Background and objectives: Previous research has found that in some contexts, suppression increases distress, whereas acceptance decreases distress. It is not clear, however, whether these two common forms of emotion regulation have comparable or divergent physiological and behavioral effects during the anticipation and receipt of a painful stimulus. Methods: To address this issue, we randomized participants to suppression, acceptance, or no instruction control groups, and assessed their cardiovascular and behavioral responses while they anticipated and then received electric shocks. Results: Findings revealed that compared to the control condition (1) acceptance and suppression led to comparable reductions in pain reports and cardiac defense responses; and (2) acceptance led to greater reductions in reports of anticipatory anxiety than suppression. Limitations: The current study tested only two emotion regulation techniques in the context of a pain-inducing stimulus that has limited ecological validity. Conclusions: In contrast to previous research, we found that both acceptance and suppression are effective in reducing pain and anxiety in response to experimentally induced pain. (c) 2012 Elsevier Ltd. All rights reserved.