Maldynia: Multidisciplinary Perspectives on the Illness of Chronic Pain, 1st Edition (Hardback) book cover


Multidisciplinary Perspectives on the Illness of Chronic Pain, 1st Edition

Edited by James Giordano

CRC Press

280 pages | 33 B/W Illus.

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Hardback: 9781439836309
pub: 2010-12-02
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pub: 2016-04-19
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Whether initiated by injury or disease, induced and sustained by changes in the nervous system, or manifested by society and culture, chronic pain can change one’s first-person experience of the body and the world, and ultimately impacts cognitions, emotions, and behavior. Many fine medical books address the causes and management of chronic intractable pain, but rarely do they focus on the ways that such pain creates illness and is experienced and expressed by persons in pain.

Maldynia: Multidisciplinary Perspectives on the Illness of Chronic Pain is about chronic pain that has progressed to a multidimensional illness state in and of itself. Although often dismissed as such, this pain is not imaginary, but rather represents an interaction of neurobiological processes, emotional and behavioral responses, and socio-cultural effects and reactions that become enduring elements in the life and world of the pain patient, and often remain enigmatic for those who provide care.

Taking a comprehensive approach that covers science, humanities, and culture, this volume emphasizes the need for researchers, clinicians, and caregivers to regard the ways in which chronic intractable pain becomes illness and affects a patient’s biological, social, and psychological states, as well as his or her sense of self. Edited by neuroscientist and neuroethicist James Giordano, this book contains 17 insightful chapters representing medicine, neuroscience, psychology, philosophy, ethics, history, art, and the ministry. This exceptional volume also looks at representations of pain in and through the arts, addresses the assignation of values and meaning in pain assessment and treatment, and considers ways to conjoin the sciences and humanities so as to inform the practice of pain medicine and improve the care of those suffering the illness of chronic pain.

Table of Contents

Maldynia: The Illness of Chronic Pain, J. Giordano

A Short History of Pain and Its Treatment, A. Valadas

From Antiquity to the Medieval Age

From Renaissance to Enlightenment

The Nineteenth Century

Pain in the Twentieth Century

Pain Does Not Suffer Misprision: The Presence and Absence that is Pain, J.D. Katz

The Positive and Negative Attributes of Pain

The Phenomenology of Pain

A Humanistic Interpretation of Pain

Understanding Suffering: The Phenomenology and Neurobiology of the Experience of Illness and of Pain, P. Moskovitz

Perceptions, Emotions and the Experience of Suffering

Understanding Consciousness

Senses of Consciousness (after Edelman (22), Zeman (52) and others)

Consciousness as Wakefulness

Consciousness as the Experience of Perceptual Contents

Consciousness as Reportable Experience

Consciousness as Self-awareness

A Theory of Consciousness: How Consciousness and Awareness Happen

The Multiple Dimensions of Perceptual Contents

Modeling Consciousness – Creating a Diagram of the Body-Brain

A Linear Versus an Oscillatory Model of Consciousness

Loss That Evokes Grief and Threat That Evokes Fear

Unrelieved Appetites and Drive States


The Threshold of Suffering

Suffering: Shock, Stasis, and Dissociation

Resilience and Coping

Coping Skills: Connectedness

Coping Skills: Symbolic Representation

Coping Reactions: Disgust, Contempt and Anger

Belief Systems and Spirituality

The Outcomes and Products of Suffering

How (Can) I Feel Your Pain: The Problem of Empathy and Hermeneutics in Pain Care, G. Venuti

Care and Relation: Empathy for Another’s Pain

Empathy, Sympathy, Compassion: All Synonyms?

Spirituality, Suffering and the Self, J. Giordano and N.B. Kohls


Pain, the "Self", and Spirituality

Support from Our Empirical Research

The Nature and Brief Anthropology of Spiritual and Religious Practices

Putative Neural Substrates of Spiritual Experience(s)

Patients’ Spirituality and Its Importance for the Clinical Practice of Medicine

Spirituality and Practical Pain Management


History of the Expression of Pain in Art, S. Karakas

Maldynia as Muse: A Recent Experiment in the Visual Arts and Medical Humanities, N. Carlin and T. Cole

Perceptions of Pain: The Essays

Looking at Pain

A Visual Language for Pain

Unspeakable Pain

Perceptions in Pain: The Art

The Process

Three Photographs: Interpretations

Contextualizing Perceptions of Pain

Conclusions and Recommendations

Padfield’s Call for Psychological Interpretations

Maldynia as Muse

Maldynic Pain in Image and Experience: Engraving Meaning through Subtraction, R. Covey

Musical Representations of Physical Pain, E. Peterson


Pain and Language

Pain and Its Object

Music and Meaning

Music and Timbre

Music and Lyrics: Masochism Tango

Music as Absolute: Pacific 231

Film Music: Psycho

Classical Music: Threnody for the Victims of Hiroshima

Popular Music: Back to Back

Screaming as Music

Conclusion: Pushing Boundaries

Beyond Technology: Narrative in Pain Medicine, L. Galvagni

Narrative and Communication in the Experience of Pain as Illness

Narrative Medical Ethics

A Phenomenology of Pain as Illness




Metaphors and Images in the Experience of Pain as Illness

Psychological Assessment of Maldynic Pain: The Need for a Phenomenological Approach, M. Schatman


The Importance of Phenomenologically Assessing the Chronic Pain Patient

The MMPI: A Tarnished "Gold Standard"

Unidimensional Assessment Tools

Multiscale Multidimensional Assessment Tools

The Strength and Meaning of the Clinical Interview

A "Patient-Centered" Approach to Assessment of Maldynic Pain Patients

Cross-Cultural Sensitivity


Painism- A New Ethics: Richard Ryder’s Moral Theory and Its Limitations, H. Werner-Ingensiep


"Can they suffer?"

Ryder’s Painism: A Middle Way Between the Scylla of Utilitarianism and the Charybdis of Rights Theory?

Is Pain Necessary and/or Sufficient for Moral Status?

Painism and Sentientism

Hurting and Harming

Pain - The Only Evil?

Pain in Non-Human Others: Speciesism– Normative and Descriptive Dimensions

Species, individuals, and Pain

Painism – Some Applications and Questions

Painism and Biotechnology

Painism and Environmental Ethics

Painism and Plants

Painism and Euthanasia

Brain, Pain, PVS and Extreme Cases

Who is the "maximum sufferer"?

Concerning the "Vegetative Language" about Human Beings Beyond Sentience and Pain

Maldynia: Chronic Pain, Complexity and Complementarity, J. Giordano and M.V. Boswell

Introduction: A Complex Problem

Chronic Pain – A Spectrum Disorder?

A Call for Complementarity in Pain Care

Precipitating Change

Navigating the Technologic Trend

Realizing Complementarity in Practice

The Current Condition of Pain Care

Proposing a Future

An Ethical Stance

Conclusion: A Way Forward

A Clinical Ethics of Chronic Pain Management: Basis, Reason and Responsibilities, E. Pellegrino

On Pain, Briefly

The Moral Management of Pain as Illness

The Pain Patient

Ethical Obligations in Clinical Contexts

Children, Pain, and the Creation of Suffering: Toward an Ethic of Lamentation, C. Gomez

Finding the Words: A Patient’s Story

A Framework for Analysis

Chronic Pain and Language

Goal-Directed Health Care and the Chronic Pain Patient: A New Vision of the Healing Encounter, D. Waters and V. Sierpina

Goal-Directed Health Care (G-DHC)

G-DHC: A Background

Health Goals And Life Goals

Changing The Dialogue

A New Vision Of The Healing Encounter

Case 1

Case 2

The Problem of Pain and the Moral Formation of Physicians, F.D. Davis


Pain, Illness, and the Ends of Medicine

The Culture of Medicine and the Moral De-Formation of Physicians

Patients, Pain, and Prospects for Change in the Culture of Medicine

About the Originator


Subject Categories

BISAC Subject Codes/Headings:
HEALTH & FITNESS / Pain Management
MEDICAL / Psychiatry / General
SCIENCE / Life Sciences / Neuroscience