Childhood Abuse and Chronic Pain: A Curious Relationship?

Robert B. MacIntyre is head of the Centre for Relationship Therapy and
Education in Orangeville, Ontario.

In this investigation into the possible relationship between abuse in
childhood and later adult chronic pain, the author finds scant empirical
support for the notion and relatively little clinical support for the
concept of “pain proneness” proposed in 1959 by Engel. His book
explores the possibility of a connection through a series of brief case
studies of adults who attended a pain clinic and reported a variety of
abusive backgrounds, including childhood neglect, physical and sexual
abuse, and adult spousal abuse.

Roy’s choice of case histories is less than systematic, with patients
ranging from those seen for only a single intake session to those who
engaged in therapy for long periods of time. Based on this clinical
work, Roy suggests that further exploration and research is needed in
this area. However, as he points out, patients who seek treatment for
intractable pain (following an automobile accident, for example), may
not respond well to probes into their childhood history. Such probes
could be seen as minimizing the importance of the event that initiated
the chronic pain, while at the same time shifting the responsibility for
it to the patient’s psychological structure.

This book will appeal to those with an interest in the psychodynamic
approach to chronic pain and in the possible outcomes of childhood
abuse. It should be pointed out, however, that the case studies it
presents do not provide strong support for the hypothesis.