Psychological Aspects of Pain
Many clinicians have observed that the effectiveness of analgesic drugs is not totally predictable, especially when given to individuals suffering chronic pain. Several reasons for this unpredictability come to mind. For example, the drug selected may be too low in potency, it may have been given in incorrect doses or the patient may not have taken it as directed. Looking beyond these everyday explanations the answer might lie in variations in the way drugs for pain relief are metabolised. Clearly any of the reasons given might be correct but, in addition, there are psychological and social factors which have a powerful influence upon the intensity of pain and complaint behaviour associated with it which should be taken into account when assessing a person’s needs for relief, although in many cases only scant or ill-informed attention is given to these issues. In addition British patients are at a disadvantage because their doctors seem reluctant to give explanations about illnesses, their causes and their treatments, and as a result fail to relieve feelings of anxiety and fear, perhaps actively generating such feelings at times. Failure to relieve the tensions aroused by pain and illness actually increases the severity of pain, and therefore of requests for pain relieving drugs. At times it leads patients to seek the advice of other doctors and ‘shopping around’ for cures for chronic pain is common in the United States. This has little to commend it because there is a definite risk that the patient may develop more pain or other symptoms as a result of unnecessary investigations or surgical operations.
KeywordsDepression Migraine Schizophrenia Monoamine Tricyclic
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