The barriers that we face when we tell patients they can learn to live with pain…they’re quite vast. There are some patients who say “I don’t want to live with pain. The pain has taken a lot out of my life and I don’t want to learn to live with it. I just want it gone.” That’s a significant barrier, but it’s understandable, and the way that we approach dealing with that is helping a patient work toward a model of acceptance. “Acceptance” doesn’t mean that they give up the fight, but accepting the reality of the chronicity of their pain and learning how they can still have very good quality of life despite the presence of pain. For a lot of patients it’s hard to conceptualize that, because their experience of pain is just what is it at that time. When you tell them you have to learn to live with pain, they think it’s learning to live with pain at that level of intensity and with that degree of interference. But managed pain is completely different. The discomfort of course will still be there, but if a person is able to be engaged in more productive activities, things that are more meaningful, then the pain becomes more of a nuisance variable. When we conceptualize that to patients, or help them start to see what that can look like, that goes a long way, and we’re able to help shift their conceptualization of learning to live with pain and they become more open to it.