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So you're saying it's all in my head- How to explain pain without…
So you're saying it's all in my head- How to explain pain without putting your foot it in!
Learning outcomes
To increase your confidence when speaking about pain
simplify the complex
language that heals/placebo
language the harms/ nocebo
To bond with our patients
deeper understanding
therapeutic allliance
building rapport
No. 1. To understand why we might want to explain pain to our patients
To reassure and re-contextualise what pain means
communication is key
It's not about explaining pain its about helping better understand pain
To understand pain we need to understand people
active listening
M.I
pain neuroscience educatin
de-threatening pan
response to a threat whether the threat is valid and sometimes not
To change the many misconceptions that exist about pain
hurt = harm
too reductionist
pain= damage
too biomedical
the rigidity of pain
It's needed to go through pain to get better
too much complexity
How to deal with that dreaded question..... "So you're saying it's all in my head"
Kinda, in a way....an opportunity to educate patients on the ways in which pain can be turned up and down by spinal and supraspinal mechanisms (opportunity).
touch into enactivism (stillwell and harman 2019....coming up in BPS preso)
Other ways we stuff it up
Get your patient to tell you their explanation.....get them to explain to you (helps show us opportunities, if we have missed the mark etc)
The double edge sword of analogies/metaphors
Useful analogies
smoke alarm
sun burn
car alarm
Pain being being not an accurate measure of danger/damage, almost like hunger for starvation
Pain being linked to psychosocial manifestations of e.g-coldsore when you are rundown etc
people having less pain on holidays
Target concepts
You are not your pain
Increase in pain does not need to equal a drop in mood
Decrease in pain does not equal increase in mood
Why do we want to explain pain
to exercise and solidify our own understanding
can you explain pain to a 10yr old
to impress/baffle our patients
to improve our reasoning, assessments, diagnosis and treatments
We want to get a sense of the beliefs that are held by our patients
accurate/inaccurate
formed through experience/relationships/ friends etc
helpful/unhelpful
firm/ malleable?
Hurt does not equal harm