Dr. David B. Adams – Psychological Blog

Psychology of Illness, Pain, Anxiety and Depression

Differentiation: Predisposing vs. Consequent

Pain treatment involves oral and injected medications and other procedures designed to minimize or eliminate pain. The will be very successful with many patients, and it is clear to me that patients enter such programs with the goal of eradicated all of their pain, not just some degree of pain. The centers appear to be successful, but they may be less successful with patients who are financially (or otherwise) compensated for their pain.

Pain management centers are, to me, quite a different concept. They appear to address a more important group of patients; those whose pain may never be eliminated.

A true pain management center would re-train a patient to cope with pain, often using the same tools as the pain treatment center, but there is an important difference. The pain management center would equip the patient with a drive, desire and conviction to again become productive regardless of the pain. A pain management center would have as its goal the patient’s living a normalized existence in which pain, and taking medication for pain, is not the sole goal of each passing day.

A true pain management center would help the patient understand what he, his family and others are doing to encourage him to spend so much time avoiding pain.

I see many, many patients who tell me that as part of their PPD rating, they have been told, and believe in, the fact that they cannot sit for more than 10 minutes. It is after after 90 minutes that they provide this information, often failing to see the contradiction.

A true pain management center would help the patient realize continuing personal and occupational goals despite the existence of chronic pain.

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