Using the World Mental Health version of WHO, CIDI, the twelve months prevalence of Chronic pain was found to be 37% in developed countries and 41% in developing countries.
A 38 yrs old lady came to us for psychiatric assessment with the complaints of chronic pain in abdomen along with a withdrawal tendency. She has left her job without any apparent reason. The pain is severe and has detrimental consequences: loss of job, family disturbances leading to social isolation and emotional loneliness. Pain without an apparent anatomical and neuro-physiological origin was labeled as psycho-pathological features.
Recent epidemiological studies reveal surprisingly high prevalence estimates for chronic pain. Using the World Mental Health version of WHO, CIDI, the twelve months prevalence of Chronic pain was found to be 37% in developed countries and 41% in developing countries. Chronic pain prevalence increases with age and is greater among females than males.
To assess her psycho-social functioning through case study and by administering psychological testing
- Bender Gestalt Test (BG)
- Draw A Person Test (DAP)
- Rorschach Ink Blot Test (RIBT)
- Thematic Apperception Test (TAT)
The above mentioned tests were administered. She was co-operative but a bit apprehensive and agitated, and took longer times to complete the tasks.
The BG test with a z score of 66 put her in the suspect category. Nature of deviation reveals difficulty in sustaining interpersonal relationships, social anxiety, aggressiveness and withdrawal tendency. Analysis of DAP shows immaturity, feeling of inadequacy, need for dependency and a regressive tendency.
The Rorschach test shows very impoverished inner resources and weak ego strength. There is only a piled up instinctual need but she is totally helpless to do anything with it successfully either by finding a social outlet or by intellectual canalization. Only means is withdrawal and somatic symptoms.
In TAT though she is able to establish emotional bonds but with a tendency to withdraw. She has strong aggression which she projects on herself. Only defense she recourses to is isolation and withdrawal. Analyzing case history, test behavior and findings it appears she is unable to take adaptive defenses, the only thing she utilizes are isolation, withdrawal and somatization resulting in “Pain Disorder”.
Composed by: “Dr. Tinni Dutta is an academician working as an Assistant Professor in the Department of Psychology, Muralidhar Girls’ College, Kolkata. Being a researcher she has visited and provided keynote speeches,lectures, posters and oral presentations in the USA, UK, Germany, Switzerland, France, South Africa and different parts of Asia and India.”
