Detailed guides to painful problems, treatments & more

We feel what we fear

 •  • by Paul Ingraham
Get posts in your inbox:
Weekly nuggets of pain science news and insight, usually 100-300 words, with the occasional longer post. The blog is the “director’s commentary” on the core content of a library of major articles and books about common painful problems and popular treatments. See the blog archives or updates for the whole site.

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.

PainSci Member Login » Submit your email to unlock member content. If you can’t remember/access your registration email, please contact me. ~ Paul Ingraham, PainSci Publisher