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Knee and sympathy

By Timothy Cocks Metaphor and language 21 Jan 2016

My dear friend Anton Harms sent me a short note today. It’s the kind of thing that keeps me going – thinking that in some small way that NOI has made a positive contribution to this change:

Hey Dave;

I assessed a guy in the OA knee clinic a couple days ago and he said the pain was so severe when it first began that ‘even sympathy made it worse’ – when people talked to him about it and expressed sympathy. 

I do not know what I would have made of that comment 10 yrs ago; but it sits beautifully into the present paradigm



My hope is that in another 10 years everyone who treats pain will be able to easily understand and explain comments and experiences, not just like these, but other ‘outlandish’, ‘weird’ or otherwise seemingly mystifying symptoms, with simple, accurate, neuroimmune science-based nuggets and narratives.

-David Butler


Get a blast of the latest and greatest neuroimmune science at a NOI course in 2016 – Combined Explain Pain and GMI courses in Townsville April 29 – May 1, and Noosa June 17-19, and Pain, Plasticity and Rehabilitation in Adelaide 14-15May.


  1. Yeh sympathy (pity) doesn’t work, since it’s an expression of ego-self. I described this on a NOI thread a while back.

    Here’s a nice, neat explanation of common healing attitudes. In fact only one of these attitudes is healing, the others are counterproductive. It’s taken from ‘Internal Family Systems Model’ by Richard Schwartz.

    “With pity, you see someone suffering and you feel sorry for him or her,
    but at the same time a part of you is glad that person isn’t you. Your mind
    is busy thinking of reasons you wouldn’t make the mistakes he or she made that led to the suffering. Pity involves both a protective distancing and
    a measure of condescension. Your sorrow for the sufferer comes
    from a place of separateness.
    When you feel empathy, you see a person suffering, and
    because you have a certain level of self-awareness, you know a part
    of you suffers in the same way, so you identify with the sufferer’s
    pain. At some level, that person is the same as you. Empathy opens
    your heart and produces a strong desire to help the person. The
    danger with empathy, however, is that if you identify too much,
    you will feel a pressure to relieve the other’s misery. **You can’t
    tolerate your own pain**, so you can’t stand for the other to spend
    any time suffering. The other common consequence of having too
    much empathy is to distance from the other person because his or
    her pain makes you hurt too much”.

    The difficulty for us clinicians is to let go of self and work from the spacious and compassionate, non-needy, non-controlling true Self. All the great therapists throughout history worked this way.

  2. oops, pasting error. Here’s the bit on true healing attitude (compassion). From the same author.

    “Compassion, then, leads to doing whatever possible to
    foster the release of the other’s Self rather than become the other’s
    healer. With compassion, you can be open-heartedly present with
    sufferers **without feeling the urge to change them or distance from
    them**. This kind of Self-presence will often release their own Self”.

  3. Thank you David, it all comes down to listening too and believing that which the patient brings to the table. It is their truth, their experience in their World. NOI supplies us with the knowledge to believe and trust that which we see, feel and hear and the tools to construct probable solutions…..
    ” Problems don’t exist only solutions do”
    London 🌧🌧🌧

  4. For example:-
    ” I am woken by the pain which feels like a jagged piece of glass wrapped in rusty barbed wire being pulled through my knee” ……” As soon as I put on my elastic tubigrip the pain goes away”
    London 😱😱😱

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