Addressing the Quandary of Chronic Pain: Learning From Phenomenological Research

Considerable research in recent years has explored the phenomenological experience of patients living with chronic pain. Numerous studies describe pain as a threat to the self and as the target of mostly unsuccessful medical or psychological interventions. Chronic pain, for many sufferers, represents a quandary. It is an alien experience—an impediment or burden imposed on the self—and also one that is intimately familiar, a condition in which the individual with pain is living. The quandary elicits continual engagement in threat detection and efforts to alleviate distress by pursuing pain control strategies of various kinds, many of which exacerbate the pain experience over time. The urge to escape from pain alternates with the pull to be heard, to convey the unique experience of pain and its onus to another. Amid this intractable experience, the patient in pain continually vacillates between urgent efforts to eradicate pain and to define the experience in terms that others, particularly medical practitioners, can understand and validate. Current interventions in medicine and clinical psychology may inadvertently perpetuate the quandary of chronic pain by participating in efforts to reduce or contain the physical symptoms of pain while failing to attend to the patient’s articulation of life experience. A descriptive alternative to mechanistic and functionalist approaches to the psychological treatment of pain offers an alternative to intervention strategies that perpetuate the quandary of chronic pain. Such an approach has the potential to help individuals embrace all aspects of themselves and lead fuller and richer lives.