Loss and grief are an inherent part of chronic illness. But while much has been written on grief associated with death and dying, the grief and losses accompanying chronic illness have received relatively little scholarly attention. In Chronic Pain, Loss, and Suffering, Ranjan Roy, a leading expert on chronic pain, addresses the complex issues related to loss among those with chronic illness.

For many patients with chronic intractable pain disorders, the course of their illness is unpredictable and varied. Many seeming losses are transient and can be redeemed over time, for instance, through retraining and physical therapy, but are still serious and pose a challenge to the common understanding of the grief process. Clinical understanding of grief is undergoing a revolution. From its Freudian roots, it is shifting more and more to a social-psychological perspective. The phase-task orientation of grief has come under serious scrutiny, and this book demonstrates some of the problems inherent in that conceptualization in its application to the chronically ill. The author attempts to combine the current state of knowledge through an examination of contemporary literature and clinical application. He presents a series of comprehensive case studies, which together indicate that the key challenge for many patients is loss of self-esteem and control. The chapters deal with a range of losses such as job loss, declining ability to function, loss of family and sexual roles, old age and its related losses, and suicide. Through discussion of the trials and tribulations and successes that chronically ill patients encounter in their journey, this work will assist clinicians in helping patients come to terms with their new reality and establish a renewed sense of self.

RANJAN ROY is a Professor in the Faculty of Social Work and the Department of Clinical Health Psychology, University of Manitoba. He is also Consultant (Scientific) in the Department of Anaesthesiology, St Boniface Hospital, Winnipeg.

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