As a behavioral scientist, one of us has worked for years with individuals, families, and communities that are trying to manage chronic disease effectively. This personal journey has made clear that for people who must deal with a heart condition, a digestive disease, a rheumatic condition, or a similar problem, pain can be a persistent companion. It can exacerbate depression, produce fatigue, hamper functioning, and diminish quality of life. It can create stress and extract high psychic and material costs in families. It also can lead to the development of unexpected personal strengths and an astonishing capacity to prevail. However, pain is a fearsome way to develop such qualities. Control of pain, and of the disease that often accompanies it, depends on the ability of individuals to garner information and assistance, of family members to give productive help, of clini- cians to explore many options, and of communities to create systems to support families and clinicians. Most people living with pain, however, are not cosseted in this way, and we are woefully lacking in understanding how to offer them with the help they need or, when we do understand, in the capacity to provide it.