How the Awareness Wheel Helps You Manage Chronic Pain
Have you ever noticed that two people can experience something similar and react in completely different ways? Or stranger still, the same thing happens to you on two different days, and one day you handle it fine, but the next day you fall apart?
For years, I thought it worked like this: pain happened, and worry and fear were the natural reactions. End of story. Pain in, reaction out.
But that’s not actually what’s happening. There are several steps in between, and once you can see them, you realize you have more influence over your response to chronic pain than you ever thought.
The tool that helped me see those steps is called the Awareness Wheel.
What Is the Awareness Wheel?
The Awareness Wheel is a self-awareness and communication model developed by Dr. Sherod Miller and his colleagues. Jim and I originally taught it years ago as part of a couples communication program. It wasn’t designed for chronic pain. But once I started applying it to how I was responding to my own pain, everything shifted.
The Awareness Wheel breaks down your reaction into five parts:
- Facts
- Thoughts
- Emotions
- Wants
- Actions
Most of us think we go straight from fact to reaction. The Awareness Wheel slows that down and shows you what’s actually happening in between. And in that space, you have choices you didn’t know you had.
1. Facts: What You Actually Observe
Facts are simply what you observe through your senses. What you see, hear, touch, smell, taste, or physically experience. Pain is a fact. Discomfort is a fact.
For example:
- I wake up in the morning, and my back hurts.
- I sit in a chair for a while, and I feel discomfort.
- My doctor says the MRI hasn’t changed recently.
Facts are just information. They are neutral. The problem is that we almost never stop at facts. Our brain moves on almost instantly to the next step.
2. Thoughts: The Story You Tell About the Fact
Once a fact registers, your brain immediately starts interpreting it. This is where things get interesting, because two people can receive the exact same fact and create completely different meanings from it.
Take “my back hurts this morning.”
One thought might be: “Oh no, here we go again. I’m getting worse.”
Another might be: “I’ve had this before. It got better. This is a temporary flare, and I’ll get through it.”
Or even: “I don’t like this, but I’ve been learning some strategies that help. I’m going to use them today.”
Same fact. Three very different interpretations.
Most of us don’t realize we’re interpreting at all. We think we’re just observing reality. But for years, my thoughts about pain sounded like, “I’m getting worse. I’m back to square one. Nothing will ever help.” Those weren’t facts. They were interpretations. And they felt completely true.
That distinction was not only important. It was profound.
The Space Between Stimulus and Response
There’s a quote from the psychiatrist Viktor Frankl that fits here. He wrote that between stimulus and response, there is a space, and in that space is our power to choose our response.
The Awareness Wheel is essentially a map of that space. The stimulus is the fact. Everything that comes after, the thoughts, emotions, wants, and actions, is the space where we have power to choose.
It’s not easy. But it makes a real difference.
3. Emotions: How the Thought Makes You Feel
Many of your emotions are shaped by the thoughts you have about a situation, not by the situation itself.
Go back to the example.
Fact: My back hurts today. Thought: “I’m getting worse.” Emotion: Scared. Discouraged. Frustrated. Maybe even hopeless.
Now keep the fact the same and change only the thought.
Fact: My back hurts today. Thought: “I’ve had flares before, and they’ve settled down.” Emotion: Calmer. Steadier. Possibly even hopeful.
The pain hasn’t changed. The interpretation did. And the emotional response shifted with it.
This isn’t about pretending emotions aren’t real, or that pain isn’t real. Both are absolutely real. It’s about recognizing that your thoughts have a powerful influence on how you feel, and sometimes even on the intensity of the pain itself.
4. Wants: What the Emotion Pulls You Toward
Once you feel an emotion, it usually causes you to want something.
- If you feel afraid, you might want safety.
- If you feel discouraged, you might want relief.
- If you feel overwhelmed, you might want to escape.
- If you feel hopeless, you might want to stop trying.
Whether the emotion is helpful or unhelpful, it pulls you toward a want. And most of the time, this is happening automatically. You’re not consciously choosing it.
Naming the want is what gives you a moment to ask, “Is what I’m about to do actually going to help me, or is it just going to give me temporary relief?”
5. Actions: What You Actually Do
The action is the visible part of the cycle. It’s what other people see. But by the time you get here, four other things have already happened.
Going back to the example:
Fact: My back hurts today. Thought: I’m getting worse. Emotion: Fear. Want: Safety. Action: Avoid movement. Cancel plans. Stay in bed.
For 21 years of unmanaged pain, I was very good at this. Avoiding movement gave me short-term relief, which is why my brain kept choosing it. But it almost always created new problems. Less movement led to more stiffness, more deconditioning, and more pain, which then became a new fact, and the wheel started over.
Why the Cycle Keeps Repeating
The Awareness Wheel doesn’t stop. Your action creates a new situation. That new situation becomes a new fact. You have a thought about it, then an emotion, then a want, then another action.
For years, I would ask myself, “Why do I keep doing this?” The Awareness Wheel helped me ask a better question: “Which part of the wheel am I in right now?”
That question is much more useful. Am I stuck in a looping thought? Am I in an emotion that’s so strong I can’t see past it? Am I about to take an action that gives me temporary relief but causes a bigger problem tomorrow?
The wheel creates awareness instead of judgment.
You Don’t Have to Change Everything
One of the things I love about this model is that you don’t have to fix every part of the wheel. You can step into it anywhere.
- Maybe you challenge an unhelpful thought.
- Maybe you work on calming an emotion before it drives an action.
- Maybe you identify what you actually want and ask whether it’s healthy.
- Maybe you put a small pause between what you want to do and what you actually do.
That pause between want and action is its own Viktor Frankl-sized space. Small changes there can completely alter the direction of the cycle.
Change doesn’t usually happen through giant breakthroughs. It happens through small moments of awareness, one at a time.
A Different Way to See Your Reactions to Chronic Pain
If you’ve ever wondered, “Why do I keep reacting this way?” please know you’re not a failure, and you’re not flawed. You’re human.
The Awareness Wheel helps you see that your responses to chronic pain aren’t random. There’s a process happening: facts, thoughts, emotions, wants, and actions. Once you can see the process, you can begin influencing it.
It doesn’t happen overnight. But one moment of awareness at a time adds up. And that awareness gives you something genuinely valuable.
It gives you hope.
Want to work with the Awareness Wheel directly? You can find the official workbooks and tools at www.awarenesswheel.com
