PERSPECTIVE article
Front. Pain Res.
Sec. Non-Pharmacological Treatment of Pain
Volume 6 - 2025 | doi: 10.3389/fpain.2025.1641571
This article is part of the Research TopicNon-biomedical Perspectives on Pain and its Prevention and Management – Volume IIView all 6 articles
An Integral Vision of Pain and Its Persistence: A Whole-Person, Whole-System, Salutogenic Perspective
Provisionally accepted
- Centre for Pain Research, School of Health, Leeds Beckett University, Leeds, United Kingdom
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Persistent pain remains a significant global health challenge, with prevailing biomedical and biopsychosocial models often falling short in capturing its full complexity. These models frequently lack conceptual and contextual coherence, overlooking the deeply subjective, cultural, and systemic dimensions of pain. As a result, care can become fragmented and suboptimal. This perspective article introduces an integral vision of pain, grounded in the All Quadrants, All Levels (AQAL) framework, which offers a multidimensional approach that integrates subjective experience, objective mechanisms, cultural meaning, spiritual perspectives, and systemic structures. The article outlines how a simplified AQAL framework can serve as a heuristic tool to synthesise individual and collective dynamics-including psychological development and socio-environmental conditions-thereby informing a more comprehensive understanding of pain and its persistence. This includes recognising the role of painogenic environments and the impact of evolutionary mismatch in shaping pain experiences. This integrative perspective reframes persistent pain within a salutogenic social model of health, adopting a whole-person, whole-system approach that supports the cocreation of compassionate, community-driven, and context-sensitive care. Ultimately, it reconceptualises persistent pain not merely as a disease state or clinical symptom, but as a dynamic, relational, and meaning-laden experience embedded within the evolving journey of life. This integral vision challenges reductionist paradigms, advancing a more coherent, salutogenic, and humanistic model for understanding and addressing persistent pain.
Keywords: Pain, integral theory integrative, All Quadrants All Levels (AQAL) Framework, salutogenic, Community, painogenic environment, Evolutionary-mismatch
Received: 05 Jun 2025; Accepted: 23 Jul 2025.
Copyright: © 2025 Johnson. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Mark I. Johnson, Centre for Pain Research, School of Health, Leeds Beckett University, Leeds, United Kingdom
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