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There
are some 50 million people throughout
the U.S. suffering from chronic pain at any given time, according to
a national survey. The total figure worldwide is estimated to be a
staggering 800 million! By definition, chronic pain is
pain that persists after the body has had time to heal. It is
pervasive and unrelenting. Because it does not go away, it impairs
one's ability to function and can impact one's entire outlook on
life. The future seems bleak and hopeless to many. Chronic pain
devastates both body and mind. Research on back pain alone reveals
facts that underscore the scope of the entire problem, not only to
individuals, but also to society at large:
 80%
of the U.S. population will experience significant back pain at some point.
One
percent of the U.S. population will become disabled due to chronic back pain.
Chronic
back pain is the leading cause of disability in men
under 45.
Back
pain is the second most frequent reason for visits to a physician.
It
is the fifth most common reason for hospitalization.
It
is the third most common reason for surgery.
No
"objective" medical cause can be found in 50% of chronic
back pain cases.
Chronic
pain costs Americans some $80 billion in healthcare costs
and lost productivity each year.
And these figures relate
just to back pain. Here are some facts relating to the most
frequent type of chronic pain: Headaches.
More
than 40 million Americans suffer from headaches severe enough to
require medical attention.
Fully
65% of migraine sufferers have never been properly diagnosed and
treated.
Lost
annual productivity in the U.S. due to headaches alone is estimated
to be as high as $17 billion.
In addition to chronic headaches and back pain, countless others
suffer from debilitation caused by, arthritis, post-herpetic
neuralgia (pain from shingles), reflex sympathetic dystrophy (RSD),
and, perhaps the most widely ignored, wide-spread, and misunderstood
pain condition, fibromyalgia. Unlike other books, Validate
Your Pain!:
Exposing the Chronic Pain Cover-Up
speaks to all sufferers, regardless of pain type.
The fact
that no "objective" medical cause can
be identified in 50 percent of chronic pain cases speaks to one of
the biggest challenges facing those with such disorders. Our medical
tradition has relied heavily on new technologies, such as CT and MRI
scans, to document "structural" causes of pain. Those
unfortunate enough to suffer from pain that cannot be documented by
such "objective" methods are relegated to second-class
membership in the chronic pain club. In other words, they are given
short shrift. The attention they deserve is withheld due to
ignorance, misunderstanding, and, often, greed. At best, they are
seen as chronic complainers and given pain pills and tranquilizers.
At worst, they are regarded as malingerers, trying to cheat the
system in order to gain sympathy and/or to collect financial
compensation.
Many of these individuals report undergoing surveillance by
insurance company private investigators armed with video cameras, in
hopes of "catching" them engaging in some kind of healthy
activity. And while we work hard to help the individual increase
such activity, they are afraid that their healthy behavior will be
used against them. In essence, the overwhelming majority of these
unfortunate individuals know that their circumstances are tragically
misunderstood and that they are being treated unfairly. They are
told There's nothing wrong with you — it's all in your head
or you'll just have to learn to live with it. Yet they are
given nowhere to turn for help. They are never told how to
live with it.
As part of
our interdisciplinary chronic pain management program,
hundreds of patients have participated in our group sessions in
which relevant topics — most of which are included in this book
— are discussed. By far, the topic most frequently raised by
patients is that their pain experience has been invalidated or
disregarded as they have moved through the medical system and they
are searching for someone (especially healthcare professionals) to
understand and to help them. It is an issue charged with emotion.
Currently in
vogue these days
is an approach that actively dissuades patients from talking about
their suffering. The idea is that pain behavior will go away if it
is not reinforced. The unfortunate result, however, is that patients
may begin to doubt their own experience and to feel alienated from
their treatment team. Pain behavior may be reduced, but it is often
only a temporary effect. Alternatively, we have seen, time and
again, that more solid and lasting success comes when patients are
first given an opportunity to fully express the ways in which pain
has disrupted their lives. When combined with opportunities to
function in ways that reinforce their efforts, emotional suffering
is weakened. It is this process that leads to changes in
beliefs and perceptions, not the differential reinforcement of using
the "correct" (often referred to as rational)
language.
Validation is
only the first, though the most important, step
toward recovery from chronic pain. And while we have the utmost
respect for our patients and their experience of chronic pain, we do
not advocate the making of victims. We do, however, advocate
telling it like it is and then moving forward to help those
afflicted to achieve a greater sense of empowerment, self-reliance,
and fulfillment as human beings.
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