Open Letter to Chronic Pain Providers
As a pain psychologist, I’ve spent years sitting with people who’ve done everything right — and are still in pain. This letter is for the providers who care deeply, the patients who keep searching, and the system that keeps asking them both to push harder instead of slow down.
Dear provider who also treats chronic pain,
I’m tired of living in a world that praises people for being “strong” when they shouldn’t have to be...
We’ve built a culture that treats exhaustion like proof of worth, where rest has to be earned, where trying harder is the only valuable choice, and if you don’t feel good, it’s somehow your fault.
But as a pain psychologist, I work with people every day who are already trying harder than anyone should have to. They’ve tracked, analyzed, medicated, stretched, breathed, journaled, followed every recommendation, and shown up to every appointment. They've read books, articles, followed self-help routines. And many could explain the pain cycle even better than you, their specialist.
And still, these patients keep going to each new referral, even when no one answer has ever felt fully satisfying. They’re running on the fumes of hope that someone, somewhere, might finally get it.
What breaks me as a fellow human is that these same people are often told (implicitly or explicitly) that they just need more willpower. But they don’t. They need safety. Real, embodied safety. Without guilt, without performance, without the pressure to “be strong.”
Safety isn’t a mindset. It’s a physiological experience.
And that’s what our medical system misses. Pain itself is the body’s danger signal, so when pain becomes chronic, the body’s alarm system never gets told it’s safe again. Yet our care models keep telling patients to “relax,” “don’t stress,” or “think positively” while the body’s still screaming "danger."
We need care that acknowledges that truth. We need providers who understand that pain is both sensory and emotional. We need a system that emphasizes calm, compassion, and connection - not control.
I want to acknowledge the providers who are already doing this work, especially the ones I’ve walked alongside who make a real difference in their patients’ experience of the medical system. The providers who slow down, listen deeply, and make space for their patients’ full humanity. You are the reason I still believe this kind of care is possible. Your presence reminds me that medicine and compassion don’t have to be separate, and that many people inside the system are just as heartbroken by its limits as their patients are. You help me stay brave enough to keep speaking these truths because I’ve seen what care looks like when safety is honored as the foundation for healing.
If there’s one thing I wish every patient could hear, it’s this:
You don’t need to try harder. You need to be met with safety.And if there’s one thing I wish every provider could remember, it’s this:
Calm can’t be commanded. It has to be co-created.
My hope is that we can all keep learning how to meet pain with presence instead of pressure, and compassion instead of control.
With the utmost gratitude to patients who have entrusted me with their lived experience,
Anahita Kalianivala, PhD
Licensed Clinical Psychologist
Alcove Mental Health | Reno, NV
PSYPACT Authorized (Serving clients across participating states)