Media release from Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine
 
Doctors and other health professionals have been urged to have greater awareness of their own potential to inadvertently contribute to the stigmatisation of their chronic pain patients through negative empathy.

A paper written by Faculty of Pain Medicine Fellows, Associate Professor Milton Cohen and Dr John Quintner and their colleagues, published recently in the journal Pain Medicine, warns health professionals they could be unintentionally contributing to the negative community stereotypes of chronic pain sufferers.

Dr Cohen says health professionals can be challenged when confronted with a clinical problem, such as chronic pain, that they cannot readily understand.

"Modern medicine is generally based on a body-mind split, where if a clinician cannot find a disease or body-related reason for the pain, they conclude it must be in a person's mind," he says.

"This in effect blames the person for their pain which contributes to the stigmatisation felt by chronic pain patients.

"The clinician can also start feeling negative towards the patient because they feel unable to help them and this can lead to an extinction of empathy for the patient, or negative empathy."

Dr Cohen says health professionals need to be aware of the reasons for their own feelings of anxiety when they are engaged with a distressed person in pain.

In the paper, Dr Cohen and his colleagues suggest that clinicians and patients find a "third space" in consultations where there is no power imbalance between the clinician, who is generally considered the expert, and the patient.

"The patient is, in fact, the expert in their particular experience of pain, while the clinician has knowledge about bodies," Dr Cohen says. "So they have different areas of expertise which need to be shared in this third space rather than one person's viewpoint dominating the other."

Destigmatisation of chronic pain is one of the major planks of the Australian National Pain Strategy, which came out of the National Pain Summit in March 2010.

The strategy recognises that people with chronic pain have substantially increased risk of depression, anxiety, physical deconditioning, poor self-esteem, social isolation and relationship breakdown. 

It also recognises that chronic pain is poorly understood by many health professionals who receive little or no training in how to treat this condition.

The Faculty of Pain Medicine is part of the Australian and New Zealand College of Anaesthetists.