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Perlman, S.D. (1996). Psychoanalytic Treatment of Chronic Pain: The Body Speaks on Multiple Levels. J. Amer. Acad. Psychoanal., 24(2):257-271.

(1996). Journal of American Academy of Psychoanalysis, 24(2):257-271

Psychoanalytic Treatment of Chronic Pain: The Body Speaks on Multiple Levels

Stuart D. Perlman, PH.D.*

The experience of pain is at the interface of the mind-body connection, as defined in modern Western medicine. In the attempt to treat chronic pain, certain questions continue to arise: To what degree can pain be considered a biological symptom, and to what degree is it a psychological experience? Therapists must grapple with these issues when dealing with a chronic-pain patient. Symptoms can be complex, and differential diagnosis is important.

This article makes the following points: (1) Pain is an experience with physical/biological, environmental and psychological causes. (2) Psychoanalytic conceptualizations can help illuminate and treat chronic pain. (3) A multiintervention approach is preferable for most chronic-pain patients; these interventions include medical consultations and other treatment modalities. (4) The patient's understanding of the meaning of chronic pain touches on broader life issues and can lead to deeper change.

General Cautions

When evaluating chronic pain, the clinician must be aware of constitutional traits, environmental influences, and personal experiences that combine and interact to create a person's behavior and thoughts (Reiser, 1948).

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