A: Personality types are very important. Certain personalities, like the so-called achievers, find it very hard to adjust their expectations. They have this picture in their heads of what it takes for them to be loved or admired. But if [the doctor has] some sense of what their sense of loss is, then you have a chance of reaching them.
The bottom line is, either they adjust their expectations and gain some peace of mind, and have positive things in their lives, or else they go around forever being angry, frustrated, and miserable. As we get old, of course, we all adjust our expectations. So it's a part of life to adjust—but you have to do it earlier and more severely.
Q: How easy is it to find a physician who will take the time to discuss coping strategies?
A: There aren't nearly enough pain physicians in the country who take the time to counsel patients. A doctor can hardly make a living doing that. So patients may have to turn to counselors who specialize in pain. But in general any variety of cognitive-behavioral therapist can help. They will talk about the consequence of your feelings, your thoughts, your actions.
Q: Because there are no actual tests for things like fibromyalgia or even migraines, do you find that pain patients are discriminated against?
A: Yes, and to add to the problem, most fibromyalgia and migraine patients are women. There's no question that there is sexism and racism in the issue of chronic pain. Research shows that women and people of other races get pain treatment in significantly smaller proportions in emergency medicine—but I have a feeling that's true in general.
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