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November 10, 1969, Vol 210, No. 6 >

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ARTICLE | November 10, 1969

Anxiety and Pain

Augustus S. Rose, MD
JAMA. 1969;210(6):1103. doi:10.1001/jama.1969.03160320085030.
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ABSTRACT

To the Editor:—  The signed editorial, "Anxiety and Pain" (209:1080, 1969), by H. K. Beecher, MD, invites comment. The statement is succinct, clear, and strongly supportive of the well-established relationship between anxiety and fear and the behavioral reaction to pain. However, I am distressed by the rather offhand use of the term "hysteria" in connection with patients who react excessively to a painful injury. Furthermore, the vivid illustration of a soldier injured in battle who was quieted by a moderate dose of barbiturate, although not presented as a recommendation for management, could be misinterpreted. A clinical case of that nature and the word hysteria used in discussion might imply to some that such patients may not actually be experiencing severe pain. It seems to me that this is inexact and possibly an unjust implication.The assessment of pain severity in a patient is always difficult. In common practice the

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