This book is an extension of my 1992 book entitled The Social Context of
Chronic Pain Sufferers. Many ideas nominally explored there are
elaborated in this volume, which is an attempt to fill a major gap in
the chronic pain literature. Although there has been a virtual flood of
new works on the medical and psychological aspects of chronic pain, such
enthusiasm is somewhat muted in relation to the social environment of
the patient. Although there is universal recognitionamongpain
expertsthat biological, psychological, and socialfactors influence the
experience ofpain, the social component (forreasons that are - clear)
has failed to attract much attention. Theneed forabook
focusedonsocialrelationsisobvious.Thepatientisnot merelyacarrierof
symptoms.Thereis alargesocialrealityinthe background of each patient;
that reality can have multidimensional consequences, from the way pain
is perceivedto seriousfinancialhardshipand other sourcesof stress, c-
plicating treatment, management, and, ultimately, the prognosis.
Clinicians rec- nize the value of incorporating the social dimension in
the overall evaluation and treatment of the patient. This book attempts
to accomplish that task. In order to achieve that objective, this volume
addresses many important e- ments inthepatient'ssocial environment-the
mostsignificantbeingthefamily. Beyond the family, for a vast majority of
patients, work represents a major source of economic security and
self-esteem. Job loss, common in this population and a major cause of
much personal and family distress, needs critical examination.
