Pain has been experienced by everyone regardless of age, gender or economicstatus. Pain is usually described as unfavorable experience that has a lastingemotional and disabling influence on the individual. Theories that explain andassist in understanding what pain is, how it originates and why we feel it arethe Specificity theory, Pattern Theory and Gate theory. In this paper I willattempt to demonstrate my understanding of the theories and also will becritically analyzing the theories about the experience of pain by incorporatingrelevant concepts from literature and relating it to psychology. Pain has beendescribed with a wide range of different words.
McCaffery (cited in Adams andBromley, p192, 1998 ) simply states that the experience of pain as being “whatthe experiencing person says it is, existing when he says it does”. Thisdefinition by McCaffery strongly indicates that pain is conceived andexperienced differently in an individualized manner .McCafferyss definitionof pain suggests experiences of pain depends only on the person experiencing thepain and that no other person is fully capable to understand how he/she may befeeling as the result of pain. McCaffery does not actually state in hisdefinition what pain is and what causes the discomfort, how and why painarises(Adams and Bromley,1998). Bond (1984) describes pain as being a personaland unique experience which arises in the brain due to injury to the bodytissue, disease or due to biochemical changes in our bodies.
There are two maintypes of pain, acute and chronic. Acute pain is experienced for a short time andusually has a specific cause and purpose such as injury to body tissue (Adamsand Bromley, 1998). Acute pain can be treated using drugs such as aspirin orother method of pain relieve. Chronic pain has no time limit therefore, can lastfor months and years, and serves no obvious biological purpose.
Chronic pain canhave a significant impact on the quality of persons life as chronic pain cantrigger psychological as well as physical and emotional problems that leads tofeelings of helplessness and hopelessness as most chronic pain can not be cured(Goleman and Gurin ,1993). Pain theories that I will discussing in this paperare specificity , pattern and gate control theory as these are the majortheories that assist in explaining the concepts of pain . The modern perspectivesees the concept of pain from a view that includes psychological factors but theearlier theories such as Specificity theory and Pattern theory were more focusedon tissue damage as the cause of pain. The Specificity theory was originated inGreece .
This theory was highlighted by Descartes in 1664 who expressed that thepain system as being like a “bell – ringing mechanism in a church”(Melzackand Wall , p196,1984) .Descartes (cited in Melzack and Wall ,1984) explainedthat when someone pulls the rope to ring the bell, the bell rings in the tower.Hence, specificity theory suggests that pain is caused by injury or damage tobody tissue. The damaged nerve fibres in our bodies sends direct messagesthrough the specific pain receptors and fibres to the pain center, the brainwhich causes the individual to feel pain (Adams and Bromley ,1998). This theorysuggest that there is a strong link between pain and injury and that theseverity of injury determines the amount of pain experienced by the person(Brannon and Feist , 2000). The Pattern theory was incorporated into thespecificity theory which added more concepts to explain and extended itshypothesis of pain .
The pattern theory states that nerve fibres that carry painsignals can also transmit messages of cold, warmth and pressure can alsotransfer pain if an injury or damage to body tissue occurs (Adams andBromley,1998).The Pattern theory claims that pain is felt as a consequence tothe amount of tissue damaged (McCance and Huether, 1990). Both Pattern theoryand Specificity Theory are part of Linear model of pain which simplydemonstrates that noxious stimulus such as tissue damage or injury results inthe nerve tissues being stimulated which causes painful sensation which causes aresponse or painful behavior (Adams and Bromley, 1998). The Specificity theoryand Pattern theory are not sufficient in explaining the experience of pain asthe theorists fail to include any psychological aspects of pain. Adams andBromley ,(1998) felt that the specificity theory does not see the individualdifference in how pain is perceived by people. Brannon and Feist (2000) alsoemphasize that this particular theory declines to incorporate how pain is feltthroughout the society. Melzack and Wall, (1984 )claims that soldiers who wereseverely injured during the wars reported experiencing little or no pain fordays after the injury while people with chronic pain show unbearable amount ofpain even though they have no detectable injury to body tissue.
Adams andBromley (1998) illustrates that if severity of injury was seen as amount of painexperienced then pain relief would be given according to the amount of injury ,not according to the person who had sustained the injury , regardless of how theperson conveys their pain . Hence clients with chronic pain would be seen ascrocks as they have no visible injury or damaged tissue and will nottreated with analgesics and would be rejected by doctors (Bond, 1984). Melzackand Wall proposed the idea of Gate Control theory in 1965. This new theory wasagainst the idea of Liner model as the theorist believed that pain perception isinfluenced by a number of factors which begins in the spinal cord.
Melzack andWall highlighted that pain messages are carried by the specific nerve fibresthat can be blocked before reaching the brain by the actions of other nerves andpsychological factors (Brannon and Feist, 2000, Polnik 1999, Goleman and Gurin,1993). Melzack and Wall suggested that when pain signals first reach the nervoussystem, the pain messages are sent the thalamus and the gate opens toallow the pain messages to be sent to superior centers in the brain(Brannon andFeist, 2000).However, the gate may remain closed if neurons come in contact withpain signals , the neurons has the ability to overpower the pain signals whichresults in the gate remaining closed(Brannon and Feist, 2000). Pain signals canalso be stopped if the hypothetical gate remains closed as our naturalpainkiller, endophins, blocks the pain signals from getting to the brain(Golemanand Gurin , 1993).
Melzack and Wall (cited in Bromley and Adams ,1998)highlights that previous memory of how the prior painful situation was handled ,supportive support members, positive thinking of pain , distraction, priorconditioning , cultural values, boredom, stress, negative thinking, poor paincoping skill may allow the gate to open or to remain closed by affecting thecentral control system.This concept can be explained by Beecher (cited inBrannon and Feist, 2000) who noticed that the soldiers during World War IIreported slight pain even though they had sever damage to tissue due to thebattle. These soldiers had positive thinking and were distracted because injurymeant that the soldiers would be allowed to go home or sustain no further injury( Beecher cited Brannon and Feist , 2000). The gate control theory states thatnon painful stimulus such as distraction competes with the painful impulse toreach the brain. This rivalary limits the number of impulses that can betransmitted in the brain by creating the hypothetical gate (Plotnik ,1999).
TheGate control theory is the first and the only theory to take into accountpsychological factors of pain experiences. Experiences of pain are influenced bymany physical and psychological factors such as beliefs , prior experience,motivation , emotional aspects, anxiety and depression can increase pain byaffecting the central control system in the brain. The specificity theory andthe pattern theory suggests that pain occurs only due to damage to body tissuewhile the gate control theory claims that pain may be experienced without anyphysical injury and individuals interpret pain differently even though theextent of injury is the same.BibliographyREFERENCE LIST Adams, B.
& Bromley, B.1998, Psychology for Health Care: Keyterms and Concepts,MACMILLAN PRESS LTD,USA. Barber,J.&Adrian,C.1982,Psychological Approaches to the management of pain,Brunner/MazelINC,USA. Brannon, L.& Feist, J.
2000, Health Psychology: An Introduction toBehaviour and Health ,4th edn ,Brooks/Cole,USA. Bond,M.1984,Pain:ItsNature,Analysis and Treatment ,2nd end, Churchhill Livingstone ,UK. Goleman ,D.& Gurin,J.
1993,Mind,Body,Medicine: How to use your mind for better health,Consumer Report Books,USA. McCaffery,M. and Beebe, A.1994, Pain:Clinical Manualfor Nursing Practice,Mosby,UK.
McCance,K.&Huether,S.1990,Pathophysiology:TheBiological Basis for Diseases in Adults and Children,Mosby Books,USA.Plotnik,R.1999, Introduction to Psychology ,5th edn,Wadsworth PublishingCompany,USA.
Sheppard, J.1981, Advances in behavioural medicine,Vol 1,CumberlandCollage of Health Science,Australia.