The disease of pain: what is it and how is it related to Psychology?

Pain has two aspects, pain that comes from outside the body and pain from internal perception.. Sometimes the two come into play. Pain is always subjective. The health professional has pain scales that do not fit in all cases with what the patient expresses. We usually talk about acute pain and chronic pain.

Acute pain has to do with the activation of the nociceptive systems associated with an injury and this will disappear with the healing of the injury. The pain, here, has an essential function of biological protection, which warns the subject of a dysfunction or an injury. The psychological elements that can be associated with these situations are not usually numerous and will have to do especially with anxiety.

Anxiety can be present in situations of illness, in the process of healing where the subject's life is disrupted and uncertainty reaches levels that the subject finds difficult to manage. Anxiety is, after all, a normal phenomenon since it is found in each of us to a greater or lesser extent.

• We recommend you read: "Emotional pain: what it is and how to manage it"

Mind and body: the perception of pain

In all organic pain there is a participation of the psychic and we know this by observing clinical cases where distraction distances the subject from his pain. That is to say, when the subject manages to be interested in something other than his pain, thus the time that the distraction lasts, the pain decreases. With that starting point, we will have to deal with the role of pain and what we might call the disease of pain.

On the one hand, pain has the function of signaling an injury, a danger. I put my hand close to the fire and the pain allows me to protect myself from the pain of an organ, from an injury it warns me that I have to go to the corresponding professional. But when we talk about the disease of pain, we refer to chronic pain. In these cases, several psychological factors are at play that maintain this pain.

We are going to expose here two fundamental elements that participate in the maintenance of pain. Specify now, that in all cases, it will be treated in analysis to listen to how the patient talks about his pain, since we will not deal with the pain itself, but with the suffering subject.

Guilt enters fully into the phenomenon of pain. The guilt inherent in the subject is the oedipal guilt. For this reason, it will not be about felt guilt, or remorse, it is about unconscious guilt. And how do we know what comes into play in pain? Because pain often serves as a punishment to calm that unconscious guilt. We know of the difficulty of the subject to deal with the guilt for the punishments that are inflicted. Thus, it is opportune to declare that chronic pain can often be considered as a punishment.

On another occasion, we will explain the constitution of guilt and its effects in everyday life. And obviously when we talk about chronic pain, we also come to talk about jouissance, masochism.. We know, thanks to Sigmund Freud, that the end of psychic energy, the end of the drive is satisfaction. The drive is always satisfied, that is, that the subject that we are is divided into conscious and unconscious, lives, suffers, two different and sometimes opposite situations.

In his consciousness he suffers but in the unconscious there is satisfaction, which explains the difficulty of the subject in leaving places of pain. The satisfaction she gets in pain doesn't allow her to easily transform his position. And I repeat, it is an unconscious satisfaction, that is to say, that neither reason nor will have the ability to intervene to modify the psychic situation that produces pain in the material life of the subject. Only psychoanalysis has the necessary instruments to intervene and modify this way of enjoying pain.

For this reason, when we speak of pain disease, we refer to those different components that enclose the subject in a psychic structure that uses pain to express itself. Starting to talk to a psychoanalyst will obviously be an opportunity to learn to direct these components towards other results. Talking is an important enjoyment for humans and also being heard.