Distortions to the passage of time during chronic pain: A mixed method study

Abstract

Background: A core aspect of the clinical assessment of pain is establishing how long pain has been present for. The reported length of pain can therefore influence diagnosis and treatment. Despite this, little is known about how chronic pain affects the passage of time. Methods: A mixed-methods cross-sectional study examined experiences of the passage of time in people identifying as living with chronic pain (n = 398). Results: Experiencing chronic pain slows the passage of time for most people. Greater pain intensity, rumination about pain, helplessness and identifying as disabled were associated with a greater slowing of the passage of time. Thematic analysis of responses to open-ended questions suggested that a slowing of time during pain was associated with (1) pain intrusion preventing activities which would otherwise enable time to pass quickly, (2) increased attention to time and (3) as sense that in retrospect, time throughout life was ‘lost’ to chronic pain. Conclusion: Chronic pain causes widespread distortion to the passage of time. The slowing of time during pain means that periods of pain feel subjectively longer than periods without, exacerbating patient distress. Significance: This study examined how chronic pain impacts on the experience of time. Chronic pain substantially slowed the passage of time for most people, subjectively lengthening the period of time that pain lasted for, exacerbating distress. Given the importance of time processing in clinical assessments of pain, medication adherence and therapeutic interventions, these findings underscore the importance of raising awareness about altered temporal processing in patients and clinicians.