| Summary: | This dissertation explores the conscious and unconscious experience of chronic pain. The study undertaken by Vrancken (1989) is used as a basis for discussion upon the medical approach to chronic pain and five different schools of thought into which the many approaches and models for chronic pain can be placed are reviewed. Documented research shows that chronic pain has significant psychological and emotional impact upon the patient, the effect of which disrupts the patient's cognitive state and conscious functioning. However literature documenting the patient's experience of chronic pain is a poorly researched and neglected area. It is asserted that the experience of chronic pain and an unconscious perception of chronic pain might add further insight into the complex subject of chronic pain. The communicative approach to psychotherapy claims a framework and methodology whereby unconscious mental functioning can be accessed and the work of Robert Langs and the theory and methodology of the communicative approach is detailed. The psychotherapy sessions of a patient suffering with chronic pain are used to test this claim and gain insight into the unconscious perception of chronic pain. The session material is examined in detail according to the communicative framework and all observations confined entirely to communicative principles. Conclusions are drawn which show that communicative adaptive listening, and trigger decoding in the light of therapist interventions and frame related issues offers insight into the unconscious perception of pain and is an area worthy of further research. These findings suggest that communicative psychotherapy may have a role in gaining greater insight into the unconscious perception of chronic pain but further evaluation of this approach is clearly necessary, involving larger numbers of patients, before a more definitive conclusion can be reached. Although this is a very small particular study, there is a broader implication concerning the role that death anxiety plays in psychotherapy in general and in particular in the role that death anxiety plays in working therapeutically with patients who suffer from chronic pain. These areas are worthy of further research.
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