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A psychological twist on the news.

Learning to Control Pain

A new review looks at the soaring social and economic costs of chronic pain and the development of psychological treatments that can help pain sufferers to manage their symptoms. Is that a new era in the study of chronic pain? Read More

Beware the Ides of March

In an era where everyone is trying to reduce health care costs, say no to drugs, and focus on utilitarian based solutions to overcome problems of those who are "too expensive","too demanding", or just otherwise annoying because people in chronic pain never seem to get better, psychological based treatment becomes the last refuge for societies castaways. This is dangerous territory.

The main problem with a chronic pain label is the implication that the patient will never get better, is a drain on society,a drain on resources, and must be taught to suck it up a deal with it. Should a child with rheumatoid arthritis be forced to see a psychologist, or forced to seek treatment in a structured pain management program rather then receive medical treatments to reduce pain and to reduce the overt manifestations of their disease under the guise of a "chronic pain" patient?

Should Olympic 1/2 pipe skier, who remained persistently undiagnosed with symptoms of Lyme disease for 14 years give up on a medical explanation and seek the care of a psychologist so that she can learn to be a more compliant, less complaining and a more functional individual (but less than fully functional human being) in the future?

Should the 80 year old grandfather suffering from disabling knee arthritis and early alzheimers be sent to a psychologist because pain medicine is too risky, surgery is deemed "inappropriate" due to his age and life expectancy, when, in fact, the knee is just worn out and needs to be replaced?

The problem with shuffling pain patients to a psychologist is that patients who might have medically reversible problems are denied further medical evaluations and evidence based treatments that could actually help. This has the potential to serve as a form of medical blacklisting and as such, it is a very slippery slope.

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Romeo Vitelli, Ph.D. is a psychologist in private practice in Toronto, Canada.

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