Are you having success at recognizing the emotions connected to your pain? If you have, how do these emotions make you feel? If not, what do you think is preventing you from doing this? I think in the back of my mind I was/maybe still am struggling with this a bit because my pain is constant, day to night, does not seem to have significant changes based on my emotions. So its hard to say "ah yes I was really stressed that day so it makes sense my pain was worse". At the same time, when I reflect, I realize that on days where my pain is worse, someone from work really agitated me, or I was getting frustrated about my pain not going away, so it got worse. And then when I was on vacation it started to feel better. So I think the way I should be thinking about it is, in my situation the pain is not going to be black and white (either here or not here) but worse or better. instead of a constant 5 it was a constant 7 or a 3. I think this just shows, in a more challenging way to recognize, that it really is about the emotional state. The one thing I do feel like I am struggling with is the "big trigger". I have previously read posts about people emphasizing that you dont need one big life event to pop up in your mind that you repressed, and that it is more about your day to day emotions. I definitely struggle with this because having the "aha!" moment followed by a huge reduction in pain is what a lot of people sound like they have. If anyone has any advice for this I'd love to hear it. I know when my pain continued to get worse I was in kind of a spiral about how miserable my back pain was, so I'm almost thinking that those thoughts really perpetuated my symptoms, and once I get rid of those thoughts I would find more relief. but again - I need to focus more on outcome independence, and I am really trying to work on that.