Ways of Hoping: Navigating the Paradox of Hope and Despair in Chronic Pain

Emery R. Eaves, Mark Nichter, Cheryl Ritenbaugh

Research output: Contribution to journalArticlepeer-review

34 Scopus citations


In this paper, we explore hope in the context of living with chronic pain. Individuals with chronic pain from temporomandibular disorder(s) were interviewed four to five times over the course of their 18-month participation in a clinical trial investigating the effectiveness of Traditional Chinese Medicine. We sought to understand shifts in participants’ descriptions of expectations and hopefulness, particularly with regard to the work involved in counterbalancing positive thinking with buffers against disappointment. We found hope to be a dynamic and multifaceted mindset as distinct from being a single entity to be measured. Drawing upon Polanyi’s concept of tacit knowing, we explore how different ways of hoping emerge and index one another in participant narratives. We offer a working typology of hope and raise as an issue the manner in which the paradox of hope—hoping enough to carry on while keeping hopes in check to avoid the ever-present possibility of despair—complicates simplistic notions of the relationship between positive thinking and the placebo response.

Original languageEnglish (US)
Pages (from-to)35-58
Number of pages24
JournalCulture, Medicine and Psychiatry
Issue number1
StatePublished - Mar 1 2016
Externally publishedYes


  • Chronic pain
  • Hope
  • Placebo
  • Tacit knowing

ASJC Scopus subject areas

  • Health(social science)
  • Anthropology
  • Arts and Humanities (miscellaneous)
  • Psychiatry and Mental health


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