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This book was written specifically as a self-help manual for lay persons. The importance of self-help measures in our present cultural climate cannot be overestimated. Both authors are psychiatrists. Dr. Smollar is also an orthopedist. They specialize in treating some of the most difficult patients with whom we have to contend, namely, those people who are in constant pain and who are desperate.
Drs. Schulman and Smollar present patients who start out in pain from a variety of disorders (i.e., arthritis, herniated discs, etc.) and, because of bad habits or regressive trends, make matters much worse. For instance, a patient with arthritic pain will coddle himself or herself by resting in a bed a lot, and finally, by cutting down his or her work. This pattern aggravates the pain and makes the patient more irritable. Then, he or she withdraws from social engagements, which results in a loss of friends. These strains lead to increased intake of painkilling drugs, which soon lose their efficiency. Side effects multiply. The pain gets worse. The patient is then caught in a vicious circle.
The book stresses the importance of finding a doctor whom the patient trusts; a positive interpersonal relationship reduces helplessness and hopelessness, which gives medications a better chance to work. The acceptance of pain is also extremely important. It avoids denial and magic thinking. There is no way to make these people painless, but there are certainly ways to reduce pain to a minimum. To insist on an absolutely painless life leads to further alienation from the self. Only the dead have no pain at all.