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.