Television report of the scientific magazine nano with an interview of the pain expert Prof. Dr. med. dent. Türp (minute 22:30).
Recent study results
The study by Prof. Dr. med. dent. Jens Christoph Türp and Dr. med. Carolin Luise Bohn from the University Center for Dental Medicine Basel and the University Medical Center Freiburg confirms that by including Dolography in the usual anamnesis, it is possible to talk about non-verbal aspects of the pain experience, thus adding diagnostic value: […] either by concretising previously reported pain descriptions in the pain anamnesis or by adding new aspects and therefore further differentiate the painful complaints. The results of the study show that different pain characteristics and levels can be expressed with the help of different cards.
The authors describe: “Patients with chronic pain are often confronted with a lack of recognition of their clinical picture, sometimes even on the part of the medical profession. Therefore, acceptance and appreciation of these patients are an important key for successful communication. Such an attitude can be promoted by giving patients the opportunity to describe their pain in detail while listening attentively. Image-based history taking can support this communication process. The extra time of a few minutes required is negligible in this context.”
The authors also state that “[…] pain-related picture cards can be helpful for differentiating different orofacial pain, especially between nociceptive […] and neuropathic pain”.
As a conclusion is listed: “The dolographic method is suitable as a communication aid to support pain description. It can serve as another component for a successful doctor-patient relationship.”
The abstract in english is listed on Pubmed.
Expert opinions
Professionals who use Dolography describe the following benefits (mostly translated from german):
“Dolography helps me a great deal in diagnostics. By means of the description of the chosen pictures clinically relevant issues can be found — which otherwise would have stayed unknown — concretized or even expressed for the first time.”
Prof. Dr. med. dent. Jens Christoph Türp, University Center for Dental Medicine Basel
Example of a case report, Dr. med. dent. Türp
“The picture cards are a great help in establishing dialogue with the patients. They have, often for the first time, the feeling that they are able to clearly explain their pain. The descriptions are more detailed and fulsome than without the Dolography cards.”
Heike-Christine Strohmeyer-Kirsch, pain nurse, Klinikum Dortmund
“Using Dolography, it is possible to gain information about subjective pain perception that is not possible with conventional imaging techniques. Pain anamnesis is thereby extended by a fascinating dimension.”
Dr. med. Niklaus Egloff, Head of the Psychosomatic Competence Center, University Hospital Bern
“The images of Dolography elude semantic distinctiveness, as do pain sensations, thereby inviting the user to specify their verbal descriptions. The balance between clarity and ambiguity in the images provides a screen for the patients to project their associations.”
Dr. med. Katharina Haas, medical specialist for psychiatry and psychotherapy
“As a psychology lecturer, I use the Dolography cards in the communication module as a possible tool when patients reach their language limits, do not understand German or when there are other communication problems. I also show the film clip in which a nurse says that there are patients who cry when they can understand how their pain feels for the first time. I also address this in the context of appreciation, which is indispensable for successful communication.”
Prof. Maya Hofer, lecturer in psychology at SUPSI Landquart
“With this method, subjective feelings that are difficult to express can be expressed in a different way. In our experience, the emotional part of the pain becomes clearer as a result and patients feel very understood when they can see ‘their pain’.”
Martin von Wachter, Senior Consultant at Ostalbklinikum Aalen and Bernd Kappis, Psychotherapist, Department of Anaesthesiology, University Medical Center Mainz in: Therapie-Tools Schmerzstörungen (2019) [Therapy Tools for Pain Disorders]
“A new and highly effective tool that we use to better understand children with pain.”
Video clip about Dolography (in spanish) by Tania García, anesthesiologist at Dolorinfantil, Spain.
“A CRPS [Complex Regional Pain Syndrome] patient who had a lot of trouble understanding and accepting his diagnosis and refused any psychotherapeutic measures or interdisciplinary rehabilitation programmes spent an entire therapy session with Dolography. I was very surprised and pleased by that.”
Franziska Salzmann, Physiotherapist BSc, Physiozentrum Luzern
“I use the Dolography cards in training sessions for nursing staff of all levels and I am thrilled:
In the first exercise, we sensitise the participants to the fact that it is about active listening and that no self-interpretation should take place: First, teams of two are formed. Person A chooses a card and describes it without showing it. Person B can ask if anything is unclear. As soon as person B is sure what the card looks like, they can look at the picture.
In the second exercise, we make the participants aware of how multifaceted the experience of pain can be. In addition, many insights are gained into how pain can be described: Person B, based on a personal experience of pain, chooses a dolographic picture, puts it face up and explains the pain with the help of this card. Person A does the assessment questions to get any further information.”
Tamara Gwerder, dipl. nurse FH, Nursing Education Unit, Obwalden
I use Dolography with children and young people to transform the idea “pain is always the same no matter what I do” into: “the pain changes and I can influence that”. It is also fascinating to see that pain can show itself in beautiful colours and surprising patterns. I have then used the latter, for example, in breathing exercises or stretching exercises hold-relax and let the pain transform into colours and flow out of the toes or fingers. The transformation of the unpleasant sensation of pain into curiosity, exploratory joy has led to a conscious reduction of pain and a refined body perception. The cards are a creative tool to express something that cannot be put into words.
Eliane Schneider, physiotherapist
“I have been using the valuable cards for almost four years. Together with the patients, I create a visible actual pain state or pain process and a counter-image with colours and shapes, which can later be used as a resource for self-efficacy. Again and again, the patients succeed in mobilising their own self-healing powers to get out of this pain spiral. The conscious findings in dealing with pain can thus be better understood and internalised. […] What is very important, the patients finally feel noticed, which from their experiences and stories is otherwise rather not the case.”
Denise Fausch, art therapist specialising in design and painting therapy, psychosomatics and psychiatry, Braunwald rehabilitation clinic
“Firstly, the patients [with the help of Dolography] perceive the pain better – where exactly it ‘sits’ and how it feels. Secondly, they have the impression that they are taken seriously by the other person.”
Corinne Braunschweig, Specialist and Emergency Psychologist FSP/NNPN
“I would not have thought that the illustrations would be so accurate: When a person is old and has little speech left and is shown the picture of their pain, it is so accurate that their eyes light up and they feel totally understood and say: ‘Exactly, that’s the pain I have!’
At the first moment – that’s how I experienced it – it’s a lot of cards. But in the second moment, when the client’s perception is deepened by looking closely, I have observed how important the choice is, because the client can control his perception with a good choice. By ‘steering’ I mean – and this was really interesting to observe – that the client himself starts to form groups of pictures and to make a selection.”
Verena Lenz, speech therapist ISP (EDK)
“The Dolography cards help with the questioning about the state of mind – with patients who cannot feel themselves or cannot express how they feel. Especially with psychosomatic pain patients, I notice that they can report and think about their pain in a more differentiated way with the help of the Dolography. […] Furthermore, they describe that by making the pain ‘visible’, the other person can now better empathise with the pain. The cards also support the understanding and relationship building between patient and therapist. However, I find the cards less helpful for patients who speak a foreign language. They are best suited for patients who have a certain cognitive performance and reflective ability.”
Valeria Spälty, sports and movement therapist, Psychiatric Services Aargau AG
“I have used the cards mainly with adolescents. With patients suffering from sickle cell anaemia and a teenager with a brain tumour. With all of them it was impressive how ‘precisely’ they could choose the cards for their pain. In the therapeutic context, we transformed the pictures by making a copy of the picture and asking the young people to change the pain by collaging, cutting or adding to the picture.”
Isabel Witschi Eberle, psychologist FH/music psychotherapist SFMT
“Patients can target something concretely [with the help of Dolography]. Because it’s a matter of learning how to control the pain.”
Barbara Meyer, certified nurse HF and adult educator
“So far, the method can be used well with people with chronic pain. Through the photos, our nursing pain experts are able to talk to people about their pain very well if they are primarily unable to give a good description on their own. We do not use the cards to get in touch with people who can describe their pain well.
For people who can’t express themselves (not speaking German or other language problems), the method is not well suited with us – because the people can’t express themselves in more detail on the subject and you can’t get into further conversation with them.”
Heike-Christine Strohmeyer-Kirsch, nursing pain expert, Dortmund Hospital
“Using the resources of visual communication, a completely novel kind of tool for the diagnosis and therapy of pain has been created. The specially developed images make an abstract statement, but still function as an altogether useful vehicle for patients suffering from pain, making it possible for them to convey what they are going through. The way in which the method was developed and tried out in cooperation with doctors is admirable. The idea of ‹pain pictures› is a surprising one. In our day above all, where the treatment of pain is a matter of ever-increasing medical importance, there can be no doubt at all of its relevance. It would be highly desirable if this project could be further developed and elaborated.”
Jury, Swiss Design Award (2013)
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You can find more experts’ opinions in the german version.
Reviews by patients
“During my ‘career as a patient’, therapists asked me very often about pain quantity (on the famous scale from 1 to 10). […] Without doubt: your image card set would definitely be helpful! Looking at your images makes me feel at ease, it makes me feel as if I could be understood and I could say: ‘Yes, this is exactly how I feel like.’ ” M. G.*
“I had difficulties classifying my pain sensations for years. I even doubted that these experiences were real rather than illusions. If I can see the pain visually in front of me, it becomes much easier to conceive and helps to accept it.” R. A.*