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Airing Pain 134 – Warwick Study of Mental Defeat in Chronic Pain

What is mental defeat and does it have an impact on the experiences of those living with pain?

In this edition of Airing Pain, Paul Evans interviews the team at the Warwick Study of Mental Defeat in Chronic Pain (WITHIN Project) and research participants, as well as taking part in the study as a participant himself.

The study, which runs until May 2023, is investigating how mental defeat can influence pain sensation, sleep patterns, social activity, physical activity and the general health of individuals who have chronic pain.

Mental defeat is defined as the perceived loss of autonomy in the face of uncontrollable, traumatic events. In the context of chronic pain this can be explained as a loss of identity and self in relation to repeated episodes of pain.

Paul talks to the team about their experimental, lab-based study and the sleep-tracking survey, then undergoes the lab experiment himself. Afterwards, he discusses how he found it and the possible outcomes of the research. He also interviews other participants on their experience.

Research into mental defeat is in its early stages. It is hoped that the WITHIN Project will generate important information to help us further understand the influence that mental defeat has on distress and disability in chronic pain patients. This is essential listening for anyone wanting to know more about the research process, or wanting to participate.

Issues covered in this programme include:

Mental defeat, pain research, insomnia, psychological effects of pain, chronic pain, patient perspective, acceptance and commitment therapy, research participation, pain thresholds.

Within study logo

Time Stamps:

0:25 – Dr Nicole Tang, the Principal Investigator at the WITHIN Study of Mental Defeat in Chronic Pain, discusses the definition of mental defeat.
5:55 – Jenna Gillett, PHD student and study researcher, on the relationship between pain and mental defeat.
7:17 – Jenna Gillett and Dr Nicole Tang explain the sleep tracker study.
10:04 – Dr Nicole Tang breaks down the elements of the study – the laboratory experiment and the sleep tracker.
11:00Dr Nicole Tang discusses how having consistently disrupted sleep effects pain and what kind of treatments can be considered.
12:19 – The impact of the COVID pandemic on the study – adaptations and the unexpected outcomes.
14:00 – Participant Lauren Pulsford describes her experience of taking part in the study.
16:00 Airing Pain Producer Paul Evans meets Research Fellow Kristy Themelis to participate in the lab-based experiment.
20:00 – Dr Nicole Tang on the association between chronic pain and Post Traumatic Stress Disorder.
21:00 – Exploring what happens to those with chronic pain have a strong sense of mental defeat.
22:00 – Explanation of the longitudinal study – looking at sense of defeat, pain and activity over time.
23:00 – Jenna Gillett talks about Acceptance and Commitment Therapy and its possible links with mental defeat.
24:00 – Back in the lab with Paul Evans and Kristy Themelis, measuring his pain pressure threshold.
27:00 – Paige Karadag, research assistant, explains the challenges of recruiting research participants online.
31:30 – Paul Evans and Kristy Themelis discuss the experiments that he participated in and how he found it.
35:30 – Paige Karadag and Jenna Gillett outline the criteria for research participants for the study, which will be running until May 2023.
39:00 – Participant Caroline Perry offers her take on why people should take part.


  • Dr Nicole Tang, Principal Investigator, WITHIN project, University of Warwick.
  • Jenna Gillett, PHD student, WITHIN project, University of Warwick.
  • Lauren Pulsford, research participant with lived experience of chronic pain.
  • Paul Evans, research participant with lived experience of chronic pain.
  • Dr Kristy Themelis, Research Fellow, WITHIN project, University of Warwick.
  • Paige Karadag, Research Assistant, WITHIN project, University of Warwick.
  • Caroline Perry, research participant with lived experience of chronic pain.

Special Thanks:

This edition of Airing Pain has been funded by grants from the Medical Research Council. Pain Concern would like to thank all at the WITHIN project, University of Warwick, for their time and support.

UKRI Medical Research Council

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