Chronic pain and family : a clinical perspective

168 Pages·2006·1.187 MB·English

by  Roy, Ranjan

Chronic Pain and Family
i
About the Author
RanjanRoyisaprofessorintheFacultyofSocialWorkandintheDepartmentof
ClinicalHealthPsychology,FacultyofMedicine,UniversityofManitoba,anda
consultant (scientific) in the Department of Anesthesia, Health Sciences Center.
Professor Roy is a Fellow of the Royal Society of Canada and the Canadian
AcademyofScienceandtheHumanities.Hehaspublishedandlecturedextensively
onthebiopsychosocialaspectsofchronicpain.
ii
Chronic Pain and Family
A Clinical Perspective
Ranjan Roy
iii
RanjanRoy
FacultyofSocialWork
UniversityofManitoba
Winnipeg,Manitoba
R3T2N2,Canada
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ISBN10:0-387-29648-4 e-ISBN0-387-29649-2
ISBN13:978-0387-29648-7
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ForRebekah
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Contents
Preface viii
Acknowledgments x
1 TheChangingNatureofFamiliesintheWest.............................. 1
2 TheImpactofChronicPainonMarriageandFamily..................... 16
3 TheHealthofthePartners(Spouses)andtheChildren................... 29
4 ChronicPainandSexualRelations............................................ 42
5 TheMeaningandFunctionofPaininMarriage:
TheInternationalPerspective.................................................. 53
6 WhatHappenstoCommunication?........................................... 65
7 WhoDoesWhat?AnExplorationofFamilyRoles........................ 75
8 WhatHappenstotheChildren?................................................ 88
9 PartnerAbuseandChronicPain............................................... 100
10 IssuesinCoupleTherapy....................................................... 114
11 FamilyTherapy................................................................... 127
12 SomeFurtherThoughts......................................................... 136
References 140
Index 150
vii
Preface
The importance of the family in the management of chronic pain and illness is
widelyrecognized.Itissurprisingtorealizethatinthelate1970sandearly1980s,
therewasverylittleliteratureonthistopic.Ipublishedaliteraturereviewonfamily
andpainin1982,anditprovedtobearelativelysimplejobduetothedearthof
pertinentliterature.Yetafewyearslater,DennisTurkandhiscolleaguesproduced
two extensive reviews on the subject in the journal Pain. There was a virtual
explosion of research and clinical reports during the 1980s and into the 1990s.
Thentheresearchdriedup.IdiscussthecurrentstateofresearchinChapter12.
Thisbookhasevolvedoveraverylongperiodoftime.Ihavebeenengagedin
workingwithfamiliesandwritingaboutthemforovertwodecades.Someofmy
earlierworkisoutofdateandinneedofrevision.Thisbookisanattempttomeld
togethermyclinicalexperiencewiththeresearch,andtoemphasizetheimportance
andthecentralityofthefamilyinthetreatmentofchronicpainsufferers.Yet,itcan
bestatedwithoutanyfearofcontradictionthattheroutineassessmentoffamily
issues in pain clinics is more the exception than the rule. This book argues that
withoutanadequateunderstandingoffamilyissues,theassessmentandtreatment
of chronic pain sufferers remain incomplete. There has been a proliferation of
research and clinical writing showing the value of the family focus approach to
the management of a variety of medical and psychiatric disorders. Much of that
literature has been incorporated here. That the family does matter is the simple
messagethatthisbookattemptstoconvey.
Chapter 1 discusses the reality of today’s family, namely, that families have
manydifferentformsandcomplexities.Thetraditionalnuclearfamilyisnowin
the minority, and the types of families now emerging were unthinkable not so
longago.Chapter1introducesthereadertofamiliesofmanykindsandthestill
evolvingonesatthedawnofthenewcentury.
The rest of the volume is devoted to the clinical dimensions of working with
chronicpainsufferersandtheirfamilies.Chapters2to8exploremanyrelatively
common issues that confront the clinician. They range from the meaning and
purposeofpaininarelationshiptothehealthofthespouseandchildren,andhow
painmayormaynotaffectvariousaspectsoffamilylife.Chapter9exploresthe
issueofspousalabuseanditsimplicationforchronicpainsufferers.Chapters10
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Preface ix
and11describecoupletherapyandfamilytherapy,respectively,withchronicpain
patients.Chapter12isabriefdiscussionaboutthecurrentstateoftheresearch.
This is a book for clinicians and those health-care professionals who may be
interested in the families of their chronically ill patients. Chronic pain serves as
anexcellentprototypeforchronicillness,andmuchofwhatisdiscussedinthis
volumehasrelevancetopatientssufferingfrommanydiversechronicillnesses.