Psychodynamic pain management for cancer patients

File attachments: 
PDF icon JPM2010_3_1.LevensonetalCancerpain.pdf177.35 KB
Average: 10 (1 vote)

The use of psychodynamic-oriented techniques has successfully been used to manage pain in 75 cancer patients by the use of psychodynamic principles. Pain is a subjective phenomenon that varies much from patient to patient with the same type and stage of cancer. This well-known variance is from a depth-psychological perspective explained by pain being a negative interpretation of inner reality caused by the patients’ sub-conscious conflicts.

Therefore much pain can be relieved, when these conflicts are resolved in the therapy, which happens when the patient bonds to the therapist and in an intimate therapeutic relationship regain deeper insight in self and life, and a positive and relaxed attitude. The intimacy with the patient was reached by selective therapeutic touch, i.e. hugs, in a holistic philosophical framework, making the intervention a type of clinical holistic medicine. The basic principle was that of “clinical medicine” and healing by supported self- exploration. Patients in acute or chronic states appeared to be able to utilize the intervention for existential healing (what Antonovsky called “salutogenesis”) only when the therapeutic relationship was close and positive.

Their resistance to a positive transference was a defense that could be resolved with reflective techniques thereby facilitating the use of these interventions. The hierarchy of degree of pain relief seemed to be 1) chemical side effects of medication being coupled with a positive suggestions of pain relief (placebo), 2) Counterfocus of irritations and pain within the soma to reduce the intensity of the actual pain site (integration of inner conflicts), 3) Directed aggressive imagery to have the patient angry at his or her pain (self- expression) and 4) Relaxation and escape imagery (letting go of tensions and negative ideas and attitudes). Estimated from the case stories one in two was helped (NNT=2 for cancer pains). 


Treatment Protocol: