Have you ever left a doctor’s appointment feeling dismissed, unheard, or like your pain doesn’t matter? Maybe you’ve been told your tests are “normal” while your body screams otherwise, or heard these words: “It’s probably just stress.” If this sounds familiar, you’re not alone, and more importantly, your pain is real.
The experience of having your pain invalidated isn’t just emotionally taxing, it can actually make your physical symptoms worse. This phenomenon, known as illness invalidation, affects millions of people with chronic pain and creates a cycle that can deepen suffering in ways many don’t realize.
What Illness Invalidation Looks Like
Illness invalidation can be subtle or obvious, but it always leaves the same mark: the feeling that your lived experience doesn’t matter. Here’s what it often looks like in practice:
In Medical Settings:
- Doctors dismissing symptoms (especially in women) as anxiety or stress without proper investigation
- Being told “your tests are normal” as if that negates your experience
- Having symptoms attributed to depression or anxiety before exploring physical causes
- Rushed appointments where you feel unheard or shuffled along
From Family and Friends:
- Comments like “you don’t look sick” or “everyone has pain sometimes”
- Suggestions that you’re being dramatic or seeking attention
- Well-meaning but harmful advice like “just think positive” or “try yoga”
- Questioning the legitimacy of your experience or need for accommodations
Medical Gaslighting:
- Implying you’re exaggerating or imagining symptoms
- Suggesting your pain tolerance is just “low”
- Making you question your own perceptions and experiences
- Dismissing the impact pain has on your daily life
The truth is, chronic pain often doesn’t fit neatly into medical boxes. When tests come back “normal,” it doesn’t mean your pain is imaginary. Often, it means what you’re experiencing is more complex than what a test can capture.
How Invalidation Actually Worsens Your Pain
Here’s what happens when doctors don’t believe chronic pain. This invalidation doesn’t just hurt emotionally, it can literally make physical pain worse. When your nervous system perceives invalidation as a threat, several things happen in your body:
Nervous System Activation
Your brain interprets dismissal and disbelief as danger, triggering your fight-or-flight response. This heightened state of activation can amplify pain signals, making everything feel more intense and threatening.
Reinforcement of Fear Patterns
When your pain is not believed, your brain becomes more hypervigilant, constantly scanning for signs of danger or dismissal. This hypervigilance can reinforce the very neural pathways that perpetuate chronic pain.
Deepening Shame and Body Mistrust
Invalidation teaches you to doubt your own body’s signals. This disconnection and shame can create a state of internal conflict that keeps your nervous system in a heightened, pain-producing state.
Increased Catastrophizing
When no one believes your pain, your mind may spiral into worst-case scenarios: “What if something is seriously wrong?” “What if I can never get better?” This catastrophic thinking directly feeds into pain amplification.
The Heavy Emotional Toll
The emotional consequences of chronic pain invalidation run deep and can be just as debilitating as the physical symptoms:
Shame and Self-Doubt
Perhaps the most insidious effect is the way invalidation makes you question your own reality. You might find yourself thinking, “Maybe it really is all in my head,” or wondering if you’re somehow making it worse than it is.
Anger and Betrayal
When healthcare providers (the very people trained to help you) dismiss your experience, the sense of betrayal can be profound. This is especially painful when it comes from trusted providers or loved ones who should be your allies.
Depression and Hopelessness
Being consistently dismissed can lead to a deep sense of hopelessness. If the experts don’t believe you, how will you ever get help? This can spiral into depression, which research shows can actually worsen pain perception.
Isolation and Withdrawal
All too often, people whose chronic pain has been dismissed will pull away from friends, avoid doctors, or give up activities they used to love. The fear of not being believed again becomes so strong, staying isolated feels like the only safe option.
Understanding the Brain-Pain Connection
To put a stop to this cycle, it’s vital to understand how your brain creates the experience of pain. Pain isn’t just a simple signal from your body to your brain—it’s a complex, protective output that your brain creates based on multiple inputs and interpretations.
Pain as Protection
Your brain’s primary job is to keep you safe. When it perceives danger, (whether physical, emotional, or social) it can create pain as a protective mechanism. Invalidation signals danger to your brain, which may respond by increasing pain signals.
The Safety Factor
Feeling safe, heard, and validated isn’t just nice to have, it’s neurologically necessary for healing. When your nervous system feels safe, it can shift out of protective mode and allow natural healing processes to occur.
Breaking the Cycle
Understanding that your pain is real, even when tests are normal, is the first step toward healing. Your brain may be misfiring pain signals due to learned patterns, trauma, or stress, but that doesn’t make your experience any less valid.
Treatment Approaches That Do Validate Pain
The good news is that there are therapeutic approaches specifically designed to validate your pain while addressing its root causes in the brain and nervous system:
Pain Reprocessing Therapy (PRT)
PRT teaches that the brain is misfiring pain signals and that the pain is real, even if there’s no tissue damage. This approach validates your pain while teaching your brain new, safer ways to interpret signals from your body. Research shows that 66% of participants in PRT studies were pain-free or nearly pain-free after treatment, with results maintained at one year follow-up.
Emotional Awareness and Expression Therapy (EAET)
EAET acknowledges that chronic pain often involves unprocessed emotions and relational trauma—including medical trauma from invalidation. This therapy helps you process these emotions safely, reducing the emotional charge that can amplify physical pain.
Intensive Short-Term Dynamic Psychotherapy (ISTDP)
ISTDP helps you discover buried emotions and mental barriers that might be connected to your physical pain. This approach can help you work through the deep emotional hurt from being dismissed while getting to the heart of what’s causing your pain.
The Goal: Internal Validation
While external validation is important for healing, the ultimate goal is to develop a strong sense of internal validation over time. When you truly know and trust your own experience, external dismissal loses much of its power to harm you.
Your Pain Matters
If you’re reading this and recognizing your own experience, please know your pain is real, your experience matters, and healing is possible. Invalidation may have worsened your symptoms, but learning about this connection is the first step toward breaking free from the cycle.
You don’t have to choose between accepting that your pain is “all in your head” or fighting to prove it’s purely physical. The reality is more complex than that. Chronic pain often involves both physical and brain-related factors, and both are completely real and valid.
The brain’s role in chronic pain doesn’t diminish your experience. Instead, it offers hope. If your brain learned to create pain patterns in response to invalidation and perceived danger, it can also learn new patterns of safety and healing.
Your path to feeling better might include:
- Finding doctors and healthcare providers who truly understand chronic pain and believe you
- Trying treatments that help with both the physical pain and the emotional hurt
- Connecting with people who get what you’re going through and support you
- Learning to trust what your body is telling you again
Seeking help for chronic pain, especially when it’s been invalidated, takes real strength. You deserve to be heard, cared for, and to get help that actually works. Your pain is real, your experience matters, and with the right support and understanding, healing is possible.
Your Chronic Pain Deserves Real Treatment
If you’re struggling with chronic pain that hasn’t been believed or validated, know that you’re not alone. At DC Metro Therapy, we understand the complex relationship between invalidation and chronic pain, and we’re here to help you break free from this cycle.
Get personalized support: Contact us for a free consultation to learn how approaches like PRT, EAET, and ISTDP can support your healing journey with one-on-one therapy.
Start healing today: Ready to take the first step on your own? Our comprehensive online course, “Calm Your Brain, Heal Your Pain,” teaches you the Pain Reprocessing Therapy framework through 5 recorded video modules and 26 practical tools and exercises. This clinically proven approach helps you understand the brain-pain connection and provides actionable strategies to reduce and even eliminate chronic pain, all from the comfort of your own home.
Whether you choose individual therapy or our self-guided course, you don’t have to let chronic pain control your life. Real relief is possible when you address pain where it truly begins—in your brain.
References:
1. Rosario, I. (2023). When doctors gaslight their patients, it’s traumatic. Healthline. https://www.healthline.com/health/mental-health/doctors-gaslighting-patients
2. Bever, L. (2022, December 13). From heart disease to IUDs: How doctors dismiss women’s pain. The Washington Post. https://www.washingtonpost.com/wellness/interactive/2022/women-pain-gender-bias-doctors/
3. Coady, A., Godard, R., & Holtzman, S. (2024). Understanding the link between pain invalidation and depressive symptoms: The role of shame and social support in people with chronic pain. Journal of Health Psychology, 29(1), 52-64. https://doi.org/10.1177/135910532311919194. Ashar, Y. K., Gordon, A., Schubiner, H., Uipi, C., Knight, K., Anderson, Z., Carlisle, J., Polisky, L., Geuter, S., Flood, T. F., Kragel, P. A., Dimidjian, S., Lumley, M. A., & Wager, T. D. (2021). Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain: A Randomized Clinical Trial. JAMA Psychiatry, 78(12), 1356-1365. https://doi.org/10.1001/jamapsychiatry.2021.2669
4. Ashar, Y. K., Gordon, A., Schubiner, H., Uipi, C., Knight, K., Anderson, Z., Carlisle, J., Polisky, L., Geuter, S., Flood, T. F., Kragel, P. A., Dimidjian, S., Lumley, M. A., & Wager, T. D. (2021). Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain: A Randomized Clinical Trial. JAMA Psychiatry, 78(12), 1356-1365. https://doi.org/10.1001/jamapsychiatry.2021.2669
