Access Type

Open Access Dissertation

Date of Award

January 2012

Degree Type

Dissertation

Degree Name

Ph.D.

Department

Anthropology

First Advisor

Sherylyn Briller

Abstract

Although chronic pain has been increasingly recognized as a critical health issue in the U.S., solely biomedical approaches to pain management are often less effective than comprehensive ones in addressing this condition (Crowley-Matoka, et al. 2009; Good 1994; Greenhalgh 2001; Institute of Medicine 2011; Kleinman 1988; National Center for Health Statistics-Centers for Disease Control and Prevention 2006). This ethnographic study describes in-depth how a Detroit metropolitan area multidisciplinary pain clinic specifically applies an integrative medicine (IM) approach to the treatment and management of chronic pain. The aims of this study included: 1) identifying the history of this IM clinic and the development of their treatment approach, 2) describing the roles of the clinic's practitioners and staff, 3) documenting patients' experiences with integrative medicine and pain treatment through the collection of narratives and 4) recording the co-created integrative medicine clinical encounter and examining how pain treatment approaches are enacted and perceived. This study took place between August 2008-August 2009, and utilized ethnographic methods that included participant-observation of the daily workings of the clinic, direct observation of the co-created clinical encounters (N=40), and formal interviews with clinic staff (N=8) and patients (N=11). Findings describe a three part process that comprises the clinic's "treating the whole person" approach: 1) identifying the cause of the patient's pain, 2) developing the patient's integrative treatment plan, and 3) customizing this treatment plan to meet the patient's life circumstances. A series of eight narratives describe how the clinic's patients engaged with their approach. These narratives reveal how the real work of healing at this clinic resides not in the integration of treatment modalities, but in the social relationships that develop between practitioners and patients. While variability exists as to whether patients chose to embrace the clinic's approach either fully or in part, the patients concur that the clinic's approach appears to at least be doing something for their pain. By working with patients' current life circumstances, the clinic provides some hope that while patients' futures may not be completely pain-free, they can at least start working towards restoring some semblance of order to their lives.

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