ABSTRACT

Chronic pain management, as it is currently practiced in its numerous medically sanctioned forms, is rmly anchored in science, with the art of the eld becoming progressively more obscure. This, unfortunately, is likely true of all of modern medicine despite the perception that its practice as a whole has improved with time. Leder writes, “Tendencies toward over-specialization, over-reliance on technology, and loss of humanitarian concern have constituted the dark side of modern medicine’s stunning achievements” (1, p. 19). Steen and Haugli (2) note that although the biomedical model may be an effective approach to disease states in which the cause is clearly dened, it is not appropriate for conditions such as chronic pain. Whether an approach to maldynic pain involves medication management, injections, implantable therapies, physical therapy, or even cognitive-behavioral psychology, practitioners consider themselves as professionals applying treatment based upon scientic principles and evidence in order to relieve pain. Sadly, chronic pain patients have come to embrace the same expectations regarding practitioners’ approaches to their

Introduction ............................................................................................................ 157 The Importance of Phenomenologically Assessing the Chronic Pain Patient ....... 159 The Minnesota Multiphasic Personality Inventory (MMPI): A Tarnished “Gold Standard” ..................................................................................................... 163 Unidimensional Assessment Tools ......................................................................... 165 Multiscale Multidimensional Assessment Tools .................................................... 165 The Strength and Meaning of the Clinical Interview ............................................. 167 A “Patient-Centered” Approach to Assessment of Patients with Maldynic Pain ........................................................................................................................ 169 Cross-Cultural Sensitivity ...................................................................................... 173 Conclusion ............................................................................................................. 173 References .............................................................................................................. 175

condition as those maintained by practitioners. This is not to suggest, however, that the maldynic pain patient needs or even wants to be treated from a purely scientic model, as such a model may be dehumanizing.