Chronic pain as a lifestyle
Authors:
P. Knotek
Authors place of work:
Oddělení klinické psychologie, Centrum pro léčení a výzkum bolestivých stavů, FN Motol, Praha
Published in the journal:
Reviz. posud. Lék., 10, 2007, č. 3, s. 67-74
Summary
Pain is the most frekvent symptom of diseases and the most common cause of a medical consultation. The acute pain roughly corresponds to pathophysiological conditions. The chronic pain implies only low dependent relations between pathophysiological conditions, psychological changes, and behavior. This article discusses psychological responses to pain, and consecutive changes of Self-assessment, behavior, and social integration, independent on pathophysiological conditions. The repeatedly tested model describes these processes (Fig. 1): Pain arises in the context of already existing pain beliefs and attitudes. The pain beliefs and pain start focusing of attention and fear of pain. If withdrawal and resignation consecutively develop, than anxiety, anger and depression grow. These affects elicit changes of Self-perception and learned pain behavior. The learned pain behavior is relatively independent on pain, and is developed and stabilized by different advantages, financial supports and other secondary gains. The patient behavior elicits reactions of other people, who support or inhibit the pain behavior. The secondary gains of other people are frequent too (see the ill grandmother, who keeps her daughter’s house and takes care of her grandchildren). The first stage of the psychological changes in a patient is characterized by the predominance of affective quality over sensory quality of pain (the first affective stage). The second affective stage is characterized by general negative affects, anxiety, anger, and depression. The final phase of the psychological changes is the learned pain behavior. The person accepts the role of a patient and the therapy becomes a mere ritual, because the recovery and the loss of the status of ill person is a threat of its life style.
Key words:
chronic pain – cognitions – affects – pain behavior – social adaptation and maladaption
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Štítky
Medical assessment Occupational medicineČlánok vyšiel v časopise
Medical Revision
2007 Číslo 3
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