The pain psychologist Rachel Zoffness expains why pain is a “biopsychosocial phenomenon“…. Ezra Klein, New York Times columnist

I 'gifted' the link to y'all below: Oh, and Zoffness says "If the brain can change the pain can change."

Oh really? I guess I haven't done enough of her New Age relaxation/CBT/guided imagery as my poor brain is still bombarded with high levels of pain signals from my PNS (or so the likeliest theory goes.)

Rachel, dearest, I cannot stop these signals. I never know why the pain is less one day and more the next.

Do you? No, you don't.


https://www.nytimes.com/2023/02/21/...7Z1DRENAC4KIlgyCcRUntkLNz6x82E&smid=url-share
 
This confusion is probably because psychologists are not able to admit that with pain they're not measuring a real phenomenon but a perception of a phenomen, which is easily influenced by many things.

One can replace the word "pain" with "the perception of pain, how it is interpreted and communicated to others in the context of social norms and demands" and suddenly biopsychosocial fits.
 
Last edited:
Had a look at her LinkedIn. She seems mainly to focus on convincing people not to have spinal operations for back pain or to take analgesic medicines.

I had a dodgy disc taken out ten years ago and replaced with titanium scaffolding and “allograft” (which means bones taken from the dead, oddly). It put an end to some deeply annoying lumbar issues. If I’d taken a wrong turn and seen the wrong clinician, I could probably have been convinced that I was hallucinating ME. But I don’t think even a world-class gaslighter could have done that for herniated discs.
 
Last edited:
Do these people literally don't know that animals exist? Animals with far lower intelligence, no theory of mind and very basic instincts? Or that they also feel pain? And heat. And touch. Even without a neocortex. Or even a complex nervous system.

It's a freaking evolutionary adaptation to promote survival, geniuses. Nothing in biology makes sense other than in the context of evolution and it makes a whole lot of sense for organisms not to harm their own freaking body just long enough to reproduce. Nature doesn't give a fig about us living happily, we're made just so we can survive, not thrive and be merry. This is something we do for ourselves. Or fail to.

This New Age medicine stuff has become an actual threat to our civilization, it's lead to stagnation in medical research and could cause major disaster if we ever face a more dangerous pandemic. Lots of people won't even listen anymore, and they won't even be wrong about it.

And anyway if this were really all about perception, then you would have to actually respect that perception. This is Main Character Disorder, people who seem unable to understand that what they're experiencing is not a universal experience.
 
DokaGirl said:
Where do the BPS'ers stop? Do they have no boundaries?
Click to expand...
No, they don't.

It is crystal clear now, both post-NICE and with the emergence of Long Covid, that psychosomatics is the hill the profession has chosen to die on.

Pity they are going to take down so many innocent sick people with them, and in such a cruel way.

But then it was never about actually helping us, was it.
 
What an odd way of practicing the scientific method. It's a model of assumptive reasoning.

She says she has CFS patients. Boy, that's an interview I'd like to be part of.

Better yet: Does she have any chronic Lyme patients? Any longstanding TBD patients?

This model can only sustain marketability if you can prove your assumptions, or at least convince your patients of the voracity of your assumptions. Or if somehow you're insulated from that basic need to sell your wares.

I'd wager she'd have trouble with many in communities like ours. Educated consumers are a nightmare to BPSers.

But then again, I suppose educated patients in any contested medical community are frequently a nightmare for most regular MD's. Isn't that an indictment of our times.
 
John Mac said:
Perhaps the author could give a public demonstration on the ability to reason pain away with themselves as the guinea pig.
I'm imagining now a whole range of painful tortures that could be tried on them.
Click to expand...

I’d like to know how these psychologists handle their crippling pain. For example, how they dealt with the pain of a broken limb. Did they scream out in agony as most do when the acute injury is made worse, or did they use CBT and kept quiet, allowing the risk of further harm?

strategist said:
This confusion is probably because psychologists are not able to admit that with pain they're not measuring a real phenomenon but a perception of a phenomen, which is easily influenced by many things.

One can replace the word "pain" with "the perception of pain, how it is interpreted and communicated to others in the context of social norms and demands" and suddenly biopsychosocial fits.
Click to expand...

Possibly a long-term strategy to keep acute care numbers down. Different types and levels of pain indicate various things, including significant injury.

I do understand the BPS model according to context, such as in a remote village without first-world medical care. Perhaps it is less culturally acceptable to howl out and complain of persisting pain because of a lack of medical facilities and cultural norms. If the same injury happened to a person within a country with first-world medical care, it's likely that, in most cases, the patient will communicate the pain more vocally because the person understands the facilities exist for the pain to be reasonably addressed. Culturally we expect access to health care services designed to meet a range of medical needs from critical to minor needs.
 
Last edited:
Just pure BPS (as we are too used to hearing... sigh ! ), affirming without complex and with great conviction that she holds THE recipe for curing all chronic pain...

And there’s many things, as we all know, that adjust pain volume. So of course, pain medication is one of those things. But it turns out that there’s three other things that I want to talk about that also change pain volume. One is stress and anxiety, one is mood and emotions and the third is attention or what we’re focusing on.
Click to expand...

And what is this magic recipe ? Simple, a CBT-flavored desensitization of this CNS that sends too many pain signals for no valid reason !

And it turns out that the treatment for chronic pain — this is just what research says, do not shoot the messenger — is that gradually over time, we can desensitize a sensitive brain by gradually increasing little bits of physical activity, and social exposure, and movement, and again, targeting this whole biopsychosocial pain recipe.
Click to expand...

Really, research proves it...??!

I treat chronic pain. I’ve had this chronic pain practice for a very long time. And I watched these miracles occur in my office all the time, and I use that word with a lot of air quotes because it’s not a miracle. It’s just what science says.

And when I get these patients who have been in bed for four years, who have no life and they have no hope, and you can gradually, gradually increase their activity and social exposure and target all the pieces of their pain recipe, they get out of bed and back to life.

And my clinical experience, and my personal experience — I think it’s useful to have lived experience — and also everything I know about 25 years of neuroscience research is that this process works for change in chronic pain.
Click to expand...

Well I doubt it very much, because if it were so true, the " good news " would have already spread throughout the world, the proof would have been scientifically made and thousands of patients cured and getting up from their pallets, Hallelujah !

So, she offers a form of GET and apparently without any notion of PEM, poor pwme !

I treat a lot of chronic fatigue syndrome and resting is an important part of recovery, and also getting back to life is an important part of recovery, depending on people’s motivations.
Click to expand...

Of course, if her therapy does not work, it is because the patient is not motivated enough, already heard that somewhere, isn't it ?



* Excerpts from the transcript by The New York Times
 
Lilas said:
Just pure BPS (as we are too used to hearing... sigh ! ), affirming without complex and with great conviction that she holds THE recipe for curing all chronic pain...



And what is this magic recipe ? Simple, a CBT-flavored desensitization of this CNS that sends too many pain signals for no valid reason !



Really, research proves it...??!



Well I doubt it very much, because if it were so true, the " good news " would have already spread throughout the world, the proof would have been scientifically made and thousands of patients cured and getting up from their pallets, Hallelujah !

So, she offers a form of GET and apparently without any notion of PEM, poor pwme !



Of course, if her therapy does not work, it is because the patient is not motivated enough, already heard that somewhere, isn't it ?



* Excerpts from the transcript by The New York Times
Click to expand...

This is always the platitude BPS clinicians fall back on. Failure to improve is merely a result of the patient’s desire to maintain the sick role. The treatment never fails, only the patient, because he doesn’t want to succeed. This is religious fundamentalism, not science.
 
Sean said:
No, they don't.

It is crystal clear now, both post-NICE and with the emergence of Long Covid, that psychosomatics is the hill the profession has chosen to die on.

Pity they are going to take down so many innocent sick people with them, and in such a cruel way.

But then it was never about actually helping us, was it.
Click to expand...

Yep, no boundaries.

Good mental picture - the last stand...
 
shak8 said:
I 'gifted' the link to y'all below: Oh, and Zoffness says "If the brain can change the pain can change."

Oh really? I guess I haven't done enough of her New Age relaxation/CBT/guided imagery as my poor brain is still bombarded with high levels of pain signals from my PNS (or so the likeliest theory goes.)

Rachel, dearest, I cannot stop these signals. I never know why the pain is less one day and more the next.

Do you? No, you don't.


https://www.nytimes.com/2023/02/21/...7Z1DRENAC4KIlgyCcRUntkLNz6x82E&smid=url-share
Click to expand...

I just read some of the comments on that article. There aren't many of the commenters I can take seriously. There is one respondent in particular who pops up on almost every comment and is very annoying.

Imagine a scenario where someone has a car accident and is impaled on a fence post through the gut. They survive with lots of medical treatment but spend the rest of their lives with severe chronic pain. Their innards will be distorted, with nerves, muscles and arteries in the wrong place, possibly under tension, and will probably barely function, and will have very severe scarring which is very dense. How anyone can say that they can tell themselves that this pain doesn't exist or doesn't hurt or isn't real is beyond me. One of the commenters said something I can agree with. If pain can be "wished away" or ignored why is torture illegal and why does anyone ever need numbing injections at a dentist?
 
DokaGirl said:
Where do the BPS'ers stop? Do they have no boundaries?

There is pain with MS. Do they believe CBT and the like can disappear demyelination?

What about other devastating, but better understood diseases that include pain? Are they cured with CBT, meditation and the like?

:wtf:
Click to expand...

There don't seem to be any boundaries. I know I'm psycho-analyzing now, but to me it looks like some therapists think the mind can practically overcome all and are never refuted in their environment. Which to me is tantamount to religious zealotry. You must speak the message of our group or you will be denounced. I think we've seen that happen with psychologists that were actually helpful to us.

Others probably just see a big fat paycheck and aren't really concerned with helping patients, just with getting as much people as possible hooked on their brand.

It makes for a world within a world that's similar to idiocracy but instead of energy drinks getting put into everything it's psychology. I'm waiting for Luke Wilson to show up and save the world from it.
 
Arnie Pye said:
I just read some of the comments on that article. There aren't many of the commenters I can take seriously. There is one respondent in particular who pops up on almost every comment and is very annoying.

Imagine a scenario where someone has a car accident and is impaled on a fence post through the gut. They survive with lots of medical treatment but spend the rest of their lives with severe chronic pain. Their innards will be distorted, with nerves, muscles and arteries in the wrong place, possibly under tension, and will probably barely function, and will have very severe scarring which is very dense. How anyone can say that they can tell themselves that this pain doesn't exist or doesn't hurt or isn't real is beyond me. One of the commenters said something I can agree with. If pain can be "wished away" or ignored why is torture illegal and why does anyone ever need numbing injections at a dentist?
Click to expand...

I can essentially guess who the one respondent popping up on every comment is without reading said comments. Is it perhaps a like minded physical therapist who takes arrogance into uncharted waters?
 
A Tale of Two Nails in which Rachel Zoffness explains pain by the simple device of logical fallacy - a cat has four legs, dogs have four legs, ergo all cats are dogs (but as it happens not all dogs are cats because that wouldn't support my book selling argument).

Zoffness doesn't actually give a proper cite for the 'boot' article, which appeared in the BMJ's Minerva column = "The BMJ does not publish standard case reports but does publish picture-based articles in our Minerva section. Intended for healthcare professionals." . Although the first few paras of the Minerva archive are viewable, the boot story is accessible to BMJ members only: https://www.bmj.com/content/310/6971/70.full however an internet search shows the 'story' has had a number of outings in pop psych articles.
 
rvallee said:
Do these people literally don't know that animals exist? Animals with far lower intelligence, no theory of mind and very basic instincts? Or that they also feel pain? And heat. And touch. Even without a neocortex. Or even a complex nervous system.

It's a freaking evolutionary adaptation to promote survival, geniuses. Nothing in biology makes sense other than in the context of evolution and it makes a whole lot of sense for organisms not to harm their own freaking body just long enough to reproduce. Nature doesn't give a fig about us living happily, we're made just so we can survive, not thrive and be merry. This is something we do for ourselves. Or fail to.

This New Age medicine stuff has become an actual threat to our civilization, it's lead to stagnation in medical research and could cause major disaster if we ever face a more dangerous pandemic. Lots of people won't even listen anymore, and they won't even be wrong about it.

And anyway if this were really all about perception, then you would have to actually respect that perception. This is Main Character Disorder, people who seem unable to understand that what they're experiencing is not a universal experience.
Click to expand...

You're right @rvallee.

Pain is an important survival mechanism. There are people who don't feel physical pain. Their's is a rather perilous situation.

It's ridiculous really, to ignore chronic pain. It might be trying to tell us something, like: "Dude, those constant terrible headaches mean you've got a brain tumour."

Chronic chest pain could be angina. We shouldn't ignore that by trying to meditate it away.

Chronic pelvic, or back pain could be cancer. Relaxation exercises aren't going to cure these.

One of the frequent things missed in this whole idea of thinking away pain, is the lack of thorough biomedical work ups before people turn to a psych healer.

The psych healer, assumimg all the physical bases having been covered, can feel free to work on the psychology of the issue. Of course, their belief that many symptoms are just psychological in the first place frees them up to skip any concern about that whole "biomedical nuisance" bit.
 
Last edited:
You must log in or register to reply here.
Back
Top Bottom