Living with Purpose: How It Connects to Pain and Health

Living with Purpose: How It Connects to Pain and Health

Dr. Stephanie Hooker is a clinical health psychologist and research investigator at Health Partners in Minneapolis. Her work focuses on how having a sense of meaning and purpose in life affects long-term health and wellbeing.

For people managing osteoarthritis, this topic matters more than it might first appear.

Research shows that a stronger sense of purpose is directly linked to less chronic pain, less disability, better physical function, and better recovery outcomes after joint procedures. It also helps break the fear-avoidance cycle that keeps many people with chronic pain stuck: the pattern where fear of pain leads to less movement, which leads to more pain.

Purpose gives you a reason to keep moving even on the hard days. And that reason turns out to be one of the most powerful tools you have.

This session brought Dr. Hooker’s insights directly to Adventurers for Life members. What follows is a summary of the key ideas and practical strategies from that conversation.

What Does “Purpose” Actually Mean?

Purpose is one component of a broader sense of meaning in life. Dr. Hooker breaks meaning into three parts:

Together, these create a felt sense that your life has weight and direction. And as the research shows, that feeling has measurable effects on your health.

Why Purpose Matters for Your Health

This is not a soft or abstract idea. The research behind it is substantial.

People with a greater sense of purpose tend to have better self-rated health, less disability, and less chronic pain. They also have more social connection, better mood, and greater physical strength. They walk faster and are less likely to have obesity or excess abdominal fat.

One large meta-analysis combined 10 studies and followed over 136,000 people for an average of seven years. People with greater purpose had a 35% reduced risk of death over that period and a 17% reduced likelihood of having a cardiac event such as a heart attack or stroke.

Among people with fibromyalgia, those with greater meaning showed higher pain tolerance and less disability.

Among adults over 50, meaning was linked to consistently engaging in preventive health screenings. People with greater purpose are also more physically active, sleep better, and are more likely to follow through on health-supporting behaviors over the long term.

“It is individuals with positive purpose who are likely to sustain practices of taking care of themselves, as well as maintain investments in meaningful life pursuits and social ties. Simply put, taking good care of oneself presupposes a life that is worth taking care of.”

– Carol Ryff, researcher in psychological wellbeing

When you feel like your life has purpose and direction, you are more motivated to invest in your health. The two reinforce each other.

Purpose and Knee Surgery Outcomes

One study that Dr. Hooker found particularly relevant to this group looked at people recovering from knee surgery.

Researchers measured sense of purpose before the surgery and then looked at outcomes six months later.

People who had a greater sense of purpose going into surgery had less depression, less anxiety, better mood, less disability, and less stiffness in the operated knee six months later.

The mindset you bring matters. Not just to how you feel day-to-day, but to how you recover.

The Fear-Avoidance Cycle and Why It Keeps Pain Going

Dr. Hooker described a well-established pattern in chronic pain called the fear-avoidance cycle. Understanding this cycle is one of the most useful things you can take from this session.

It works like this: pain leads to catastrophizing, which means mentally treating the pain as the worst possible thing. That increases fear and anxiety. Fear and anxiety lead to avoiding movement and being constantly on guard for pain signals. Avoidance leads to less activity, more disability, more depression, and ultimately more pain.

Avoiding movement because of pain is a natural short-term response. If you sprain your ankle, resting it for a few days makes sense. But with chronic pain like osteoarthritis, prolonged avoidance becomes harmful.

The goal of most psychological interventions in chronic pain is to help people gently break out of this cycle and re-engage with life.

This is one reason why keeping purpose and meaningful activity in your life is not just emotionally important. It is physically protective.

People who stay connected to what matters to them are less likely to spiral into avoidance and isolation.

Behavioral Activation: Doing More of What Matters

The primary approach Dr. Hooker uses in her work is called behavioral activation. The core idea is simple: when people start doing more of what is meaningful and important to them, they feel better. And when they feel better, they tend to do more.

That positive cycle is the opposite of the fear-avoidance spiral.

Behavioral activation is as effective as cognitive behavioral therapy for treating depression and has been successfully applied in chronic pain settings. It does not require overhauling your life. It starts with small, intentional steps toward what you value.

A Practical Exercise: Values and Time

Dr. Hooker led members through a two-part reflection that you can do on your own. It takes only a few minutes but can be surprisingly revealing.

Step 1: Rank your values

Write down the domains of life that matter to you. Common ones include family, friendships, health, work, spirituality, community, recreation, personal growth, and partnership. Add anything else that is meaningful to you, such as pets, creative pursuits, or learning.

Rank them from most important to least important. There is no right or wrong answer. Be honest with yourself rather than listing what you think you should value.

Step 2: Rank how you actually spend your time

Take the same list and rank the items by how much time you actually spend on each in a typical week. The item at the top is where most of your time goes. The item at the bottom is where the least goes.

Now compare the two lists. Most people find significant gaps. Something important to them is getting very little time. Something they care less about is consuming most of their days.

The goal is not to perfectly align the two lists, but to start moving them closer together.

One member shared that she ranked work and career fourth in importance but first in time spent. Another noted that health had become her top priority in terms of time, which was allowing her to show up more fully for everything else in her life. The lists simply reveal where the opportunities are.

Setting a Goal That Actually Gets Done

Once you identify a gap between your values and how you spend your time, set one small, specific goal to start closing it.

Dr. Hooker recommends using the SMART framework:

The goal should be something you can achieve in the next week or two. Not a long-term aspiration. Something concrete and small enough to actually happen.

One of the best strategies: pair two values in the same activity. If health and family are both important to you, a walk with a family member or cooking a healthy meal together serves both at once. Getting two values for the same investment of time is one of the most effective approaches to values-based living.

On Setting Realistic Expectations

One honest moment in this session came when a member shared that her goal felt unattainable because she wanted to get back to who she was before osteoarthritis, and she did not think that was possible.

Dr. Hooker’s response was gentle and practical: wanting to return to exactly who you were before can itself become a barrier.

The goal does not have to be going back. It can be finding your way toward a version of the life you want now, with what you have today. Small goals that move you in the right direction are more useful than large goals you cannot yet reach. Progress still counts, even when it does not look like what you originally imagined.

On Fear and Facing It

Another member described being afraid of the next challenge in her exercise progression, even though she was exercising every single day and had made remarkable progress over the past year.

Dr. Hooker’s response is worth holding onto:

Fear is anticipation. It is not prediction.

The best way to treat a fear is to do the thing, in small manageable chunks, so your brain can learn that the anticipated threat is not as bad as imagined. Self-talk matters. Telling yourself you can do it, setting small goals, and building on each success is how confidence grows.

You may already have the physical ability. Sometimes the only thing left to overcome is the mental barrier of believing you are ready.

Celebrate What You Are Already Doing

One of the most resonant moments of the session came from a member who noted that many people in this program are doing things they never expected to do again.

We often keep our eyes fixed on what is ahead and forget to acknowledge what is already behind us.

Celebrating progress, genuinely and regularly, is not just feel-good advice. It reinforces the belief that your effort is working, which makes it easier to keep going.

You are not working toward your goal. In a very real sense, you are achieving it every day by showing up and doing the work. That is worth recognizing.

Watch the Full Session

Want to hear Dr. Hooker walk through the research and lead the values exercise herself? Watch the full session below.

Key Takeaways