Chronic Pain

Chronic illness is explained as the “continual disruption of a person’s ongoing life, touching the individual’s sense of self or even causing a loss of self” (Werner). Chronic muscular pain is one such chronic illness and includes fibromyalgia and chronic fatigue syndrome. Culture influences the illness experience of people living with chronic pain because of the stigmas associated with this illness. There is social criticism put on people for the way they manage their chronic pain. Examples include taking too many naps to put distance between their pains or the inability to work because of extreme pain, and this can result in sufferers being labeled lazy or irrational. Additionally, chronic pain isn’t a convincing physical illness for some people, but rather an imagined condition, which can result in negative experiences with medical professionals. Many medical doctors were apprehensive of the chronic conditions the women were reporting. This doubt can significantly influence their illness experience because the women won’t receive the management and treatment they need for their conditions if the doctor doesn’t believe they are actually ill. The patients are then powerless to achieve a sick role and unable to be excused from their responsibilities or seeking the care they need. (Lecture 4.1) The women are “judged either to be not ill, suffering from an imaginary illness or given a psychiatric label” in addition to not receiving treatment for their pain. (Werner)

I think that there is a direct correlation between beliefs and healing. Someone with an optimistic outlook will have a significantly higher chance of survival compared to a person with an unenthusiastic view of his or her illness experience. The placebo effect is an example of this relationship between belief and healing. The placebo effect occurs when a beneficial health outcome or change in symptoms occurs when a person is given a substance with no therapeutic value. “Placebos are about the beliefs loaded onto it” and so the placebo effect can be present in medical treatments if the patient prefers taking a capsule to a pill, taking double the medication or taking the treatment two times a day instead of once twice a day. Personally, I find myself buying name brand pain relievers instead of plain pills even though they contain similar ingredients because I believe brand pills work better. This is another aspect of the placebo effect. Another dimension of this relationship is the doctor has to believe that the patient is ill. If people don’t believe you are really suffering then you can not fully exercise the rights and responsibilities of the sick role” and the likelihood that you will recover is minimized. In addition, the patient has to have faith in the healing performance of the doctor otherwise influencing a negative result of the treatment. Such experience is called the nocebo effect and results in psychological and physical pain. (Lecture 4.1) One story recounted in the film “Placebo: Cracking the Code” that models the nocebo effect is the case of Sam Londe. Londe suffered from esophageal cancer, a cancer with 100% fatality and he along with his doctor had no expectations for survival. However, the autopsy report for Londe after his death only a few weeks later showed that his cancer had shrunk and that, although he had cancer when he died, he didn’t die from the cancer.

 

Lecture 4.1 Experiencing Illness. Week 4: Experimental Approach.” ANP 204 course website. http://anthropology.msu.edu/anp204-us14/week-4-lecture-1

Nicholas Humphrey. “Placebo: Cracking the Code”. YouTube video, 52:38. November 5, 2011. https://www.youtube.com

Werner A, Isaksen LW, Malterud, K. “‘I am not the kind of woman who complains of everything’: Illness stories on self and shame in women with chronic pain.” Social Science & Medicine. 2004; 59: 1035-1045

This Post Has 2 Comments

  1. Laceey Ruble says:

    Being someone who has experienced long periods of stomach pain, I have some understanding of the social criticisms one can experience, and how one can even can try to buy into the social commentary of what is and what is not pain. Other people may try to tell you you’re not sick, so you try to believe you’re not, but in reality you still feel the pain, but now you’re trying your hardest to ignore it. Before reading Haley’s reflection of chronic pain I had not given too much thought into what my perceptions were. I now often feel healthy and because of that it is hard for me to understand and gage how much pain others are feeling, especially if that pain is chronic. To be honest, because of my social upbringing I try to ignore pain in others and myself. If someone is experiencing chronic pain, I often think to myself they should be able to get over it because that is what I have always been told. I know I don’t experience the pain I used to feel, so others should do the same. Right? On the other hand, I know this is a very dim way to approach chronic pain, because pain is a highly difficult thing to understand. The most intense pain one person has felt in her entire life could feel like nothing to another. In the case of females with chronic pain, I think our culture has a large contribution to how these women experience pain and how professionals interpret their pain. To be honest, our culture tends to naturally label women as crazy and hysterical, so it is no surprise to me that medical professionals would label chronic pain in women as “all in their heads.” It is a sad truth that we have been structured to think this way, but in knowing that we should be able to do something about it. Understanding the sick role through our cultural lens can allow us to see our perceptions, stereotypes, and preconceived notions of what illness is. From there, we open up the possibility of improving treatment by understanding illness as not merely a medical condition one goes to the doctor to treat but an individual experience that is woven with culture.

  2. Ashley Webb says:

    Chronic pain is an interesting condition to examine due to its biomedical, cultural, and psychological aspects. First off, I hope I never experience chronic pain like those we have seen in the course material. It must be miserable to constantly experience such extreme pain, and to have your normal life crippled due to it. However, I would like to more closely examine the psychological and emotional aspect of healing with regard to chronic pain. I believe cultural aspects certainly play a critical role in determining our views and attitudes towards certain conditions and healing. I also thought the placebo experiment with the two veterans with knee pain was very telling and ultimately highlighted the psychological component of healing. Overall, I agree with the notion in “Placebo: Cracking the Code” that our mind is a powerful healing tool. However, this is not to say all conditions of chronic pain are purely psychological. Does it play a critical role? Absolutely. Is it the sole contributor to the pain? I doubt it. With that said, my perception of chronic is largely due to the class materials we have examined this week as opposed to friends, family, and culture. Perhaps my lack of knowledge of chronic pain, is in fact due to this condition lacking amongst my family, and friends.

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