The Social Context of the Chronic Pain Sufferer

John H. Gryfe is an oral and maxillofacial surgeon practicing in
Toronto.

Chronic pain has both sensory and psychological components, and cannot
be explained solely on the basis of organic findings. In one North
American study, 15 percent of the subjects interviewed in 500 randomly
selected households reported experiencing on-going debilitation with
chronic pain. The effects of this affliction on a patient’s social
system can be devastating. Ranjan Roy observes that “once the patient
embarks on the path to chronicity, inexorable forces seem to set in
which cause widespread dislocations; disrupted family relationships, job
loss, litigation, conflict with [the] health care system and with other
institutions and a withering away of social support.”

The longer it persists, the more difficult chronic pain is to
eradicate. For Roy, understanding and resolving the patient’s
psychosocial problems must assume a “central place in ... [his or her]
treatment plan.”

In a particularly strong section, Roy examines the interrelationship
between childhood abuse and/or neglect and the subsequent adoption of
“a lifestyle characterized by pain.”

This is a scholarly text replete with quotes from hundreds of reports
in the professional literature. The information is excellent and
effectively delivered through numerous case studies.