Interpersonal tensions may cause someone to develop chronic pain, and vice versa. In many families and cultural groups, a “performance” of pain may be the only way of signalling personal distress, whatever its cause. This is an example of somatisation, and may take many forms, from “pain everywhere” to recurrent pain in a particular organ or body part. As Kleinman and colleagues put it, “Depression and anxiety, serious family tensions, conflicted work relationships – all conduce to the onset of or exacerbation of chronic pain conditions and, in turn, may be worsened by chronic pain.”