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Had the wonderful opportunity to hear @nabualaw lead the discussion for the @BPSPainEthics talk on self-management today. The thing that stuck with me the most was when Jackie talked about how we seem to operate within a personal responsibility model of pain.
That in western models of care, pain is situated wholly w/in the individual, & the treatment or management of pain is about changing the individual in some way, be it through biomedical or behavioral approaches. The 'social' in biopsychosocial is barely there, rarely touched upon
During the discussion, Professor Loeser talked about taking a sociopsychobiological approach to understanding and treating pain, particularly complex pain, which was reinforced by @DeepakRavindra5 further along the discussion as well. All of this resonates strongly with me!
These individual bio-& behavioral-focused approaches of changing the individual lend themselves to perpetuating stigma, to blaming patients when the complexity of their pain isn't well understood or doesn't respond to treatment as it 'should', & associated shame patients may feel
How do we change this? How do we shift from only treating individuals bereft of their particular contexts to treating from a more socially oriented perspective? Afterall, the social does not just happen external to the person, it's not somehow separate from our biology/psychology
What happens if we view pain not as a personal responsibility, but a social responsibility that, in part, has social solutions? @DeepakRavindra5 talked about community-driven solutions (& gave us pain patient advocates a shout out-thx Deepak!) that are being done at local levels
and @mellojonny noted that complex pain is a difficult problem that needs lots of local/small projects to coalesce into a SOCIAL movement and CULTURUAL change. That local contexts will determine how services will evolve. @DeepakRavindra5 called it co-creating an eco-system.
Into all this fits what @IntegraTherapy called the safe container (shoutout @MaxiMiciak), @betsanwellbeing's work in well-being clinics, @mellojonny's mention of salutogenesis, @LivingWellPain's mention of supported self-management & @DeepakRavindra5's community driven solutions.
How do we bring it all together? It gives me such hope these conversations are even taking place! There's a revolution afoot, & people living w/pain have to be a part of it if we are to truly revolutionize pain care. We all have to come together to create these paths forward.
End note - I have paraphrased and summarized a really rich discussion and missed really important bits and I'm sure I got some bits wrong - all of that is on me, not anyone I've tagged (& please correct me if I did get it wrong!)! I really appreciate @nabualaw leading this today!
