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Whereas a considerable body of literature exists on the neurophysiological, clinical and therapeutic aspects of chronic pain, it is only recently that there have been specific analyses
of Chronic Pain Syndrome (CPS) itself. Eliane Ferragut has put together contributions from a number of authors in a multidisciplinary and multidimensional approach to the different psychological aspects most frequently observed in patients suffering from chronic pain and to the underlying problem complexes.
On the basis of the established findings of psychoanalysis and with a didactic intention, the authors range over the extensive field of pain science, from mere identification of the ‘symptom of suffering’ in different situations and at different ages, to the role and meaning of pain in the more strictly psychoanalytic sense. The field of CPS is defined by Ferragut in her paper ‘Clinical aspects and psychological treatment of patients suffering from chronic pain’, which distinguishes cases of CPS with a predominantly organic component from those where the psychic element is in the forefront. Using the concept of the ‘envelope of suffering’, which performs a protective function for the subject, she advocates a kind of therapy involving a unity of time, place and team with a view to avoiding the body/mind dichotomy, providing narcissistic restoration and recathexis of the body, and allowing verbal elaboration of suffering and anxiety.
Lorin's paper is entitled ‘Evaluation of the pain dimension and of chemotherapeutic treatment’. Dufour analyses the disturbances of body scheme and body image following surgery or accident. Identifying all the concomitant psychogenic upheavals, he stresses the need for an appropriate relationship between the patient and his doctors and surgeons, to allow the former's complaint to be heard as a privileged means of relationship. For pain is a way of asserting a ‘claim’, the medico-legal aspects of which