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Women With Fibromyalgia: Distress Avoidance Interferes with Gaps in Pain

Artikel i vetenskaplig tidskrift
Författare Kerstin Wentz
Publicerad i Journal of Pain Management
Volym 5
Nummer/häfte 3
Sidor 245-259
ISSN 1939-5914
Publiceringsår 2012
Publicerad vid Psykologiska institutionen
Sidor 245-259
Språk en
Ämnesord Fibromyalgia dissociation crisis acceptance rehabilitation aetiology
Ämneskategorier Tillämpad psykologi, Psykologi, Klinisk medicin


The aetiology and the mechanisms involved in fibromyalgia pain are insufficiently understood. Pain intensity varies with stress. The pain itself is continuous during waking hours for the majority affected. For one in three the pain is interrupted by breaks. The lengths of these pain-gaps vary substantially. Aim: The study aim was to explore initiation, maintenance and termination of these breaks. Method: Twenty-four women with fibromyalgia pain-gaps were interviewed in depth. The interviews were analysed inductively using Grounded Theory. Result: A dominating quality of dissociation keeping distress out of sight meant that psychological vulnerability was dealt with through habitual use of avoidance including incoherence, overemphasis on positive affect and an over-active/health jeopardizing approach. A state of permanent crisis and not accepting fibromyalgia was identified. The disease was unmapped and unmanaged. Unplanned gaps in pain ‘happened’ during happiness/absence from stress, physical conditions of warmth or paced exercise or absorption during joyous events. The pain-gaps were lost during reversed conditions as intense activity or emotional stress. A subgroup of informants had ceased to dissociate. The disease became recognized/managed. Pain-gaps were planned, promoted, preserved and lengthened. Discussion: Careful crisis intervention in treatment of fibromyalgia seems to be an important measure. Automatic forms of dissociation could thereby pass. Regarding aetiology and mechanism in fibromyalgia pain the effect of efforts at dissociating unwanted mental content needs to be investigated further. Suppression and recoil relapse that creates permanent suppression and relapse engendering chronic stress might exert an explanatory power regarding both the development and maintenance of fibromyalgia. Keywords: Fibromyalgia dissociation crisis acceptance rehabilitation aetiology

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