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Pain has been experienced by everyone regardless of age, gender or economic status.
Pain is usually described as unfavorable experience that has a lasting emotional and
disabling influence on the individual. Theories that explain and assist in
understanding what pain is, how it originates and why we feel it are the Specificity
theory, Pattern Theory and Gate theory. In this paper I will attempt to demonstrate my
understanding of the theories and also will be critically analyzing the theories about
the experience of pain by incorporating relevant concepts from literature and relating
it to psychology.
Pain has been described with a wide range of different words. McCaffery (cited in
Adams and Bromley, p192, 1998 ) simply states that the experience of pain as being
“what the experiencing person says it is, existing when he says it does”. This
definition by McCaffery strongly indicates that pain is conceived and experienced
differently in an individualized manner .McCafferys’s definition of pain suggests
experiences of pain depends only on the person experiencing the pain and that no
other person is fully capable to understand how he/she may be feeling as the result of
pain. McCaffery does not actually state in his definition what pain is and what causes
the discomfort, how and why pain arises(Adams and Bromley,1998). Bond (1984)
describes pain as being a personal and unique experience which arises in the brain
due to injury to the body tissue, disease or due to biochemical changes in our bodies.
There are two main types of pain, acute and chronic. Acute pain is experienced for a
short time and usually has a specific cause and purpose such as injury to body tissue
(Adams and Bromley, 1998). Acute pain can be treated using drugs such as aspirin or
other method of pain relieve. Chronic pain has no time limit therefore, can last for
months and years, and serves no obvious biological purpose. Chronic pain can have a
significant impact on the quality of person’s life as chronic pain can trigger
psychological as well as physical and emotional problems that leads to feelings of
helplessness and hopelessness as most chronic pain can not be cured (Goleman and
Gurin ,1993).
Pain theories that I will discussing in this paper are specificity , pattern and gate
control theory as these are the major theories that assist in explaining the concepts of
pain . The modern perspective sees the concept of pain from a view that includes
psychological factors but the earlier theories such as Specificity theory and Pattern
theory were more focused on tissue damage as the cause of pain.
The Specificity theory was originated in Greece .This theory was highlighted by
Descartes in 1664 who expressed that the pain system as being like a “bell - ringing
mechanism in a church”(Melzack and Wall , p196,1984) .Descartes (cited in Melzack
and Wall ,1984) explained that when someone pulls the rope to ring the bell, the bell
rings in the tower. Hence, specificity theory suggests that pain is caused by injury or
damage to body tissue. The damaged nerve fibres in our bodies sends direct
messages through the specific pain receptors and fibres to the pain center, the brain
which causes the individual to feel pain (Adams and Bromley ,1998). This theory
suggest that there is a strong link between pain and injury and that the severity of
injury determines the amount of pain experienced by the person (Brannon and Feist ,
2000).
The Pattern theory was incorporated into the specificity theory which added more
concepts to explain and extended its hypothesis of pain .The pattern theory states that
nerve fibres that carry pain signals can also transmit messages of cold, warmth and
pressure can also transfer pain if an injury or damage to body tissue occurs (Adams
and Bromley,1998).The Pattern theory claims that pain is felt as a consequence to the
amount of tissue damaged (McCance and Huether, 1990). Both Pattern theory and
Specificity Theory are part of Linear model of pain which simply demonstrates that
noxious stimulus such as tissue damage or injury results in the nerve tissues being
stimulated which causes painful sensation which causes a response or painful
behavior (Adams and Bromley, 1998).
The Specificity theory and Pattern theory are not sufficient in explaining the
experience of pain as the theorists fail to include any psychological aspects of pain.
Adams and Bromley ,(1998) felt that the specificity theory does not see the individual
difference in how pain is perceived by people. Brannon and Feist (2000) also
emphasize that this particular theory declines to incorporate how pain is felt
throughout the society. Melzack and Wall, (1984 )claims that soldiers who were
severely injured during the wars reported experiencing little or no pain for days after
the injury while people with chronic pain show unbearable amount of pain even
though they have no detectable injury to body tissue. Adams and Bromley (1998)
illustrates that if severity of injury was seen as amount of pain experienced then pain
relief would be given according to the amount of injury , not according to the person
who had sustained the injury , regardless of how the person conveys their pain .
Hence clients with chronic pain would be seen as ‘crocks’ as they have no visible
injury or damaged tissue and will not treated with analgesics and would be rejected
by doctors (Bond, 1984).
Melzack and Wall proposed the idea of Gate Control theory in 1965. This new
theory was against the idea of Liner model as the theorist believed that pain
perception is influenced by a number of factors which begins in the spinal cord.
Melzack and Wall highlighted that pain messages are carried by the specific nerve
fibres that can be blocked before reaching the brain by the actions of other nerves and
psychological factors (Brannon and Feist, 2000, Polnik 1999, Goleman and Gurin,
1993).
Melzack and Wall suggested that when pain signals first reach the nervous system,
the pain messages are sent the thalamus and the ‘gate’ opens to allow the pain
messages to be sent to superior centers in the brain(Brannon and Feist,
2000).However, the gate may remain closed if neurons come in contact with pain
signals , the neurons has the ability to overpower the pain signals which results in the
gate remaining closed(Brannon and Feist, 2000). Pain signals can also be stopped if
the hypothetical gate remains closed as our natural painkiller, endophins, blocks the
pain signals from getting to the brain(Goleman and Gurin , 1993). Melzack and Wall
(cited in Bromley and Adams ,1998) highlights that previous memory of how the
prior painful situation was handled , supportive support members, positive thinking of
pain , distraction, prior conditioning , cultural values, boredom, stress, negative
thinking, poor pain coping skill may allow the gate to open or to remain closed by
affecting the central control system.This concept can be explained by Beecher (cited
in Brannon and Feist, 2000) who noticed that the soldiers during World War II
reported slight pain even though they had sever damage to tissue due to the battle.
These soldiers had positive thinking and were distracted because injury meant that
the soldiers would be allowed to go home or sustain no further injury ( Beecher cited
Brannon and Feist , 2000).
The gate control theory states that non painful stimulus such as distraction competes
with the painful impulse to reach the brain. This rivalary limits the number of
impulses that can be transmitted in the brain by creating the hypothetical gate
(Plotnik ,1999). The Gate control theory is the first and the only theory to take into
account psychological factors of pain experiences.
Experiences of pain are influenced by many physical and psychological factors such
as beliefs , prior experience, motivation , emotional aspects, anxiety and depression
can increase pain by affecting the central control system in the brain. The specificity
theory and the pattern theory suggests that pain occurs only due to damage to body
tissue while the gate control theory claims that pain may be experienced without any
physical injury and individuals interpret pain differently even though the extent of
injury is the same.
Bibliography
REFERENCE
LIST
Adams, B. & Bromley, B.1998, Psychology for Health Care: Key terms and
Concepts,MACMILLAN PRESS LTD,USA.
Barber,J.& Adrian,C.1982,Psychological Approaches to the management of
pain,Brunner/Mazel INC,USA.
Brannon, L.& Feist, J.2000, Health Psychology: An Introduction to Behaviour and
Health ,4th edn ,Brooks/Cole,USA.
Bond,M.1984,Pain:Its Nature,Analysis and Treatment ,2nd end, Churchhill
Livingstone ,UK.
Goleman ,D. & Gurin,J.1993,Mind,Body,Medicine: How to use your mind for better
health, Consumer Report Books,USA.
McCaffery,M. and Beebe, A.1994, Pain:Clinical Manual for Nursing
Practice,Mosby,UK.
McCance,K.&Huether,S.1990,Pathophysiology:The Biological Basis for Diseases in
Adults and Children,Mosby Books,USA.
Plotnik,R.1999, Introduction to Psychology ,5th edn,Wadsworth Publishing
Company,USA.
Sheppard, J.1981, Advances in behavioural medicine,Vol 1,Cumberland Collage of
Health Science,Australia.
Word Count: 1355
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