In some cases of chronic pain, the complaints seem out of proportion to pathophysiological findings. Several models of pain have been forwarded to account for such cases, but no one explanation can account for the underlying processes involved in the genesis of chronic pain in all cases. The present analysis offers the additional factor of self—deception, defined as a contradiction between one's words or attitude and behavior. By attempting to demonstrate subjective pain to observers, a pain

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... ient convinces him- or herself of the displayed painfulness through a process of self—deception. Several psychological phenomena are included in the model of self—deception, including coping strategies, cognitive dissonance, self-perception, impression management, and attentional and memory biases. To explore the self—deception model of chronic pain, a laboratory analogue study was devised using female student volunteers who rated the painfulness of shock—induced stimuli under conditions designed to foster self—deception. Painfulness was measured 1) verbally by means of two visual analogue scales which reflected the pain intensity and affective unpleasantness and 2) nonverbally by means of quantified facial muscle movements. For each subject, individual pain threshold and tolerance levels were established. She then underwent a pretest comprising five random shocks from her threshold to tolerance range. Next, in the manipulation phase the subject was asked to display more, less or the same degree of pain while undergoing another random series of shocks. A final posttest was identical to the pretest and provided a measure of the durability of the altered pain display effect. In the first of two studies, the altered pain display was nonverbal: subjects exaggerated, diminished or did not change their facial expressiveness while undergoing the pain stimuli. In the second study, the altered pain display was verbal: subjects were told that at the end of the series they would be required to tell a fe [...]