“…Much of this research has examined partners' responses to pain communication (Romano, Jensen, Turner, Good, & Hops, 2000;Romano, Turner, Friedman, & Bulcroft, 1991;Romano et al, 1992;Romano et al, 1995). Spouses often make errors when estimating the pain and disability of persons with pain (Cano, Johansen, & Franz, 2005;Cano, Johansen, & Geisser, 2004b;Clipp & George, 1992;Miaskowski, Zimmer, Barrett, Dibble, & Wallhagen, 1997). The assumption in the pain field has been that each spouse shares the same symbol system, which may not always be the case as in a husband who values visual symbols of pain and a wife who primarily uses verbal symbols.…”