Author: Donald W. Schafer, M.D.
Publisher: Jason Aronson, New Jersey, 1995
Reviewed by: Lawrence E. Hedges
An essential addition to every clinician’s ready reference shelf, Shafer’s clarifying and enlightened Understanding and Relieving Pain boldly asserts, “Once a pain is understood, no one should have to hurt.”
A senior psychiatrist and hypnotherapist now retired in Laguna Beach, California, Donald W. Schafer, packs a lifetime of clinical wisdom and research into an utterly fascinating journey into the interior of the human body to discover the ways that mind influences and is influenced by somatic processes. Most critically for clinicians, this exhaustive compendium of pain syndromes elaborates the physiology of each different kind of pain, the somatic therapies which will and will not help, and the kinds of psychological issues which are likely to be in play. This master-work of clinical knowledge and insight is a giant leap forward from the Franz Alexander approach which lies at the root of most current clinical understandings regarding the interaction of psyche and soma.
Schafer’s approach to Understanding and Relieving Pain is founded on clearly distinguishing acute, acute recurrent, chronic-logical and chronic-career types of pain which arise from
distinctly different kinds of physiological processes and interact very differently with psychological processes. Schafer holds that a clear understanding of the diverse causes and conditions giving rise to and accompanying different kinds of pain is essential for conceptualizing an overall treatment approach which addresses both the physical and psychological needs of the suffering person.
Shafer searches for the multiple sources of human pain within a historical context which reaches back from modern medicine through the Renaissance to the ancient Greeks and even to prehistoric times. But the focus of his study are the syndromes in which pain is the dominating symptom, often with no known medical cause. Schafer declares, “Pain should never be considered generic, but instead should be a pain experienced in a certain place in a certain patient or client, in a certain milieu and caused by a comprehensible situation” (p. xv). “There are reasons for pain and pain patients are treatable, more so if they have some understanding of their condition” (p.5).
Schafer’s direct and lucid discussion of hypnosis as an altered state which can aid healing seeks to remove the aura of mysticism which often enshrouds hypnosis in the popular mind. He presents hypnosis and self hypnosis not only as ways of understanding psyche but as tools for controlling pain. His emphasis is the suffering aspect of pain—the way the mind interprets neurological and emotional information. Schafer sees modern hypnosis as permissive in that it does not suggest that the hypnotherapist dominate the patient or that the patient should be required to give up any pain that he or she needs to
hold onto for any reason. “With the help of a hypnotherapist, any motivated patient should be able to control pain” (p.219). “No one should have to have pain. However, both physical and psychological understanding of the patient is necessary to alleviate any specific pain” (p. 227). Schafer includes two lengthy and substantively rich appendices regarding the five stages of hypnosis, the many factors which influence the use of hypnosis, and specific induction and hypnotherapy treatment techniques to be used for the alleviation of pain.
Running throughout this rich treasure trove of clinical wisdom and research is Schafer’s unique and original contribution—his understanding that pain often arises in the service of memory. A lifelong student of pain and the dissociative disorders, Dr. Schafer points to the ways in which a resurgence of pain in adulthood (even though caused by accident or disease) may be serving the purposes of recalling and dealing with childhood traumas which could not be dealt with at the time.
Straightforward enough for the lay reader, fascinating enough to arrest the interest of medical and mental health professionals, and complex enough to engage even the most advanced practitioners of psychotherapy and hypnosis, Donald Schafer’s Understanding and Relieving Pain is destined to have an honored place in our clinical literature for a long time to come.