The Impact of Chronic Pain on Marriage and Family

The global impact of chronic pain was borne out by a survey of 4611 individuals (Smith et al., 2001), in which 14.1 reported significant chronic pain and another 6.3 severe chronic pain. The presence of any significant and severe chronic pain had progressively more marked adverse effects on employment, daily activities, and all measured dimensions of general health. The scope of the pain problem is illustrated by a recent survey that reported that 43 of households have at least one family...

Further Thoughts on Mrs Christy and Her Family

We adopt an eclectic, albeit systemic, family therapy approach in discussing Mrs. Christy's case. First and foremost, family is an organization with hierarchy, roles, rules, styles of communication, affectional bonds, and mutual obligations. The executive function of the Christy family, the domain of the two parents, was seriously challenged with the onset of Mrs. Christy's chronic pain problems. Normally, with Mr. Christy's regular absence from home, a good deal of the executive functions were...

The Health of the Partners Spouses and the Children

Caregiving for a sick or disabled partner is a complex issue. At a commonsense level, the fact that an elderly caregiver for a partner with Alzheimer's disease would experience inordinate pressures and anxieties, and even develop physical symptoms, does not hold any mystery. However, when the question of the spouse or partner as a source of social and emotional support is taken into account, then the magnitude of the difficulties associated with caregiving becomes palpable. In many discussions...

Newly Married Couple

Erikson (see Chapter 7), in her mid-twenties, was referred to the pain clinic for chronic head pain. The referring physician stated that she had over the past 2 months not been coping very well with her stress. She complained of frequent frontal headaches, which lasted for 2 to 3 days at a time. She was suffering from some insomnia, waking frequently during the night. There were no abnormal clinical findings, and the physician suggested that this very intelligent woman seek psychological...

Is This Paternalism or Abuse

Jacky, in her forties, presented with a very complicated medical history. Her multiple pain problems, of many years' duration, was increasingly unresponsive to medical ministrations. Jacky was born with a congenital hip problem and had bilateral prosthetic replacement. She did not have this correction until the fourth year of her life, which left her with difficulty in walking and chronic pain. She had corrective surgery, but later as an adult she fractured her hip and had to have another...

Premorbid Sexual Problems

For many of the couples, sexual problems do not begin with the onset of chronic pain. Many marriages are strife-ridden before the onset of pain, and it may be reasonable to assume that intimate and satisfactory sexual relations in these couples are a casualty of faulty and unsatisfactory relationships rather than of pain. One patient with a long history of headaches always regarded her husband as distant and uninvolved. He spent a great deal of time on the road, due to business. The sexual...

Spousal Distress and

Spousal distress due to medical and psychiatric disorder in the partner is relatively common. All the major investigations pertaining to distress in the spouses of chronic pain patients so testify. Distress among many of the partners of chronic pain patients is commonly observed. Male as well as female spouses are adversely affected. The reasons for anxiety and depression in the spouses are perhaps not unduly complex. At its simplest, most of the spouses are forced into assuming greater levels...

Diabetes and Sexual Dysfunction

A clear physiological association between diabetes and male sexual dysfunction is well established. In a comprehensive review of the literature, Eretekin (1998) found ample research evidence for chronic progressive impotence directly related to diabetes mellitus. It is either neuropathic or vascular, or both. In some instances impotence may lead to the discovery of the disease. Another rare sexual dysfunction affecting 1 to 2 of diabetic men is retrograde ejaculation. However, some researchers...