Patient Communication of Chronic Pain in the Complementary and Alternative Medicine Therapeutic Relationship

J Patient Exp. 2020 Apr;7(2):238-244. doi: 10.1177/2374373519826137. Epub 2019 Mar 11.

Abstract

Background: Patient descriptions of pain shape the pain experience, yet there is insufficient understanding of how patient communication can help providers lessen pain's psychological and physical impact.

Objective: To examine how individuals communicate their pain experience in the complementary and alternative medicine (CAM) provider-patient relationship.

Method: Qualitative thematic framing examining semistructured interviews of a purposive and snowball sample of CAM patients (N = 13; 850 double-spaced pages) recruited from the mid-Atlantic region of the United States.

Results: Complementary and alternative medicine patients communicate the pain experience through an awareness of their interdependence with: (a) relational spaces as attention to the self, the healing practices, and the provider; (b) physical spaces as openness to surroundings and the spatiality and temporality of self; and (c) physiological spaces as breathing and neurological and immune system functioning.

Conclusion: A therapeutic relationship cultivating interdependence through awareness of relational, physical, and physiological spaces supports patients' ability to open up to, know, and accept their body. The CAM provider's work connects their practice with patient awareness of control over their environment, relationships, and physiology to redefine their pain experience.

Keywords: alternative medicine; chronic pain; interdependence; pain management; patient-centered care; patient–provider communication; therapeutic relationship.