When we are injured or have a disease, a large number of biologically definable coping systems come into play to help us manage the state, repair and heal us and help us return to pre-trauma life. These output systems, essentially merging from the brain include the motor, autonomic, linguistic, cognitive, emotional, respiratory, endocrine and immune systems among others. They interact with each other, they feed back to the brain, their activation is often useful in the acute stages but these systems are not designed to be left “turned on”.
Clinicians confront this daily – you can be with a patient with a chronic state and wonder… “why in this person did the brain select an endocrine, autonomic and immune coping recipe to manage this but has called upon these systems for so long and hard that they have developed into a CRPS state”. Or in another person, the motor system has been called on as a prime defender and the patient has gone on to develop a severe imbalance state or, at worst “stiff man syndrome”. In yet another person the immune system may have been preferentially called on and his/her problem has progressed to an immune based disease. Or in another, cognitions, once useful in the early stages have advanced to pathological catastrophisation.
Scientists rarely reflect on these things – many clinical scientists would.
I would love some thoughts on the things that might help construct the particular and individual output recipes that clinicians contend with daily.