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Psychological Overlay

By David Butler Metaphor and language, Education for all 15 Nov 2015

“Oh – she has a few problems in her back but heaps of psychological overlay,” I recently heard. Overlay suggests a blanket, something covering the “real” thing, something happening after the fact, but not a part of it. This is an unfortunate dualism-enhancing metaphor and it’s used so frequently that it’s embedded (like the metaphor pins and needles).

– David Butler

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  1. Ive heard this so many times with therapists discussing about fibromyalgia patients. Seems like this is the only time that some therapists recognize (or are faced with) that there is more to pain than nociceptor firing.

  2. davidbutler0noi

    Hi Stephane – I agree – “psychological overlay’ is a very commonly used metaphor – medicos as well as therapists use it. It is so embedded in our language that it’s hard to retrieve and correct.

    For some time now, I have been collecting common societally held metaphors that I feel are unhelpful based on a modern understanding of pain.

    They include:
    “noone ever dies of pain” and pain is weakness leaving the body.” I am teaching in New Zealand at present and have picked up “put your big girl panties on” and “take a cup of concrete and harden up”!.


  3. Oh! I am truly shocked. I like to think that kind of talk is not happening in our profession in America. But that kind of thinking is pervasive in our entire culture.
    I know you already know this but people do die of pain, physical and emotional and whatever else, everywhere and all the time.
    I appreciate that you question our assumptions about pain and with those same question you ask us to look at our assumptions about being human.

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