Modes of remembering in patients with chronic pain: relation to current pain

The objective of our study was to assess the relation of current pain ratings to observer versus field modes of memory retrieval in patients with chronic pain. Memories from an observer perspective involve seeing oneself in the original event as if from an external point of view; memories from a field perspective involve recalling the event as if viewing it through one's own eyes. Sixty-one patients with chronic pain were asked to (1) recall a painful memory, (2) indicate whether they saw themselves in the memory (observer mode) or re-experienced events of the memory from the first-person perspective (field mode), and (3) rate various phenomenologic properties of the memory. Twenty of these pain patients were also given two frontal lobe tests to examine potential neuropsychologic correlates of memory retrieval preferences. Memory retrieval in the field mode was associated with (a) significantly higher self-reported pain scores on the McGill Pain Questionnaire, (b) nonright-handedness, and (c) poorer performance on the tests of frontal function. Patients with chronic pain who adopt the field mode of memory retrieval when recalling painful memories experience greater current pain severity than chronic pain patients who adopt observer retrieval strategies. Those adopting field retrieval strategies may also evidence frontal system neuropsychologic anomalies.