The role of paradoxical beliefs in chronic pain: a complex adaptive systems perspective

The biological sciences have contributed an extensive volume of research in efforts to resolve chronic pain, and an expanding body of research focusing on the psychosocial aspects of chronic pain, is now also evident. Paradigms applied to chronic pain appear to compete and lack an integrative framework. This paper builds a case for framing chronic pain within a complex adaptive systems (CAS) paradigm and explores how paradox, one of the key features of a CAS, contributes to maintaining 'chronicity' in the system. A complexity science paradigm can serve as a meta-framework, integrating theoretical models employed in chronic pain and reframing dissent and conflict as positive generative forces for change. Interventions, based on complexity science principles, can effect change in the highly interactive systems that constitute the chronic pain experience.