Merskey H
University of Western Ontario London, Canada.
Qual Life Res. 1994 Dec;3 Suppl 1:S69-76. doi: 10.1007/BF00433379.
Logic and language influence our ideas about the truth of pain, and can alter our understanding of it. Physicians should not tell their patients that there is nothing wrong with them if all their test results are negative, as this denies their patients' experiences of pain. Popular methods of conceptualizing pain may be erroneous. Diagrams of pain or disability are misleading and unhelpful--it is not usually possible to distinguish their components in practice. Giving patients a high or low score for pain behaviour, depression or for health locus of control can influence our views on aetiology in a seriously misleading way. Anyway, aetiological attributions are not always possible from analyses of the experience of pain. The problems of logic and language inherent in assigning pain to emotional causes, in using behavioural approaches, and in defining idiopathic pain and somatization are discussed. The IASP definition of pain is important and useful, provided that it is used appropriately. The recommended version is now 'an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.'
逻辑和语言影响着我们对疼痛真实性的看法，并可能改变我们对它的理解。如果所有检查结果均为阴性，医生不应告诉患者他们没有任何问题，因为这否认了患者的疼痛体验。流行的疼痛概念化方法可能是错误的。疼痛或残疾图表具有误导性且毫无帮助——在实际中通常无法区分其组成部分。给患者的疼痛行为、抑郁或健康控制点打高分或低分，可能会以严重误导的方式影响我们对病因的看法。无论如何，仅通过对疼痛体验的分析并不总是能够做出病因归因。本文讨论了在将疼痛归因于情感原因、使用行为方法以及定义特发性疼痛和躯体化时所固有的逻辑和语言问题。国际疼痛研究协会（IASP）对疼痛的定义很重要且有用，前提是使用得当。目前推荐的版本是“一种与实际或潜在组织损伤相关的不愉快的感觉和情感体验，或以这种损伤来描述”。
