Validating pain communication: current state of the science.

Abstract

There is growing recognition that pain communication is important, and the way that people (e.g. partners, healthcare providers) respond to patients sharing their pain-related thoughts and feelings may have significant implications for pain-related outcomes[8]. One potentially important factor that has been relatively understudied until recently is the level of validation that may or may not be provided by people who are the recipients of a pain communication [4]. Many patients with chronic pain believe that others do not understand their pain or even consider their pain condition to be legitimate[9], beliefs which are likely to lead to increases in psychological distress and negative affect. It is possible that validation of pain-related thoughts and feelings for these patients may lead to reductions in negative affect. Furthermore, validation from a romantic partner may enhance relationship intimacy, which is related to several positive benefits (e.g. increased positive affect, improved psychological well-being) [10; 11]. Despite the potential benefits of validation, some research suggests that receiving social reinforcement (including validation) after sharing pain-related thoughts and feelings may be associated with worse patient outcomes such as increased pain[22]. This paper highlights studies examining the effects of validation of pain-related thoughts and feelings. It is divided into four sections. In the first section, we describe the concept of validation. The second section describes several theories that attempt to explain the impact of validation on patient outcomes (e.g. affect, report of pain intensity). In the third section, we review a number of studies examining validation and invalidation in the context of pain. In the final section of the paper, we highlight several important future directions for research on the influence of validation on chronic pain.