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My Doctor Told Me My Pain Was All in My Head. It Ended Up Saving Me. 2021 Medical examiner article
- Thread starter Woolie
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Sphyrna
Established Member (Voting Rights)
https://pubmed.ncbi.nlm.nih.gov/33471404/
By the way, is there anyone here who would describe success in pain treatment as best quantified via improvements in self-compassion? I often see doctors state that patients don't want the pain to be gone, but rather that they just want the negative effects of it on their lives to be gone, thus the propensity to choose more "meaningful" outcomes for trials than say, some more direct measure of pain intensity, whatever that looks like. To me, that just sounds like a cop-out answer for not being able to actually do anything "meaningful" about the pain.
By the way, is there anyone here who would describe success in pain treatment as best quantified via improvements in self-compassion? I often see doctors state that patients don't want the pain to be gone, but rather that they just want the negative effects of it on their lives to be gone, thus the propensity to choose more "meaningful" outcomes for trials than say, some more direct measure of pain intensity, whatever that looks like. To me, that just sounds like a cop-out answer for not being able to actually do anything "meaningful" about the pain.
Woolie
Senior Member
This is hilarious, @Sphyma! A self-compassion intervention for pain whose primary outcome measure is not pain, but self-compassion. Its like attempting to treat pain by pouring green paint over people, then observing that they do indeed turn green, proving the pain treatment successful!
In the study, there's no significant benefit of the therapy (compared to the control condition) at reducing self-reported pain intensity, but you would never know that from reading the Abstract, which presents the whole thing as a roaring success.
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Sphyrna
Established Member (Voting Rights)
https://onlinelibrary.wiley.com/doi/pdf/10.1002/ejp.1739
I'd recommend reading this commentary on the above trial. Chances are, you'll burst out laughing at one specific part, as I did. You'll know it once you start reading the second paragraph...
yes I did
Woolie
Senior Member
CBT a "high bar" 
!!!
Just thinking on it a bit more, it reminds me of the "recovery" stuff. Since these psychological interventions don't actually help people recover - in the plain meaning of the word - they slyly redefine recovery as "acceptance". That is, lowering your expectations about what getting better would look like.
Likewise, these pain interventions have no effect on pain perception, so they redefine success as "acceptance" of the pain. Its not at all what patients are looking for when they enter pain treatment - its not like they say "I just need help accepting that I'm in constant pain, I need to learn to lower my expectations. I'm so hopelessly unable to do that, I need help!"
!!!Just thinking on it a bit more, it reminds me of the "recovery" stuff. Since these psychological interventions don't actually help people recover - in the plain meaning of the word - they slyly redefine recovery as "acceptance". That is, lowering your expectations about what getting better would look like.
Likewise, these pain interventions have no effect on pain perception, so they redefine success as "acceptance" of the pain. Its not at all what patients are looking for when they enter pain treatment - its not like they say "I just need help accepting that I'm in constant pain, I need to learn to lower my expectations. I'm so hopelessly unable to do that, I need help!"
On the one hand we are told to increase our self-compassion, and redefine recovery as acceptance of limited lives (and stop bothering the medical system).
On the other hand, we are told to increase our self-management skills to work towards recovery by pushing beyond our moral and physical limitations (so any failure to recover is our fault).
Mithriel
Senior Member (Voting Rights)
People who run these trials and make all these pronouncements have never experienced real pain. They could not have, it is impossible to be so wishy washy about it.
I experience a lot of pain with my ME. When they stopped my painkillers I could not think it was so overwhelming. Yet the pain from my eye disease was searing, screaming and burning and nothing could relieve it except waiting for it to dull down a bit which took about 30 to 40 minutes. The dull pain was bad but nothing like the immediate thing. This cycle kept recurring through the night and I was close to suicidal at the thought this would never end.
A combination of treatments means it is rarely so bad but if I drop my vigilance it builds up again.
I tried to keep a diary when I started the treatment and it helped as I began to see that it was not many times every night anymore but what was strange was how bad I found it to rate the pain. I knew when it was really bad and I knew when it was very mild but in between it was no more than a guess.
Humans don't have a good insight into comparing pain at one point with another.
edit because I left out my main point. There must be people with really severe chronic pain and to offer them these simplistic solutions is inhumane
I experience a lot of pain with my ME. When they stopped my painkillers I could not think it was so overwhelming. Yet the pain from my eye disease was searing, screaming and burning and nothing could relieve it except waiting for it to dull down a bit which took about 30 to 40 minutes. The dull pain was bad but nothing like the immediate thing. This cycle kept recurring through the night and I was close to suicidal at the thought this would never end.
A combination of treatments means it is rarely so bad but if I drop my vigilance it builds up again.
I tried to keep a diary when I started the treatment and it helped as I began to see that it was not many times every night anymore but what was strange was how bad I found it to rate the pain. I knew when it was really bad and I knew when it was very mild but in between it was no more than a guess.
Humans don't have a good insight into comparing pain at one point with another.
edit because I left out my main point. There must be people with really severe chronic pain and to offer them these simplistic solutions is inhumane
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It's a cruel cowardly fraud.
While also being told that we are obsessed by our symptoms, too self-pitying, too attention seeking, etc.
So, we are supposed to not pay attention to them in order to break the vicious cycle, and also pay attention to them in order to self-manage and overcome them.
But it has been quite clear for some time that consistency is not their strong point.