Saturday, December 9, 2017

Involvement of the brain in the experience of chronic pain

At several points the article comes close to "blaming" the patient insofar as there now has been shown to be a direct contribution by the brain (rather than a mere reaction by the body) in the experience of pain. This is nothing new though, but I fear the fact that cognitive behavioral therapy has been shown to "affect" changes in the brain (although studies have not conclusively shown this nor have studies shown that the affect is experienced as a reduction in the perception of pain) may be used as further excuse to place pain almost exclusively in the category of "mere perception." Naturally, then, the experience of pain is said to be the patient's fault because only the patient would be unwilling (or unable) to change that perception of pain.  Terms such as "guarding," "pain catastrophizing," and "fear avoidant behavior" make their appearances in tandem with stating explicitly that "over sensitization" in the perception of pain is physiologically explained by genetics, and implicitly stating that cognitive behavioral therapy alone is an appropriate form of treatment in cases of severe chronic pain (because afterall, pain is "all in the head anyway"). Making matters worse, this new line of thinking follows upon the United State's current hysterics over opioids and considering what positive role opioids might play when appropriately included in a regimen that would actually treat pain, rather than just explain its perception - for the research cited suggests that simply stating pain is mostly a subjective perception is enough to serve as some form of treatment of it (i.e. explanation of pain somehow equals treatment). This puts pain patients at even more of a disadvantage in getting the help they need, moreso than ever before.

Link HERE.