PATIENTS AND PROFESSIONALS UNDERSTANDINGS OF THE CAUSES OF CHRONIC PAIN - BLAME, RESPONSIBILITY AND IDENTITY PROTECTION

A social constructionist analysis of how sense is made of the causes o f chronic pain is reported. It is recognised that there is a multiplic ity of stories available in any culture from which understanding can b e reached. Q-factor analysis is used within a critical framework as Q- methodology. Sixty chronic pain patients and pain professionals comple ted the sorting procedure. Four factors were derived that account for the causes of chronic pain. These are reported as the patients' accoun t, the professionals' account, the scientists' account and the alterna tive practitioner's account. Common to all four accounts are the theme s of responsibility, blame and the need to protect identity. It is arg ued that in all accounts responsibility is repositioned away from the sufferer or the healer. In all of the accounts blame is resisted or de flected away from individual ownership. Finally, it is argued that whe n pain is no longer useful as a symptom, identity is challenged, weake ned and at risk for both chronic pain patients and pain professionals. Implications of this study for chronic pain research and treatment ar e discussed. (C) 1997 Elsevier Science Ltd.