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Chronic pain: the need for a "second-person" account.

M D Sullivan1

  • 1Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98195, USA.

Seminars in Clinical Neuropsychiatry
|September 28, 1999
PubMed
Summary

Chronic pain is difficult to diagnose due to the disconnect between patient experience and objective findings. This study proposes a social, second-person theory of pain, viewing it as intersubjective action to overcome this challenge.

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Area of Science:

  • Philosophy of Medicine
  • Pain Research
  • Social Psychology

Background:

  • Clinicopathological correlation often fails in chronic pain patients.
  • Reconciling first-person patient complaints with third-person pathology is challenging.
  • The concept of 'private pain' hinders understanding.

Purpose of the Study:

  • To critique the notion of private pain.
  • To propose a second-person theory of pain.
  • To offer a new framework for understanding chronic pain.

Main Methods:

  • Critique of the 'private pain' concept using Wittgenstein's philosophy.
  • Development of a second-person theory of pain.
  • Analysis of the link between pain and pain behavior.

Main Results:

  • Pain and pain behavior are inextricably linked.
  • Human pain is essentially social in nature.
  • A second-person perspective reframes pain as intersubjective action.

Conclusions:

  • The private pain model is inadequate for chronic pain.
  • A second-person theory provides a more effective framework.
  • This approach helps overcome dualistic notions in chronic pain management.

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