The three-systems model of emotions, so far exclusively applied for fear and anxiety, is summarized and its suitability for chronic back pain is examined. For each of the three systems, a possible conceptualisation and paradigm is suggested. Although arguments are given in favor of the use of this model as a heuristic frame-work in chronic pain research, assessment and treatment, unresolved problems are discussed. Some of the clinical and research consequences as well as suggestions for further research are presented.