Chronischer Schmerz als existenzielle Herausforderung

[Spiritual interventions in multimodal pain management]

If we understand chronic pain not only as a disease but also as an existential crisis, it seems logical and reasonable to consider spiritual aspects in the treatment process. Spirituality is understood as an umbrella term for all activities and experiences that give meaning and significance to people's lives-irrespective of their religious affiliation. So far, spiritual aspects have been considered therapeutically mainly in the palliative context. According to current survey-based studies of pain patients, the inclusion of spiritual themes in therapy leads to an improvement in quality of life and pain tolerance and is moreover explicitly desired by those patients. A consistent expansion of multimodal treatment approaches in the sense of a biopsychosocial-spiritual concept has not yet been implemented. The following basic attitudes and behaviors are relevant for practical implementation: openness to spiritual themes and authenticity, taking a spiritual history, listening, standing firm, activation of values, use of motives from religion, mythology, and art. Professional competence generally involves all practitioners, but may also require qualified professionals for specialized assistance. The integration of authentic spiritual assistance into multimodal pain management should help to stabilize self-esteem and the experience of identity of the patients through resource activation and identification of burdensome spiritual beliefs. The detailed integration and investigation of the efficiency of spiritual interventions in multimodal pain therapy require further research.