Reattribution to Mind-Brain Processes and Recovery From Chronic Back Pain

Ashar, Yoni K.; Lumley, Mark A.; Perlis, Roy H.; Liston, Conor; Gunning, Faith M.; Wager, Tor D.

doi:10.1001/jamanetworkopen.2023.33846

Cited by 3 publications

(2 citation statements)

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“…Other recently developed psychological therapies, such as emotional awareness and expression therapy ( 219 ), pain reprocessing therapy ( 220 , 221 ), and cognitive functional therapy ( 222 ), have also shown promise for COPC, including IC ( 223 ). Although the studies need to be replicated in larger populations with longer follow-ups, effective therapies should also reduce the severity of associated comorbidities, as has been reported in humans with IBS ( 224 ) and cats with IC ( 62 ).…”

Section: Discussionmentioning

confidence: 99%

Interstitial cystitis—an imbalance of risk and protective factors?

Westropp,

Stella,

Buffington

2024

Front. Pain Res.

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Interstitial cystitis (IC) presents as a chronic pain condition with variable combinations of symptoms depending on the species and individual patient. It is diagnosed by the presence of lower urinary tract signs and symptoms in combination with a variety of comorbid health problems, a history of life adversities, and the absence of other conditions that could cause the lower urinary tract signs. IC occurs naturally in humans and cats as a dimensional condition, with patients presenting with mild, moderate, and severe symptoms. Most patients appear to recover without specific treatment. A number of rodent models of IC have been used to study its causes and treatments. Unfortunately, current therapies generally fail to ameliorate IC symptoms long-term. The recent classification of IC as a chronic primary pain disorder calls for a rethinking of current clinical and research approaches to it. Beginning when a patient encounters a clinician, precipitating, perpetuating, and palliating risk factors can be addressed until a cause or reliably effective therapy is identified, and identifying predisposing and preventive factors can inform epidemiological studies and health promotion interventions. Predisposing, precipitating, and perpetuating risk factors, including environmental, psychological, and biological, increase the activity of the central threat response system (CTRS), which plays a clinically important role in IC symptoms. Studies in cats and rodent models have revealed that environmental enrichment (EE), in the absence of bladder-directed therapies, leads to amelioration of IC symptoms, implying a central role for the CTRS in symptom precipitation and perpetuation. Conceptually moving the source of IC pain to the brain as a motivational state rather than one resulting from peripheral nociceptive input offers both clinicians and researchers novel opportunities to improve care for patients with IC and for researchers to use more ecologically valid rodent models. It may even be that IC results from an excess of risk to protective factors, making this imbalance a targetable cause rather than a consequence of IC.

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Section: Discussionmentioning

confidence: 99%

Interstitial cystitis—an imbalance of risk and protective factors?

Westropp,

Stella,

Buffington

2024

Front. Pain Res.

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“…The use of education is a central component of many guidelines, particularly in pain management. Recent studies also show that reinterpreting pain as a neurobiological correlate (rather than a physical defect) is therapeutically effective (Ashar et al, 2022(Ashar et al, , 2023. In addition, physical activity was chosen as a complementary component because some of the participants were very exhausted by the therapy and physical activity could have a positive and complementary counteracting effect.…”

Section: Contents Of the Intensified Emdr Group Programmentioning

confidence: 99%

Group eye movement desensitization and reprocessing (EMDR) in chronic pain patients

Vock,

Delker,

Rinderknecht

et al. 2024

Front. Psychol.

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The prevalence of chronic pain is increasing, and conventional pain therapies often have limited efficacy in individuals with high levels of psychological distress and a history of trauma. In this context, the use of Eye Movement Desensitization and Reprocessing (EMDR), an evidence-based psychotherapy approach for the treatment of posttraumatic stress disorder, is becoming increasingly important. EMDR shows promising results, particularly for patients with pain and high levels of emotional distress. Although group therapy is becoming increasingly popular in pain management, EMDR has mainly been studied as an individual treatment. However, a systematic review suggests that group therapy can be an effective tool for improving mental health outcomes, especially when trauma is addressed together. Based on these findings, an outpatient EMDR group program was developed for patients with chronic pain. The program consists of a total of four treatment days with 5–5.5 h therapy sessions each day and provides patients with a supportive environment in which they can learn effective pain management strategies and interact with other patients with similar experiences. Initial pilot evaluations indicate high efficacy and adequate safety for patients with chronic pain.

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Hacking the Predictive Mind

Clark

2024

Entropy

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According to active inference, constantly running prediction engines in our brain play a large role in delivering all human experience. These predictions help deliver everything we see, hear, touch, and feel. In this paper, I pursue one apparent consequence of this increasingly well-supported view. Given the constant influence of hidden predictions on human experience, can we leverage the power of prediction in the service of human flourishing? Can we learn to hack our own predictive regimes in ways that better serve our needs and purposes? Asking this question rapidly reveals a landscape that is at once familiar and new. It is also challenging, suggesting important questions about scope and dangers while casting further doubt (as if any was needed) on old assumptions about a firm mind/body divide. I review a range of possible hacks, starting with the careful use of placebos, moving on to look at chronic pain and functional disorders, and ending with some speculations concerning the complex role of genetic influences on the predictive brain.

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Reattribution to Mind-Brain Processes and Recovery From Chronic Back Pain

Cited by 3 publications

References 50 publications

Interstitial cystitis—an imbalance of risk and protective factors?

Interstitial cystitis—an imbalance of risk and protective factors?

Group eye movement desensitization and reprocessing (EMDR) in chronic pain patients

Hacking the Predictive Mind

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