Table 5.

Other negative themes common to both the physiological and psychological explanations

Subtheme	Patient	Physiological explanation	Patient	Psychological explanation
Lack of hope	12	“My pain is always gonna be there.”	20	“I don’t know if I [would] use despair, that kind of makes it sound like the situation is never going to improve. So maybe a little bit more optimistic terminology …”
	18	“... this is very curt ... I would expect the kind of explanation that offered some kind of hope, this does not offer anything.”
It does not represent the stress and emotion of having pain	14	“... I think they call it the suicide disease … because they say the pain is so bad you just want to die ... if that’s all they were gonna say about it, I would probably be very frustrated.”	17	“... that pain can actually affect the mood, and your energy level and you’re, you know, being anxious and so I do not believe that the mind is always the driving force here. It could be very well the opposite …”
Aligns with “despair comes after pain”	29	“… [with the central sensitization explanation] you’re just working on your nerves, and that will get you out of your despair.”