Thank you for NOT Promising a cure 👀

I recently had a great conversation with Carolyn Harrison, a Pain Coach, pain advocate, and someone with lived experience of chronic pain. Our discussion covered pain scales, intake forms, language, flare-ups, progress, identity, and much more. Carolyn holds an MSc and has worked in health promotion, teaching, and counselling. She currently volunteers as a coach with Pain BC and is passionate about contributing to research, training, and policy to improve life for people with pain.

Watch her speak in this episode of One Thing here.

What stood out

The most powerful interventions in chronic pain care aren’t always physical. They’re relational, linguistic, and identity-shaping. Carolyn reminded me that how we name and frame experiences can transform them.

She began calling her pain “bananas”—a playful reframe that softened its grip and made conversations with her care team lighter and more manageable. And when a clinician once prescribed her more “fun”, it turned out to be one of the most meaningful and effective “treatments” she’s ever received.

For many living with persistent pain, the difference between surviving and living well hinges on being—feeling seen, valued, and whole beyond the symptoms. This edition explores our conversation, some related research and revisits how small clinical shifts—reading an intake form with intention, choosing strength-based language, and redefining success—can build trust, safety, and a sense of self that endures beyond pain.

Language can harm — or heal
Words become beliefs. Beliefs become behaviour.

Carolyn’s reminder: “Phrases stick.”
A single careless word can seed fear or identity loss that lasts for years. Many of us have seen this firsthand—a surgeon saying, “You’ve got the back of an 80-year-old.” A physio remarking, “Your core is incredibly weak.” A chiro insisting, “Your hips are out of place.”

These phrases linger. They shape how people see themselves and move through the world. They become sticky stories—often unhelpful, sometimes harmful—that patients carry into every context and stage of their lives.

Subtle harms:

• “Your back is unstable” → avoidance, fragility mindset
• “Failed surgery” → self-blame
• “You’re degenerating” → hopelessness

Healing alternatives:

• “Your system’s sensitive, not broken.”
• “Your body’s adapting — we’ll build its capacity.”
• “You’re learning new ways to move safely.”

This is about neurobiological safety. When words and narratives reduce threat, movement becomes possible. When words convey trust and agency, patients begin re-occupying their lives.

🧠 Use Language that Builds Identity:

• From deficit → strength:

“You’ve been resilient through so much — let’s build on that.”

• From fixed → changeable:

“Pain can fluctuate, but progress also happens in waves.”

• From fear → curiosity:

“What’s your body teaching us today?”

Jo Myllyoja writes that acceptance isn’t giving up — it’s making space for reality so there’s room for what still matters. Language is how we create that room. Read more about it here. 

Clinician reflection:
Each word you use either narrows or expands the patient’s possible future. 
Choose expansion.

Redefine success — beyond “cure”

Here’s where a story from my practice fits perfectly.

"I remember a new patient who had seen three physios, a pharmacist, a physiatrist, her family doctor, massage therapists, and many others over the course of 10 years. She’d stopped working as a professor. In our first conversation, I said something like: “I want to walk with you on this journey and see where we get. If we can reduce pain, that’s a huge win, but let’s also focus on what you want to be doing, and how to manage the ups and downs if this doesn’t go away.” She thanked me for being the first person who didn’t promise a cure.”

That moment reframed care from cure to companionship, from outcome control to shared navigation. This is something that Carolyn also mentioned in her interview on One Things (see the above video). 

This is also what Bronnie calls working toward flexibly persisting — staying engaged with valued life roles even when symptoms fluctuate.

Practical shift:
Measure participation, consistency, and confidence, not just pain.
Normalize variability: “Flares are feedback versus failure.”
Create Plan A/B/C so adaptation is success, not a setback.
Ask: “What’s your minimum viable day?” — keep identity alive on hard days.

This approach tells the truth gently: pain may stay, but life can still grow.

Identity, joy, and the courage to keep living

When pain dominates, people risk losing their who.

Ask:

• “What do you love doing?”
• “What would your best life look like?”
• "If you didn't have this issue, what you be doing?"

Jo’s reflection: It wasn’t being a firefighter that made me who I was — it was who I was that made me a firefighter.

Clinicians can help patients rediscover roles that still fit — perhaps adapted, but intact.

And joy? It’s not disrespectful to suffering — it’s essential.

Encourage moments of lightness; they’re part of the therapy dose.

Safety first — and it’s built in micro-moments

Carolyn’s message: the “little things” are the big things.
✅ Reading the file
✅ Adjusting the plan mid-flare
✅ Celebrating a small win
✅ Asking about life, not just symptoms

Each micro-moment builds safety → movement → confidence → capacity.

When patients feel believed and invited into shared decision-making, they stop performing pain for legitimacy — and start performing life. Pain relief is a goal, but not the only one, especially those with persistent issues.