The phenomenological-existential comprehension of chronic pain: going beyond the standing healthcare models

Abstract

A distinguishing characteristic of the biomedical model is its compartmentalized view of man. This way of seeing human beings has its origin in Greek thought; it was stated by Descartes and to this day it still considers humans as beings composed of distinct entities combined into a certain form. Because of this observation, one began to believe that the focus of a health treatment could be exclusively on the affected area of the body, without the need to pay attention to patient’s subjectivity. By seeing pain as a merely sensory response, this model was not capable of encompassing chronic pain, since the latter is a complex process that can occur independently of tissue damage. As of the second half of the twentieth century, when it became impossible to deny the relationship between psyche and soma, the current understanding of chronic pain emerges: that of chronic pain as an individual experience, the result of a sum of physical, psychological, and social factors that, for this reason, cannot be approached separately from the individual who expresses pain. This understanding has allowed a significant improvement in perspective, emphasizing the characteristic of pain as an individual experience. However, the understanding of chronic pain as a sum of factors corresponds to the current way of seeing the process of falling ill, for its conception holds a Cartesian duality and the positivist premise of a single reality. For phenomenology, on the other hand, the individual in his/her unity is more than a simple sum of parts. Phenomenology sees a human being as an intending entity, in which body, mind, and the world are intertwined and constitute each other mutually, thus establishing the human being’s integral functioning. Therefore, a real understanding of the chronic pain process would only be possible from a phenomenological point of view at the experience lived by the individual who expresses and communicates pain.

Meanings of “acceptance” for patients with long-term pain when starting rehabilitation

“…lived experiences of one's body, sense of self and whole life-world (Bullington, 2009;Svenaeus, 2000Svenaeus, , 2015. This is in line with Lima, Alves and Turato (2014) and Carel (2011) who advocate a phenomenological existential approach within pain rehabilitation.…”

‘I just don't have the tools’ - Italian osteopaths' attitudes and beliefs about the management of patients with chronic pain: A qualitative study

“…Recent advances in the understanding of pain [11,41,49,88] have outlined that health professionals working with patients experiencing musculoskeletal pain need to be better equipped and go beyond the traditional biomedical structure/pathology-oriented explanations of pain in the evaluation, treatment and management of chronic pain conditions [65,66,89]. Firstly, because of ongoing changes in understanding pain experience, which is now accepted to involve complex neural processes including sensory [83], emotional [64], cognitive [52], and interoceptive processes [14,20]; secondly, because the influence of patient's beliefs and attitudes in altering pain development and control [17], together with the potential negative impact of practitioner's pain beliefs and behaviours when managing patients with chronic pain conditions, such as in chronic low back pain (CLBP) [16,44].…”

Transformation of the Concept "Subject" in the Clinical Discourse of Philosophical Anthropology

“…Сучасна медицина продовжує концентрувати свої зусилля на неживому тілі, трупі: медична освіта досі починається з розсічення трупа, так само, як клінічний випадок закінчується в лабораторії патологоанатома. Д. Ліма, В. Алвес та Е. Турато (Lima, Alves, & Turato, 2014) звертають увагу на те, що пацієнти часто розглядаються як трупи під час медоглядів, коли їх просять взяти на себе позу мертвого тіла: плоскі, пасивні, німі і голі; якщо вони мають виразити себе, то тільки для їх механічного функціонування. У якості альтернативи ці філософи пропонують мерло-понтіанські ідеї, які наближаються до моделі людини, яка не вбудована у західну дуалістичну думку та заперечує суб'єктно-об'єктну дихотомію.…”