[Chronic pain as an existential challenge]. / Chronischer Schmerz als existenzielle Herausforderung.

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.

Chronic pain as a blind spot in the diagnosis of a depressed society. On the implications of the connection between depression and chronic pain for interpretations of contemporary society.

One popular description of current society is that it is a depressed society and medical evidence about depression's prevalence may well make such an estimation plausible. However, such normative-critical assessments surrounding depression have to date usually operated with a one-sided understanding of depression. This understanding widely neglects the various ways depression manifests as well as its comorbidities. This becomes evident at the latest when considering one of depression's most prominent and well-known comorbidities: chronic pain. Against this background, we aim in this article to substantiate our leading claim that the phenomenal interconnection between depression and chronic pain must be acknowledged in the global diagnosis of a depressive society. Thus, we argue here for a complementation of the dominant interpretation of a depressed society. This would support the overcoming of oversimplified images and estimations about depression in current society and further, help to recognize chronic pain properly on the larger scale of assessments that address society as a whole.

[From why to what for : On the relevance of a philosophical-existentialistic approach in the treatment of patients with chronic pain]. / Vom Warum zum Wozu : Zur Bedeutung einer philosophisch-existenzialistischen Haltung bei der Behandlung von Patienten mit chronischen Schmerzen.

BACKGROUND: People have the need to find explanations for the events that occur in their lives. This is especially true when it comes to experiences that impact a person's entire existence and endanger their self-esteem and sense of identity. Chronic pain is one such experience. The search for the cause behind such pain is primarily motivated by the expectation that once the cause of the pain has been identified, an effective pain-alleviating therapy should ensue. Due to the numerous advances in the last several decades towards understanding the fundamental mechanisms governing the origins and processing as well as the treatment of pain, such expectations towards medicine can frequently be met; however, in many cases the experiences of chronic pain remain difficult to explain and, above all, very difficult to manage. GOAL: In this article the authors aim to show that it is important to avoid fixation on the question of why, especially with people suffering from chronic pain. METHOD: The article starts by describing how an exclusive orientation towards cause-effect-relationship in the medical context can also lead to negative consequences. Through recourse to the central theses of the existentialist philosopher Albert Camus, the meaning of the what for perspective is then discussed. Finally, with the example of a case study, it is illustrated how this change of perspective can result within the framework of a therapeutic treatment. RESULTS: The following changes in perspective are recommended: the search for the past-centered why should make way for the future-oriented quest for the what for of continuing to live a life with chronic pain.

[Chronic pain and society : Sociological analysis of a complex interconnection]. / Chronischer Schmerz und Gesellschaft : Soziologische Analyse einer komplexen Verschränkung.

The current debate about the interconnection between chronic pain and society is economically narrowed. This involves the threat of losing sight of the fact that the interconnection between society and chronic pain is a complex entanglement that goes beyond economic costs. This article addresses the mentioned entanglement by acknowledging the following four levels of society: (1) the social structure, (2) the way of life, with special reference to occupation and its counterpart, leisure time, (3) the (normative) interpretation patterns of chronic pain and (4) the treatment situation. The applied sociological perspective shows that society, and this also includes medicine, is more than a mere addressee of problems. Society has to be considered as an influencing factor with respect to the development and stabilization of chronic pain. The outlined broadening of the perspective should contribute to a better understanding of the societal impact on chronic pain in order to stimulate an improvement in care and possibly a long-term reduction in costs.