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Now on the wishlist...
Review of Melanie Thernstrom's The Pain Chronicles: Cures, Myths, Mysteries, Prayers, Diaries, Brain Scans, Healing, and the Science of Suffering. from the review: "She shows that medical treatment of pain is suboptimal because most doctors have not yet incorporated recent scientific discoveries into their thinking, discoveries indicating that chronic pain is a disease in its own right, a state of pathological pain sensitivity."
Essentially, if I'm reading this right, her argument is that a certain amount of chronic pain is caused by the pain itself: sometimes because the people who have it behave or carry themselves in maladaptive ways which cause muscles to be disused and new pain to occur, and sometimes because the pain itself or the treatment of the pain causes changes in the brain or body.
Essentially, if I'm reading this right, her argument is that a certain amount of chronic pain is caused by the pain itself: sometimes because the people who have it behave or carry themselves in maladaptive ways which cause muscles to be disused and new pain to occur, and sometimes because the pain itself or the treatment of the pain causes changes in the brain or body.
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What makes me wary about this book is the idea of thinking the pain away, which is not in fact new, but very old, and very punishment based. That's Dr Sarno all over and he makes flames shoot up the side of my face. (I have encountered him before.)
Part of the problem with his treatment approach and some other similar approaches, is that it leaves out the true psycho-social dynamics, emphasis on the social. That is to say, if you treat someone with chronic pain by telling them that it is all in their head, and that they need to think their way out of it, especially if they are female, they will seem to 'get better' but only because they are lying their ass off. And then they go see another doctor. I look at some of these dudes reports on 'curing' chronic pain and discovered that part of what they said was success was that patients weren't going back to them. Which....is not a sign of a cure. At all. There's so much shame around having pain at all that many people with it just lie anyway, and essentially don't get better, but suffer.
Anyway. It is true that pain changes the body, but...eh. There's lots there, reading between the lines, that makes me go hmmmmm.
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And having read about the problems Japanese baseball players had in the 1980s (I haven't read anything more recent about it, so I have no idea if this still occurs), I know the suck-it-up and work-through-the-pain attitude is a serious problem if there's something physically wrong: IIRC, several pitchers screwed themselves up permanently because the cultural ethos on those teams was, when something started hurting, to work it harder so they'd, say, strain their shoulder from pitching, then spend hours continuing to work it in order to work through the pain, and cause more and more damage.
(However, I don't have medical training and would not presume to diagnose anyone's pain or treatment thereof!)
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I think it depends on what the chronic pain sufferer's internal tapes read and whether they match what is helpful (or not). Fer instance, one of the first things I was taught in PT was that limping is the Devil. It's better to not walk than limp, because it'll just screw up my back and cause New Exciting Problems. (That's why I have the cane, because it reduces limping; counter intuitively, it's better for me to use the cane than to limp.) There's lots of maladjustments that can cause injury, like never excercising, but on the other hand, the wrong kind will cause injury. It often startles people that I'm OK'd to do very twisty yoga, but not to do long walks, because to a lot of people, twisty yoga is hard, but walking is easy. Arthritis really improves for a lot of people if they walk, which is one of those that isn't common knowledge, I think. (And heat is OK for me, for some times, but most people will scream that heat is BAD.) I'm definitely all for adjusting the tapes. And I've gotten some good relief from fairly woo-y guided imagery. It's just the "repressed emotion" dude that flips all my internal Aiiieee switches, heh. (Simmer down VM self.)
That's very interesting about the baseball players. I read something similar about early years Navy Seal training.
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But that pain is still real, and not amenable to "thinking it away." The V. S. Ramachandran book I read discussed a treatment of his for phantom limb pain which essentially changed the brain's perception of itself, and so made it stop sending pain signals. But it didn't work in all cases, and was much more sophisticated than "think it away." (It involved an elaborate arrangement of mirrors.)
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I also suspect it's a lot more complicated than "thinking it away," but as I haven't read the book yet, I'll decline on commenting about what might be contained in the book on the subject.
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I'm absolutely pro changing the circuits of the brain to redirect the feeling in new ways, for sure. Plenty of studies on meditation and imagery, etc, are helpful and I do some of that myself. What I reject out of hand is Dr Whatsits thesis which is that chronic pain is caused by "repressed negative emotions". Paging Dr Freud!
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On the other hand, while I found the interview fascinating, I was not so enthralled by the book. (No particular reason, just didn't care for its approach and pacing.) So y'know.
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1. Dr. Sorsen (or whatever, I'm too exhausted to go look), literally believes that chronic pain is caused by repressed negative emotions and that therefore, if people fix their thoughts, hey presto. I hate him.
2. The author, who is arguing that people can learn to live with pain. (Among other things. I am fine with the physical maladaption problems that can happen.) Goodie for her.
This is being presented as some new idea. It's not. It's the way things have been done forever, and it does. not. work. Unless you consider people killing themselves to be working, which I don't. Look at any psych group arguing against assisted suicide and they will tell you that a big part of it is incomplete pain control and draconian ideas (learn to live with it) about pain that make suicide seem like a rational option. This is a disability issue, and a huge one, and I do not give a shit if people use the word lame ever, but if I could wave my wand and have any one thing, it is to not tell people that they should learn to live with their pain or that there's some societal good in doing so, because if it was actually liveable and dealable, people would already be doing it, because many do. If it's gotten to the point where you're in a doctor's office, begging, then it's not 'liveable'. Also, any learning to live with does not solve the very real, very ongoing destructive chemical changes that pain causes. But anyway. More than you wanted to know, probably.
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I've been a pain sufferer for over 20 years now. I've had it up to here with the 'power of positive thinking' crowd.
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Gah, yes, I remember reading on a Usenet group a few years back a long exchange in which one person (who did not have, nor ever had, chronic pain/health issues) was arguing that she thought yes, suffering made you somehow more ... I forgot exactly what, but it was something like wise/holy/whatever. In the face of and directly contradicting a number of people who *had* chronic pain and health issues who were arguing back that all it made them was bitchy, tired, and in pain!
It's a good thing I was reading Usenet through something that I hadn't worked out how to post with, otherwise I'd probably have attempted to punch them through the internet.
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I've had some sort of chronic pain or other all of my life. I do agree that at times I am my own worst enemy and move around in ways that would avoid pain when I'm not actually experiencing that pain. I've had to work hard to pay attention to make sure that I'm walking the right way rather than the avoiding-knee-pain walk that I'd started doing the last year or so.
But I've also noticed that some things cause me pain that don't cause others pain. For years I've heard people talk about this special gel that all the other RA sufferers love, but hadn't tried it because it was hard to get. Finally got some and guess what: it makes me hurt worse. Terrifically painful stuff for me, but works wonders in others.
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Well, that just proves her point! *ducks and runs*
I pulled a ligament in my ankle in 6th grade and because it didn't heal for six years* I ended up walking with my right foot turned inwards to avoid the pain, and it became such a habit that I didn't notice it until people pointed it out to me. It's mostly gone now - it still doesn't feel weird to walk that way - but it cannot have done me any good.
* My parents refused to take me to the doctor for something they thought could be cured with exercise, which the doctor said was bad for it when I finally got to one in college. Nooooo, I'm not bitter about that...