Exploring people’s experiences of Psychological Flexibility and Self-compassion whilst living with persistent pain.

Moore, Phil and Curvis, Will and Bourne, Katy and Malpus, Zoey (2025) Exploring people’s experiences of Psychological Flexibility and Self-compassion whilst living with persistent pain. PhD thesis, Lancaster University.

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Abstract

This thesis contains two research studies focusing on people’s experiences of persistent pain. Section one of this thesis is a systematic literature review exploring patients’ experience of psychological flexibility whilst living with persistent pain. Section two of this thesis is an empirical paper which explores participants’ experience of self-compassion and its role in adjustment to persistent pain. The literature review used a narrative synthesis of 17 studies focusing on patients’ experience of at least one aspect of the psychological flexibility Hexaflex and how this interacted with their persistent pain. The review highlighted that cultural influences and stages of treatment influenced participants’ experiences of different aspects of the Hexaflex. These findings should be considered an initial insight into how psychological flexibility is experienced and further research should expand this understanding by further developing insights into the individual components of the Hexaflex. The empirical study explored participants’ experience of self-compassion and how this impacted their adjustment to persistent pain. Participants took part in 1:1 semi-structured interviews and were interpreted through narrative analysis. Three narrative chapters emerged 1) Origins of self-compassion and persistent pain, 2) Compassion and persistent pain in context and, 3) Life beyond pain. This study found that interpersonal expectations about being seen to cope with pain led to participants developing self-criticism and shame. These unhelpful emotions contributed to the development of ‘striving’ coping strategies. Participants shared positive experiences of compassion-focused interventions which helped them to manage their pain more flexibly. Section three is a critical appraisal which focused on the researchers’ experience of conducting these research studies and the wider reflections which may not have fit into either research paper. The critical appraisal also further explored limitations of the research and additional clinical implications.