Communicating the experience of living with chronic pain: The role of non-verbal communication and the power of lessons learned

Background: Chronic pain is hard to communicate due to its invisible, inaudible, and imprecise nature. Outside of pain scales that try to quantify pain, individuals with chronic pain have a hard time expressing it, yet pain management relies on effective communication. This study explores how women with chronic pain enrolled in an online therapeutic writing workshop communicate the experience of living with chronic pain to fellow sufferers. Methods: A six-week online therapeutic writing workshop was conducted with individuals with chronic pain who responded to weekly creative writing prompts that focused on mindfulness and cognitive behavioral therapy strategies including attention, emotional regulation, and examining thoughts and attitudes. Participants were recruited by their primary care provider; seven participants enrolled. All posts were aggregated and analyzed using thematic analysis. Results: Data analysis from participants’ posts reveal two interpretive repertoires including physical evidence of pain where participants expressed visible impacts of pain occurring in their home environments and communicated non-verbally in gestures and behaviors. Secondly, the theme of lessons learned from living with pain emerged including enhanced empathy, the need for self-care, and sharing coping skills. Conclusion: This study extends our understanding of the experience of living with chronic pain outside of a medical context by providing new insights gained from their creative writing responses. The online therapeutic writing workshop fostered a community of support where participants were empowered to express their pain, identify their pain behaviors, and invite cognitive restructuring to learn from their pain

Developing A Chronic Pain Vocabulary: Communication Preferences Among Individuals With Chronic Pain

In order to be acknowledged, chronic pain must be voiced yet disclosing of chronic pain is fraught with social and professional repercussions. Moreover, there is a perceived disinterest in hearing about, and a stigma associated with the experience of chronic pain. This research explores the therapeutic value of communicating about pain. Nineteen individuals with chronic pain participated in a six-week online writing workshop to describe the way chronic pain impacts daily activities. These qualitative responses were analyzed using discourse analysis and four interpretive repertoires emerged which convey the multi-faceted impacts of living with chronic pain. These findings informed the creation of a quantitative survey tool which was widely disseminated using social media to chronic pain dedicated forums and websites. Findings indicate that audience and gender have a large sway on communication preferences. Individuals with chronic pain desire to receive cure-centered information from health care providers and care-centered information, including empathy, from family and friends when they communicate about their pain. Women in particular aspire to receive emotional support for their well-being and empathy upon communicating about their pain. These results help to fill in the void of patient communication preference within the framework of delivering patient centered care. Understanding patients’ communication preferences has high clinical value as providers can tailor their communication practices to increase rapport, improve patient satisfaction and promote treatment adherence. They place a heightened role on family and friends in the treatment plan as they can offer needed emotional support. Implications include educating family and friends to be aware of pain behavior so they can recognize early indicators and provide empathetic responses. Additionally, using computer mediated communication is a recommended platform to engage individuals with chronic pain due to its convenience, low-cost, and anonymity as well as its potential to connect disparate individuals and build community among marginalized group

Relating the philosophy and practice of ecological economics: The role of concepts, models, and case studies in inter- and transdisciplinary sustainability research

We develop a comprehensive multi-level approach to ecological economics (CML-approach) which integrates philosophical considerations on the foundations of ecological economics with an adequate operationalization. We argue that the subject matter and aims of ecological economics require a specific combination of inter- and transdisciplinary research, and discuss the epistemological position on which this approach is based. In accordance with this understanding of inter- and transdisciplinarity and the underlying epistemological position, we develop an operationalization which comprises simultaneous analysis on three levels of abstraction: concepts, models and case studies. We explain these levels in detail, and, in particular, deduce our way of generic modeling in this context. Finally, we illustrate the CML-approach and demonstrate its fruitfulness by the example of the sustainable management of semi-arid rangelands. --ecological economics,interdisciplinarity,philosophy of science,transdisciplinarity