Pain as a threat—psychological and phenomenological aspects

Abstract

Introduction: Pain is a multidimensional experience of injury or threat of future damage, with sensory, cognitive, motivational and emotional aspects. The essence of the pain experience depends on the meaning that the individual gives to pain in a particular situation. Aim: The aim of the article is to analyze and structure the concept of pain as a threat, covering its psychological and phenomenological aspects Materials and Methods: A review and critical analysis of relevant literature have been conducted. Results: It has been established that a predisposing factor for maintaining acute pain and turning it into a chronic one is the expectation (threat) of future harm. The emotional components of the threat of pain (fear and anxiety), as well as the cognitive ones (overvigilance and catastrophizing), have been studied. The assessments of the situation during pain and of the pain-coping resources are the main cognitive mediators that determine the outcome. The perception of pain as a threat provokes fear, anxiety, experiences of insecurity, helplessness, and maladaptive behaviors. Pain-avoiding behavior is in the basis of the stress-diathesis in the manifestation of chronic pain and it predicts future disability. Conclusion: Pain is a threat to the physical and the psychosocial functioning. The assessment of the emotional, cognitive and situational aspects related to pain should be a part of the multidisciplinary approaches to pain management. Manipulating these factors is key to reducing the risk of pain becoming chronic. The application of effective behavioral and cognitive techniques, aimed at increasing the resources for coping with and controlling pain enables patients to continue to function normally in spite of the pain.