FEELING GOOD

were once considered psycho-
somatic have been found to
have a physical origin.
Dr. Roberta Ball, co-director
of the Pain Treatment Center
at Thomas Jefferson Univer-
sity, in Philadelphia, Pa.,
often poses a series of ques-
tions to her patients. Since
pain can -not be measured like
temperature or blood
pressure, Ball asks, instead, if
pain is the whole focus of
their communication? How
preoccupied with pain are
they? What is their activity
level? How many hours are
they active? How many hours
do they spend not sleeping?
Do they still have the ability
to experience pleasure? The
answers to these questions
help Ball determine the
severity of the pain and the
course of treatment.
Experts agree that a per-
son's reaction to pain is deter-
mined by many factors. These
include our physical makeup,
familial influences, en-
vironmental cues, levels of
need, and even gender ("big
boys don't cry").

PAT SHAPIRO

Special to The Jewish News

N

o one escapes it. Whe-
ther it's a dull throb
in the temple, a cons-
tant ache at the back of the
neck or a vise-like pressure
between the ears, pain affects
us all at some time.
Some of us, the lucky ones,
have only experienced the
acute pain of an occasional
headache or toothache; others
know the warning signal of
an appendicitis about to burst
or the lingering pain after
surgery or injury. A third of
all Americans live in chronic
pain, a discomfort so per-
vasive that it lasts more than
six months and becomes a dis-
ease in itself.
Each person reacts differ-
ently to pain. Studies indicate
that your tolerance level to
pain is a combination of phy-
siology and upbringing.
Other studies suggest that
how pain affects you and im-
pacts on your daily life may
have more to do with your
family's past than with your
present ache.
The International Associa-
tion for the Study of Pain
defines pain as an "unplea-
sant sensory and emotional
experience associated with
actual or potential tissue
damage!' The Association
was founded several years ago
by Dr. J. J. Bonica of the
University of Washington, in
Seattle. Dr. Bonica, an anes-
thesiologist, treated people in
chronic pain, and he himself
was in chronic pain from his
school wrestling days.
Experts divide pain into
two categories: acute (when,
for example, "you get opera-
ted on, you have pain, it goes
away in a couple of days or
weeks," says Dr. Nelson
Hendler, the author of three
books on the subject) and
chronic (when "you get pain
and it stays and stays, and pa-
tients get very depressed").
Chronic pain is treated dif-
ferently than acute pain be-
cause it is different, Hendler
says. "With chronic pain, it's
important to have a diagnosis
for your pain. Once the pa-
tient knows what the problem
is, not only can you treat the
condition but it relieves the
anxiety of chronic pain, which
is very frightening?'
Current research is examin-
ing various aspects of pain; in
particular, researchers are
seeking long-acting, non-ad-
dictive pain relievers. More-
over, in the past 10 years,
tools have been developed —
both new ones and refine-
ments of old ones — that
allow for more precise mea-
surements. Thus, Hendler
continues, conditions that

Coming To
Grips With Pain

Each person has his own tolerance level
to pain, but how you cope with pain
often depends on your past.

Mark Aborowski, author of
People In Pain, found that an
individual's reaction to pain
was based on his cultural
and ethnic background. For
example, Latin and Jewish
families, who tend to be more
emotional, are more expres-
sive of pain, fear illness and
seek medical attention early.
White Anglo-Saxon Protest-
ants, on the other hand, tend
to be more stoical because
they see pain as a sign of
weakness; they generally in-
hibit expressing pain and do
not seek medical help until
the problem is severe. In con-
clusion, Zborowski found that
the amount of emotion ex-
pressed did not correlate with
the degree of pain actually
experienced.
According to Ball, it has
been well documented in the
pediatric literature that
children who have been
abused or abandoned in ear-
ly life are more likely to have
chronic pain. Stress can also
make pain worse.
One of the most critical fact-
ors in determining reactions
to pain, though, is how
parents "teach" their
children to handle hurt. Dr.
Patrick Edwards, a
psychologist at North Dakota
State University, quizzed 288
college students and found
that children who grew up in
pain-plagued homes were
more likely to to experience
pain themselves as an adult.
"Anyone who has had a
painful medical experience or
a parent with constant pain
may be more pain-prone in
later life," Ball says. She also
feels that someone who has

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