Der Schmerz
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Methodological reflections on pain research and pain therapy focussing on addiction risks are addressed in this article. Starting from the incompleteness of objectification of the purely subjectively fully understandable phenomena of pain and addiction, the relevance of a comprehensive general psychology is underlined. It is shown that that reduction of pain and addiction to a mainly focally arguing neurobiology is only possible if both disciplines have a systemic concept of pain and addiction. With this aim, parallelized conceptual network models are presented.
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The number of invalidity pensions for mental and psychosomatic disorders has dramatically increased in the last decade. Given the experience in sociomedical assessment of people with chronical pain diseases, we developed the impression that primarily social problems-especially long-term unemployment-play an important role in the processes of chronification of pain diseases. We evaluated 100 expert opinions from 2002-2007 according to quantitative and qualitative critieria. ⋯ Only during the course of their disease-usually after the rejection of their application for pension by expert medical opinions-did they receive the diagnosis in the field of psychiatry and psychosomatics. In a next step they were assessed by experts in the field of psychiatry and psychosomatics. In this article, the important social factors that influence this development are discussed.
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This article focuses on the philosophical perspective of what pain actually is, how pain is defined and what functions pain has. It is unclear, for example, whether pain generally correlates with physical harm, if it is categorically unpleasant, if it can be objectified and how observable neuronal processes correlate with different experiences of pain. ⋯ The different functions of pain are presented, especially regarding the extent to which pain represents an experience that constitutes both the body and the identity. Some functions of pain discussed here are: defense and indicator, immediate bodily sensation, perceptibility of the body, self-reassurance of existence, congregating and materializing, psychological regulatory mechanism and communication.
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Medicine is increasingly being confronted with expectations that it provide more permanent and comprehensive freedom from pain - and the prospect of being pain free is partially even being held out by medical science itself. In our cultural context, there is now the established idea that pain is something that medical science and technology can - and must - "get rid of." This idea is particularly problematic when it comes to chronic pain. Furthermore, it obscures the fact that pain is a significant element of life and one that can have existential meaning. Therefore, it is crucial to reflect on the scope of this wish for medicine to relieve and eliminate pain.
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From the point of view of healthcare policies, improvement in pain care has been required for years; however, there is a great discrepancy between the current need for pain care and the actual provision by healthcare services. This article seeks to demonstrate that while healthcare policies are one of the critical factors involved, a variety of conceptual, diagnostic and therapeutic causes should also be taken into account. Firstly, considering that pain care is primarily concerned with the suffering of pain by patients, the focus lies with their conscious experience in order to define the patients' understanding of pain. Additionally, in this article current biomedical and psychosocial comprehension concerning chronic pain will be illustrated and why it is necessary to broaden our horizons in order to do justice to patients with chronic pain.