2010). The Interactive Effects of Chronic Pain, Guilt, and Perfectionism on Work Outcomes Journal of Applied Social Psychology, 40 (1), 76-100 DOI: 10.1111/j.1559-1816.2009.00564.x
  • Sheikh, S., & Janoff-Bulman, R. (2009). The “Shoulds” and “Should Nots” of Moral Emotions: A Self-Regulatory Perspective on Shame and Guilt Personality and Social Psychology Bulletin, 36 (2), 213-224 DOI: 10.1177/0146167209356788

{ 3 comments… read them below or add one }

Nathan January 14, 2021 at 4:14 am

I thought the description of work behavior to be self relevant. From what I’ve heard my mother is the same way at work, and we both have issues with guilt and chronic pain. It’s sounds a lot better to say that we have a good work ethic, but I guess even a behavior that can present as positive–possibly to one’s employer–can still be the product of some unhealthy mental and physical states. Interesting post to say the least.

Dot March 26, 2021 at 2:05 am

Hi Hayzell, thank you for this thoughtful piece. I’ve found mindfulness meditation particularly helpful in dealing with daily pain, as well as the cyclical emotions like the disappointment that arises when I cannot accomplish even the small daily tasks that I set as goals for myself. I have to completely rely on my mother for almost every need and feel guilty that she has to spend every waking moment taking care of me. However, we both realize that for the patient-caregiver dynamic to work, that we communicate often and try to have a little bit of fun every day. (I’m also constantly trying to find her little gifts online to reciprocate, which drives her crazy!) :)
I’m also a fan of Jon Kabat-Zinn and have been working through his Mindfulness Meditations for Pain Relief during the last few months. Have you tried them, too? Thanks again!

Hayzell March 26, 2021 at 10:15 am

Thanks Dot! I will certainly check out your recommendation. I’m happy to hear you liked this article and welcome you to write about your relationship with your mom for the PFAM carnival I’m hosting this month. From what you wrote, it sounds perfect for the theme (Is help a four letter word).

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