Play Therapy to Control Pain and Suffering in Pediatric Oncology

“Pain can be defined as an unpleasant sensation and an emotional experience endowed of a negative affective tone, associated with a potential or real tissue damage and, anyway, described in relation to this damage” (1). In other words, pain is perceived as such by each individual. Whatever its origin, it provides defense mechanisms and protective reactions, which modify the psychological trauma risk management (TRiM): mood alteration, anxiety, depression, fear, and rage, as well as the somatic TRiM: antalgic posture, facial expression alteration, activation of the autonomous nervous system, tachycardia, nausea, vomiting, and sweating (2). For these reasons, “total pain” is now recognized as a complex of physical and emotional suffering (fear, anxiety, depression, and rage), linked to cultural, spiritual, and social factors. In pediatric patients, pain frequently occurs during diagnostic and therapeutic procedures. All children have an irrational fear of these maneuvers, particularly punctures, which are experienced as a physical intrusion in the body, through the barrier of the skin. Anxiety and tension worsen the pain, amplifying the perception, and voiding their psychophysical resources. Distraction and cognitive behavioral techniques aim to reduce these correlated factors, “shifting” the cognitive and emotional attention onto something else, and controlling muscular contraction, nausea, vomiting, and migraines (3). Analytically oriented individual and group psychotherapy is a non-pharmacological technique used for controlling the perception of pain and for communicating the most intimate feelings related to dramatic illness events (4).