Psychological characteristics of chronic pain include fear of movement, pain catastrophizing, depression and anxiety, low self-efficacy, low interoceptive awareness, and impulsivity. Patients with chronic pain commonly exhibit fear-avoidance behaviors and overactivity, both associated with pain-related psychology. Pain acts as an antireward, suppressing the dopaminergic reward system in general and resulting in depression. In addition, negative emotions affect the descending pain modulation system. Neural alterations in the brain are associated with the psychological characteristics and are likely to contribute to mechanisms of central sensitization and chronic pain. Given the intricate interplay of physical and psychological factors contributing to chronic pain and the development of a vicious cycle, interdisciplinary approaches are required to treat severe chronic pain, including medication, nerve blockade, surgery, physical therapy, and psychological therapy.