Abstract
In this paper, we investigated the relationship between changes in the family system and our health from the standpoint of family therapy for chronic pain which we often conducted in our hospital. Chronic pain has in particular the characteristics as a way of communication between patients and their families or circumstances. Thus it can be a good model by which to investigate not only the psychosomatic correlation but also the relation between upper and lower systems. In the Department of Psychosomatic Medicine, Kyushu University, a chronic pain patient is defined on the basis of our clinical experiences and reviews of associated literature as "a patient whose pain complaint or occupational impairment is in excess of what would be expected from the underlying organic pathology." Treatment of chronic pain patients has made remarkable progress by means of our psychosomatic approach in addition to medication such as anti-depressant, nerve block and rehabilitation, etc. However, even now there are many patients who are difficult to treat. We have tried to treat such cases by understanding their symptoms in relation to uppr systems. In the systems approach, symptoms are the result and cause of the distortion of human relationships among family members. The system theory cannot suppose the ideal healthy family relationship. The index of our health is the nexibility by which we adapt to the changes of family development such as marriage and birth, growth and independence of sons and daughters, aging and death of family members. Therefore, the family system becomes rigid when family members cannot adjust to the current social system in the course of familial life cycle. Psychosomatic symptoms can be one of the driving forces to regain the flexibility of the system. In recent years, the reduction of family size and privatization are progressing due to the development of industry and the decrease in birth rate. In Japan the father-oriented family system supported by the traditional social standard has been transformed into the mother-oriented family system that has been covered by it. ln this paper, we presented case reports of a young patient and an old one with chronic pain. In both cases, the role of the hospital seems to provide a buffer for the families to adjust to the new social system. In the current of familial transformation. the function of the hospital which supports the nuclear family and family members can be very important. We have to take such social back ground into consideration to treat psychosomatic patients.
