3.9. Pain = pieces of hurt

The Pieces of Hurt Pain Tool asks subjects 5 years old and up to, "stack pieces of hurt," to indicate their level of pain.
The logic behind using gambling paraphernalia with pediatric patients is beyond the scope of this discussion, but the the idea of turning pain into something as concrete and mundane as plastic chips, and stacking them to show the additive nature of "hurt," is nothing short of poetry. It also serves as a reminder that while pain cannot be seen, whatever the patient feels is real, and the causes of pain may not always be visible or physical.

Somatic pain arises from deep body structures such as muscles and bone. Visceral pain involves sensations that arise from internal organs. There's also neuropathic pain involving damage to nerves. Most interesting, however, is psychosomatic pain.

Contrary to popular misconception, psychosomatic does not mean something is not real. It means the cause of an issue or pain arises from psychological factors such as stress, emotions, or repression of trauma. Pain, asthma, irritable bowel syndrome, fibromyalgia, migraines, and allergies can all be affected by psychological factors, which in turn affect hormones and neurotransmitters, which then cause chemical and physiological changes that lead to very real, physical, manifestations.  Every human body system from respiratory to gastrointestinal can be affected. Additionally, patterns of emotional repression leading to physical symptoms occur more in perfectionist personality types.

In some subjects, pain serves as a distractor to protect a patient from past emotional trauma. There's only so much the human psyche can handle, and so much hurt in the world.

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