The leading psychological approaches for chronic pain management have only modest efficacy. Dr. Lumley examines the limitations of these approaches and presents new concepts and treatments that hold promise for larger effects, including Pain Reprocessing Therapy and Emotional Awareness and Expression Therapy. These therapies: a) target specifically primary or centralized pain; b) seek pain reduction or elimination rather than just improved functioning; and c) emphasize reduction of fear and avoidance, including emotional processing of the psychological trauma and conflicts. Results of clinical trials are presented to support these proposals as well as challenges to their use.