Practitioners today are confronted with an avalanche of difficult to treat patients with chronic pain for 2 reasons: (1) The culture increasingly encourages patients to conceive vague and nonspecific symptoms as evidence of real disease and to seek specialist help for them; and (2) the rising ascendancy of the media and the breakdown of the family encourage patients to acquire the fixed belief that they have a given illness, often a trendy nondisease such as repetition strain injury or chronic fatigue syndrome. In historic terms, many of these complaints, especially sensory ones featuring chronic pain and chronic fatigue, are relatively new. Patients tend to adopt them on the basis of what the culture considers to be legitimate illness, whereby different patterns exist for men and women.