Lorimer Moseley is a famous pain scientists and author of the book explain pain (read it in German and although he does not know about TMS I found it to be very informative and good).Please have a look at this interesting article in L. Moseleys blog:Well, my English understanding is not as good as I wished, but as I understood it he now is in severe pain himself, or did I get it wrong? He hasn't got a clue why and I guess he never ever heard of TMS before and I feel the strong need to tell him about (in the blog below one can post suggestions), but perhaps someone with better English should do thisI am very curious about your opinions!
Birdie- as Moseley is an Australian 'pain expert' i sent him a nearly completed draft of my book, 'The Hidden Psychology of Pain', over a year ago. I got no reply- no interest from him at all. His approach to chronic pain is referred to as the neuromatrix model. While it is quite fascinating to learn how we can become neurologically sensitised to pain, my criticism has always been that i fail to see how it can help anyone over come chronic pain. Exact details (or at least good scientific hypothesis) of the specific nuts and bolts of the body in pain are simply not enough to help a person out of pain. I am yet to hear one person report that the neuromatrix model has eliminated or even reduced their pain- but biological scientists are very enthusiastic for it, and tend to view the TMS approach with contempt. It is interesting to learn that Moseley is now in chronic pain.
He will learn (if he hasnt already) that his scientific knowledge of biology is almost completely irrelevant, and that if he ever wants to overcome his shoulder pain, he needs to look into the psychology of it (specifically, the unconscious psychology of it). He has the information to heal himself already (unless my draft book landed immediately in his waste paper bin- i suspect it could have). Rather than simply bad luck, or the misfortune of not having access to helpful information, his problem is a willful ignorance.
Explain Pain (2nd edition), and Explain Pain Supercharged - Butler. Painful Yarns, by Lorimer Moseley. The 'Twin peaks' model. Leading pain scientist Professor Lorimer Moseley explains the science behind 'Explain Pain' - and the good news for chronic pain sufferers. With fascinating examples and the latest research Lorimer.
He is emblematic of our messed up and self defeating culture. I hope the enthusiasts of the neuromatrix model (usually detractors of the TMS model) are watching his case with interest. It is a cruel but informative irony.this is what i have just posted on Lorimer Moseley's room- will see if it gets moderated out of existence? Hope i didnt sound too smug (not my intention).Lorimer- sorry to hear you are in pain.
As a psychologist with many years experiences of successfully treating people in chronic pain (and being a former chronic pain sufferer myself), the criticism i have long had in regards to the neuromatrix model of chronic pain is that i am yet to see one person overcome the problem with this understanding. Scientific understanding does not equate with healing- it makes biological scientists feel good about their advanced state of knowledge, but it makes no real difference to the sufferers. I gather you are now finding this to be the case. Ditto for many/most of the physical treatments of chronic pain. I am surprised that you are pursuing these approaches, as i assumed you would know what the research says about the poor efficacy of physical treatments for chronic pain. You may remember that i sent you a draft copy of my book last year, 'The Hidden Psychology of Pain'?
If you still have the copy, you might like to read it as it addresses exactly the type of problem you now have. I have seen many people (including myself) overcome chronic pain using this depth-psychology approach. If you threw my draft book out, please let me know and i will send you the final (now published) copy of the book for free.
I would suggest now is a good time for you to investigate the psychological contributors to chronic pain. It's ironic that bio-mechanical models of how chronic pain develops and persists are quite interesting as descriptions of a process, but lack the one element that would make them really useful in developing a therapy to treat the condition: Why? What's that Alfred North Whitehead says about misplaced concreteness that only assigns ontological validity to matter located in spacial temporal co-ordinates? You just can't ignore that the original cause of the bio-mechanical chain of events leading to chronic pain is psychological and deeply emotional. If you don't tackle the underlying emotions, the pain will just keep reoccurring again and again in different forms and in different physical locations. Sort of like one of those shape-changing magicians in medieval romances.
Vi) I had an MRI. Now, my is pretty mangled, BUT the interesting thing is this – my pain has increased a couple of points on a 10 point scale since I read the report that outlined, in detail, all the bits that are damaged.
How amazing is that? Here I am – studying all this stuff – wise to a large extent to the power of descending modulation and upregulation of protective systems, and the knowledge of how much is damaged in there has absolutely, positively, increased my pain. I know for sure that I could not have done all that damage, in fact almost any of it, on the day before my pain started.
So I really have no idea how much that damage is related to my pain. Even still – my pain is now officially brutal. I am both very annoyed at this development and very impressed in all that happens inside us without us making it happen. I shall now embark on the tricky process of deciphering what are the main contributors to my shoulder pain and how I should best address them. Here comes a journey. Click to expand.Within the TMS community we are very aware of how damaging medical imaging can be - it takes regular grey hair of the spine and makes us feel like we have come across something truly terrible. The nocebo effect kicks in and our pain gets far worse.
It sounds like there are a lot of things that he doesn't get, but at least he he sees the beginning of the mind body connection. He also seemed to do a good job of seeing through the placebo effect of injections, which are completely useless against TMS (accept as a placebo). Iv) I had an ultrasound six weeks ago and a couple of injections. I wanted the ultrasound doctor fellow to do a double blind placebo controlled injection of the bursa, but he said they did not have the resources for that. I said well how do you know if you have modulated the pain by an effect on nociception. He said ‘you just do’. So, injection of anaesthetic into the bursa did nothing.
I then had an intra-articular injection (I always thought it was along those lines) and I got immediate relief. The consensus in the room was that if i got immediate relief with the intraarticular and nothing with the bursa, it can’t be placebo. Anaesthetic and steroids – a few days I will be right as rain. Well my pain returned a few days later. Sounds pretty placebo to me – could have untangled that with double-blind injections.
Lorimer Moseley is a leading pain researcher whose work is dedicated to understanding and explaining pain (see Butler and Moseley, Explain Pain, 2003 and Moseley, Painful Yarns, 2007). In Painful Yarns, he tells a story from his own life that helps us understand important mechanisms of pain. As a young boy, Lorimer took hikes in the country and frequently came home with lots of nicks and scrapes on his legs. Although his mother was alarmed, they never bothered him or hurt him. bravo!
While on a hike at age twenty-five, he got nicked on the and kept walking not thinking anything of it. When he got home, he saw fang marks fo the very poisonous Eastern Brown snake and found his left leg to be very swollen and painful. He spent several days in the hospital recovering from the bite and the left leg pain subsided. Five years later, he was walking in apark and noted a nick on his leg. He immediately fell to the ground experiencing a great deal of pain that was all the way up and down his left leg.
He was rushed to a hsoptial only to find that he simply had a scrape, not a snake bite. Why all the pain? When he was a boy, his brain disregarded the mild pain from nicks and scrapes because they were interpreted as 'not dangerous' and simply part of the enjoyment of walking in the country.
However, after the life threatening situation with the snakebite, his brian now interpreted a small scrape as 'very dangerous' and activated the same pain pathways that were learned five years earlier.What is amazing is that the pain after a small scrape on Lorimer's leg lasted for two weeks. He's a pain researcher; he understands pain; he knew that nerve pathways rather than tissue damage caused his whole leg to feel real pain; yet the pain persisted for two weeks! The nerve patterns were activated and took a while to calm down and reverse, which they eventually did. But what might have happened if he didn't understand pain, and after one week he went to his doctor and asked, 'Why am I still having so much pain from a small scrape? The doctor might say, 'Oh, I'm afraid that you might have 'post-snake bite venom' syndrome. It's a chronic disorder.
We don't know what causes it and we have no effective treatment for it.' This is exactly the situation that occurs to people with fibromyalgia, whiplash, and chronic fatigue syndrome. The labeling of these disorders as being chronic and incurable leads to more fear, more resentment, and more pain. Another factor can greatly activate pain pathways. What if, during those two weeks after the scrape, something was happening in Lorimer's life: maybe his son got arrested, his mother passed away, or his wife had an affair.
Emotions associated with those events trigger the same brain pathways that activate pain thus turning what would have been a self-limited disorder into a chronic one with little hope of cure. Forest- i agree, Moseley is thoughtful and appears to want to join the dots with psychology in the equation, but i suspect his own mechanistic bias makes this a bit difficult (i quote him in various places in my book as i think his observations about neurological sensitisation are an important part of the chornic pain jib-saw puzzle). I am happy to report that he got back to me today, with a thanks for me sending him my draft manuscript and a genuine apology for not getting back to me sooner- he says he is somewhat inundated with such books as well as unsolicited suggestions. The good news is that his pain has subsided over the last 3 months, and he says that he has learnt a lot as a result of the journey. I have asked him what helped to reduce the pain.
When he replies, i will post his answer here (with his permission) as it may be of interest to others. This is what i wrote about Moseley in 'The Hidden Psychology of Pain' (p.370)Biological scientists, David Butler and Lorimer Moseley present a very sound explanation of the physiology and neurology of chronic pain. They go into the physical ‘nuts and bolts’ details to a minute degree, but also acknowledge the essential role which psychological factors like emotions and pain beliefs play in the maintenance of chronic pain. The Hidden Psychology of Pain does not attempt to replicate their physiological level of analysis— this can best be gained by reading their book.
Both their, and the more psychological approaches, are echoing the same message, albeit fromdifferent directions and disciplines— both physiology and psychology are fundamentally important in the production and maintenance of chronic pain, as humans are clearly both physiological and psychological beings.There is no inherent contradiction between these two approaches— they are merely two sides of the one coin—a reflection of the mind/bodysplit espoused by Decartes hundreds of years ago. It is possible, with the greater awareness of mind/body holism, for these approaches to converge. Explain Pain and The Hidden Psychology of Pain represent physiologist’s and psychologist’s respective attempts to overcome the artificial distinctions between mind and body.
Each discipline will approach it in a manner which may be different, but these differences can ultimately be complementary and inform each other. That is all fascinating stuff.
Thanks for sharing it. I'd be very curious to hear what his response is.I think it's an important point that you mentioned in the excerpt from your book about biology vs. It feels like psychology is much more useful to people who are trying to heal because it is information that we can actually use.I'm in the process of reading appendix 2 in your book and am finding it very interesting. It's already been helpful to learn a little bit about the mechanisms of pain. For a while I've been curious about the different types of pain fibers.
Plus, I had no idea that our brains use 400 calories per day! It's ironic that bio-mechanical models of how chronic pain develops and persists are quite interesting as descriptions of a process, but lack the one element that would make them really useful in developing a therapy to treat the condition: Why? What's that Alfred North Whitehead says about misplaced concreteness that only assigns ontological validity to matter located in spacial temporal co-ordinates? You just can't ignore that the original cause of the bio-mechanical chain of events leading to chronic pain is psychological and deeply emotional. If you don't tackle the underlying emotions, the pain will just keep reoccurring again and again in different forms and in different physical locations. Sort of like one of those shape-changing magicians in medieval romances.
Click to expand.I am now realizing this!! Replying to this comment after 4 year to point out HOW FREAKING TRUE IT IS.YOU WANNA BEAT TMS? Only two things you have to do:1- Read and practice it, or read balto's story.
Basically stop the FEAR!!!2- You absolutely MUST address the underlying emotions, they are the culprit! Address them so that your pain does not manifest elsewere.
Perfect example is ezer's story on this site.I overcame CPPS/ prostatitis/ pudedndal neuralgia just to get the pain manifested in other places of my body as buttocks and legs. Click to expand.Imo changing the locations of pain is a perfect example that the brain has not given up his strategy yet, it is still trying to use PAIN as distraction/signal (doesnt matter, dont obsess with the science, that wont make you free of pain). I am dealing with the same situation, my pain disappears in pelvis, goes to legs, buttocks or sometimes feet (i even had for two days lol). Crazy I know, why it takes for some to beat this for good just by reading the book and others struggle with TMS for years is a complete mistery, but I partly suspect that those people with book cures did not get lured into the world of TMS or as steveo calls them TMSers. They read the book, believed whats going on a gut level and moved on, did not join any site, did not stay distracted. Whenever felt pain they immediately applied Sarno's KEY instruction: 'Whenever you find your self distracted by pain, think psychological'.
Joining forums and spending countless hours on them is another strategy of the brain to use as distraction/signal,blahblah doesnt matter, you get me, right.The best explanation to 'think psychological' which is REALLY CONFUSING btw was provided by, read his success story.