The Pain of Ambivalence over Emotional Expression

Purpose: Ambivalence over emotional expression (AEE) is defined as the desire to express emotion but failing to do so. Recent studies have revealed that AEE is associated with more pain. Pain is common among cancer survivors. This cross-sectional study investigated the association between AEE and pain, its underlying mechanism, and cultural relevance among cancer survivors. Methods: Ninety-six Chinese American breast cancer survivors completed a questionnaire package assessing AEE and pain. Results: AEE was positively associated with pain severity and pain interference. The association between AEE and pain interference was mediated by intrusive thoughts. Conclusion: Cancer survivors who are ambivalent over emotional expression may experience high levels of intrusive thoughts, which results in high levels of symptom reports in their pain. The study confirmed the association between AEE and pain and its underlying mechanism among a group whose culture generally encourages emotional suppression. Findings suggest interventions focusing on reducing intrusive thoughts may be effective at reducing pain.