Conceptions of the pain experience: The emergence of multidimensional models and their implications for contemporary clinical practice

The present article selectively overviews the history of the pain concept in the West, from Greek naturalism to the contemporary interactionist position represented, most notably, by the "gate-control" model. Dualistic thinking is shown to have a powerful hold over both lay and scientific conceptions; and, although the reduction of pain to a pure sensory experience no longer serves as the predominant neurologic or psychologic guiding principle, neither medical nor psychological interventions have yet fully reconnected what Descartes so skillfully split in the seventeenth century. The technological advances of physiology and biochemistry and the all-or-none concepts of "cure" and "disease" have hampered the acknowledgment of the cognitive, emotional, and contextual components of pain. Similarly, the absence of a uniform field methodology for assessing the psychological components of acute and chronic pain sets further limits on the potential for a genuine integration of the perspectives of mind and body.