Neuroanatomical and Affective Responsiveness to Unethical Counseling without Empathy in Pain Patients

This study has been designed to reveal alterations in both the neurological as well as emotional states of patients dealing with long lasting pain, while being exposed to one on one psychological talks that included emotional comforting. The study was performed during a 3-month period at Square Hospital Ltd., Dhaka included 100 patients, among whom the procedures of pain management were observed. Only clinical observation was made, while no interviews were performed, and a qualitative study design was adopted in data collection. Observational measures focused on emotional expressions, changes in behavior during and after counseling, and on a number of bodily responses associated with neurological control of stress. Patients who simply had advice without empathy conveyed with emotional support demonstrated marked psychological distress and withdrawal behavior. Such patients frequently had more irritability, were passively resistant when questioned on treatment and denied their illness. Moreover, repeated patterns indicated increased neurological sensitivity, that is, the patients became more susceptible to intensity despite negative references and feedback on treatment given. The lack of emotional reassurance seemed to increase their overall stress reactivity and exacerbated pain and emotion processing. These results highlight the need for a greater integration of emotionally responsive communication within pain counseling interventions. It also implies a possible association between emotional neglect that occurs during the medical examination and unfavorable neurological consequences in chronic pain patients.