Whenever I (as a General Practitioner, Pain Doctor and researcher) am giving a teaching session about pain, I always begin by asking people to define "pain". After discussing a few approaches to such a definition, I then present two on a slide: (1) the IASP definition (which I think is good); and (2) "pain is what the person says it is." In fact, the latter is almost a cliché, in my experience, and has always been received positively. So that makes me wonder how we got from that understanding to the point that you're describing in your excellent article - a point which I fully recognise, and do my best to address in my own practice. Thank you.
You've given me the topic for our weekly team CPD with all those validating and invalidating statements. The invalidating ones are so useful as I can see ones that I know I'm guilty of despite my best efforts to centre everything around the person in pain.
Replacing the persons story with a clinical narrative is one that I constantly have to be careful about. My intention is to help them make sense of their story and be able to engage with it in a more objective way but I'm going to redouble my efforts to listen better so I'm expanding their story to include a clinical narrative rather than replacing.
Starting with believing the person in pain to me feels like a no brainer as they are the expert on them. How am I supposed to help them in a person centred way if I can't get an understanding of what being them is like and what is meaningful to them.
Your last months writing gave me so much to think about that I never managed to put it succinctly into a 'comment'.
This is the nearest I've got... reflecting on you talking about everything sitting together at a level table and discussing essentially why they are here as equals.
This made me think that for the majority of healthcare I don't see people getting into it in the first place for the right reasons which can only ever be to help people surely!!! Medicine and healthcare in general comes with status, power and control as practices in the mainstream and this starts with putting people in their place by calling them patients. Generally then people (patients) respect, listen to and consider the healthcare provider to be the most important person in the room all whilst the healthcare profession is increasingly saying they follow a patient centred approach, which is bollocks if they are not starting with listening and wanting, no needing to know the person's story if they are to truly help.
So you keep standing on the platform you've earnt and be you at conferences and point out that the system for ongoing pain isn't as a whole winning. Last time I checked low back pain was still the leading cause of disability globally.
In the business world the companies that obsess about their customers are the best ones so why should healthcare be any different and why is it only a recent thing that the 'customers' of healthcare are being involved in research and asked to present at conferences.
Keep going and pushback even if polite shows you're going in the right direction ♥️
You made it to our Cedar Grove! My Mum will be thrilled. Thanks for making the trip all the way down South.
Whenever I (as a General Practitioner, Pain Doctor and researcher) am giving a teaching session about pain, I always begin by asking people to define "pain". After discussing a few approaches to such a definition, I then present two on a slide: (1) the IASP definition (which I think is good); and (2) "pain is what the person says it is." In fact, the latter is almost a cliché, in my experience, and has always been received positively. So that makes me wonder how we got from that understanding to the point that you're describing in your excellent article - a point which I fully recognise, and do my best to address in my own practice. Thank you.
Again dynamite writing!
You've given me the topic for our weekly team CPD with all those validating and invalidating statements. The invalidating ones are so useful as I can see ones that I know I'm guilty of despite my best efforts to centre everything around the person in pain.
Replacing the persons story with a clinical narrative is one that I constantly have to be careful about. My intention is to help them make sense of their story and be able to engage with it in a more objective way but I'm going to redouble my efforts to listen better so I'm expanding their story to include a clinical narrative rather than replacing.
Starting with believing the person in pain to me feels like a no brainer as they are the expert on them. How am I supposed to help them in a person centred way if I can't get an understanding of what being them is like and what is meaningful to them.
Your last months writing gave me so much to think about that I never managed to put it succinctly into a 'comment'.
This is the nearest I've got... reflecting on you talking about everything sitting together at a level table and discussing essentially why they are here as equals.
This made me think that for the majority of healthcare I don't see people getting into it in the first place for the right reasons which can only ever be to help people surely!!! Medicine and healthcare in general comes with status, power and control as practices in the mainstream and this starts with putting people in their place by calling them patients. Generally then people (patients) respect, listen to and consider the healthcare provider to be the most important person in the room all whilst the healthcare profession is increasingly saying they follow a patient centred approach, which is bollocks if they are not starting with listening and wanting, no needing to know the person's story if they are to truly help.
So you keep standing on the platform you've earnt and be you at conferences and point out that the system for ongoing pain isn't as a whole winning. Last time I checked low back pain was still the leading cause of disability globally.
In the business world the companies that obsess about their customers are the best ones so why should healthcare be any different and why is it only a recent thing that the 'customers' of healthcare are being involved in research and asked to present at conferences.
Keep going and pushback even if polite shows you're going in the right direction ♥️