Date of Award


Degree Name

Doctor of Philosophy


Counselor Education and Counseling Psychology

First Advisor

Dr. Alan J. Hovestadt

Second Advisor

Dr. Stephen Craig

Third Advisor

Dr. Glinda Rawls


Pain, chronic pain, back, neck, depression, anxiety


More than 1.5 billion people worldwide suffer from chronic pain (CP). People who experience chronic pain are 20 to 40% more likely to meet criteria for an anxiety disorder, and three to four times more likely to be clinically depressed than their pain-free counterparts. The relationship between CP and mental health has been studied quantitatively; however, few researchers have investigated co-morbid CP and mental health through a phenomenological lens. The subjective nature of the relationship is not comprehensively addressed within the literature.

This qualitative phenomenological study explored (a) how individuals with chronic back and/or neck pain (CBNP) experience, understand, and draw conclusions about the relationship between their physical pain and mental health; and (b) how individuals perceive talking about their experiences with CBNP and depression and/or anxiety. To further understand the intersection between CP and mental health, 10 individuals diagnosed with CBNP and depression and/or anxiety, were interviewed. Lengths of diagnoses ranged from 1 year to 30 years. The participants are six females and four males. Racially, they are black, Latino, or white, and between the ages of 19 and 53.

Major findings of this study are as follows. Participants perceived (a) a direct and positive relationship between their CBNP and depression and/or anxiety; (b) pain to precede depressive and/or anxiety symptoms; (c) a cyclical nature of the relationship; (d) five underlying mechanisms that affect the relationship (disability, tension, vulnerability, thought patterns, stress); (e) navigating institutions, conflicting treatment protocols, identity changes, invalidation, isolation, and lethargy as unique experiences; (f) the opportunity to talk about CBNP and depression and/or anxiety as beneficial; (g) themes around coping strategies, the process of acceptance, future plans, and treatment utilization; and (h) that the experience transcended all contexts and was all-encompassing.

Discussion of the findings include relating findings to existing research, implications for medical and mental health professionals, limitations and strengths, and recommendations for future research. This researcher sought to give voice to this often silenced population and aid in the development of effective strategies to improve the quality of life for individuals with co-morbid CP and mental health distress.

Access Setting

Dissertation-Open Access