Schools of thought on pain

Through an analysis of the way pain specialists speak about pain and deal with pain patients, the prevailing approaches to pain in eight academic pain centers in the Netherlands have been traced and studied. Major categories for distinguishing between the diverse approaches to pain are: theoretical statements about pain, definitions of pain patients, statements about therapy, and about recovery. On the basis of these categories, five ideal typical schools or approaches have been deduced. After a brief description of these schools, according to the above categories, and from the point of view of an ideal typical adherent (actor) of each school, I proceed to an in-depth inquiry into the major basic assumptions of these approaches with respect to their portrayal of man and the role of medicine. Finally, envisaging the phenomenon of pain within the context of everyday life, a new model is proposed for understanding the experience of pain; this also sheds light on the medical problem of patients with 'intractable' pain.