Kotarba J A
Soc Sci Med. 1983;17(10):681-9. doi: 10.1016/0277-9536(83)90374-x.
Chronic pain is an on-going experience of embodied discomfort, quite often associated with neuromuscular pathologies, which fails either to heal naturally or to respond to normal medical intervention. The process of coping with chronic pain most commonly involves both the search for medical or non-medical cure, and the search for meaning for intractable suffering. In this paper, I survey various religious, philosophical and mystical belief systems and their empirical use as resources for meaning. The great variability in the ways ideas of death, the key elements extracted from belief systems during the process of coping, are used reflects the variable success in normalizing chronic pain. Theoretically, this paper adds an important dimension to the concept of the chronic illness trajectory, namely, the issue of inevitability, and discusses clinical and non-clinical aspects of depression among people with chronic pain.
慢性疼痛是一种持续存在的身体不适体验,常与神经肌肉病变相关,既无法自然痊愈,也难以对常规医学干预做出反应。应对慢性疼痛的过程通常既包括寻求医学或非医学的治愈方法,也包括探寻难以治愈的痛苦的意义。在本文中,我考察了各种宗教、哲学和神秘主义信仰体系,以及它们作为意义来源的实证应用。死亡观念在应对过程中从信仰体系中提取出的关键要素,其使用方式的巨大差异反映了在使慢性疼痛正常化方面的不同成效。从理论上讲,本文为慢性病轨迹概念增添了一个重要维度,即必然性问题,并讨论了慢性疼痛患者中抑郁症的临床和非临床方面。