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How Important is this Really?

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  • How Important is this Really?

    Posted by Eric Matheson<script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,3,30,23,45,0), dfrm, tfrm, 0, 0, 0, 0)); </script> (Member # 2368) on 01-05-2005 06:45<noscript>April 30, 2005 11:45 PM</noscript>:

    A few weeks ago Lorimer Moseley was in Vancouver to give a lecture which I managed to attend. He spoke passionately about his work for an entertaining four hours.
    To illustrate how the subconscious mind arrives at decisions regarding the signals it receives from the periphery he used examples pertaining to our perception of visual information. These aren’t the same examples he used but they do very nicely. lightness and perception illusions (they come with sound!) Thanks to Matthias for providing a link to these on noi.
    I’m trying to incorporate a few of these into pain education sessions I provide for my patients.

    What do these images teach us about the experience of pain?

    I think firstly this shows how fast this processing actually takes place (80 milliseconds?). With respect to incoming potential danger signals, Moseley argued the brain works the same way in deciding, “how important is this, really?” Now matter how many times I look at these images or read the explanations, I can’t ever see the apparently different shades of grey as being the same. (wishful thinking and prolonged staring at the screen only dries out my contact lenses) I don’t seem able to consciously teach the unconscious to interpret the visual signals differently. I realize I may be comparing apples and oranges, but to some extent are our unconscious responses to danger signals similarly hard-wired or do we have potential to make them change? How plastic is this mechanism and is it worth the effort? Or am I just in a cynical mood tonight?
    <hr> Posted by Diane (Member # 1064) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,1,0,3,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 01-05-2005 07:03<noscript>May 01, 2005 12:03 AM</noscript>:

    You must be cynical Eric. [IMG]smile.gif[/IMG]

    I recall from the lecture the work Lorimer is doing (it's not done yet) about longterm outcomes regarding pain perception and downregulation following pain physiology education. Do you remember? the figure was something like 60% less overall in pain measurements, something quite large like that, compared to the groups who were treated but did not receive pain physiology education. Short term there wasn't much difference in the reported improvements from both types of treatment, but the graph was spreading further apart over time, so the main improvements were seen way downstream in the long term, after the cognitive information had had a chance to percolate through and be used by the patients in their own lives.

    Gave me lots of hope actually, fueled me to continue to explain pain to people.
    <hr> Posted by nari (Member # 2772) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,1,3,35,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 01-05-2005 10:35<noscript>May 01, 2005 03:35 AM</noscript>:

    It certainly does tend to percolate down the line, more so in some than in others.
    It helps to explain in language that most people will understand, and on their own terms of pain experience. I find patients come back after a long term of absence, still remembering that the brain decides on whether they will feel pain, and insted of 'them', owning the pain, the brain does.
    Some of them tell the pain off -'go away, I don't need you today' and find that it helps quite a bit. Others believe it is mere distraction that works, but it isn't - it goes deeper.

    <hr> Posted by Jon Newman (Member # 3148) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,1,8,0,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 01-05-2005 15:00<noscript>May 01, 2005 08:00 AM</noscript>:

    Hi Eric,

    Here are some of my thoughts.

    First, the visual illusions (which they all were) demonstrate the importance of context in perception. Change the context, change the perception. Interestingly, in order to perceive the true situation, one must also have the appropriate context...assuming the truth one seeks is picking out equivalent grey scales.

    I wonder if someone well versed in the use of color, etc would be able to pick out the similar greys? That is, while you studied it I'm assuming you didn't devote your life to trying to figure it out.

    Still, that doesn't mean that someone who may be able to figure this out doesn't see what you or I see--I'm sure they do. I think this is where the apples and oranges part comes in. In the visual illusion example the stuff being manipulated is external to our bodies. And thus is subject to some sort of stability or objective reality accessible by others. In painful conditions we are manipulating our internal environment.
    This is one of the reasons I find touch so fasicinating. It happens on the boundry between the two environments.

    In A Boat On This Lake

    <hr> Posted by Eric Matheson (Member # 2368) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,1,11,49,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 01-05-2005 18:49<noscript>May 01, 2005 11:49 AM</noscript>:

    As usual excellent answers, thanks for helping me play with these ideas. Jon's post reminds us that the only way we can actually impact perception in the present is by changing the context. That's what physiotherapy for pain relief is really all about. Simple isn't it! Great poem by the way.
    <hr> Posted by Jon Newman (Member # 3148) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,7,21,16,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 08-05-2005 04:16<noscript>May 07, 2005 09:16 PM</noscript>:

    I just read this today and thought it was quite interesting.

    I posted it here because it highlights that context of the problem may actually be quite important in ways I didn't previously consider.

    I posted it at all because the way we study pain separate from a social interaction seems at least similar to the way the two different puzzles were presented.

    <hr> Posted by nari (Member # 2772) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,8,5,59,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 08-05-2005 12:59<noscript>May 08, 2005 05:59 AM</noscript>:


    Predictably, I got #1 wrong and #2 right.

    There are lots of these illusory puzzles around on the net and it just seems so easy for the brain to trick us. We form opinions about people or our patients that are based on what we see and hear, but primarily on what we see, and that is biased by our beliefs and perceptions. If someone walks in with a nearly shaven head, studs and torn jeans, assumptions are made that he is weird or unsavoury or dumb or all three. Likewise, if he has pain, we might suspect he is not 'for real' and form opinions about the 'credibility' of his pain, though we would never show it.

    How visual input is interpreted is fascinating. Indeed the brain may well decide 'this is not important' whether we agree or not - if we had the choice.

    <hr> Posted by Jon Newman (Member # 3148) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,9,7,55,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 09-05-2005 14:55<noscript>May 09, 2005 07:55 AM</noscript>:

    Hi Nari,

    I too got the first one wrong. I think the reason is that we understand that beer=alcohol and soda = non-alcohol. However, we make an assumption that since d is always paired with 3 that 3 is always paired with d, which it is not. Thus we are tempted to flip it.

    The social scenario brings with it implicit understanding of the rules of logic. However, it is also dualistic while the other example is not. You are either over 21 or not. You are either drinking alcohol or not (and we can recoginize drinks which are alcoholic).

    Still, the fMRI demonstrated that these scenarios are processed differently and leads to why I now think I found this interesting. I had just posted an article titled Different Ways Of Thinking And Thinking In Different Ways that states

    quote: <hr> Now, a great part of the nature vs. nurture debate is also directed towards establishing which is more deeply embedded in the mind’s structure. Somehow scientists think that the deeper one is, the more it determines behavior and the more powerful and significant their findings or claims. However, depth shouldn’t be the issue here. The planes described above serve to approach the problem of what is universal in a more comprehensible way not to set a hierarchical order of importance, measure the impact of nature/nurture or justify deterministic explanations. Besides, although the third plane can seem to have less depth, the variables (“x’s” and “y’s”) are in fact part of the computations of plane two so they could also be seen as deeply ingrained in a person’s mind. The important thing is to see them as the variables (no matter their “depth”) not as the actual computations.

    However, it would seem that since these two puzzles seem to share similarity (logic problem) they are indeed processed differently. In other words, people use different ways of thinking, as expressed by the fMRI, to solve the two types of puzzles suggesting that the 'thinking' article may be in some error.

    However, I could be the one in error in that perhaps when solving social scenario logic problems we 'ping' other areas of the brain that the strict numbers and letter don't but these areas don't help in solving the problem as much as they are an artifact in the problem solving--value added so to speak.

    Ultimately I think this might be the case and that the reason one problem gets solved more readily than the other is because they are not logical equivalents. I'll have to read the original paper to find out.

    If it turns out that we do indeed use different ways of thinking, I think this would have some impact on how we educate patients as it relates to pain (or anything) which is why I'm bothering with this post at all.

    Lastly, it seems to me people crave the letters and numbers explanation when it comes to their pain versus a social scenario explanation. In fact those who use the social scenario to explain their pain are the 'yellow flag' patients.

    <hr> Posted by nari (Member # 2772) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,9,19,16,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 10-05-2005 02:16<noscript>May 09, 2005 07:16 PM</noscript>:

    Hello jon

    I like the plane concept, and I can run to four 'planes' / dimensions, then lose the plot altogether.
    This aspect of thinking in different ways and different ways of thinking is a bit circular..but it has come up time and time again in the BBs, here and the other two. Different ways of thinking, certainly, but the outcome is often very similar or the same. Yet we as a tribe take the topic quite seriously; major wars have occurred for centuries because a couple of tribes had different ways of thinking; only to find that in the end. things were much the same as before.

    To me, yellow flag patients are the ones who seem to be very cagey and vague about the facts of their life and pain; the ones who want figures such as in the pain disability scales, often say:
    "So I'm better, then, am I?" which amazes me, and says a lot about their loss of integrity..and leaves me speechless as to how to get around that statement, (which is often unexpected).

    But as a whole, one could say that some patients feel happy about the rise in positive values, and that aspect in itself will improve the pain experience.

    <hr> Posted by Jon Newman (Member # 3148) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,9,21,35,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 10-05-2005 04:35<noscript>May 09, 2005 09:35 PM</noscript>:

    Hi Nari,

    I agree that the person with the non-pathological pain is ultimately the one that produces a behavior that relieves their pain and helping them toward that behavior is an intriguing part of the job, at least for me.

    I would like to clarify a bit of my earlier post with an example.

    Consider a person with persistent low back pain. That person in likely to want to understand the cause of their pain but on a "plane" particular to them. The "thinking in different ways" article suggests it shouldn't matter what plane because the the processing is ultimately the same. But according to the essay that considered differences in fMRI scanning and the results of using similar logic in disparate contexts suggests one should frame the explanation of pain in terms of a social scenario in order to convey the logic of how one comes to find themselves in pain. Barrett does this frequently (ala "The Culture")when speaking to therapists (and perhaps his patients) but is not always well recieved when he does so, at least not that I can tell. This suprises me because it should actually be easier to understand according to the one study. Of course in his Cross Country presentations he uses a variety of contexts to provide info.

    I use both methods in treatment hoping to reinforce a concept by framing it in different contexts. However, like the above example, I've noted that people often only get it when the appropriate context for delivering the information was choosen. Picking the context continues to be a challenge for me (in a "this makes my job more interesting" sort of way).

    <hr> Posted by Eric Matheson (Member # 2368) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,10,7,19,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 10-05-2005 14:19<noscript>May 10, 2005 07:19 AM</noscript>:

    Has either of you read this?
    inevitable illusions
    I haven't yet, but it is on a list I made sometime ago.
    <hr> Posted by Jon Newman (Member # 3148) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,10,8,53,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 10-05-2005 15:53<noscript>May 10, 2005 08:53 AM</noscript>:

    Hi Eric,

    No I haven't read it but since I make these types of mistakes more often than I care to admit, I've become well aware of the phenomena.

    <hr> Posted by Diane (Member # 1064) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,10,19,9,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 11-05-2005 02:09<noscript>May 10, 2005 07:09 PM</noscript>:

    I have that book. I inevitably fall prey to the illusion that I'll have all the time in the world to read all the books I accumulate.
    <hr> Posted by nari (Member # 2772) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,10,20,15,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 11-05-2005 03:15<noscript>May 10, 2005 08:15 PM</noscript>:

    I agree with Diane and jon- illusion holes are easy to fall into, and i will never get to read all the books I want to, because publishers keep on printing more and more, due to those pesky authors writing more..

    I'll just have to retire...

    Last edited by bernard; 29-12-2005, 05:37 PM.
    Simplicity is the ultimate sophistication. L VINCI
    We are to admit no more causes of natural things than such as are both true and sufficient to explain their appearances. I NEWTON

    Everything should be made as simple as possible, but not a bit simpler.
    If you can't explain it simply, you don't understand it well enough. Albert Einstein