A Phenomenological Exploration of Identity Development in Adolescents with Chronic Pain

The aim of this study was to explore identity development in adolescents with chronic pain. Jointly, the high prevalence of chronic pain in adolescents, the importance of identity development for the wellbeing of adolescents, and the theoretical knowledge about the potentially unhelpful interactions between chronic illness and identity informed the rationale for this study. Considering the paucity of research regarding adolescents’ perspectives about their identity in the context of chronic pain, this study adopted an interpretative phenomenological epistemology to understand how adolescents with chronic pain made sense of their identity. For this purpose, semi-structured interviews were conducted with seven participants aged 16 to 18. Participants included five females and two males and had varied chronic pain conditions such as fibromyalgia, arthritis and back pain. Interviews were analysed using Interpretative Phenomenological Analysis resulting in five group experiential themes: “A limited identity”, “A mismatch”, “Not belonging as an adolescent”, “Paradoxical role of diagnosis” and “Protecting identity from pain”. Each group experiential theme contained two to three sub-themes.

Novel findings of this study included participants’ understanding of the sources limiting the development of their identity, the differences between participants’ view of their identity versus how they thought they were viewed by others, the varied meanings linked with a diagnosis or medical explanation of pain, and the impact chronic pain had over participants’ collective identity of being an adolescent. Notably, participants made efforts to retain important parts of their identity despite chronic pain, and even gained new valued parts to their identity.

Findings of this study enhance current knowledge about identity difficulties among adolescents with chronic pain. Implications for clinical practice are discussed, to support adolescents with chronic pain to manage changes and difficulties in their identity. The limitations of this study and recommendations for future research are also provided.