Pain: a kaleidoscope of ideas, concepts and approaches.

The following pages contain summaries and short statements on chronic pain providing further material for reflection and debate, namely: a) synopses of recent findings on: the physiology and biochemistry of pain; the contribution of psychoneuroimmunology; b) some views on a sociology of pain; c) analysis of various concepts and approaches which consider pain as: a symptom of disease a form of behaviour a psychosomatic reaction and a social learning process a communication phenomenon a symptom of disintegrated life a disruption in the integrity of the system a signal of broken unity a breach in the wholeness of the individual; d) a holistic approach in pain therapy; e) some unanswered questions.

Behaviour analysis and treatment of essential hypertensives.

Various relaxation techniques have the potential to bring about promising blood pressure (BP) reductions in essential hypertension; but the treatment gains often fail to be sustained over a prolonged period of time. Until now, behavioural treatment approaches have not included efforts to increase patient awareness of situations that provoke BP elevations. In our study, numerous BP measurements were therefore taken In various situations by approximately 120 essential hypertensives. These measures were used to acquaint the patients with their own BP variability, to help them understand psychologically induced BP-variations, and to encourage them to cope with their hyper-reactivity in general and in response to specific stressful situations. Forty-eight patients were given the opportunity to learn to relax and to cope with stressful life situations. They showed promising BP reductions after treatment and at follow-up one year later. But our diagnostic findings using these methods indicate that essential hypertensives are anything but a homogeneous group. A variety of treatment approaches may therefore be required.