Pain Management: Somatoform Disorders

[synapse131]

This is such BS. "Conversion Disorder" explaining hyperalgesia and micro-circulatory dysfunction? When there is such a wealth of evidence explaining the neurology of hyperalgesia and illuminating the causes, such as ischemia and viral infection in the brain, the presentation of this overly simplistic notion from the 19th century that lacks any scientific basis (or even basic logic) is irresponsible. Nice theory but.... These guys are about 30-40 years behind current research.

[synapse131]

Thanks to the guy who stands up for scientific integrity later on in the video. That people with psych issues who experience hypochondriasis exist can't be denied but I like how this guy does stand up and explain that there are things that we don't understand and to dismiss the patient as a psych case is inappropriate. Much of what these doctors are talking about is the need for counter-transferrence.

[synapse131]

But again, the need for counter-transferrence is demonstrated when the bearded guy comes up with this nice little "logical explanation" for why the patient might be attention seeking. It might just be that he is desperately trying to manage (obviously without support or resources from family; sometimes they just check out and can't handle a serious medical condition) and the only help that he has is the doctor's office.

[synapse131]

The bearded guy is only seeing it from the perspective of the "harrassed" doctor and not even trying to put himself into the context of the patient and what he might really be going through. Conveniently, he gets to blame the patient for the problem and then write that patient off or treat them brusqely instead of doing their job and helping the patient obtain assistance and further services that might further stabilize the patient.

[xSimplyAmusedx]

couldnt make it any shorter?

[simonjoverton]

I read a great book on this subject called "Charcot's Bad Idea"

[malcolm9001]

professional all the way through, nothing anti-social going on here gets my stamp of approval

[TerryBerry999]

good discussion on complicated pain case. Good to docs want to help. I'm not in total agreement with Cleveland Clinic doc, however. There are times when holding your back offers support, stretches muscles. I didn't appreciate what I felt were judgments of people in pain, ie, his determining that grunting is to let others know of one's pain. I grunt if no one is around - it is not conscious, but I think it is probably a release after holding my breathe from pain (not a good response, I know.)

[axollot]

yeah I liked the Cleveland Doc and disliked him almost in equal measure. I too make noises, stretch etc just as much if not MORE (I'm more vocal about my pain alone & will let it out) when alone. Also, when the nerve or muscles seizes it's a reflex action to grab your back! But I could see his point on many of his suggestions & he is looking to treat the whole patient not just 1 segment. Thank God I have a good doctor right now. I've seen so many jerks in the 10yrs of chronic pain.

[synapse131]

@TerryBerry999 I never understand how people can come to the conclusion that making noise or expressing pain in some other way is only a way of gaining attention. It's just an assumption without any basis. People do these things naturally without even realizing it.

[ee910285]

pain experts and do not know how to quantisize pain.! lol

[gnikhilg]

seemed a bit of an invasion of privacy- no sense that patient consented. but interesting discussion- maybe should have called a psychologist/social worker too-

[JamesTypeO]

This is a very good discussion. If you take the time to watch the whole thing, there is some valuable information.

[Mynaeris]

Takes a really long time to get to the real discussion

[gsthobois]

The details are important and to be fair if this was about your life, What parts would you want to be taken out OR I mean what details or facts would you want your doc to leave when getting help with this comprehensive team or panel?

[back2nrml]

ya maybe i would whach the fuckin clip if their wasnet a dumb ass introduction.

[cujoforlife]

wow take your time

[back2nrml]

ya maybe i would whach the fuckin clip if their wasnet a dumb ass introduction.