Der Schmerz
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This article deals with the interrelationship between body, mind and culture with respect to being healthy and being ill. If one wants to treat not only sickness but also sick people, it is helpful to be aware not only of the somatic and psychological dimensions of a disease but also of the "cultural" dimension of a disease. ⋯ Furthermore, it is shown that not only being sick but also the sick body can be understood in somatic, psychological and cultural dimensions and that a distinction must be made between the body as it physically is and as it is subjectively perceived. Finally, an insight into the complexity of the somatopsychic and psychosomatic interactions is provided in order to derivatively show how mental stress can lead to physical pain and physical pain can become a mental stressor.
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If we understand chronic pain not only as a disease but also as an existential crisis, it seems logical and reasonable to consider spiritual aspects in the treatment process. Spirituality is understood as an umbrella term for all activities and experiences that give meaning and significance to people's lives-irrespective of their religious affiliation. So far, spiritual aspects have been considered therapeutically mainly in the palliative context. ⋯ Professional competence generally involves all practitioners, but may also require qualified professionals for specialized assistance. The integration of authentic spiritual assistance into multimodal pain management should help to stabilize self-esteem and the experience of identity of the patients through resource activation and identification of burdensome spiritual beliefs. The detailed integration and investigation of the efficiency of spiritual interventions in multimodal pain therapy require further research.
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Chronic pain poses a significant global socio-medical challenge causing significant costs. It is only since the mid-20th century that pain syndromes have been considered diseases in their own right. ⋯ This analysis aims at a characterisation of pain including a-mainly phenomenological and enactivist-philosophical perspective. The discourse will be guided by the concept of the limit(s) of the lived body: what is the relationship between pain and the perception of the lived body's boundaries? Does a reciprocal influence exist? And may the perception be modified in order to reduce the patient's suffering? These musings will also clarify that neurosciences and philosophy are not competing sciences, but rather inform each other.