Up to date thinking
The idea that our thoughts can fundamentally alter our pain is powerful stuff – it’s just about as far away from the out of date notions of ‘pain receptors’ and ‘pain pathways’, as you can get. Like pain, you can’t see a thought, but we know that both pain and thoughts are real and involve complex neuroimmune interactions. If a person says “it hurts”, then no one can say it doesn’t – there is only one witness to the event.
When Explain Pain was first published in 2003, there was a very curious response to the section on “Thoughts and beliefs are nerve Impulses too”. While some readers, especially physical therapists were outraged “you want us to be counsellors and psychologists too!”, and others felt lost “how do I even start talking about this stuff with my patients?”, patients seemed to ‘get it’, and many sent in notes explaining that they finally understood their pain – especially the odd ups and downs that they experienced, and wondered why nobody had explained this to them before. Of course there were some psychologists who were just a bit amused… “you’ve only just realised this now!”
You are not your thoughts
Delving into this territory can be tricky and requires tact, appropriate knowledge, getting a bit philosophical at times – “you are not your thoughts”, and often, the right stories and metaphor. We introduced the notion of ‘thought viruses’ to people experiencing pain, therapists and clinicians in Explain Pain, and it has spread and been picked up around the world now.
Thought viruses are DIMs
Thought viruses can be powerful DIMs – and likely to be found across the seven categories, for example:
Things You Hear, See, Smell, Taste and Touch – hearing “you have the back of an 80 year old” or seeing normal, age related changes on x-ray (that remain unexplained and threatening)
Things you Say – “I am riddled with arthritis”
Things you think and believe – “movement is dangerous” or “pain is forever”
Thought viruses will also:
Powerfully influence the Things you do – “I am not bending forwards” is a logical consequence of the thoughts, beliefs and other thought viruses above.
Have a real biological effect on the Things happening in your body, such as inflammation.
Finally, thought viruses might be picked up from the People in your Life or the Places you go.
Knowledge can be like a ‘Thought Vaccine’
We’ve made a short clip that we hope therapists will be able to use to introduce the idea of thought viruses (and their ‘vaccines’) to patients. You could watch it in your clinic, have it playing in your waiting room, or perhaps set it as some homework – we know that good education uses multimedia, and hearing new ideas in different ways can help it to ‘stick’ and influence future behavior.
I can imagine a short introduction that might go something like this,
“We’ve been talking about your pain and your brain over a few sessions now, and I want to introduce you to the idea of ‘though viruses’ – these are things that we hear, think or say that are scary and threatening – they are nearly always incorrect, but can be powerful enough to maintain or even increase your pain. Let’s watch this short clip and then we can have a chat about it more – maybe you have a few thought viruses that we need to deal with, what do you think?”
We’d love to hear some of the thought viruses that you have come across out there, as well as how you ‘vaccinated’ against them, and let us know how you use the clip – leave a comment below.
– David Butler and Tim Cocks