We feel what we fear

Even at their sharpest, brains mistake new stimuli for scary old wounds. We feel what we fear. And what if we fear a lot? What if our judgement is poor? This grave tweet grabbed my attention recently:

The worst diseases known to science pale in comparison to the chronic and untreatable nature of somatoform disorders.

Mark Reid, MD, Twitter, @MedicalAxioms, Apr 16, 2015

Somatoform disorders are mental illnesses that cause bodily symptoms, including pain (especially pain). There are several sub-types of somatoform disorder, such as conversion disorders, in which emotional stress is “converted” into physical disabilities like blindness or trouble swallowing. They are a big deal and an extreme example — maybe the most extreme example — of how pain is weird, because it is entirely generated by the brain… which can be fooled. By a red herring on an MRI. By a doctor who warns, “This might need surgery.” By a Google search that turns up a scary possibility. By the sneaky side effect of a drug. Or by the haze of mental illness.

Even “just” depression and anxiety are strongly associated with chronic pain, because they warp our reasoning towards worst-case scenarios, but that’s just the tip of the iceberg. Imagine how much worse it can be, how completely a mind might succumb to the fear that something dangerous is going on.

But imagine it carefully, please.