Maldynia

Multidisciplinary Perspectives on the Illness of Chronic Pain

  • Price: $159.95 $143.96
  • Hardback: 280 pages
  • Also available in e-Book
  • Published: December 2010
  • ISBN: 978-1-4398363-0-9
  • Publisher: CRC Press

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Whether initiated by injury or disease, induced and sustained by changes in the nervous system, or manifested by society and culture, chronic pain can change one’s first-person experience of the body and the world, and ultimately impacts cognitions, emotions, and behavior. Many fine medical books address the causes and management of chronic intractable pain, but rarely do they focus on the ways that such pain creates illness and is experienced and expressed by persons in pain.

Maldynia: Multidisciplinary Perspectives on the Illness of Chronic Pain is about chronic pain that has progressed to a multidimensional illness state in and of itself. Although often dismissed as such, this pain is not imaginary, but rather represents an interaction of neurobiological processes, emotional and behavioral responses, and socio-cultural effects and reactions that become enduring elements in the life and world of the pain patient, and often remain enigmatic for those who provide care.

Taking a comprehensive approach that covers science, humanities, and culture, this volume emphasizes the need for researchers, clinicians, and caregivers to regard the ways in which chronic intractable pain becomes illness and affects a patient’s biological, social, and psychological states, as well as his or her sense of self. Edited by neuroscientist and neuroethicist James Giordano, this book contains 17 insightful chapters representing medicine, neuroscience, psychology, philosophy, ethics, history, art, and the ministry.

This exceptional volume also looks at representations of pain in and through the arts, addresses the assignation of values and meaning in pain assessment and treatment, and considers ways to conjoin the sciences and humanities so as to inform the practice of pain medicine and improve the care of those suffering the illness of chronic pain.

Table of Contents

    Maldynia: The Illness of Chronic Pain, J. Giordano

    A Short History of Pain and Its Treatment, A. Valadas

    From Antiquity to the Medieval Age

    From Renaissance to Enlightenment

    The Nineteenth Century

    Pain in the Twentieth Century

    Pain Does Not Suffer Misprision: The Presence and Absence that is Pain, J.D. Katz

    The Positive and Negative Attributes of Pain

    The Phenomenology of Pain

    A Humanistic Interpretation of Pain

    Understanding Suffering: The Phenomenology and Neurobiology of the Experience of Illness and of Pain, P. Moskovitz

    Perceptions, Emotions and the Experience of Suffering

    Understanding Consciousness

    Senses of Consciousness (after Edelman (22), Zeman (52) and others)

    Consciousness as Wakefulness

    Consciousness as the Experience of Perceptual Contents

    Consciousness as Reportable Experience

    Consciousness as Self-awareness

    A Theory of Consciousness: How Consciousness and Awareness Happen

    The Multiple Dimensions of Perceptual Contents

    Modeling Consciousness – Creating a Diagram of the Body-Brain

    A Linear Versus an Oscillatory Model of Consciousness

    Loss That Evokes Grief and Threat That Evokes Fear

    Unrelieved Appetites and Drive States

    Pain

    The Threshold of Suffering

    Suffering: Shock, Stasis, and Dissociation

    Resilience and Coping

    Coping Skills: Connectedness

    Coping Skills: Symbolic Representation

    Coping Reactions: Disgust, Contempt and Anger

    Belief Systems and Spirituality

    The Outcomes and Products of Suffering

    How (Can) I Feel Your Pain: The Problem of Empathy and Hermeneutics in Pain Care, G. Venuti

    Care and Relation: Empathy for Another’s Pain

    Empathy, Sympathy, Compassion: All Synonyms?

    Spirituality, Suffering and the Self, J. Giordano and N.B. Kohls

    Introduction

    Pain, the "Self", and Spirituality

    Support from Our Empirical Research

    The Nature and Brief Anthropology of Spiritual and Religious Practices

    Putative Neural Substrates of Spiritual Experience(s)

    Patients’ Spirituality and Its Importance for the Clinical Practice of Medicine

    Spirituality and Practical Pain Management

    Conclusion

    History of the Expression of Pain in Art, S. Karakas

    Maldynia as Muse: A Recent Experiment in the Visual Arts and Medical Humanities, N. Carlin and T. Cole

    Perceptions of Pain: The Essays

    Looking at Pain

    A Visual Language for Pain

    Unspeakable Pain

    Perceptions in Pain: The Art

    The Process

    Three Photographs: Interpretations

    Contextualizing Perceptions of Pain

    Conclusions and Recommendations

    Padfield’s Call for Psychological Interpretations

    Maldynia as Muse

    Maldynic Pain in Image and Experience: Engraving Meaning through Subtraction, R. Covey

    Musical Representations of Physical Pain, E. Peterson

    Introduction

    Pain and Language

    Pain and Its Object

    Music and Meaning

    Music and Timbre

    Music and Lyrics: Masochism Tango

    Music as Absolute: Pacific 231

    Film Music: Psycho

    Classical Music: Threnody for the Victims of Hiroshima

    Popular Music: Back to Back

    Screaming as Music

    Conclusion: Pushing Boundaries

    Beyond Technology: Narrative in Pain Medicine, L. Galvagni

    Narrative and Communication in the Experience of Pain as Illness

    Narrative Medical Ethics

    A Phenomenology of Pain as Illness

    Embodiment

    Temporality

    Subjectivity

    Metaphors and Images in the Experience of Pain as Illness

    Psychological Assessment of Maldynic Pain: The Need for a Phenomenological Approach, M. Schatman

    Introduction

    The Importance of Phenomenologically Assessing the Chronic Pain Patient

    The MMPI: A Tarnished "Gold Standard"

    Unidimensional Assessment Tools

    Multiscale Multidimensional Assessment Tools

    The Strength and Meaning of the Clinical Interview

    A "Patient-Centered" Approach to Assessment of Maldynic Pain Patients

    Cross-Cultural Sensitivity

    Conclusion

    Painism- A New Ethics: Richard Ryder’s Moral Theory and Its Limitations, H. Werner-Ingensiep

    Introduction

    "Can they suffer?"

    Ryder’s Painism: A Middle Way Between the Scylla of Utilitarianism and the Charybdis of Rights Theory?

    Is Pain Necessary and/or Sufficient for Moral Status?

    Painism and Sentientism

    Hurting and Harming

    Pain - The Only Evil?

    Pain in Non-Human Others: Speciesism– Normative and Descriptive Dimensions

    Species, individuals, and Pain

    Painism – Some Applications and Questions

    Painism and Biotechnology

    Painism and Environmental Ethics

    Painism and Plants

    Painism and Euthanasia

    Brain, Pain, PVS and Extreme Cases

    Who is the "maximum sufferer"?

    Concerning the "Vegetative Language" about Human Beings Beyond Sentience and Pain

    Maldynia: Chronic Pain, Complexity and Complementarity, J. Giordano and M.V. Boswell

    Introduction: A Complex Problem

    Chronic Pain – A Spectrum Disorder?

    A Call for Complementarity in Pain Care

    Precipitating Change

    Navigating the Technologic Trend

    Realizing Complementarity in Practice

    The Current Condition of Pain Care

    Proposing a Future

    An Ethical Stance

    Conclusion: A Way Forward

    A Clinical Ethics of Chronic Pain Management: Basis, Reason and Responsibilities, E. Pellegrino

    On Pain, Briefly

    The Moral Management of Pain as Illness

    The Pain Patient

    Ethical Obligations in Clinical Contexts

    Children, Pain, and the Creation of Suffering: Toward an Ethic of Lamentation, C. Gomez

    Finding the Words: A Patient’s Story

    A Framework for Analysis

    Chronic Pain and Language

    Goal-Directed Health Care and the Chronic Pain Patient: A New Vision of the Healing Encounter, D. Waters and V. Sierpina

    Goal-Directed Health Care (G-DHC)

    G-DHC: A Background

    Health Goals And Life Goals

    Changing The Dialogue

    A New Vision Of The Healing Encounter

    Case 1

    Case 2

    The Problem of Pain and the Moral Formation of Physicians, F.D. Davis

    Introduction

    Pain, Illness, and the Ends of Medicine

    The Culture of Medicine and the Moral De-Formation of Physicians

    Patients, Pain, and Prospects for Change in the Culture of Medicine

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