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Logic, truth and language in concepts of pain

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Abstract

Logic and language influence our ideas about the truth of pain, and can alter our understanding of it. Physicians should not tell their patients that there is nothing wrong with them if all their test results are negative, as this denies their patients' experiences of pain. Popular methods of conceptualizing pain may be erroneous. Diagrams of pain or disability are misleading and unhelpful—it is not usually possible to distinguish their components in practice. Giving patients a high or low score for pain behaviour, depression or for health locus of control can influence our views on aetiology in a seriously misleading way. Anyway, aetiological attributions are not always possible from analyses of the experience of pain. The problems of logic and language inherent in assigning pain to emotional causes, in using behavioural approaches, and in defining idiopathic pain and somatization are discussed. The IASP definition of pain is important and useful, provided that it is used appropriately. The recommended version is now ‘an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.’

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References

  1. Devine R, Merskey H. The description of pain in psychiatric and general medical patients. J Psychosom Res 1965; 9: 311–316.

    Google Scholar 

  2. Keefe FJ, Block AR. Development of an observation method for assessing pain behavior in chronic low back pain patients. Behav Ther 1982; 13: 363–375.

    Google Scholar 

  3. Anderson KO, Keefe FR, Bradley LA et al. Prediction of pain behavior and functional status of rheumatioid arthritis patients using medical status and psychological variables. Pain 1988; 3: 25–32.

    Google Scholar 

  4. Merskey H, Spear FG. The concept of pain. Proc 10th Ann Conf Soc Psychosom Res. J Psychosom Res 1967; 11: 59–67.

    Google Scholar 

  5. Merskey H, Spear FG. Pain: Psychological and Psychiatric Aspects. London: Bailliere, Tindall & Cassell, 1967.

    Google Scholar 

  6. Sternbach RA. Pain. A Psychophysiological Analysis. New York: Academic Press, 1968.

    Google Scholar 

  7. Fordyce WE, Fowler RS, Lehmann JE, et al. Some implications of learning in problems of chronic pain. J Chronic Dis 1968; 21: 179–190.

    Google Scholar 

  8. Bonica JJ. The relation of injury to pain. Pain 1979; 7: 203–207.

    Google Scholar 

  9. Sternbach RA. Fundamentals of psychological methods in chronic pain. Pain 1981; (Suppl 1): S162.

  10. Linton SJ, Götestam KG. A controlled study of the effects of applied relaxation and applied relaxation plus operant procedures in the regulation of chronic pain. Br J Clin Psychol 1984; 23: 291–299.

    Google Scholar 

  11. Aronoff GM, Evans WO, Enders PL. A review of follow-up studies of multidisciplinary pain units. Pain 1983; 16: 1–11.

    Google Scholar 

  12. Fordyce WE. Behavioral Methods in Chronic Pain and Illness. St. Louis: Mosby, 1976.

    Google Scholar 

  13. Turk DC, Flor H. Pain > pain behaviors: The utility and limitations of the pain behavior construct. Pain 1987; 31: 277–295.

    Google Scholar 

  14. Von Knorring L. The Experience of Pain in Patients with Depressive Disorders. Umeå Sweden: Umeå University Med Diss, New Series No.2, 1975.

  15. Almay BGL. Patients with Idiopathic Pain Syndromes. A Clinical Biochemical and Neuroendocrinological Study. Umeaa9 University Medical Dissertations, New Series No. 191, 1987a.

  16. Almay BGL. Clinical characteristics of patients with idiopathic pain syndromes. Depressive symptomatology and patient pain drawings. Pain 1987; 29: 335–346.

    Google Scholar 

  17. Williams JBW, Spitzer RL. Idiopathic pain disorder: A critique of pain-prone disorder and a proposal for a revision of the DSM-III category psychogenic pain disorder. J Nerv Ment Dis 1982; 170: 415.

    Google Scholar 

  18. Magni G. On the relationship between chronic pain and depression when there is no organic lesion. Pain 1987; 31: 1–21.

    Google Scholar 

  19. Magni G, Andreoli F, Arduino C et al. 3H-imipramine binding sites are decreased in platelets of chronic pain patients. Acta Psychiat Scand 1987; 75: 108–110.

    Google Scholar 

  20. Lipowski ZJ. Review of consultation psychiatry and psychosomatic medicine, III. Psychosom Med 1968; 30: 394–422.

    Google Scholar 

  21. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 3rd edn. (DSM-III). Washington DC: APA, 1980.

    Google Scholar 

  22. Guze SB, Woodruff RA, Clayton PJ. Sex, age and the diagnosis of hysteria (Briquet's syndrome). Am J Psychiat 1972; 129: 745–748.

    Google Scholar 

  23. Von Korff M, Dworkin SF, LeResche L et al. An epidemiologic comparison of pain complaints. Pain 1988; 32: 173–183.

    Google Scholar 

  24. Dworkin SF, von Korff M, LeResche L. Multiple pains and psychiatric disturbance: An epidemiologic investigation. Arch Gen Psychiat 1990; 47: 239–244.

    Google Scholar 

  25. Pilowsky I. Dimensions of hypochondriasis. Br J Psychiat 1967; 113: 89.

    Google Scholar 

  26. International Association for the Study of Pain. Merskey H et al. Pain Terms: A List with Definitions and Notes on Usage. Recommended by an IASP Subcommittee on Taxonomy. Pain 1979; 6: 249–252.

    Google Scholar 

  27. Merskey H. An Investigation of Pain in Psychological Illness. Oxford: DM Thesis, 1964.

  28. Beecher HK Measurement of Subjective Responses. Quantitative Effects of Drugs. New York: Oxford University Press, 1959.

    Google Scholar 

  29. Livingstone WK. Pain Mechanisms: A Physiologic Interpretation of Causalgia and its Related States. London: Macmillan, 1943.

    Google Scholar 

  30. Medvei VC. The Mental and Physical Effects of Pain. Edinburgh: Livingstone, 1949.

    Google Scholar 

  31. Holmes G. Some clinical aspects of pain. In: Ogilvie H, Thomson WAR (eds). Pain and its Problems London: Eyre & Spottiswoode, 1950.

    Google Scholar 

  32. Kolb LC. The Painful Phantom Psychology, Physiology and Treatment. Springfield, IL: Charles C Thomas, 1954.

    Google Scholar 

  33. Adrian ED. Personal communication, 1956. Cit. Beecher 1959.

  34. Bishop GH. Personal communication, 1956. Cit. Beecher 1959.

  35. Lhermitte J. Les algo-hallucinoses: les hallucinations de la douleur. In: Alajouanine T (ed.) La Douleur et Les Douleurs. Paris: Masson, 1957.

    Google Scholar 

  36. Walters A. The psychological aspects of bodily pain. Appl Ther 1963; 5: 853–856.

    Google Scholar 

  37. Behan RJ. Pain. Its Origin, Conduction, Perception and Diagnostic Significance. New York: Appleton, 1914.

    Google Scholar 

  38. Merskey H. Psychiatric patients with persistent pain. J Psychosom Res 1965; 9: 299–309.

    Google Scholar 

  39. Stengel E. Pain and the psychiatrist. Br J Psychiat 1965; 111: 795–802.

    Google Scholar 

  40. Slater E. Pain and the psychiatrist. Br J Psychiat 1966; 112: 329.

    Google Scholar 

  41. Stengel E. Pain and the psychiatrist. Br J Psychiat, 1966; 112: 329–331.

    Google Scholar 

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Merskey, H. Logic, truth and language in concepts of pain. Qual Life Res 3 (Suppl 1), S69–S76 (1994). https://doi.org/10.1007/BF00433379

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