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Chronic pain often has no physical cause. Psychotherapy can reduce the suffering.

Discussion in 'Health News and Research unrelated to ME/CFS' started by Andy, May 17, 2018.

  1. Andy

    Andy Committee Member

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    Right, of course it can.. ;)
    https://www.vox.com/science-and-hea...treatment-psychology-cbt-mindfulness-evidence
     
    Barry, alktipping, Inara and 3 others like this.
  2. JemPD

    JemPD Senior Member (Voting Rights)

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    this is what irritates me sometimes, I dont really understand such catastrophising, i mean i understand it & am not judging anyone who feels that way, i guess it might be natural to feel like that.... what i mean is that i never thought or think like that, it's just not where my thoughts go, & the assumption that people with chronic 'anything' always think in this way & therefore changing that thinking will sort it out, really gets up my nose....
    what if you simply dont think like that, indeed think quite the reverse & dismiss your pain/ignore it & fully expect it to disappear, but instead it gets worse? Presumably then it's your fault for not listening to it?

    my emphasis, the emphasis also being the point i wanted to make.
     
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  3. Allele

    Allele Senior Member (Voting Rights)

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    Also the assertion that "chronic pain often has no cause".
    The hubris!
     
  4. strategist

    strategist Senior Member (Voting Rights)

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    Same mistakes being made again. Nevermind all these other illnesses that were falsely claimed to be psychogenic, this time they surely got it right. The quality of the research and reasoning seems poor as well.
     
  5. Alvin

    Alvin Senior Member (Voting Rights)

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    I just saw the article but don't have the energy to read it (was planning to post it here later when i did).
    Without reading it my impression is the opposite is true, virtually all pain has a physical cause, psychotherapy can help patients cope with something we don't have the technology yet to treat for but is at best a band aid. There are cases of pain of psychogenic origin, but they are probably a few percent of cases at best, and can be treated with therapy or antidepressants, though separating them would need a good clinician and antidepressants would just be a better band aid if they work. And the incidence of this is likely in the single digits
     
    Last edited: May 17, 2018
  6. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    Absolutely right. Of all the many hundreds of people I saw in the clinic with pain not more than a score or so had pain that was inexplicable. And one of those turned out to be lung cancer. One person in three has chronic pain because their discs are squashed down or their cartilage is worn out, or a nerve is pinched. This is just complete crap.
     
  7. Alvin

    Alvin Senior Member (Voting Rights)

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    Indeed, thats a good point as well, often we do have the technology but doctors just need to dig deeper to find the cause.

    This is also true, i took an older relative to my chiropractor and after some xrays she told him he had damaged discs, and that she could not fix it, just take the pressure off and reduce the pain. Psychotherapy was not needed, just someone who knew how to do some proper investigation.
     
  8. Allele

    Allele Senior Member (Voting Rights)

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    Yeah psychos, show me definitive proof that there is even such a thing as psychogenic pain.
    Inexplicable pain just means that the explainer can't explain it.

    These people are so goddam arrogant and I don't understand why they've been allowed to ride roughshod all over science, medicine, and humanity.

    Why aren't they simply relegated to the domain where they could actually do some good, instead of harm--teaching coping skills.
     
  9. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    If the pain is real it cannot be psychogenic because it wasn't 'thought up by the mind'. It might be brainogenic or hypothalamusogeneic but what it cannot be is psychogenic. The psyche is the thinking me. The unconscious is not another 'mind' hiding out of sight. It is just the brain doing what it does without telling you. It does not have reasons or feelings.It has connections between brain cells. But try telling a 'psychologist' that.
     
  10. Inara

    Inara Senior Member (Voting Rights)

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    Thank you, and @Alvin. This feels so very good right now, you don't know how good and important that was for me right now.

    It is so cruel that pain is often so easily dismissed.
     
  11. Alvin

    Alvin Senior Member (Voting Rights)

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    I agree :emoji_face_palm:

    Teaching someone to accept and emotionally handle untreatable pain is acceptable when there is no other option but making that the default is completely stupid, it should only be reserved for cases that cannot be treated and even that is fraught with problems because if you believe that psychosomatic pain is a common thing then you won't look for the real cause since you think you already know it, and many people never get to specialists or the right specialists to find the real cause of their pain (and i have been to many doctors where i have wondered why am i here, i know more then this "professional"...).
    Thats what bugs me, i know many people who have conditions but have never been referred to specialist by their GP or have seen ones whose knowledge is decades out of date. I've had to push many times not just for myself to keep going when doctors gave up or were satisfied with crummy treatments or poor control of the condition... :emoji_rage:
     
  12. Alvin

    Alvin Senior Member (Voting Rights)

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    :hug:
    Indeed, I doubt there is malicious intent involved but a someone with (only) a little bit of knowledge is a dangerous thing
     
  13. Lidia

    Lidia Established Member (Voting Rights)

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    Absolutely, hallelujah. But if the pain is neuropathic, it can improve with TCAs (but not SSRIs) so a psychologist, or an insurance doctor, will say this proves the pain is psychogenic.
     
  14. adambeyoncelowe

    adambeyoncelowe Senior Member (Voting Rights)

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    But the method of action is thought to be independent of their AD effect. Most TCAs used for pain are used in smaller doses than works for depression (and most of them aren't very good for that primary indication).

    TCAs are thought to work, if I understand my doctor properly, by interfering with nerve signals that are causing pain (perhaps the epinephrine, antihistamine and sodium channel blocking action). They're also used for definitely biological causes of pain, including diabetic neuropathy.
     
  15. sea

    sea Senior Member (Voting Rights)

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    This is the direction chronic pain management is heading. All pain they say is caused by the brain, learned neural pathways. There is dismissal even when a physical cause is found. Herniated discs? Pinched nerves? That can’t be the cause because they’re found incidentally on mri in patients without pain. They’re “normal”. So the problem isn’t the physical it’s the perception, the fear, the belief that it’s physical etc. :banghead:
     

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