Social Relations and Chronic Pain
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Plenum Series in Rehabilitation and Health SERIES EDITORS Michael Feuerstein Uniformed Services University of the Health Sciences (USUHS) Bethesda, Maryland and Anthony J. Goreczny Chatham College Pittsburgh, Pennsylvania
ENABLING ENVIRONMENTS: Measuring the Impact of Environment on Disability and Rehabilitation Edited by Edward Steinfeld and Gary Scott Danford HANDBOOK OF HEALTH AND REHABILITATION PSYCHOLOGY Edited by Anthony J. Goreczny INTERACTIVE STAFF TRAINING: Rehabilitation Teams that Work Patrick W. Corrigan and Stanley G. McCracken SOCIAL RELATIONS AND CHRONIC PAIN Ranjan Roy SOURCEBOOK OF OCCUPATIONAL REHABILITATION Edited by Phyllis M. King
A Continuation Order Plan is available for this series. A continuation order will bring delivery of each new volume immediately upon publication. Volumes are billed only upon actual shipment. For further information please contact the publisher.
Social Relations and Chronic Pain Ranjan Roy University of Manitoba Winnipeg, Manitoba, Canada
Kluwer Academic Publishers New York, Boston, Dordrecht, London, Moscow
eBook ISBN: Print ISBN:
0-306-47197-3 0-306-46496-9
©2002 Kluwer Academic Publishers New York, Boston, Dordrecht, London, Moscow
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To Margaret
PREFACE
This book is an extension of my 1992 book entitled The Social Context of Chronic Pain Sufferers. Many ideas nominally explored there are elaborated in this volume, which is an attempt to fill a major gap in the chronic pain literature. Although there has been a virtual flood of new works on the medical and psychological aspects of chronic pain, such enthusiasm is somewhat muted in relation to the social environment of the patient. Although there is universal recognition among pain experts that biological, psychological,and social factors influence the experience of pain, the social component (for reasons that are unclear) has failed to attract much attention. The need for a book focused on social relations is obvious. The patient is not merely a carrier of symptoms. There is a large social reality in the background of each patient; that reality can have multidimensional consequences, from the way pain is perceived to serious financial hardship and other sources of stress, complicating treatment, management, and, ultimately, the prognosis. Clinicians recognize the value of incorporating the social dimension in the overall evaluation and treatment of the patient. This book attempts to accomplish that task. In order to achieve that objective, this volume addresses many important elements in the patient’s social environment—the most significant being the family. Beyond the family, for a vast majority of patients, work represents a major source of economic se
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