Thread by @JillPiggott

Time for "What's My #ChronicPain Personality Disorder?"

Does continual #pain make you suspect others aren't on your side? Does severe pain make you detach from relationships or restrict your emotions? You have a CLUSTER A Disorder! / thread

When you're in #pain, do you feel excessively emotional & seek attention? ... Congratulations! You're histrionic! (Cluster B)

Does having continual #pain give you an "excessive need to be taken care of"? Join the 17.4% of #CPPs in Cluster C Personality Disorders!

(17.4 strikes me as a little low, peeps. Who's not having enough pain? We should be in the 20s, if not the 30s on this baby.)

I know you're thinking, "Dr Piggott, this thread suggests you're indirectly expressing negative feelings about being diagnosed with a 'personality disorder' simply because your DNA carries genes for severe #migraine. Sounds like you're in the 14.9% of passive-aggressive #CPPs!"

#Bullshit! I'm calling out the Cluster B.S. School of Psychology directly & @PracticalPain board member David Cosio by name.

Personality disorders can sometimes wreck lives or result in #suicide. Overdiagnosis trivializes this suffering & makes it harder for people to get care.

Psychologizing #pain is dangerous. Imaging studies show that "repetitive #pain over years leads to profound functional as well as structural changes in the brain" (Brennan 2018). That's how undertreated acute pain progresses to #ChronicPain & acute #migraine to CM.

Effective treatment of acute #pain or episodic #migraine is vital to slowing or preventing progression to continual pain.

But pressured doctors too often stop effective #opioids & refer people for ineffective counseling.

Your #ChronicPain Personality Profile gives them cover.

I'm 58. I've had daily #migraine for 50 years. I earned a PhD & was a prof until disability at 43 ONLY because my parents blew off doctors who diagnosed me w/ a "Migraine Personality" & found neurologists who gave me effective treatment from the start.

Hi mother! @janpurcell2

People in pain ought to be able to accurately describe the catastrophe of accident or disease without being accused of catastrophizing.

The experience of #pain is emotional. We need attention. We withdraw when we hurt.

But we're ALSO resilient, empathetic, funny. So fuck off.

I haven't linked to Cosio's paper because it's bad science & bullshit. Here's the response from Ann Marie Gaudon, MSW, psychotherapist & #ChronicPain sufferer, 33 years and counting. (That's how she signed it.) practicalpainmanagement.com/treatments/psy…

.@PROPkills This is for you. Sorry about the bad language. I'm of the "reserve obscenities for obscenities" school of thought. You can see why I felt it appropriate here.

@NitaGhei @ravensspirit68 @LelenaPeacock

@PROPkills @NitaGhei @ravensspirit68 @LelenaPeacock @threadreaderapp #unroll