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Pain is an emergent system

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  • #16
    Throw something into a cauldron (referenced in this thread). Large things happen, small things, invisible things, things that have a large effect and are flashy, things that have a small effect and are flashy - and the opposite.

    As long as we remain convinced that the world has a causal nature we will feel compelled to search for that.

    But it doesn't.
    Barrett L. Dorko

    Comment


    • #17
      Nokian do.

      I think this illustrates perfectly, a lot of what we are discussing in this thread. Well, IMOHO anyways...

      [YT]uub0z8wJfhU&feature=player_embedded[/YT]

      Last edited by caro; 06-02-2012, 06:53 PM.
      Carol Lynn Chevrier LMT
      " The truth is, people may see things differently. But they don't really want to. '' Don Draper.

      Comment


      • #18
        Carol,

        Interesting selection. This months ISPI newsletter contained an editorial about a quote that Lorimer wrote in this therapists Explain Pain book when he signed it.

        "May your Ornithology never highjack Amazing Grace."
        This quote confused me significantly at first because I was thinking of ornithology as the study of birds, but I'm sure Lorimer meant this ornithology. I think in your example the nokia ring tone definitely high-jacked this wonderful performance.
        Kory Zimney, PT, DPT

        http://koryzimney.blogspot.com

        "Study principles not methods, a mind that can grasp principles will create its own methods." - Gill

        "All truths are easy to understand once they are discovered; the point is to discover them." - Galileo Galilei

        Comment


        • #19
          Not sure if I have been taking at cross purposes. I would understand pain as being an emergent property arising from the complex interaction that gives rise to a particular pattern of neural excitation associated with its perception. It was the property that I initially would see as emergent, I would not I think be adverse to the assertion that the nervous system is an emergent system arising from a similar the complex interaction. I thought we were looking at emergence from chaos?

          I am not sure that I swallow Damasio's assertion,
          The different parts of the consciousness puzzle have to be treated separately and given their due before we can attempt a comprehensive account.
          To me this smacks of a reductionist seeking to have their cake an eat it but I have only this quote to go on and have evidently not read the book so lack context.

          regards

          ANdy
          "Here is Edward Bear coming downstairs now, bump, bump, bump, on the back of his head behind Christopher Robin. It is, as far as he knows, the only way of coming downstairs, but sometimes he feels that there is another way, if only he could stop bumping for a moment and think of it." A.A. Milne

          Comment


          • #20
            Yes, Andy I think we have to see emergence from chaos.

            It goes without saying that the construction of a conscious mind is a very
            complex process, the result of additions and deletions of brain mechanisms over
            millions of years of biological evolution. No single device or mechanism can
            account for the complexity of the conscious mind. The different parts of the
            consciousness puzzle have to be treated separately and given their due before we
            can attempt a comprehensive account.
            Still, it is helpful to start with a general hypothesis.
            I really like how Damasio's statement fits into this. Let me reword it specific to pain.
            It goes without saying that the consturction of pain is a very complex process, the result of additions and deletions of brain mechanisms over millions of years of biological evolution. No single device or mechanism (posture, biomechanics, trigger point, strength/stability, nociceptioin, etc) can account for the complexity of pain. The different parts ot the pain puzzle have to be treated seperately and given their due (understand them in a linear fasion) before we can attempt a comprehensive account (complete understanding of how they all fit together in an emergent, nonlinear, system). Still, it is helpful to start with a general hypothesis (neuromatrix of pain).

            Back to your elephant parts view. We need to see and understand each part of the elephant (trunk, tail, ears, foot, etc) in full due before we can fully understand the elephant. But as he stated we need to start with a general hypothesis, framework if you will, to start putting these parts together in proper context with each other.

            This has been stated before, it's not that biomechanics, posture, strength/stability, maybe even trigger points (whatever they actually are) aren't important just they need to be seen within the bigger framework of pain (neuromatrix). While each property is probably linear in nature in isolation, but because they are under this bigger overarching framework they are not linear in nature as a whole, because the overarching framework is emergent. An emergent system is never linear.

            If you take a muscle out of the nervous system it has distinct properties - so many volts to get it to contract, it can produce so much force depending on amount of volts and motor units stimulated. In of itself a muscle can be very linear in our prediction of what it can do. But when put into an overarching emergent nervous system it no longer holds those same linear patterns on any basis that we can predict. (I think we have heard others say that before.) Those that are stuck on the individual parts of the elephant, looking at their specific part as linear struggle with this. Because in isolation their individual part is predictable, but they're missing that it functions in an emergent system that is not linear.

            (I hope to get into the original text about Eric Turheimer's example with poverty this evening to expand on this thought)
            Last edited by zimney3pt; 06-02-2012, 10:12 PM.
            Kory Zimney, PT, DPT

            http://koryzimney.blogspot.com

            "Study principles not methods, a mind that can grasp principles will create its own methods." - Gill

            "All truths are easy to understand once they are discovered; the point is to discover them." - Galileo Galilei

            Comment


            • #21
              It might just be a polite submission gesture, included to deflect academic gear grinding from those of his troop who feel threatened by his fame and clarity.
              Diane
              www.dermoneuromodulation.com
              SensibleSolutionsPhysiotherapy
              HumanAntiGravitySuit blog
              Neurotonics PT Teamblog
              Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
              Canadian Physiotherapy Association Pain Science Division Facebook page
              @PainPhysiosCan
              WCPT PhysiotherapyPainNetwork on Facebook
              @WCPTPTPN
              Neuroscience and Pain Science for Manual PTs Facebook page

              @dfjpt
              SomaSimple on Facebook
              @somasimple

              "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

              “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

              “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

              "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

              "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

              Comment


              • #22
                That it might Diane,

                I am troubled a bit by the bits of the elephant although I think we might be at sixes and sevens over this. It seems to me that part of the trouble is many PT's and other lay claim to parts of the elephant as if it were the elephant itself, e.g. trigger points being a recent example or MFR as another where there are claims made unwarranted by the evidence at hand (a trunk or tail or some other feature of elephantishness). The actual elephant is something altogether different both qualitatively and quantitatively. I wonder do we need the complexity of the components in order to address the issue and is that not maybe where we get lost and become biological schismatics where no schism belongs?

                I do wonder also about the linearity of parts, can we use such terms when we are referring however simplistically to "parts" such as neuro-immunology and neuro-transmission?

                regards

                ANdy
                Last edited by amacs; 06-02-2012, 11:24 PM.
                "Here is Edward Bear coming downstairs now, bump, bump, bump, on the back of his head behind Christopher Robin. It is, as far as he knows, the only way of coming downstairs, but sometimes he feels that there is another way, if only he could stop bumping for a moment and think of it." A.A. Milne

                Comment


                • #23
                  Yes, I think category errors are universal. Not that we should stop trying to untangle them all..
                  Diane
                  www.dermoneuromodulation.com
                  SensibleSolutionsPhysiotherapy
                  HumanAntiGravitySuit blog
                  Neurotonics PT Teamblog
                  Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
                  Canadian Physiotherapy Association Pain Science Division Facebook page
                  @PainPhysiosCan
                  WCPT PhysiotherapyPainNetwork on Facebook
                  @WCPTPTPN
                  Neuroscience and Pain Science for Manual PTs Facebook page

                  @dfjpt
                  SomaSimple on Facebook
                  @somasimple

                  "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

                  “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

                  “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

                  "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

                  "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

                  Comment


                  • #24
                    It might be a bit overstated to assert that all such errors are of the category variety!
                    "Here is Edward Bear coming downstairs now, bump, bump, bump, on the back of his head behind Christopher Robin. It is, as far as he knows, the only way of coming downstairs, but sometimes he feels that there is another way, if only he could stop bumping for a moment and think of it." A.A. Milne

                    Comment


                    • #25
                      Originally posted by amacs View Post
                      It might be a bit overstated to assert that all such errors are of the category variety!

                      Of course! That's the first category of error I jump to!
                      Diane
                      www.dermoneuromodulation.com
                      SensibleSolutionsPhysiotherapy
                      HumanAntiGravitySuit blog
                      Neurotonics PT Teamblog
                      Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
                      Canadian Physiotherapy Association Pain Science Division Facebook page
                      @PainPhysiosCan
                      WCPT PhysiotherapyPainNetwork on Facebook
                      @WCPTPTPN
                      Neuroscience and Pain Science for Manual PTs Facebook page

                      @dfjpt
                      SomaSimple on Facebook
                      @somasimple

                      "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

                      “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

                      “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

                      "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

                      "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

                      Comment


                      • #26
                        Andy, your right on the money:
                        It seems to me that part of the trouble is many PT's and other lay claim to parts of the elephant as if it were the elephant itself,
                        And that is what I want to get into with the example from Eric Turheimer and poverty. But I don't want it to look like I'm skipping over that cultures are also an emergent system as I try to break the lines for The Social Animal down. I plan on coming back to it. But for now lets just appreciate the complexity within the complexity.

                        We have an emergent nervous system that functions in an emergent culture system. So that is a nonlinear system working in a nonlinear culture, and people think they can predict with any sort of certainty what the outcome will be? They don't cancel each other out in this algebraic equation, they only multiply the complexity as far as I can tell.
                        Kory Zimney, PT, DPT

                        http://koryzimney.blogspot.com

                        "Study principles not methods, a mind that can grasp principles will create its own methods." - Gill

                        "All truths are easy to understand once they are discovered; the point is to discover them." - Galileo Galilei

                        Comment


                        • #27
                          In 2003 Eric Turheimer of the University of Virginia published a study that showed that growing up in poverty can lead to a lower IQ. Journalists naturally asked him: what can be done to boost IQ development in poor children? “The honest answer to the question is that I don’t think there is anything in particular about the environment that is responsible for the effects of poverty,” he wrote later. “I don’t think there is any single thing in an impoverished environment that is responsible for the deleterious effects of poverty.”
                          Turheimer noticed that their was nothing particular in the environment that was responsible for the effects of poverty. Again lets restate what he said in the last sentence by replacing the emergent system of poverty with the emergent system we are dealing with here.
                          I don't think there is any single thing in a persistent pain patient that is responsible for the deleterious effects of pain.
                          Sure those in poverty tended to have lower IQs (but there were some that had higher IQs I would guess and still were in poverty), as if raising their IQ would get them out of poverty. Turheimer realized it would not help. Those with persistent pain tend to have decrease muscle strength/stability, smudged body image/proprioception, more tender points, etc but none of those in of themselves are responsible for pain. And solely working on them will never work on getting them out of pain (long term, I'll be coming back to this idea).
                          Kory Zimney, PT, DPT

                          http://koryzimney.blogspot.com

                          "Study principles not methods, a mind that can grasp principles will create its own methods." - Gill

                          "All truths are easy to understand once they are discovered; the point is to discover them." - Galileo Galilei

                          Comment


                          • #28
                            Turkheimer had spent years trying to find which parts of growing up with a poor background produced the most negative results. He could easily show the total results of poverty, but when he tried to measure the impact of specific variables, he found there was nothing there. He conducted a meta-analysis of forty-three studies that scrutinized which specific elements of a child’s background most powerfully shaped cognitive deficiencies. The studies failed to demonstrate the power of any specific variable, even though the total effect of all the variables put together was very clear.
                            That doesn’t mean you do nothing to alleviate the effects of poverty. It means you don’t try to break down those effects into constituent parts. It’s the total emergent system that has its effects. As Turkheimer notes, “No complex behaviors in free-ranging humans are caused by a linear and additive set of causes. Any important outcome, like adolescent delinquent behavior, has a myriad of interrelated causes, and each of these causes has a myriad of potential effects, inducing a squared-myriad of environmental complexity even before one gets to the certainty that the environmental effects co-determine each other, or that the package interacts with the just-as-myriad effects of genes.”
                            Can we list all the therapists that have spent years trying to find which part of the mesoderm (and possibly the ectoderm) produced the most negative results to "cause" pain.

                            Turkheimer saw the results of poverty, just as we can see the results of pain. But just as he could not find anything in the specific variables, we have to admit there is nothing in the specific variables we poke, scrap, needle, move, etc.

                            This line is so good I pulled it out of the text above:
                            That doesn’t mean you do nothing to alleviate the effects of poverty. It means you don’t try to break down those effects into constituent parts. It’s the total emergent system that has its effects.
                            Again let me restate in our terms:
                            That doesn't mean you do nothing to alleviate the effects of pain. It means you don't try to break down those effects into constituent parts (strength/stability, joint mobility/ROM, trigger/tender points, biomechanics, posture, etc). It's the total emergent system that has its effects.
                            We keep looking at the elephant parts and not the elephant. We have to realize that the parts are meaningless without looking at as an elephant.
                            Kory Zimney, PT, DPT

                            http://koryzimney.blogspot.com

                            "Study principles not methods, a mind that can grasp principles will create its own methods." - Gill

                            "All truths are easy to understand once they are discovered; the point is to discover them." - Galileo Galilei

                            Comment


                            • #29
                              I really like what you are doing here.
                              :thumbs_up

                              Respectfully,
                              Keith
                              Blog: Keith's Korner
                              Twitter: @18mmPT

                              Comment


                              • #30
                                Originally posted by keithp View Post
                                I really like what you are doing here.
                                :thumbs_up

                                Respectfully,
                                Keith
                                Ditto that.

                                The metaphor that occurs to me these days is that there is a hall of mirrors on the inside of the brain (bio), and a hall of mirrors on the outside of the brain (psychosocial): there is only one tiny point of control, the constructed "self": the job of this "self" (if he or she can figure it out in time) is to angle the mirrors at each other as best he or she can, with whatever mirrors they can get at, figure out how to block them at whatever angle they want, but leave them somewhat moveable, like sails on a ship, because tacking the mirrors will be necessary at various times during life, in order to move forward.

                                The mirrors on the inside ideally will match in number, and reflect necessarily and sufficiently, what's available on the outside. If a mirror appears spontaneously on the inside (natural development) but there is nothing on the outside for it to reflect, it will likely be useless, or at worst, confusing, and lead to mental illness.

                                Sometimes, through genetic fluke, too many mirrors will reflect the same thing (too efficient, like an upregulated nociceptive system). Sometimes, a mirror isn't there at all. (CIP).
                                Diane
                                www.dermoneuromodulation.com
                                SensibleSolutionsPhysiotherapy
                                HumanAntiGravitySuit blog
                                Neurotonics PT Teamblog
                                Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
                                Canadian Physiotherapy Association Pain Science Division Facebook page
                                @PainPhysiosCan
                                WCPT PhysiotherapyPainNetwork on Facebook
                                @WCPTPTPN
                                Neuroscience and Pain Science for Manual PTs Facebook page

                                @dfjpt
                                SomaSimple on Facebook
                                @somasimple

                                "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

                                “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

                                “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

                                "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

                                "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

                                Comment

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