Chronic pain, alexithymia, and object relations

In the treatment of chronic neck and back pain patients, the influence of early life experiences, or object relations, and the inability to verbalize feelings. or alexithymia, have not been explored. This study investigated the object relations and presence of alexithymia in chronic pain patients in comparison to a sample of non-pain workers. In addition, a comparison was made of the level of object relations and presence of alexithymia in chronic pain patients who returned to work versus chronic pain patients who did not return to work at six months following a prototypical work-hardening program.

One hundred patients diagnosed with chronic pain following a neck or back injury and one hundred non-injured individuals in similar job categories completed the Toronto Alexithymia Scale (TAS) and the Bell Object Relations Inventory (BORI). Discriminant analysis was used to test two hypotheses:(a) Neither Object Relations scores as measured by the BORI four scales of Alienation, Insecure Attachment, Egocentricity, and Social Incompetence, nor Alexithymia as measured by the TAS differentiate chronic pain patients from non-pain individuals. (b) Neither Object Relations scores as measured by the BORI four scales of Alienation, Insecure Attachment, Egocentricity, and SocialIncompetence, nor Alexithymia as measured by the TAS predict whether chronic pain patients return to work at six months following treatment for chronic pain.

Results of the discriminant analyses indicated that all five of the predictor variables were significant (<.05) in classifying individuals as being members of the chronic pain or non-injured group (at the rate of 86%) and in classifying chronic pain patients who return to work versus chronic pain patients who do not (at the rate of 92%). In comparing individuals with and without chronic pain, alexithymia had the highest correlation to chronic pain patients, followed by alienation, insecure attachment, egocentricity, and social incompetence. In comparing chronic pain patients who returned to work or not, alienation was the variable with the highest correlation, followed by alexithymia, egocentricity, insecure attachment, and social incompetence.