Psychodynamische und interaktionelle Aspekte bei chronischem Schmerz

摘要

Chronic pain patients often show a striking illness behaviour and produce thereby in the treatment team a series of often very stressful negative emotions such as anger, helplessness and frustration. This article occupies with specific transference and countertransference constellations that occur frequently in the context of chronic, therapeutically unsatisfactory influenceable pain. After a brief summary of psychodynamic factors that play role in the development of pain syndromes a case report of a female patient with a herniated disc and a so-called “psychogenic overlay” is presented. On hand the analysis of this case the mechanism of depressive somatization, as it G. Rudolf [1] describes, is discussed in detail. Only when the meanings of the interaction pattern and the relationship happening can be understood, an appropriate and effective therapeutic handling with patients is possible.