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Awaiting moderation 9640 Article |
Reaction to pain REACTION TO PAIN
Many pain patients are obsessional. An inability to cope with their pain is a reflection of this trait. Many of these people are perfectionists. They feel that their pain makes them seem less perfect — a fact that many cannot tolerate. This in turn leads to an accompanying loss of self-esteem which further leads to deepening depression.
Both cultural and psychological factors are reflected in the ability to communicate pain. They represent the effects of both social learning and relatively stable personality factors. Any pain behaviour followed by a favourable response will be reinforced, just as any behaviour that is followed by an unfavourable response will be avoided.
A decrease in pain is always a positive reinforcer. Thus, in therapy, abnormal or sick behaviour is ignored and appropriate behaviour is both rewarded and encouraged.This led Dr W. Fordyce, of the United States, to introduce the treatment of operant conditioning, which has become the model for in-patient programs throughout the world. An important concept here is that of operant and respondent behaviour. Respondent behaviour is produced by unpleasant or harmful stimuli. It is normally reflex in nature. For example, withdrawal and calling out. This behaviour is usually conditioned by repeated stimuli, such as attending the doctor's surgery. Where needed, pain-killing medication may be freely given. Operants are observable types of behaviour which lead to repetition of that behaviour — for example, the repetition of such behaviour as moaning, family rewards for illness, being allowed to rest from unpleasant duties — and are conditioned in many ways.
The complaint of the pain may be the final expression for physical, emotional and financial stress and is often compounded by an economic system where pain and disability are rewarded by the insurance industry and by governments.lt has been suggested that being poor and engaging in physical labour predisposes an individual to pain. Unskilled labourers may perceive the doctor and the lawyer as authority figures and resent them. The doctor is seen as wealthy and not in pain. The doctor is able to grant compensation and gives information to agencies which further decide amounts for compensation. So, it can be easily seen how pain causes frustration leading to the doctor rejecting the patient and to patients 'doctor shopping'. Patients often complain that their previous doctors have just thrown up their hands and told the patient 'the pain will eventually go away' or 'you'll just have to learn to live with it'.
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Pain
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