Creating Empathy for Pain

Colin T. Son, MD

Disclosures

November 24, 2009

Chronic pain syndromes are some of the most difficult things the medical community has to help patients with. Care is often multidisciplinary and fragmented; the symptoms, are often misunderstood and, in fairness, are often dismissed or confronted with a lack of empathy by providers.

Suppose someone tells you that she's feeling a horrible aching pain in her stomach. What can you really know about what she's feeling? Can you know, for example, that the way her stomach pain feels to her is more or less the same way an aching stomach pain feels to you?

If you think the answer to this question is yes -- and I assume that most of you do -- then I, your Friendly Philosopher, am going to ask, "How do you know this?"

All you can really tell by your inference is that both you and the other person are experiencing something that you both call "pain." But it doesn't show that your and her pain are similar in the way that they feel. For all you know, the way her stomach pain feels to her is the way a tickle feels to you. Yes, she behaves as you do and her anatomy is like yours. But since you can't experience her pain, you have no philosophically adequate reason to believe that her pain feels like yours.

So while you might think you know what someone else's pain feels like, you can never really know. This philosophical problem may be the reason why it sometimes can be difficult for me to empathize with others who are experiencing pain.

So begins "No One Understands Your Pain? Here's the Philosophical Reason Why," one of the latest blog entries at the Website How to Cope With Pain.

How to Cope With Pain hosts Grand Rounds
on November 24, 2009.


On-line communities that support those with chronic pain have been featured before at Pre-Rounds, but How to Cope With Pain is something special and comprehensive. On it, a board-certified psychiatrist with an interest in chronic pain management offers exercises, advice, support, and a conduit to discussion with other patients suffering from pain.

The site offers a little bit of everything: from discussions on medications for pain to a series on relaxation and breathing techniques that can help deal with pain to more off-beat but interesting topics, such as a detailed and lengthy series on what Hinduism can offer those with chronic pain.

Acceptance is both a central concept in Hindu traditions and one that has been studied in pain medicine.

The practice of acceptance is also a means to a greater end. By accepting your condition, you become less attached to changing it. Acceptance of pain, and detachment from any struggle with the experience of pain, means that painful or pain-free states would be accepted equally. Detachment from this world, in order to be focused on God/The Ultimate, is a primary goal in Hindu traditions.

In medicine, acceptance of chronic pain means living as fully as possible with pain, and not struggling to change pain. We've seen that studies looking at acceptance show that acceptance means better functioning, as well as higher tolerance of pain.

While the community aspect of How to Cope With Pain is important and charming, what makes How to Cope With Pain stand out is the breadth and volume of its real-world, vetted advice for those who are living with pain. And all of this comes from a practitioner who has experienced such himself.

In addition, How To Cope With Pain continues to be a part of the Grand Rounds experience and will be hosting Grand Rounds this week. Grand Rounds is an on-line weekly blog carnival that features the best writing from patients, physicians, nurses, pharmacists, policy wonks, and others.

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