What is it about?

Tens of thousands of adults belong to private Facebook groups for chronic pain. The effects of being a member are largely unknown, and members may be exposed to both helpful and harmful group processes. Our team at Wayne State University created and studied a Facebook intervention for chronic pain to test the effects, including looking at discussion content (posts and comments) to see how these groups advance or impede patient functioning and treatment engagement for chronic pain. Based on discussion content, we identified an "us versus them" mentality, which is described as a view of the world that includes two groups: people with pain who can understand the pain experience, and everyone else who does not understand (including family, friends, and providers). Because of this mentality, group members discussed their tendency to withdraw from friends and family due to feeling judged or misunderstood in regard to their pain, and instead become closer to other people with pain. Therefore, we identified a contradictory process of increased connection with pain peers and disconnection from others without pain.

Featured Image

Why is it important?

Facebook groups for chronic pain and other health conditions can have many benefits for members, including feeling supported and validated by others who share similar health challenges. However, based on our findings from member posts and comments, this increased support among peers may simultaneously and inadvertently increase isolation from people without pain. Although family, friends, and romantic partners may have difficulty relating to or fully understanding the chronic pain experience, these people can provide invaluable emotional and practical support, and increase healthy behaviors like exercise and diet. Because Facebook groups can be a valuable resource for many people, we need to figure out how to maintain their benefits, while reducing their risks. Additionally, as healthcare providers, we can help reduce the "us versus them" mentality that some people with chronic pain may have, by showing them that we are with them, not against them.


When I started researching chronic pain, my team and I attempted to recruit study participants from Facebook groups for chronic pain. We quickly learned of the private nature of these groups, as not only was our request to recruit denied, but we were blocked from the groups. I appreciated the private nature of these groups and the protection of their members, as some people with chronic pain have poor experiences with healthcare, including feeling dismissed and invalidated by providers. However, being blocked from the groups also led to a larger curiosity--what is happening in these groups? Are they helpful for people with chronic pain, or are they harmful? Conducting this study and writing this article with my co-authors was a rewarding process. I am especially grateful to the study participants who dedicated their time and energy to participate in the study for 30 days, complete surveys, and gave me access to their posts and comments. This study gave our team an intimate view into the thoughts and feelings of people with chronic pain, and for that I am very appreciative. I hope you find this article thought-provoking. I also hope that it leads us as a wider healthcare community to be mindful of how we communicate with our patients with chronic pain, as we can take a significant role in down-regulating the "us versus them" mentality that some people with pain experience. Thank you.

Dr. Hallie Tankha
Cleveland Clinic

Read the Original

This page is a summary of: A mixed-methods investigation into the us versus them mentality in Facebook groups for chronic pain., Health Psychology, May 2023, American Psychological Association (APA), DOI: 10.1037/hea0001289.
You can read the full text:



The following have contributed to this page