DOES PAIN MAKE YOU ANGRY?

I’m acutely aware of the kinds of emotions that can be associated with having chronic pain. For me, anger was definitely one of them.

I was interested to find out if and why anger is something that’s commonly felt by others experiencing chronic pain. This article looks at research into the emotional experiences of people in pain, to answer the question of whether pain generally makes you angry, and why.

Research confirms that anger is frequently felt by people with chronic pain. A 2012 review of the research found three main themes underlying anger: Frustration about pain limiting the ability to achieve goals; a sense of external blame for the pain; and a sense of injustice or unfairness.

What makes people angry when in pain depends on their thoughts and beliefs associated with the pain, how frustrated they are with it interfering with their ability to be and do, how much they attribute blame to external sources, and their sense of injustice associated with having the pain.

This article will cover more of what makes people angry when in pain, and look at how anger affects the pain, and go on to talk about how to deal with it.

Can chronic pain cause anger?

Chronic pain can be like living with a constant background noise. It’s always there, sometimes it can be a hum, not too loud but persistent, trying to divert your attention to it. Other times it can be screeching, screaming or blaring like a car horn.

Just existing with pain can feel exhausting at times.

You might also be finding that pain has turned the whole of your life upside down. It can affect your ability to do things in the way that you’d done them before. In a 2012 review of the research on anger and chronic pain, causes of anger were found to be either frustration at the pain creating obstacles to goals, through blaming something believed to be at fault, or through a sense of injustice for the pain.

Frustration over inability to achieve goals

It can be incredibly frustrating if the activities pain interferes with are closely tied with social roles, like being a parent, being a worker in a particular profession, or being a caregiver, etc.

Anger can come from a place of deep frustration over the losses in your life that you associate with the pain, and how it can affect your sense of self-identity. My post on chronic pain and relationships looks at this in more detail.

Researchers suggest that when people are frustrated about pain getting in the way of their goals, they are more focused on trying to eradicate the pain.

“When increased attention to pain and its eradication occurs at the cost of once valued or identity-relevant pursuits, this narrowed motivational perspective may further exacerbate pain-related losses and identity disruption”
(Trost et al., 2012)

It can become a viscous cycle, causing anger though the frustration.

Anger through blame

Another aspect of chronic pain that can lead to anger is when a person blames something external for the pain. The negative impacts of the pain could be blamed on:

“Medical and mental health providers, the legal system, third-party payer, employers, significant others, god, self, and the whole world.”
(Trost et al., 2012)

The sense of blame is attached to how much a person perceives they have lost in their life due to the pain.

Anger through sense of injustice

People with chronic pain can find anger arising from a sense of unfairness or over the injury.

“Recent work has drawn attention to the fact that chronic pain patients often perceive themselves as victims of injustice.”
(Trost et al., 2012)

Does anger make pain worse?

Not only does chronic pain cause a person anger, but the anger, in turn, can affect their experience of the pain.

“Anger may have greater effects on chronic pain severity and vice versa than any other negative emotions.”
(Sommer et al., 2019)

The team reviewing the research found that the reason behind the anger could affect the pain itself in a variety of ways.

Those whose anger came from frustration:

Tended to focus more on pain relief and hyper focus on sensations of pain
Their anger may disrupt engagement with treatment

Those who expressed anger through blaming:

Felt less control over outcomes
Had greater distress and pain

Those whose anger was associated with perceived injustice:

Had increased missed medical appointments
Had less physical function
Were less likely to return to work
Focus may be on seeking to restore justice, and away from treatment

All of these outcomes of anger, regardless of cause, can hinder a person with chronic pain.

How to deal with pain and anger

People may find that they naturally cycle through stages of anger, as part of the grieving process for the losses they feel in their lives.

How people manage anger in general may have an effect.

“How anger is managed may exert unique influence on outcomes apart from the effects of mere anger proneness, at least among male pain patients.”
(Burns et al., 1998)

Attention to anger management could be helpful for those in pain who find it troubling.

One method of dealing with anger is to put it in writing. Researchers in 2008 tested the effects of expressing anger constructively in the style of a letter. The participants who were in this group noticed more improvement in control over pain and mood, and also some improvement in pain severity.

It could be that people’s emotions become less associated with pain levels as they reach a stage of acceptance of the pain.

Researchers in 2007 found that people who were preoccupied with finding a cure for their pain seemed more focused on their mood being associated with more severe pain days.

Acceptance of pain has been shown in the lab setting to be associated with lower recovery time and increased pain tolerance, compared to other strategies like distraction.

This 2011 randomized controlled trial of acceptance and commitment therapy showed that it improved the level of interference of the pain, along with improvements in depression and anxiety of those with chronic pain.

“Given that participants in this study had an average of 15 years of pain, an extensive history of treatment, and high rates of disability status and prevalence of psychiatric comorbidity, the fact that behavioral treatments were effective was very encouraging.”
(Wetherell et al., 2011)