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J Pain. 2019 Feb 26. pii: S1526-5900(18)31021-6. doi: 10.1016/j.jpain.2019.02.013. [Epub ahead of print]

How an understanding of our ability to adhere to verbal rules can increase insight into (mal)adaptive functioning in chronic pain.

Author information

1
Ghent University, Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, BELGIUM. Electronic address: Mebeeckm.Beeckman@UGent.be.
2
Ghent University, Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, BELGIUM.
3
Stanford University School of Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Palo Alto, CA, USA.

Abstract

Research on chronic pain has traditionally focused on how direct pain experiences lead to maladaptive thoughts, feelings, and actions which set the stage for, and maintain, pain-related disability. Yet the capacity for language (and more specifically verbal instructions or rules) to put people into indirect contact with pain has never been systematically investigated. In this paper we introduce a novel theoretical perspective on verbal processes and discuss how the study of verbal rules may increase our understanding of both maladaptive and adaptive functioning in chronic pain. Several useful characteristics of verbal rules and rule-following in the context of chronic pain are outlined. Future research directions and implications for clinical practice are then discussed. Perspective: This focus article argues that by studying verbal rules and rule-following we will gain a better understanding of (mal)adaptive functioning in the context of chronic pain. Future research directions are outlined and suggestions for improving clinical practice are considered.

KEYWORDS:

Chronic pain; adaptive functioning; indirect learning; maladaptive functioning; rule-following; verbal rules

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