Acute and chronic pain complaints are in part determined by psychological factors unrelated to disease or trauma. Suffering associated with acute pain is greatly influenced by the anxiety of the patient, and it can be managed by helping him form useful defensive attitudes toward the pain he will experience. Chronic pain, in contrast, tends to be linked to personality problems and payoffs in the home and job situation for adopting a sick role. Both pain states may be usefully construed as problems of perceptual distortion. A model for the perception of pain is presented and suggestions for applying psychological considerations in the diagnosis and management of pain states are offered.