When the Social Foundations of the World are Disrupted: An Interpretative Phenomenological Analysis of Suffering in Pain and Stress Among Individuals Living with Chronic Pain.

Background: Chronic pain is a multidimensional experience shaped by biopsychosocial factors. How individuals appraise situations plays a key role in chronic pain and is closely linked to stress and suffering. However, the specific ways in which interactions between pain and stress contribute to suffering remain underexplored. Aim: This exploratory study examined how pain and stress, as lived experiences, shape suffering in Canadian adults living with chronic pain. Methods: The study's approach was Interpretative Phenomenological Analysis (IPA). Six participants with chronic non-cancer pain were interviewed twice using semi-structured interview guides. Initial exploratory interviews were followed by more targeted interviews focused on appraisals and stress. Data were transcribed and analyzed using the steps outlined in IPA. Results: When asked to reflect on stress, participants often described their experiences in terms of suffering or as a pathway to suffering. Participants described suffering as deeply rooted in disruptions to the social dimensions of their lived experience. Three themes were identified: (1) pain intensity is not enough to explain suffering, the social aspects are essential; (2) pain disrupts the social structure of the world; and (3) there is a tension between social normality and the validation of lived pain experiences. Conclusion: This study contributes to a broader understanding of pain that moves towards an intersubjective conceptualization of pain-related suffering. Recognizing and addressing the social dimensions of pain may better reflect the needs, experiences, and circumstances of people living with chronic pain.