I am looking for some documentation describing how a persons own
concious and subconcious focus on pain or ailment will actually
increase that pain although nothing has physically changed to create
additional pain. I hope this is clear enough.

---

Request for Question Clarification by pinkfreud-ga on 27 Feb 2003 18:47 PST

Hello, skykat.

Concentrating or focusing on one's pain is called "catastrophizing." I
have found an excellent article on the subject which was originally
printed in the journal "Pain," the official publication of the
International Association for the Study of Pain.

Here you may read the article, in your choice of two display formats:

In cached html format: http://tinyurl.com/6l5f

In pdf format: http://tinyurl.com/6l5h

An excerpt from this document:

"Catastrophizing ­ the tendency to ruminate, magnify, or feel helpless
about pain (Rosenstiel and Keefe, 1983; Sullivan et al., 1995; Keefe
et al., 1989; Keefe et al., 2000) ­ has been shown to contribute to
the experience of pain in anumber of ways. In individuals with pain
disorders, the tendency to focus on and exaggerate the threat value of
painful stimuli and/or to negatively evaluate one's ability to deal
with pain has been shown to predict increases in pain reported over
time (Keefe et al., 1989), severity of reported pain (Tan et al.,
2001), emotional distress in response to pain (Severeijns et al.,
2001, Turner et al., 2001), and disability in response to pain
(Sullivan et al., 1998; Sever-eijns et al., 2001; Turner et al.,
2001). Further, interventions that lead to improvements in
catastrophizing, and in related psychological variables such as
self-efficacy and perceived control over pain, have been shown to be
associated with reductions in chronic pain (Parker et al., 1988; Keefe
et al.,1990a,b; Jensen et al., 2001). Higher levels of
catastrophiz-ing are also associated with greater pain reports during
experimental pain (Sullivan et al., 1995, Sullivan et al.,1997) and
painful medical or dental procedures (Sullivan et al., 1995, Sullivan
and Neish, 1998)."

If this is the kind of documentation that you seek, I'd be glad to
search for similar material. If this isn't quite what you want, it
would be very helpful if you could provide more detail on exactly what
you're looking for. The more we know about your precise needs, the
better we will be able to help.

~pinkfreud

---

Clarification of Question by skykat-ga on 01 Mar 2003 11:54 PST

Pinkfreud-ga,

You are on the right track. Thank you.

---

Request for Question Clarification by pinkfreud-ga on 01 Mar 2003 17:33 PST

Academic documents on this matter are apparently not plentiful. Will
you accept appropriate excerpts from articles on broader subjects? Do
you require that the material be from medical or academic sources, or
will articles directed at the layman be acceptable?

Sorry to bother you with all the questions, but it's very helpful to
know precisely what the customer expects in an answer.

Hi, skycat !

Here is a purely subjective comment from my own experience.

As a result of a congenital injury, I have osteoarthritis in my left
hip and have had pain from it for well over thirty years. I decided
long ago that I had a choice between allowing it to dominate my life
or simply getting on with things and doing whatever I wanted to do.

That's what I opted to do. I married, I had kids. I travel, I work. I
still do not use a stick, I still wear high heels, swim, and dance at
New Year although I do now need to use a handrail on stairs. I would
limp if it eased the pain, but it doesn't, so I mostly don't bother to
limp. Only now that the joint is so worn as to be sometimes unreliable
am I seriously beginning to consider a replacement. I rarely use
anti-inflammatories or pain-killers.

I am an actress by profession, and oddly enough when I am working, if
my character does not feel pain, then neither do I.

Interestingly, some years ago I saw a surgeon for an assessment. The
patient before me struggled in on two sticks, and as he was very deaf
the entire consultation was conducted at a bellow and was perfectly
audible in the waiting room. He was told his condition was not
suffieciently advanced to warrant a hip repalcement, and struggled out
again in clear pain. I'd parked some distance away, and walked briskly
to the surgery, and was in nowhere near the (subjective) amount of
pain. But I was told I could have a replacement whenever I chose. My
condition was worse than his.

Perhaps the worst thing that has happened to me, paradoxically, was a
year or so ago when I was put under general anaesthetic for a minor
unrelated day proceedure. For roughly twelve hours I was completely
pain free - and then it crept back. Pain I had coped with by taking it
for granted, became much harder to put up with for a while.

The worst can be when a weather change comes in during the night and
the pain wakes me (mercifully rare). It can take a while to refocus
away from the pain and onto a book or other distraction.

As long as I don't make the pain the focus of my attention, it's
bearable. Just writing about it for you has made it worse !!!

I hope this is useful.

Ronald Melzack of McGill University is one of the pioneers of modern
pain theory, including the involvment of the mind. One of his books is
entitled, "The Puzzle of Pain". You might find further helpful
information in his works.

vitalmed-ga