Psychosocial vulnerability and maintaining forces related to fibromyalgia. In-depth interviews with twenty-two female patients.

The aim of this qualitative study was to describe, from the perspective of 22 women (aged 22-60 years) with fibromyalgia, their experiences and beliefs of the pain and its origin and how the pain affects family and social life. Open-ended interviews were analysed via a method influenced by grounded theory. Seven descriptive categories were grounded in the data, forming two higher-order concepts: psychosocial vulnerability and maintaining forces. The first of these core concepts, psychosocial vulnerability, comprises the categories: traumatic life history, over-compensatory perseverance, pessimistic life view, and unsatisfying work situation. In the interviews, there are abundant examples of early loss, high degree of responsibility early in life, and social problems with feelings of helplessness and hoplessness later in life. The second core concept, maintaining forces, consists of the categories professional care, pain benefits and family support, which seem to contribute to the persistence of pain. Our results indicate intrapsychic and psychosocial dimensions, which support the hypothesis that individuals with insecure attachment styles are overrepresented among patients with chronic pain.