Cheatsheet
Chronic Pain, Fear of Movement, and Protective Tension
A session map for pain-related fear, muscle guarding, loss of roles, uncertainty, and gradual activity within a medical plan.
Use when
- fear of pain substantially narrows activity;
- pain has affected roles, relationships, and the sense of future.
Do not use as a substitute for
- new or progressive pain has not been medically assessed;
- the client is being pressured to move against medical advice.
Criteria, checks, and next step
01
Pain experience
Separate sensation and prediction.
- How does the client describe the physical sensation?
- What prediction about damage or the future is added?
02
Protective cycle
Identify guarding and avoidance.
- Where does the body brace in anticipation?
- What provides short-term safety but maintains restriction?
03
Loss and needs
Acknowledge the broader impact.
- Which roles or relationships have changed?
- What support is missing from care or daily life?
04
Flexible activity
Find a medically aligned step.
- Which activity fits current guidance?
- How can the client remain connected to values while pain is present?
Summary
Reduce the decision to a few points
- Coordinate activity limits with the treatment plan.
- Choose one action that reduces unnecessary effort.
- Name one valued area for gradual re-engagement.
Scope
What this cheatsheet does not solve
- The client may skip any question, change direction, or stop the exercise at any time.
- This session map does not diagnose a condition or prove that a physical symptom has a psychological cause.
- New, severe, or changing symptoms deserve medical assessment. Mental health work should not cancel prescribed treatment.
- These educational materials are not a substitute for professional judgment, supervision, local law, or scope-of-practice requirements.
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