Levels of pain, activity, marital satisfaction, and contingent reinforcement for expressions of pain and suffering were assessed in chronic pain patients. In addition, spouses' marital satisfaction, mood, life control, and self-reported responses to the patient's pain were examined. Multiple regression analyses revealed that spouse reinforcement of overt expressions of pain was significantly related to both perceived pain and activity levels of chronic pain patients. The best predictor of patients' pain and activity levels was patients' perception of spouse reinforcement, followed by spouses' self-reported responses to the patients' pain. Spouse reinforcement of pain was not associated with spouses' marital satisfaction or perception of patients' pain levels. Rather, spouse reinforcement was associated with high interference of patients' pain with spouses' lives, spouses' positive mood, spouses' perception of more life control, as well as longer duration of the pain problem. The data support the importance of the spouse as a potential source of reinforcement of pain behavior.