Table 1.

Family Dynamics Interacting with Pain and Functioning

Family Dynamic	Description
Overprotection	Belief that restricting patient from activity is needed for improvement in symptoms.
Misguided support	Parental behaviors that either lower expectations or apply excessive pressure for rapid change and improvement in function.
Dysfunctional Communication Patterns	Poor conflict resolution, difficulty communicating affect and avoidance of discussing emotionally charged issues.
Externalized Attributions	Patient and family attribute both illness and recovery solely to factors outside themselves and often beyond their control.
Dependence	Loss of self-confidence due to family members increasingly taking over patient responsibilities and providing assistance that may not necessarily be needed.
Social Isolation and Avoidance	Patient becomes anxious and avoidant of normal peer situations.