Bozzaro Claudia, Koesling Dominik, Frede Ursula
Institut für Ethik und Geschichte der Medizin, Albert-Ludwigs-Universität Freiburg, Stefan-Meier-Str. 26, 79104, Freiburg, Deutschland.
, Hofgasse 2a, 78337, Öhningen, Deutschland.
Schmerz. 2020 Aug;34(4):326-331. doi: 10.1007/s00482-020-00454-0.
People have the need to find explanations for the events that occur in their lives. This is especially true when it comes to experiences that impact a person's entire existence and endanger their self-esteem and sense of identity. Chronic pain is one such experience. The search for the cause behind such pain is primarily motivated by the expectation that once the cause of the pain has been identified, an effective pain-alleviating therapy should ensue. Due to the numerous advances in the last several decades towards understanding the fundamental mechanisms governing the origins and processing as well as the treatment of pain, such expectations towards medicine can frequently be met; however, in many cases the experiences of chronic pain remain difficult to explain and, above all, very difficult to manage.
In this article the authors aim to show that it is important to avoid fixation on the question of why, especially with people suffering from chronic pain.
The article starts by describing how an exclusive orientation towards cause-effect-relationship in the medical context can also lead to negative consequences. Through recourse to the central theses of the existentialist philosopher Albert Camus, the meaning of the what for perspective is then discussed. Finally, with the example of a case study, it is illustrated how this change of perspective can result within the framework of a therapeutic treatment.
The following changes in perspective are recommended: the search for the past-centered why should make way for the future-oriented quest for the what for of continuing to live a life with chronic pain.
人们需要为生活中发生的事件寻找解释。当涉及到影响一个人整个生存、危及他们自尊和身份感的经历时，情况尤其如此。慢性疼痛就是这样一种经历。对这种疼痛背后原因的探寻主要是出于这样一种期望，即一旦确定了疼痛的原因，就应该随之采取有效的止痛疗法。由于在过去几十年里，在理解疼痛的起源、处理以及治疗的基本机制方面取得了众多进展，对医学的这种期望常常能够得到满足；然而，在许多情况下，慢性疼痛的经历仍然难以解释，而且最重要的是，很难管理。
在本文中，作者旨在表明，避免执着于“为什么”的问题很重要，尤其是对于患有慢性疼痛的人。
本文首先描述了在医学背景下，仅仅专注于因果关系会如何导致负面后果。通过借鉴存在主义哲学家阿尔贝·加缪的核心论点，接着讨论了“为了什么”视角的意义。最后，以一个案例研究为例，说明了这种视角的转变在治疗过程中是如何产生的。
建议进行以下视角转变：以过去为中心寻找“为什么”应该让位于以未来为导向探寻带着慢性疼痛继续生活的“为了什么”。
