Understanding and Promoting Resiliency in Patients with Chronic Headache


Even among patients with the same type and severity of headache, there is considerable variability in functional outcomes. Some individuals are resilient, able to thrive despite pain, whereas others find that pain is an overwhelming burden that comes to define their lives. A substantial body of evidence suggests that patients’ cognitive, emotional, and behavioral coping responses to their pain play a significant role in determining their long-term health. Resilient pain responses, which are shaped by both qualities of the individual and his/her social environment, can be learned and thus hold promise as targets for treatment. We draw on recent empirical findings that identify which pain beliefs, appraisals, and behaviors in response to pain are key to resilient and non-resilient coping among patients with chronic headache. We discuss how pain self-efficacy and pain acceptance set the stage for adaptive behaviors that have been linked to sustained well-being and good quality of life. We then describe psychosocial and behavioral interventions that show promise in promoting resilience among headache patients and conclude by considering areas ripe for further inquiry.

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The authors thank Betty Darby, Ph.D., for her helpful comments and for the development of the Mindfulness-Based Resilience Training programs for patients and employees at Mayo Clinic, which informed and inspired some of the content of this article.


No funding was applied to this review paper.

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Correspondence to Cynthia M. Stonnington.

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Cynthia M. Stonnington, Dhwani J. Kothari, and Mary C. Davis declare that they have no conflict of interest.

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Stonnington, C.M., Kothari, D.J. & Davis, M.C. Understanding and Promoting Resiliency in Patients with Chronic Headache. Curr Neurol Neurosci Rep 16, 6 (2016). https://doi.org/10.1007/s11910-015-0609-2

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  • Headache
  • Resilience
  • Functional health
  • Acceptance
  • Self-efficacy
  • Values-based action