Terms and Theories of Pain

  • H. Merskey


All writers and all psychiatrists make mistakes. This applies even to the greatest names of past and present. If I pick out one such error, by a deservedly famous man, it is not meant to detract from his achievement or to cast a posthumous slur on his reputation. It is meant, rather, to show the insidious and universal nature of the error which he made. In saying this I have in mind a remark by Jaspers (1963) that “severe pains need not be felt”. Perhaps all of us, at some time, have made the observation about a sick or injured person “He did not feel the pain”. Usually this is done when someone has an injury which seems likely to give rise to pain but does not provoke any signs which ordinarily accompany severe pain such as wincing, gasping and the like. We are all, incidentally, well aware that although trauma normally gives rise to pain there are some striking instances in which it does not do so, or else the pain sustained is much less than expected. Such instances include patients with a congenital or acquired inability to experience pain either for unknown reasons (Ogden et al., 1959) or because of nervous system disorders such as the Riley-Day syndrome or Tabes Dorsalis. They also include trauma in battle (Beecher, 1956) and the very important examples of anaesthesia or local analgesia.


Chronic Pain Subjective Experience Injured Person Local Analgesia Nervous System Disorder 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Agnew, D.C. and Merskey, H. 1976. Words of chronic pain. Pain 2: 73–81.PubMedCrossRefGoogle Scholar
  2. 2.
    Beecher, H.K. 1956. Relationship of significance of wound to the pain experienced. J. Amer. med. Ass. 161: 1609–1613.CrossRefGoogle Scholar
  3. 3.
    Bishop, G.H. 1943. Responses to electrical stimulation of single sensory units of skin. J. Neurophysiol. 6: 361–382.Google Scholar
  4. 4..
    Neural mechanisms of cutaneous sense. Physiol. Rev. 26: 77–102.Google Scholar
  5. 5.
    Boyd, D.B. and Merskey, H. 1978. A note on the description of pain and its causes. Pain 5: 1–3.PubMedCrossRefGoogle Scholar
  6. 6.
    Department of Health and Social Security. 1973. Report of the professional investigation into medical and nursing practices on certain wards at Napsbury Hospital, nr. St. Albans. London: Her Majesty’s Stationery Office, U.K. Government Publication, pp. 1–22.Google Scholar
  7. 7.
    Devine, R. and Merskey, H. 1965. The description of pain in psychiatric and general medical patients. J. Psychosom. Res. 9: 311–316.PubMedCrossRefGoogle Scholar
  8. 8.
    Hare, R.M. 1964. Pain and evil. Proc. Aristot. Soc. supp. 38: 91–106.Google Scholar
  9. 9.
    Herman, E. and Baptiste, S. 1981. Pain control: mastery through group experience. Pain 10, 1: 79–86.PubMedCrossRefGoogle Scholar
  10. 10.
    Jaspers, K. 1963. General Psychopathology. 7th ed. (Trans. J. Hoenig and M.W. Hamilton). Manchester University Press.Google Scholar
  11. 11.
    Keele, C.A. 1962. Addendum. In Keele, C.A. and Smith, R. 1962, 41–42.Google Scholar
  12. 12.
    Krafft-Ebing, R. von. Psychopathia sexualis: a medico-forensic study. (Trans. H.E. Wedeck). New York: G.P. Putnam, 1965.Google Scholar
  13. 13.
    Leavitt, F. and Garron, D.C. 1979. Psychological disturbance and pain report differences in both organic and non-organic low back pain patients. Pain 7: 187–195.PubMedCrossRefGoogle Scholar
  14. 14.
    Merskey, H. and Spear, F.G. 1967. Pain: Psychological and Psychiatric Aspects. London: Bailliére, Tindall and Cassell.Google Scholar
  15. 15.
    Merskey, H. 1979. The role of the psychiatrist in the investigation and treatment of pain. Research Pbulication. In: Ass. Res. Nerv. Ment. Vol. 58. Pain, ed. J.J. Bonica. New York: Raven Press, pp. 249–260.Google Scholar
  16. 16.
    Ogden, T.E., Robert, F. and Carmichael, E.A. 1959. Some sensory syndromes in children: indifference to pain and sensory neuropathy. J. Neurol. Neurosurg. Psychiat. 22: 267–276.PubMedCrossRefGoogle Scholar
  17. 17.
    Reading, A.E. 1979. The internal structure of the McGill pain questionnaire in dysmenorrhoea patients. Pain 7: 353–358.PubMedCrossRefGoogle Scholar
  18. 18.
    Roberts, A.H. and Reinhardt, L. 1980. The behavioural management of chronic pain: long term follow-up with comparison groups. Pain 8: 151–162.PubMedCrossRefGoogle Scholar
  19. 19.
    Russell, B. 1948. Human Knowledge: Its Scope and Limits. Simon and Schuster.Google Scholar
  20. 20.
    Ryle, G. 1949. Concept of Mind. London: Hutchinson’s University Library.Google Scholar
  21. 21.
    Stengel, E. 1966. Pain and the psychiatrist: Brit. J. Psychiat. 112: 329–331.CrossRefGoogle Scholar
  22. 22.
    Szasz, T.S. 1957. Pain and Pleasure. A Study Feelings. London: Tavistock Publications.Google Scholar
  23. 23.
    Watson, G.D., Chandarana, P.C. and Merskey, H. ships between pain and schizophrenia. Brit. 138: 33–36.Google Scholar

Copyright information

© Plenum Press, New York 1983

Authors and Affiliations

  • H. Merskey
    • 1
  1. 1.London Psychiatric HospitalUniversity of Western OntarioLondonCanada

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