Psychological Discussion of "Unmanageable Pain" in Adult Patients(Workshop/How to Deal with "Unmanageable Pain" in Clinical Practice - Knowledge of Intractable Pain for Clinical Psychologist)

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  • Kim Woe-Sook
    College of Nursing Art and Science, University of Hyogo:Division of Psychology, Nihon University School of Medicine
  • Matsuno Toshio
    Division of Psychology, Nihon University School of Medicine:Department of Psychosomatic Internal Medicine, Nihon University Itabashi Hospital
  • Murakami Masato
    Department of Psychosomatic Internal Medicine, Nihon University Itabashi Hospital

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Other Title
  • 大人の"困った痛み"の心理学的検討(ワークショップ:日常診療における"困った痛み"をどう考える?-心理士のための難治性疼痛の理解-,2013年,第54回日本心身医学会総会ならびに学術講演会(横浜))
  • 大人の"困った痛み"の心理学的検討
  • オトナ ノ"コマッタ イタミ"ノ シンリガクテキ ケントウ

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This paper focuses on the pain in fibromyalgia patients and discusses the characteristics of the pain felt all over the body. It emphasizes the importance of a multi angle treatment, including methods of alleviating the pain and of orienting patients towards a regular everyday life. It also discusses the influence of various forms of patient behavior - behavior triggered by pain, by excessive patience, and by avoidance patterns - on the self-management of the pain. From a cognitive behavioral standpoint, we also experimented with the clinical application of this treatment to Fibromyalgia patients, using self-assessment tools focused on self-cognizance induced by pain, expression of emotions, and problems of behavior. The result obtained was as follows. At the stage of the self-evaluation of pain, the patients acquired the skill of verbally describing to others what the pain feels like, which led them to better understand the pain. At the stage of the self-management of pain, identifying the causes of the pain was helpful in clarifying the goals of the treatment, as well as in the prevention of pain. Adopting an at-a-glance self-assessment sheet in which patients could record their self-evaluation of the pain and a self-management plan of pain has enabled us to realize that the "unmanageable pain" mentioned by patients in daily consultation was indeed a psychosomatic symptom caused by interrelated factors of the body and the mind, which thus required psychosomatic treatment.

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