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SOME PSYCHOLOGICAL ASPECTS OF PAIN AND THE RELIEF OF SUFFERING *
Author(s) -
Petrie Asenath
Publication year - 1960
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1111/j.1749-6632.1960.tb42787.x
Subject(s) - psychology , psychotherapist , medicine
There are many important things to say about the psychology of pain and the relief of suffering, four of which are the main purpose of this paper. The first is that certain aspects of personality and perceptual style, which are changed by a prefrontal lobotomy carried out for the relief of pain, are precisely those that differentiate within the normal population those who can tolerate pain well from those who suffer greatly from it. The second point is that these differences in tolerance for pain are paralleled by other striking differences in the subjectively perceived intensity of sensation other than pain. Some persons, whose nature it is to reduce the intensity of their perceptions subjectively, can tolerate pain well. The third point is that there appear to be sex differences in this tendency to reduce the subjectively perceived intensity of sensation. Finally-and this is the fourth point-the tendency to reduce the perceived intensity of sensation can temporarily be so accentuated by drugs as temporarily to establish greater tolerance of pain. Before going further, however, it is necessary to recapitulate some of the facts that have appeared in earlier reports.*S2 A first point concerns the aspects of personality that are changed by a prefrontal lobotomy carried out for the relief of pain. Surgery in the prefrontal areas of the brain so increases tolerance for pain that the patient can sleep without morphine and wake without moaning. What is remarkable about this surgery is that the source of the pain has not been dealt with, nor has the threshold for pain been altered; instead, the person experiencing the pain has been altered. The alteration in personality following brain surgery is quite specific when it achieves this effect, as earlier work with about 100 patients has demon~tra ted .~ ,~ Our work2 has indicated that a person who is exceptionally tolerant of pain has the personality and perceptual style of the individual after a prefrontal lobotomy, whereas one who cannot tolerate pain resembles in personality a patient before prefrontal lobotomy. We have shown that this correlation is true with regard to pain of major surgery, minor surgery, and bronchoscopy, and that it is also true of tolerance for experimental pain as measured by the pain that can be endured above the threshold. This conclusion is based upon a study of 70 patients.