So I’m supposed to stop caring whether I’m in pain?
When I first learned about outcome independence, this was roughly my reaction. Actually, if I’m being completely accurate, the concept pissed me off. I was doing all of this work because I wanted to feel better. That was the entire point. I wasn’t reading books about chronic pain, practicing somatic tracking, changing how I thought about symptoms, and trying to convince my nervous system that my body was safe because I had suddenly developed a deep appreciation for being in pain. I wanted the pain to go away. So when I was introduced to the idea that I needed to care less about whether it went away, it felt a little like someone had changed the rules halfway through the game. And I wanted to punch them in the face.
That’s why I think the phrase outcome independence can be misleading at first. It doesn’t mean you stop wanting to feel better. It doesn’t mean you have to become so enlightened that pain appears and you think, Wonderful. I hope it stays all afternoon. And it definitely doesn’t mean pretending you’re fine when you’re miserable. Outcome independence is really about changing what counts as success.
When recovery becomes one long performance review
Imagine you decide to go for a walk after avoiding one for months because walking has been associated with pain. You’ve been learning about neuroplastic symptoms, you have some evidence that your body may be safer than it feels, and today you’re going to try walking around the block. You make it to the end of the driveway. How does my leg feel? Halfway down the street. Still okay? Is that tightness? Was that there before? You turn the corner. Wait. I think it’s starting. By the time you get home, you may have technically taken a walk, but your brain has also received about forty-seven status updates on the condition of your leg.
I see versions of this all the time, and it makes perfect sense. When you’ve been hurting for a long time, of course you want to know whether what you’re doing is helping. You try something new and check the pain afterward. You wake up feeling good and wonder if today is finally going to be a good day. You go out to dinner and, somewhere between ordering and the food arriving, take a quick internal survey to determine whether your body is ruining the evening yet. The checking can become so automatic that you barely realize you’re doing it.
The problem is that suddenly everything becomes a test. The walk isn’t really a walk anymore; it’s an experiment to see whether your leg behaves. Dinner isn’t really dinner; it’s an opportunity to find out whether you can sit in that chair for ninety minutes. A good day isn’t simply a good day; it’s evidence that recovery is working, which means tomorrow had better cooperate too. Somatic tracking can even become, I’ve been curious for five minutes. Why is this still here? Suddenly recovery has become one very long performance review, and your symptoms are apparently in charge of completing it.
Outcome independence changes what counts as success
Let’s go back to the walk. If the definition of success is I went for a walk and had no pain, then the moment pain appears, the outing has failed. Maybe you walked farther than you have in six months. Maybe you were less afraid. Maybe you noticed the pain and kept talking to your spouse instead of immediately turning around. Maybe you had fifteen minutes in which your world became a little bigger again.
Doesn’t matter. Pain showed up.
Outcome independence asks us to move the goalposts: I went for the walk. That was the success. Pain may have come with you. Maybe it didn’t. You would obviously prefer that it stay home. I would too. But its presence doesn’t get to decide whether you accomplished what you set out to do.
There’s a difference between I would really like the pain to be gone and I need the pain to be gone before I can be okay. I think that distinction gets much closer to what outcome independence actually means than telling someone they need to stop caring about the outcome. The second version gives symptoms an awful lot of authority. You can go to the party if the headache improves. You can enjoy vacation if your stomach behaves. You can believe PRT is working as long as tomorrow morning’s pain score cooperates. Before you know it, your life is waiting for your body to issue a permission slip.
Outcome independence is slowly taking some of that authority back. If you go to dinner, can the goal be having dinner with your friend rather than finding out whether you can sit in a restaurant pain-free? If you take your kids to the park, can success be that you went to the park with your kids? If you try a food you’ve been afraid of, can the experience be eating it rather than spending the next six hours watching your stomach for a verdict? This doesn’t mean ignoring symptoms or overriding your body, and it certainly doesn’t mean assuming every physical sensation is neuroplastic. It means noticing when reasonable awareness has quietly turned into constant surveillance.
The life I wanted back wasn’t a life spent thinking about recovery
I know how difficult this shift can be because I spent years living in a body that felt like it required constant management. When symptoms have taken huge pieces of your life away, it is very hard not to make getting better the center of everything. You want your life back so badly that recovery can become its own full-time job. And then somehow you’re still spending your entire day thinking about symptoms—only now you’re thinking about them in a much more therapeutically sophisticated way.
That wasn’t the life I was trying to get back to.
The goal wasn’t for me to become excellent at monitoring my nervous system. I wanted to eventually have whole stretches of my life where I wasn’t thinking very much about my nervous system at all. That doesn’t mean I stopped caring whether I felt good. Of course I cared. It meant that feeling good could stop being the admission price for participating in my own life.
This is also why I want to know about more than someone’s pain level when I’m working with them. I absolutely care whether their symptoms are changing; they came to me because they want to feel better. But I’m also interested in whether they’re doing things they had stopped doing, whether a sensation can appear without hijacking the next three hours, whether they’re checking their body less, or whether they had a moment this week when they were simply living and forgot to evaluate how recovery was going. Sometimes those changes tell me something that a pain score doesn’t.
And yes, you can become perfectionistic about outcome independence
There is one more trap here, especially for the perfectionists among us. You can become perfectionistic about outcome independence too. Was I outcome-independent enough at the grocery store? I checked my pain three times. I should only have checked it twice. Maybe I reinforced the neural pathway. Now I need to do another exposure correctly.
We have successfully turned not monitoring your symptoms into another thing to monitor.
This is why I don’t want PRT to become another full-time job for the people I work with. Sometimes you’re going to check. Sometimes a flare will scare you. Sometimes you’ll have an amazing symptom-free day and be wildly excited about it, and then feel disappointed when pain shows up again the next morning. None of that means you’re doing this wrong. Outcome independence isn’t another standard you have to meet perfectly.
And this is also where the concept becomes much more individual than it sounds when you read about it online. One person may be checking their pain every time they stand up. Someone else barely checks at all but has quietly made a rule that they can’t make plans unless they’ve had two good days first. Another person may be doing all the “right” PRT things but evaluating every single one by whether the symptom decreases afterward. Those are different patterns, and they’re exactly why I’m less interested in telling someone to “practice outcome independence” than I am in understanding where symptoms have been given authority in their particular life.
What are you waiting to do until you feel better? What has quietly become a test? Where are you checking without realizing you’re checking? And what would change if the goal of an experience became the experience itself rather than the report your body gives you afterward?
Those are the questions I find interesting.
Because the goal was never to become really, really good at having chronic symptoms. The goal was to get your life back.
If you understand the idea of outcome independence but find yourself thinking, Okay, but I have no idea what this is supposed to look like with my symptoms, that’s exactly the kind of thing I work through with clients. Sometimes it’s surprisingly hard to see the little rules, tests, and check-ins that have worked themselves into your day until we slow down and look at your specific pattern together.
If you’d like to do that, I offer free 15-minute connect calls where we can talk about what you’ve been experiencing and whether working together through Pain Reprocessing Therapy might make sense.
About the Author
Amberleigh Maida, ICF-ACC, is an Advanced Pain Reprocessing Therapy (PRT) Practitioner with additional training in Emotional Awareness and Expression Therapy (EAET). Having experienced and recovered from years of debilitating chronic pain herself, she brings both professional training and lived experience to her work. She also holds a master’s degree in creative writing with a focus on nonfiction. Through her writing, she explores neuroplastic symptoms, the brain-body connection, and evidence-based approaches to chronic pain and other persistent symptoms.
Learn more about Amberleigh’s personal story and approach or explore her professional credentials and training.
