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“Is the pain real?” and other questions your family member might have

January 19th, 2007 · No Comments

Family Issues #2

Today’s post is the second in our series about family issues and your pain.

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.

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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