Richmond Stace Profile picture
Mar 27 9 tweets 3 min read
What the biomedical model does… 🧵

Well or unwell.

Mind or body.

Healthy or sick.

#thepaincoach #chronicpain

1. #thread
Fortunately more and more clinicians are noticing that despite being trained to think this way, it does not work. Why?
Because it’s not the experience we have as humans.

Take pain as an example.
It’s the person who feels pain, not the body part, not the brain, not a body system.

You can’t see pain. So there’s no test for it. Except the one when you ask the person what it is like to be them.
And if you ignore that, you’re immediately going down the wrong path.
Recently I heard of a lady in her 70s who was told that she needed bilateral knee replacements because of her xrays. She told the doctor that her knees were fine and worked perfectly well. Still he insisted. Fortunately so did she and is continuing to be active.
This is a blatant example of ignoring the lived experience, only using an objective test together with a healthy dose of arrogance—‘I know better than you about your experience and your life’. This approach is out-dated and needs to be cast into the bin forever.
Instead:

Collaboration. Communication. Caring concern.

#thepaincoach #chronicpain

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More from @painphysio

Mar 27
.@Womenworking Essential reading for:

All in healthcare
All in education
All employers
All leaders

All.

@gabriellecj
@emilyhwilson

(1)
Having worked with so many women suffering persistent pain, it has long been an area I wanted to understand and have been studying.

The narratives, the biology, the sociocultural dimensions and importantly, how they interact and unify as the lived experience.

(2)
Read 4 tweets
Mar 27
Real.

#thread 🧵

Many people have been led to believe that we need to look for something to blame for our pain.

A single cause.

A body part or system perhaps.

Blame the bit that hurts.

#thepaincoach #chronicpain

1.
Yet it is not that bit that is in pain. You are, the person.

The person feels pain, not the body part or the brain.

We want something tangible to blame. Something you can point at—‘there it is; the cause.’
But that’s not how it works.

The body state is one thing: objective. Our experience of the body is another: subjective.

When you have this insight, you can understand your experience. How pain and other feelings vary and change. Nothing is permanent.
Read 7 tweets
Mar 14
Why does my pain persist?

There is a kind of stuckness.

Not that each pain experience is the same — this cannot be, because each moment is new.

A #thread 🧵by #thepaincoach #chronicpain 👇
There was an expectation of getting better but the reality was different. Things you tried did not work. Perhaps your timelines were inaccurate: it often takes longer than you think.
There comes a point when the expectation switches to pain rather than getting better.
Read 7 tweets
Mar 12
You are doing your best

Often, it’s easy to listen to the self critic.

And harder to acknowledge that you are doing your best.

#thread 🧵
#thepaincoach #chronicpain
Considering the circumstances — what is going on for you right now?

This gives perspective. A wider view.

One that is more realistic and less driven by lofty expectations.
You are doing your best with what you have.

You may need more.

For instance, guidance, support, or encouragement.
Read 6 tweets
Mar 12
There’s nothing to fix

There is a traditional idea with pain and injury (they are completely different) that we are fixed by someone.

I disagree.

#thread #thepaincoach #chronicpain #pain
Despite the fact that the system of healthcare training is all about finding something to fix, a problem, and then fixing it.

Somewhere in there you may remember a person.

Let’s turn that on it’s head.
There is a person who is suffering. They decide that they need some help.

We don’t then fix them, although you might think you are because of the aforementioned training.
Read 7 tweets
Mar 11
I can🧵1/7

Focus on what you can do, rather than what you can’t.

This is the start. The baseline.

#thepaincoach #chronicpain #pain
2/7

Think of something that you have stopped doing or is limited.

Next, clarify what you can do. What is realistic? Considering the circumstances.

Eg/ I want to go for a coffee with a friend.
3/7

If she picks me up and drops me home, I can go to a coffee shop for 1/2 an hour.

That’s the start.
Read 8 tweets

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