Chronic physical and emotional distress : fighting a battle or finding a balance?

Chronic illness has reached epidemic proportions in Western societies, and comorbidity of emotional and physical disorders is substantial. Despite the underlying unity of mind and body, a dualistic biomedical model of illness continues to prevail in the Western medical system, assuming that all disease is connected with a specific physical cause, and that physical treatment alone is adequate to provide a cure. Individuals and society at large are portrayed as engaging in a "war" or battle against illness, in which the goal is to control and defeat this dreaded enemy. Our predominantly action-oriented fighting mode is in contrast to the model of acceptance and understanding espoused by more "primitive" healing practitioners. This study examined the progression of a single individual's treatment for a chronic pain syndrome known as Reflex Sympathetic Dystrophy, as a dynamic process which includes biological, psychological, and social elements. Verbal transcripts of psychotherapy sessions were analyzed, along with physiological measures of peripheral vascular response and subjective ratings of pain-related intensity and affect. Quantitative analysis of outcome measures showed that by the end of her psychological treatment, the participant had developed a more complex and tolerant view of herself and her ecosystem. Both pain intensity and pain-related affect decreased, while peripheral finger temperature stabilized within a clearly defined modal range. The theoretical concept of "balance" was operationalized, and shown to be an element important in the individual's healthy functioning.