APS Annual Scientific Meeting

[Jon Newman]

I was able to attend the annual meeting in 2006 and I recommend it for anyone interested in pain physiology and treatment. There were very few PTs that I know of at the last event. Perhaps we can change that this year.

Apparently registration is now open although the program is not yet set.

So for you early birds with faith that this will be worth attending, here's a link (http://www.ampainsoc.org/meeting/)

[Jon Newman]

Here are some highlights of the meeting according to some early literature.

Robert Gatchel, PhD. won this year's Wilbert E. Fordyce Clinical Investigator award and his lecture will be "Biopsychosocial approach to the etiology, assessment, treatment, and prevention of chronic pain"

George Wilcox, PhD., won the Frederick W.L. Kerr Basic Science Research and his lecture will be, "Neurochemistry of Pain and Analgesia at the First Afferent Synapse."

There will be some plenary sessions that include the following titles and lecturers

"Glial-Neuronal Interactions" by Joyce DeLeo, PhD.

"The Nature and Nurture of Pain" by Jeffrey Mogil, PhD.

"Obstetric Pain: Acute and Chronic?" by James Eisenach, MD

"Decade of Pain Lecture: Advancing Pain and Palliative Care Nationally and Globally" by Kathleen Foley, MD

There will also be a pediatric pain forum for those interested.

[Jon Newman]

Here's the program description of the conference (the pre-conference course centers on pediatric pain for those interested)

Thursday (http://www.ampainsoc.org/meeting/annual_07/prog_desc_thurs.htm)

Friday (http://www.ampainsoc.org/meeting/annual_07/prog_desc_fri.htm)

Saturday (http://www.ampainsoc.org/meeting/annual_07/prog_desc_sat.htm)

Those participating in the Discussion on another forum (http://www.somasimple.com/forums/showthread.php?t=3401&highlight=discussion+another) thread might find some clarification to lingering questions.

I see Julie Fritz is presenting this year if that is incentive for anyone. I'm glad to see a PT has made one of the main lecture events this year. Yeah Julie.

[Jason Silvernail]

I see my friend Kathleen Sluka is presenting. She tortures small animals for a living. She was at CSM a few years ago presenting about pain patterns in rats. Which is real helpful the next time I have a rat in the clinic. I've no idea how she sleeps at night. Yea science!
On a positive note, it appears Julie Fritz is there to talk about mechanism of action and use of spinal manipulation therapy. The fact that a PT is there and not a US Osteopath or Chiropractor, is significant I think. In a good way.

"Atrocites are not less atrocities when the occur in labs and are called 'medical research'" -- GB Shaw

[bernard]

Which is real helpful the next time I have a rat in the clinic.

It may happen, Jason, It may happen...

[Jon Newman]

Oh thanks for the heads up Jason I missed that.

So a shout out (HEY!) to Kathleen Sluka, Marie Hoeger Bement, and Julie Fritz for getting to the APS meeting this year.

And you'll be relieved to know that they're considering "principles of exercise prescription, derived from human clinical studies" in the session that Kathleen is moderating.

[Diane]

As a generally kind sort of human who belongs to a profession that overall is comprised of people who have kindness in them, and who want to make a living helping not hurting others, I want to paradoxically stick up for the pain researchers who torture rats. :sad: It would be pretty hard to build biological science without rat sacrifices, especially pain science.

Rat sacrifices may seem cruel, but the studies meticulously done upon them are important. Rats don't fake pain, so if they exhibit pain behavior, one can presume they actually have it. Down the line, it becomes important to have winnowed out all the pathways when other people have to draw conclusions about policy. :secret: When we think about it relative to all the deaths that have ever taken place at the hands of human primates, deaths of entire ecosystems and extinction (by starvation! how cruel is that?) of all the animals that depended on them, rat sacrifices to further pain science doesn't seem as big a crime. How about the fact that human primates sacrificed lots of animals (ok, maybe not rats as such) over the years strictly for religious reasons.. is that less cruel? I think not. :mad: :thumbs_do
How about meat eating, slaughterhouses.. the carnage is ubiquitous. :(

I forgive the pain researchers their rat studies, however I do not forgive the spine researchers their cat sacrifices to study manipulation effects. That's how arbitrary I am. I also forgive the cranial researchers the rabbits sacrificed to show definitively that cranial bones don't separate with five grams of tug. :eek: It was an important study and I hope everyone reads it so it never needs to be repeated.

[Jon Newman]

For those interested in the pediatric pain pre-conference course, here is a description (http://www.ampainsoc.org/meeting/annual_07/pediatric.htm).

I received a message from Mike Sangster today who is planning on attending the meeting this year. He was wondering about a PT meet up this year. If anyone else is going to the conference this year chime in and maybe something can be arranged.

Drew, are you still reading along?

[Jon Newman]

Well Mike, it's quite possible that there will be twice as many PTs at this meeting than last year if you count yourself and the PT lecturers. As probably should be, most US PTs attending any big conference will be attending the APTA conference in Boston.

By the way, if anyone going to Boston finds a mooninite let me know. And don't call the cops.

Or maybe you should call the cops but you may want to ask if they the a counter-cultural specialist.

[Jon Newman]

Hi Mike,

Did you make it to the conference? It would be nice to have another point of view represented.

One of the presentations I attended was titled Acceptance, Mindfulness, Values, and Cognition in a Contextual, Cognitive-Behavioral Approach to Chronic Pain.

This might be a multi-part entry depending on my motivation. The researchers in attendance included Kevin Vowles (http://www.bath.ac.uk/psychology/about/staffdetail.cfm?StaffID=kv), Lance McCracken (http://www.bath.ac.uk/psychology/about/staffdetail.cfm?StaffID=mccracken) and Jennifer Haythornthwaite (http://www.hopkinsmedicine.org/Psychiatry/Faculty/H/Haythornthwaite.html). I think I've got that right. Beth Dinoff was also scheduled but unable to attend.

I'll start with some definitions/descriptions from the presentation

Psychological Inflexibility--Process based in interactions of language and cognition with direct experiences that produce an inability to persist in or change a behavior pattern in the service of long term goals or values.See also this paper (http://www.somasimple.com/forums/showpost.php?p=32283&postcount=1).


They then went on to describe the concept of cognitive fusion/defusion.

First consider a spectrum of cognitions with true, rational and helpful cognitions at one end and untrue, irrational and unhelpful cognitions at the other. Cognitive fusion/defusion exist on a somewhat orthogonal scale.

Fused, in this context, means being

overwhelmed by thought content, loss of contact with present situation, behavior options narrowed.Defused means being

aware of reactions as reactions, contact with wider situation beyond thoughts, access to a range of responses.In other words thoughts have a dimension of literal truth or consistency with reality. They also have a dimension of the functions or influences they exert. Cognitive fusion is the degree to which these influences are exclusive or response narrowing, the degree to which they produce insensitivity and inflexibility.I'll finish with a quick example in their power point presentation. Consider the cognition "I can't go on"

In the context of having a loss of contact with the present, experiential unwillingness, cognitive fusion and values failure the available action is likely "stopping". On the other hand with the same cognition, the context of mindfulness, acceptance, cognitive defusion and values based action results in the options of "stopping" or "carrying on."

They presented the radical idea that

It may be difficult for patients to talk or think their way out of problems based in talking or thinkingThey go on to state

In many cases of pain, at least some the time, control is not the solution, it's the problem.Later I'll post about acceptance, mindfulness and values. If there is an outcry for outcomes I'll post those too.

[Jon Newman]

Here's some more descriptions of concepts.

Acceptance (of chronic pain)

Process of flexible and practical action free from unnecessary restrictions by pain.

--Engagement in activities with pain present
--Absence of attempt to limit contact with pain

Mindfulness

--Moment to moment non-judgemental awareness
--A quality of behavior that includes full, flexible, non-defensive, non-reactive, and present focused contact with experienced events.

Values

--Verbally construed, global, desired life consequences
--Chosen life directions or guides for living in relation to family, intimate relations, friends, work, health, growth, learning.

[Jon Newman]

Summary


No one wants pain
It appears that largely verbally-based processes mix with direct experiences of of pain and exert restricting influences on patient behavior that are contextually determined.
The result is referred to as psychological inflexibility.
Treatment approaches to chronic pain can now aim to alter the content of experience or the context by which these experiences (a) generate additional negatively evaluated experiences, and (b) occasion unworkable behavior patterns.

During the course of the lecture it was emphasized that everyone involved with the patients possessed a similar understanding of the concepts presented in the previous posts (which is not meant to be interpreted as an exhaustive description of the approach.) PT/OTs were encouraged to use these concepts within the framework of their practice.
The evidence used to support this work can be found by checking out the published work of these researchers (http://www.somasimple.com/forums/showpost.php?p=32556&postcount=10). They also presented some work that is still under review for publication.

[Line M]

Hello all,

Enclosed are 2 presentations held on 12 and 13 June 2007 in Hoensbroek Revalidation Centre in the Netherlans on Acceptance and Commitment Therapy (ACT) and its implementation in chronic pain treatment by JoAnne Dahl from Uppsala, Sweden and Lance McCracken from Bath, United Kingdom. Also enclosed an abstract of the meeting, partially in dutch, partially in english.
I found them in open source and hope I posted them in the right place.

Kind regards,
Line

[Jon Newman]

Hi Line,

Thanks for those. The second slide set was essentially the same as one (of three) slide sets used at the conference I blogged about in this thread.

The first slide set you posted featured a "tiger metaphor" (slides 16, 17, 18) but it wasn't in English and I couldn't read it. I'm guessing it was Dutch or Danish? Can anyone translate it? There were a few other slides also but the metaphor might be the most useful one to translate.

One of the great things about Barrett's course are the metaphors he uses. You can unpack some of those in the clinic the very next day.

I think Lance's work is very important because he addresses one of the most feared issues (I think) in PT. Acceptance.

[Line M]

The slides of the "tiger metaphore" and other in JoAnne Dahls presentation are in Swedish I guess... Hypothesis dropped on a course i attended: without acceptance one keeps being attached to emotional and physical pain.

[Mary C]

Thanks Line. The references list will keep me busy for a while. :)