Pain Across the Lifespan: What Therapists Need to Know
When we think about pain, we often picture older adults dealing with aching joints or chronic illness. But here’s the truth: pain isn’t reserved for one stage of life. From infancy through late adulthood, pain is a universal human experience.
In this Not Boring CEs conversation, I sat down with pediatric pain psychologist Emily Foxen-Craft, PhD, to explore how pain shows up across the lifespan and what therapists need to know when supporting clients of all ages.
If you’re looking for CEs for therapists that expand your clinical lens, this is one of those conversations that changes how you see your work.
Pain Is Universal—and Always Biopsychosocial
Emily starts us off with a reminder: pain is universal. Unless someone has a rare genetic condition, we all experience it—acute, chronic, or both. And no matter the form, pain is always biopsychosocial.
- Biological: Nerves, muscles, and neurochemistry.
- Psychological: Interpretation, memory, identity, and emotional responses.
- Social: Relationships, communication, and cultural context.
These elements are so intertwined that teasing them apart is nearly impossible. Which means: when we, as therapists, talk about pain, we’re always talking about the whole person.
Childhood: Pain That’s Hard to Name
Children experience pain differently than adults—not only biologically but also in how they communicate about it.
- Infants begin developing self-regulation around pain as early as one month old.
- Middle childhood and adolescence bring on new pain presentations like migraines, abdominal pain, and musculoskeletal issues.
- Kids often lack the words to describe what they’re feeling. A “tummy ache” might actually be a migraine.
This is where therapists can play a crucial role. By listening with curiosity, we help bridge the gap between a child’s experience and an adult’s understanding.
Adolescence and Identity
As teens grow, pain can become entangled with identity. Some adolescents resist identifying as “someone with chronic illness,” while others may over-identify, finding belonging in the label. Either way, therapists can help clients strike a balance—acknowledging the reality of pain while holding space for growth, resilience, and change.
Adulthood: The “Sandwich Generation” and Beyond
Adults often encounter pain alongside life’s biggest role changes—caregiving, parenting, career transitions, and aging parents. For many in their 40s–60s, pain isn’t just a physical experience. It’s tied to stress, caregiving responsibilities, and emotional responses like depression or frustration.
Emily points out that pain is often harder to accept in midlife than in later years, when it may be more easily attributed to aging. That mindset—how we interpret pain—can shape everything from treatment response to overall well-being.
Older Adulthood: Strengths and Strains
In later adulthood, pain can feel compounded by musculoskeletal decline, mobility changes, and accumulated health conditions. Yet, Emily reminds us, older adults also carry a lifetime of psychological resilience. Therapists can help clients draw on those strengths while navigating the new realities of aging.
Psychological Interventions That Help
One of the most hopeful takeaways from our conversation? Therapy works. Psychological approaches are increasingly seen as first-line treatments for pain. Some of the most evidence-based options include:
- CBT (Cognitive Behavioral Therapy)
- ACT (Acceptance & Commitment Therapy)—now being adapted for children as well as adults
- Mindfulness-Based Stress Reduction
- EMDR and trauma-informed care
- Positive psychology and strength-based approaches
The goal isn’t to “fix” the pain, but to support function, resilience, and well-being alongside symptom management.
The Biopsychosocial Model in Action
Breaking pain into “physical vs. psychological” is misleading and harmful. All pain is real. All pain is valid. The biopsychosocial model gives us a framework for both validating and treating it.
- A child’s chronic abdominal pain may involve anxiety and family dynamics.
- An adult’s back pain may worsen under caregiving stress.
- An older client’s hip pain may be both biological and deeply tied to social isolation.
As therapists, we can expand our lens to see the whole picture.
Why This Matters for Counselors and Therapists
One-third of adults with chronic pain report having experienced pain in childhood. What happens early matters across the lifespan. As Emily put it: early recognition and intervention can change the trajectory of a life.
That’s why expanding your training through continuing education for counselors on topics like pain psychology is so powerful. With the right tools, we can help clients at any age navigate their pain, not just endure it.
Final Thoughts
Pain psychology isn’t just about “aches and pains.” It’s about identity, relationships, resilience, and growth across every stage of life.
Whether you’re working with a child who can’t describe their migraines, an adult stretched thin in the sandwich generation, or an older adult balancing resilience with decline, understanding pain through a biopsychosocial lens gives you a richer way to support them.
And if you’re ready to deepen your skills, explore this conversation in full as part of our online education courses at Not Boring CEs. Because keeping your license current doesn’t have to be boring—and your clients deserve your very best.
