THE ‘REWARDS’ OF PAIN: THE ROLE OF THE CHRONIC PAIN PATIENT

Many pain patients also manage to play a good game of ‘my daughter is killing me’, or ‘my son, husband, wife, mother, father is trying to do me in’, and so on. Family disturbances are common sources for perpetuating pain. The most frequent causes of an emotional crisis are unfaithful spouses and errant children.

It is surprising how often pain patients are addicted to habit-forming drugs. This has become one of the behaviourial games. We have also had patients who have been easily withdrawn from the drug while in the hospital, only to go home and immediately contact three or four different doctors and get narcotics from every physician they can convince about their suffering.

Clearly the role of the chronic pain patient is to seek appropriate professional help and to make all efforts to try to become well again. However, Adelaide pain researcher Professor Issy Pilowsky has identified abnormal illness behaviour as a form of hypochondriasis. This is the condition in which a patient believes he or she is ill, without appropriate medical evidence. The patient is preoccupied with pain symptoms to the exclusion of all else and is convinced of the presence of significant illness or injury and is resistant to all medical explanations and reassurance.

Once a pain associated with tissue damage has occurred, and becomes chronic, the patient becomes filled with self-inflicted negative ideas and thoughts. All family and other stresses and problems are conveniently blamed on the pain! The sufferer may then become oblivious to family and occupational causes of tension, can gratify the need to become dependent or child-like by the adoption of the ‘sick role’ which leads to a legitimate reason for narcotic medication.

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