Kieselbach Kristin, Koesling Dominik, Wabel Thomas, Frede Ursula, Bozzaro Claudia
Interdisziplinäres Schmerzzentrum ISZ, Albert-Ludwigs-Universität Freiburg im Breisgau, Breisacher Str. 117, 79106, Freiburg, Deutschland.
Institut für experimentelle Medizin, Arbeitsgruppe Medizinethik, Christian-Albrechts-Universität zu Kiel, Preusserstr. 1-9, Merkurhaus, 24105, Kiel, Deutschland.
Schmerz. 2023 Apr;37(2):116-122. doi: 10.1007/s00482-022-00632-2. Epub 2022 Mar 14.
There is currently an emphasis on the biopsychosocial concept of pain in pain therapy programs. However, the complexity of chronic pain, in particular its importance for those affected by it, can only be insufficiently captured with this concept. This is due to the fact that, to date, one core aspect of the phenomenon chronic pain has only rarely been taken into account: its existential character. Chronic pain can threaten the self-image and the individual's understanding of the world, their wishes and goals in life, and ultimately the entire integrity of those affected. Statements by chronic pain sufferers show that such pain always represents an existential experience and affects the person as a whole. Two aspects make this very clear: the existential despair of the pain on the one hand, as well as questions of meaning and reorientation on the other. Current treatment concepts, however, do not adequately consider the existential character of such challenges. Chronic pain should therefore always be perceived and treated from a holistic perspective. In this context, the aspects of recognizing its uniqueness, helping to express the pain and giving space to the experience are to be given special consideration in order to support chronic pain patients in dealing with their pain.
目前，疼痛治疗项目强调疼痛的生物心理社会概念。然而，慢性疼痛的复杂性，尤其是其对受影响者的重要性，用这一概念只能得到不充分的体现。这是因为，迄今为止，慢性疼痛这一现象的一个核心方面很少被考虑到：它的存在特性。慢性疼痛会威胁到自我形象以及个体对世界的理解、他们的生活愿望和目标，最终还会威胁到受影响者的整体完整性。慢性疼痛患者的表述表明，这种疼痛始终代表着一种存在体验，并会影响整个人。有两个方面非常清楚地说明了这一点：一方面是疼痛带来的存在绝望，另一方面是意义和重新定位的问题。然而，目前的治疗理念并未充分考虑此类挑战的存在特性。因此，慢性疼痛应始终从整体角度来认识和治疗。在此背景下，为了支持慢性疼痛患者应对疼痛，应特别考虑认识其独特性、帮助表达疼痛以及为这种体验留出空间等方面。
