LIFE Before Death #37: Total Pain & Mental Health

2012 February 10
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Host a Screening!

Short Film 37 of 50 in the LIFE Before Death documentary series about the global crisis in untreated pain and the dramatic life changing affect palliative care services can deliver to patients and their families around the world.

In “Total Pain & Mental Health” we discover that the way patients experiences pain is not simply about their physical symptoms but also about their emotional state.

“There’s a very complex interaction between the psyche and emotions and physical pain,” explains Dr Natalya Dinat (South Africa). “If we’re able to understand that we’re able to treat the physical pain in a much more effective way.”

“Obviously if you’ve still got tissue damage after an operation or trauma you’re going to have some pain,” continues Professor Michael Cousins (Australia). “But the pain won’t only be due to the tissue damage.”

“Severe pain can be very detrimental to someone’s emotional state,” explains Dr Scott Irwin (USA). “It can cause them to be sad, it can cause them not to want to interact with their life in normal ways, it can even cause clinical depression. And once they become clinically depressed it makes their physical pain harder to treat.”

“Depression, before my diagnosis, was a condition that I really thought was only for people who had no control of their life, were not optimistic, allowed themselves to be victims, chronic patient mentality, belonged in a padded room. That was really my perception of someone that was depressed,” confesses cancer Patient Don (USA).

“Don is actually a good example of what we call ‘total pain’,” explains Dr Jay Thomas (USA). “Where we believe that something’s wrong with the body that causing the pain, but in addition to that he also has other aspects… things going on psychologically for him.”

“Pain was there and was manageable but it was really the depression that needed the most treatment initially,” continues Don.

“I think a psychologist in palliative care is essential,” states Dr Johanne de Montigny (Canada). “Patients are anxious, depressed, demoralized.”

“I would argue that no matter how skilled a single physician is it actually takes a team to optimally treat patients with this kind of complex total pain,” agrees Dr Thomas.

“Once I was diagnosed I had a whole different appreciation for the struggle that depression brings,” contemplates Don.

“Emotional issues are very prevalent with people in pain, especially chronic pain,” explains Dr Irwin. “Taking a multi-disciplinary interventional approach both pharmacologically and non- pharmacologically is really important for the best treatment of these patients.”

Featuring: Dr Natalya Dinat (South Africa), Professor Michael Cousins (Australia), Dr Kathleen Foley (USA), Dr Scott Irwin (USA), Dr Jay Thomas (USA), Dr Johanne de Montigny (Canada), Don (USA).

Baltimore’s Dr Paul Christo is featuring LIFE Before Death on his radio show, Aches & Gains.

  • Listen to his first podcast: Will We Die in Pain? (Part 1) here…
    Mike Hill, the director, writer, and producer joins us to share his vision for the film. Then Dr. Kathleen Foley, cancer pain & palliative care specialist, and featured expert in the documentary discusses solutions to this problem of universal dimensions.
  • Part 2 will be broadcast on Sat Feb 11 at 8pm EST (GMT-5) – listen live here or to the podcasts at anytime here
    Mike Hill shares some powerful, behind the scenes moments that he experienced while filming this compelling documentary. Dr. Kathleen Foley then gives us the hope we need to ease our fear of dying a painful death.

If you’ve missed previous episodes, catch up on the LIFE Before Death website…


The LIFE Before Death feature film was premiered on 1 February 2012 in Singapore. Pallium India will be screening the film on February 3 in Trivandrum.

Why not organise a screening in your community? GET MORE INFORMATION HERE…

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