Family Issues #2

Today’s post is the second in our Friday series about family issues and your pain. As we discussed last Friday, pain conditions affect not only you, but also your family. Your husband or wife… your children… your Mom and Dad… even your friends.

These posts are excerpts from a handout for family members (and friends) of patients with pain that I’ve written with a colleague, Dr. David Kannerstein, who is the lead author.  The excerpts are reprinted with permission from Practical Pain Management, 2007, Vol 7, 48-52.  We’ve written this handout to provide information for family members and to help them with what they’re going through.

You’re invited to copy these posts and discuss them with your loved ones. If you’d like a copy of the complete handout, information is available at the end of today’s post.

Let’s look today at a few more questions that your family member might ask…

4. Is the pain all in my loved one’s head?

Chronic pain is rarely imaginary (psychogenic) or simply a way for your loved one’s psychological problems to come out. Even if a patient is referred to a pain management psychiatrist or psychologist, this rarely means they’re imagining pain. The pain is real.

However, negative emotions such as depressed mood, anger, or anxiety can play an important role in making pain worse. For example, anxiety or anger can cause an increase in muscle tension leading to more pain. Post-Traumatic Stress Disorder (PTSD) causes one’s nervous system to become very sensitive and can make it harder to recover from a physical injury. Certain types of personalities may find it more difficult to cope with pain and/or the losses and disabilities it brings. For example, some people get much of their self-esteem from working and can’t tolerate being disabled.

5. Could they be faking it, say, to get out of work?

Faking pain, on purpose, to get out of something or to get a reward is known as malingering. While it does occur, it’s rare. Most patients feel very guilty about not being able to do the things they used to do, whether working at a job or taking care of their family around the house. Very few patients with pain make more money out of work than working. Most suffer severe financial losses.

Unconsciously producing symptoms to get rewards or get out of unpleasant things is called “secondary gain.” It’s rarely the cause of someone’s pain, although it sometimes may reinforce a negative situation. For example, someone on disability may fear vocational training because they’re afraid to lose their income, in case going back to work doesn’t work out. For some, there may be positive outcomes that make it easier to accept one’s situation. However, for most pain patients, the losses far outweigh the gains.

Remember, this is a family challenge, not just an individual one. Try to see it as one that you’ll face together - ‘we,’ not ‘he’ or ’she,’ will fight this together.

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Next Friday… Family Issues #3: As a family member, how do I take good care of myself, too?

You’re welcome to copy this handout from this site, with a notation that it’s from www.howtocopewithpain.org. For a copy of the complete handout, you can contact my co-author Dr. David Kannerstein at dkanner@comcast.net. David Kannerstein is a psychologist in private practice with Margolis Berman Byrne Health Psychology in Philadelphia and SRI Psychological Services in Jenkintown, PA. He specializes in helping individuals and their families manage chronic pain.