Improving mental or psychological flexibility

Author: Chris McCarthy

For the last 12 months I’ve been working alongside physiotherapists who are highly trained in pain management. One thing that I have observed working with this population is that many, if not all, seem to have one thing in common: difficulties mentally adjusting to changes in circumstance 

As psychologists, one of our goals for this population is always to help patients to improve their mental or psychological flexibility. This creates a level of resilience in someones psychological functioning. Psychological flexibility has been described as the cornerstone of healthy personal and social functioning (e.g., Bonanno, Papa, Lalande, Westphal, & Coifman, 2004) and can be thought of as a construct which helps us ‘flex’ with our circumstances rather than fighting against it. It helps us consider and act on the longer-term values rather than the short-term thoughts, feelings, and impulses. These short-term thoughts are often inked with experiential avoidance, and represent an unhelpful attempt to grasp the illusion of control over our external environment and inner events. 

Quite often, I hear people say how frustrated / angry / disappointed / fed-up they are with their pain and how much it has taken over their lives. It’s heartbreaking to hear some of their stories! I witness incredible fighting spirit of people people  who are navigating their pain journey. No-one can say they aren’t trying!! What is important to educate and communicate to people putting up this fight, is that whilst it seems like the logical thing to do (based on their understanding of pain and recovery),  often it can be having a detrimental impact on their experience of pain. 

Put it this way: The brain is a problem-solving machine. It is such an efficient machine, that it sometimes even creates problems out of thin air, just to try and solve them. A situation where pain persists past normal healing times (i.e., chronic pain) can be thought of as a problem that the brain needs to solve. The brain concludes that movement was a contributing factor the initial injury (problem), so if we limit movement, that should help (solution)… hence, we tense our bodies, specifically around the area of pain. We believe this is supporting the ‘injured’ structure. Although well meaning, this is actually contributing to the problem! 

Fighting against our circumstances creates tension. It starts as psychological tension and can.  

Enter Psychological flexibility. 

Psychological flexibility allows an individual to accept their current circumstances (not to like it!) and to work with it rather than against it.  

In practice this looks like ‘allowing’ oneself to do things differently in the short term, in the service of their long-term goals and objectives. 

All too often, people   adopt an all or nothing approach, and if they can’t do all – they don’t do much.  

In summary, the challenge is to try and work ‘with’ your circumstances, rather than against them. Thereby reducing the overall tension and allowing your body to turn down the volume on the negative energy this tension creates.  

It is simple in theory, but challenging to say the least in practice. That’s where sometimes it is helpful to get a professional to guide you through these psychological changes – just like we would get a professional to help us with physical changes.  

I’ll end with what I mentioned earlier, but I say to all the people I meet in the pain program: Allow yourself to do things differently, in the short term, in the service of your long-term self. 



Davey, A, Chilcot, J, Driscoll, E, McCracken, L, M (2020). Psychological flexibility, self-compassion and daily functioning in chronic pain. Journal of Contextual Behavioral Science. 17:79-85. 

Bonanno GA, Papa A, Lalande K, Westphal M, Coifman K (2004). The importance of being flexible: The ability to enhance and suppress emotional expression predicts long-term adjustment. Psychological Science. 157:482–487. 

Ramaci T, Bellini D, Presti G and Santisi G (2019) Psychological Flexibility and Mindfulness as Predictors of Individual Outcomes in Hospital Health Workers. Front. Psychol. 10:1302.