Vadim Kogan - Osteopath / Athletic therapist

07/28/2023

End of one chapter, beginning of a new one.

I am grateful for this sacred little space that has been home to many transformations, inner growth and reconnection for the past 3 years.

May it serve its next host in fulfilling ways 💛

New location in Outremont! Appointments will resume on Monday August 7th.

✌️

01/07/2022

Do you even lift? Bro.

12/23/2021

✨ ALIGNMENT ✨

As this year is approaching its end and we are embarking on a new chapter, I would like to take this opportunity to share with you a very relevant message. I feel that it is especially needed during these trying and uncertain times.

I would like to talk to you about a concept called Alignment. I will define it as being in harmony with that which is Absolute BEST for me. That which is Absolute BEST for me is also implied to be Absolute BEST for the Collective Whole.

I call it concept because we are going to discuss it here; however, it is a lot more than a concept – it is a reality to be *experienced*. Why do I say Absolute? It means that it is undeniably true for every single one of us.

Let’s talk about what it means to be in Alignment with that which is Absolute BEST for us. Have you experienced moments of complete ease, rock solid confidence, unquestionable passion, being in the zone, genuine appreciation for what is, thrilling eagerness for what’s to come, fulfilling or**sm, ecstasy, rolling on the floor laughing our fu***ng ass off, being happy in the here and now..

What do all of these have in common? Is it the people that we are surrounded with? Is it the physical material that we are using? Is it a particular season? Is it a particular action?

If you look into this question, you will eventually realise that it is simply a *state of being*. It is a *feeling*. And this feeling is infused into the experience that we are currently having whether it is executing our job, playing our favorite instrument, watching our favorite show, or talking to our favorite person. It is not the experience that is generating the feeling, it is the feeling that is generating the pleasant experience. The feeling PRECEDES everything.

This feeling is your *witness* of your Alignment with that which is Absolute BEST for you and the Collective Whole.

How can you bring yourself into Alignment? Now that is the million dollar question 🙂

If your current state of being, your current mood, your current feeling is your direct witness for your current Alignment. And Alignment is defined as being in *harmony* with that which is Absolute BEST for me, then what is the link between where I am and where I would like to be?

This link, bridge, connection, is in fact our intention *to feel good*. If I can give it a name, it would simply be love.

11/25/2021

Your body is capable of GREAT output. That is, if you allow yourself to believe it and gradually work to achieve it. It’s about building momentum in the direction that gets your juices flowing. Regardless of where you are, how you feel, or what your doctor has diagnosed you with, at any point - you can begin to shift your focus toward the kind of life that you truly desire. If you haven’t had the chance to read my previous post about the Power of Thoughts, check it out 🤓

09/24/2021

✨ Mechanics of Life - Power of Thoughts ✨

Ever wondered about the subtleties of existence? “I got bills to pay and things to worry about, ain’t nobody got time for that” you say. Well, this is your moment to *remember* some seriously important powerful stuff.

What if I told you that there are 2 realities. The first one is the reality that we are mostly accustomed to. The second reality is the one that many of us no longer perceive because we are too caught up in the first reality.

Bare with me for a moment 🙂

Let’s do a little experiment. Ready?

Here it is:

Sit back, relax, and simply be still.

Come on! Try it

Just 1 minute. Go.
...

Did you do it? Come on fu**er give it a shot.
...

What did you notice?
...

Thoughts? Feelings? Memories? Your next snack perhaps? A mix of everything? A certain weirdness about the whole experience?
.

Did you notice something else?
...

Did you notice the bouncing of 2 realities? Going from 1 to the other? Going from stillness to thoughts, back to stillness back to thoughts?
.

Good enough.
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🔅 Let’s talk about thoughts.

When you think, are you perceiving your surrounding reality? Is it possible to think and to be consciously present at the same time? Try it.

FYI - you actually did try it in the experiment above. As weird as it might have been, you were able to experience moments of thoughts and moments of presence. However you cannot experience both at the same time.

Let’s call these 2 realities the psychological reality (thoughts) and the existential reality (consciousness).

If we are able to distinguish between these two, if we are able to perceive when we are thinking versus when we simply are (not thinking) then we can begin to truly take charge of the direction of our life.
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🔅 Let’s talk about momentum.

When we are in our thought-reality, we can notice that momentum begins to grow and take form. It means that our thoughts will grow in intensity and connect with similar thoughts unless we change the direction of our focus. Momentum is probably one of the most important subjects that I believe we can benefit from being aware of. When we have strong momentum, it is easier to move in a specific direction. However, we can also have strong momentum going in a direction that is simply not beneficial to us. For instance, if we are worrying about a specific situation, we can notice that it will amplify itself as other worrying thoughts will manifest and we will become increasingly more anxious as the momentum of these thoughts continues to grow. If on the other hand we are experiencing a pleasant thought, we can notice that other pleasant thoughts will occur and we will be able to benefit from that accumulated momentum as it continues to grow in that pleasant direction. Let’s talk about S*X.
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Just kidding.
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🔅 Let’s talk about focus.

Focus is monumental. All day long we focus. Where our focus is, is where momentum begins to grow. The question is: are we deliberately focusing or are we on an automatic-pilote? This is a critical question because this is where we are either creating the Life that we truly desire versus simply reacting and riding the “old pattern” momentum that might not serve us anymore. In order to deliberately focus, we must first learn to distinguish between the 2 realities. If we are “stuck” in the first reality, we will not be able to efficiently change the direction of our focus because strong momentum will continue carrying us.
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🔅 Let’s talk about emotions.

Each one of us has their own personal compass called emotions. This is where we instantaneously receive feedback as per the benefit or lack of, of the *current* thoughts/momentum we have going on. No need for anybody’s opinion, approval, or intervention regarding our personal experience. Can you believe it? Holy s**t, if that doesn’t give you goosebumps, you need to take the red pill and read this again. No need for religion, no need for gurus, we are perfectly equipped to move through life joyfully and autonomously.

How about that?
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🔅 Finally, let’s talk about intention.

Intention is the driver of our momentum. It’s the *why* we do what we do. Behind every word, behind every action, lies intention. Have you ever observed someone’s action that *appeared* to be in a certain manner, but you felt some sort of discord inside of you as you were observing them. That’s your intuition telling you that what this person is presenting to you doesn’t match what their *true* intention is. Have you ever listened to somebody’s story and felt that they aren’t being authentic regarding what they are telling you? That’s your intuition telling you that there’s a discord between what the person *appears* to be telling you versus what their intention is in telling you this thing.

When our current intention matches any of our CORE intentions that we have deep inside of us, we experience pleasant emotion. If you are curious about what I believe our deepest intention is, please read my previous post called *Bliss*.
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What is the usefulness of all of this Vadim? 🤓

I’m glad you asked. If you’re satisfied with your life and you’re a happy f**k, then I am truly happy for you and you should continue as you are! However, if you appear to be stuck in a miserable reality (psychological reality), whether it is in the way that you feel, the current health of your body, or any *unpleasant* situation (financial, social, etc.) then this is for you my friend. You can begin to gradually shift the direction of your life momentum.

Oh yes you can.
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Stick around for my next post where I will be discussing the power of meditation, consciousness and deliberate focus.

Be well 💛

08/16/2021

A little inspiration folks 💪

07/10/2021

✨ BLISS ✨

I feel very honored to share with you this next post.

It took me some time to gain enough clarity to translate what first became an intention to contribute to your Well-Being into words that you can read, connect with and find your own personal resonance with. I feel incredible appreciation for the simple and yet profound personal discovery that has been in the making since a very, very long time. I ain’t that old tho 😉

Here it is friend, I hope this message reaches the depths of your heart and reminds you of what I believe you already know.

Well-Being is the most natural process of life. It is not something you need to work for, to effort your way to, to earn or to deserve. It is already there, inside of you. It has always been there and it will always be there. And there’s nothing that you can do to cut yourself from it. Colisss eh…

This Life-Force is what animates every single cell in your body, it’s what drives all your metabolic processes, and is what sustains you in your body! It doesn’t require your help or your intervention. Only your cooperation 🙂 It is an Innate Inner Intelligence. It is Energy. And it has intentions. Tam tam tam…

If you’ve had the chance to read my last post in the series on the subject of Chronic Pain, then you are familiar with my philosophy on the subject of pain. For me, pain is a *good* thing. And I believe that the purpose of pain is to bring our awareness to something *specific* in our life. The greater the intensity of pain, the greater our subconscious desire is to move in the direction of this Life-Force.

I believe that when we resist moving in the direction of this Stream, dis-ease begins to manifest in our life. And when we chronically resist moving in the direction of our Well-Being, then increasing pathological physical and mental conditions begin to take form.

What is it that we resist? It is my belief that we resist the VERY THING we most desire. Remember those intentions? It is my belief that our deepest most sincere intention is to love.

Oy vey…

To love what? Who? And HOW?! Well isn’t that the process of Life 🙂

I promised I would talk about the quantum leap towards health, wellness and happiness. For me it’s all the same thing. Bliss. The real stuff na’mean?! So, did you guess already… 🙂

If Well-Being is the most natural process of life and if we don’t need to work for it and earn it, then how do we come back to resonance with it? If it is always there, always ON, then how can we connect to it? Well if resistance is what is pinching this Stream of Well-Being, then the answer must be: releasing our resistance (le fameux Lâcher-prise le là), and allowing this Energy to flow again.

How?

Love.

What is Love? Dammit if that is not the most important question then I don’t know what is.. 😉

Each one of us has their own definition. And I don’t want to tell you what Love should be for you. But I will tell you this, and I will bet my Life on it: Love never hurts.

For me, if I can give one word to define what Love is – it would be, Gentleness. Tsk awww…

For the record I also really like the definition of the Judeo-Christian bible: 1 Corinthians, chapter 13 verse 4-8.

Love is how we get back on track. I truly believe that. And it all starts with ourselves. We owe it to ourselves bi***es! It is nobody else’s job to love us. In fact, when we perceive love to be some kind of responsibility, we *immediately* disconnect from it.

Love is not an action.
Love is what flows through our actions.
Love cannot be forced.
Love cannot be earned.
Love cannot be deserved.
Love is its own Free Radical.
Love is Freedom.
Love simply is.

And when we allow it, then everything starts to fall back in its place. And I really do mean Everything.

Let’s talk about the path of least resistance. So this is a relatively new concept for me, I will admit that to you. In my personal life, going the hard way has been the way I operated and coped with life. Through lots and lots of effort. You want it? Go get it. Earning, working and fighting for what I want. The hard way. This path has brought me a lot of personal success in all spheres of my life and I am grateful for all of it.

However.

Now, I don’t feel like fighting or efforting my way to move in the direction of my desires. Why? Quite frankly cause I know my worth. Shieeet. I just know that I deserve everything that I want and there’s nothing that stands in my way. Damn bro what you been smoking. Getting high on Self-Love 😉

The path of least resistance is the *easiest* way for you to get back on the Bliss Horse. When you allow Love to flow through you, you give yourself a Fu***ng break and you cater the S**t out for yourself. Sometimes that means blowing off some steam, taking revenge, or eating a case of Nutella. Whatever.

Giving ourselves permission to be where we’re at without judgment is where Love begins.

Stick around for my next post where I will be discussing the power of thoughts, focus, intention, momentum, and the role of emotions.

**t

On this note, Be Well 💛

06/14/2021

Back to the gym, back to the basics, chest-bras-dos.

Bon retour à l’entraînement MTL 💪

02/27/2021

CHRONIC PAIN - part 5 (of 5)

Welcome to the last part of the chronic pain series! If you haven’t had the chance to read the previous parts, I would highly encourage you to do so. It will situate you better in relations to a very complex topic and it will give you a scientific foundation from which you can base your own personal research on.

Unlike acute pain, chronic pain could potentially evolve into a complex systemic condition which could be very hard to manage, let alone treat. Once disease gathers enough momentum, it becomes increasingly more difficult and complex to manage and treat.

We’ve learned that pain is both a physical sensation and an emotional experience. We’ve also learned that it takes a bio-psycho-social multi-disciplinary approach to treat chronic pain as in the majority of cases, 1 approach is not enough to create significant change.

My intention in this last entry is to share with you my own personal philosophy on the subject of pain. It is a subject that relates to a deeper desire of mine to understand the root cause of psycho-somatic disease. I have always been a solution-man and the idea of a problem not having a solution has never settled well in my being. I always believed that if we can identify the root of the problem, then we can find resolution.

From this point on, you are about to step into Vadim’s Mind. Beware 😛

❇️ Mechanics of pain

I believe that pain is the by-product of inner conflict manifested through the emotional experience. Pain is the cherry on top of the cake, the tip of the iceberg, the end of a story. Pain is the last messenger attempting to bring our awareness, by its uncomfortable nature, to a specific situation in our life. The greater the intensity of perceived pain or psychological distress, the greater our inner desire to resolve the conflict. It is the equivalent of stepping on the gas pedal while the parking brake is still on. This conflict is generated by the friction between what we deeply desire and the layer of self-induced resistance to allowing ourself to move in the direction of that desire.

Resistance is the by-product of a compensatory mechanism. Compensation is a protective adaptation that we develop in order to cope with the emotional discomfort of pain. The role of compensatory mechanisms is to decrease perception of pain and increase perception of security. It is our Body Guard. The level of compensation (strength, size, density of the Body Guard) is proportional to the intensity of our inner desire. When the intensity of desire increases beyond the level of resistance, pain is manifested.

❇️ Freedom of choice

Once desire surpasses resistance, one will face several options:

👉 Remain stationary (indecisive):

🔸 This will perpetuate pain levels.
🔸 The discomfort will eventually motivate one of the following options.
🔸 Common to ask for help or consult a professional.

👉 Action-based behavior:

🔹 This will perpetuate pain levels.
🔹 Current compensatory mechanism at work to find a fix.
🔹 If unable to find a solution, will proceed to fight or flight.
🔹 Common to ask for help or consult a professional.
🔹 This will lead to the following option.

👉 Develop a new level of compensation to match the increased level of desire:

🔸 Manifested through a progression of feelings going from discomfort to anger, blame and finally to resentment.
🔸 This will result in a temporary decrease of pain perception.
🔸 It is the equivalent of extinguishing a fire without dealing with the underlying cause of that fire.

👉 Decrease the level of desire:

🔹 Accomplished via dissociation.
🔹 This will result in a decreased perception of pain.
🔹 An increase in overall feeling of lethargy.
🔹 It is the equivalent of hitting a plateau.
🔹 Evolves into a state of powerlessness and depression.

👉 Continue moving in the direction of that desire:

🔸 We will discuss the significance and implications of choosing this path.

❇️ Compensation

When desire rises above the level of resistance, the compensatory mechanism in its early stage will attempt to find a solution to fix the problem of pain perception. If unsuccessful, it is further fueled by energy manifested as anger to fight or flight in order to protect us. If still unsuccessful, blame and resentment are manifested at the level of the Body Guard. If this process persists, it will evolve into further compensatory adaptations whereby another layer of resistance will be added to match the desire. This will temporarily soothe the pain.

❇️ Path of allowing

Once our desire surpasses our resistance and we experience pain, we can choose to allow ourself to move in the direction of that desire instead of relying on our compensatory mechanism to find a “fix”. When we move in the direction of our desire, we will inevitably run into a varying degree of discomfort (mild to severe) and meet the obstacles that were there in the first place which discouraged us from proceeding to move in the direction of our desire. These obstacles are fear, guilt and shame. The mighty dragons that we must face if we are to discharge our compensatory mechanisms. If unwilling to face these dragons, our Body Guard takes over and secures us in a safe place. We are back in square 1 🙂 And then desire begins to intensify once again.

❇️ Physiological limit

After undergoing countless number of compensatory mechanisms, one layer on top of another, each getting thicker, stiffer, and more resistant – the physiology reaches a breaking point. This breaking point occurs because desire has intensified to the point that resistance cannot keep up. It is my belief that every chronic condition that has worsen with time has evolved in this manner. A new problem seems to be added on top of another until disease takes full course.

❇️ Facing the dragon

When desire surpasses resistance, we are faced with a decision: either allow ourself to move in the direction of our discomfort or resist and rely on our compensatory mechanism. If anger is present, it means the compensatory mechanism is at work to try to find a “fix”. If blame or resentment is present, it means that we are in conflict with our Body Guard and it will ultimately evolve into further compensation. We must remember that the role of our compensatory mechanisms, our Body Guard, is to protect us from pain perception. Once we accept that and no longer wage war against it, then we can face the mighty dragons of fear, guilt and shame. They are guarding the vault. It is my belief that the root cause of psycho-somatic disease is found inside of that vault.

❇️ What’s next?

I decided to conclude the series of chronic pain on this note. Suspense! It is my intention to share with you my vision on Wellness sometime in the near future and I’m excited to have you on board with me in this journey together. I will be discussing the essence of what I believe that we deeply desire, the path of least resistance, and the quantum leap towards health, wellness and happiness. I would like to thank you for your interest and support and I hope that you’ve been able to gain valuable insight on a very complex topic. If you are having trouble dealing with chronic pain in your personal life, I would encourage you to seek help. Remember that it’s a multi-dimensional condition that requires attention in a holistic manner. Biological, psychological and social factors must be addressed in order to treat and manage chronic pain.

I wish you Well-Being and ease in your hearts 💛

❇️ Suggested readings:

🔹 ‘When the Body Says No’ – Gabor Maté, M.D.
🔹 ‘Nonviolent Communication’ – Dr. Marshall Rosenberg

02/24/2021

Great reminder about the importance of regular movement in order to decrease the risk of developing myofascial adhesions (ie. low back, neck, hips etc). Motion is lotion 😉

I post a lot about adhesions and what to do about them. But how do we avoid them? Adhesions, aside from the surgical variety, typically form as an adaptation to prolonged, excessive mechanical stresses such as tension, friction, and compression. Inflammation can often lead to adhesion as well. These stresses lead to reduced circulation which leads to the laying down of additional tissue for reinforcement. Whatever stresses may be involved, two things are necessary to allow adhesions to really happen; limited motion and limited circulation. If you keep an area moving regularly, that not only limits the ability of adhesions to develop, but also helps maintain circulation to the area. This won't do much for adhesions you already have, but it can prevent the ones you don't.

02/14/2021

Happy ❤️

02/09/2021

CHRONIC PAIN - part 4 (of 5)

While creating the series on the topic of chronic pain, I wanted to share with you the most condensed and detailed information pertaining to a very complex subject. As tempting as it was for me to just give you the highlights in a short and sweet fashion, I realized that it was important for me to leave you with a thorough resource reference so that 1) you would be better informed, and 2) know where the information is coming from. In this way, you would be more critical and be able to do your own research. I encourage you to read the original posts of part 1-2-3 to better understand what chronic pain is.

In the last part of the series – Part 5 – I will share with you my personal philosophy on the subject of pain and how I conduct my practice.

The goal of this post is to summarize parts 1-2-3 🤓

✅ Part 1

🔸Pain is both a physical sensation and an emotional experience.
🔹Different mechanisms (nociception, neurological, centralized) could be involved in generating the painful stimuli.
🔸The bio-psycho-social (BPS) model takes into account the different variables which can impact the painful condition.
🔹A pathology has 2 elements: 1) biological disruption of homeostasis 2) subjective experience.
🔸Pain perception is not always proportional to the identified cause.
🔹Pain could persist even after complete resolution of the pathology or the concerned lesion.
🔸Similar lesions or pathologies produce different pain perceptions for each individual.
🔹The presence of lesions or pathologies doesn’t necessarily produce painful conditions.
🔸Chronic pain (present at least 3-6 months) could evolve into a condition of its own - actual physical changes in the central nervous system.
🔹Psychological and emotional distress, especially internalized, can maintain and exacerbate chronic pain.
🔸Depression, anxiety and anger are among the most common negative emotions present in individuals who have chronic pain.
🔹Personal beliefs shaped through the cumulative experiences in one’s life dictate how a person reacts to painful stimuli and consequently how they experience it.
🔸Pain catastrophizing contributes to avoidance and hyper-vigilant behaviors which could lead to disability, disuse and depression.

✅ Part 2

The most commonly used treatments to manage chronic non-cancerous
pain include:

🔸Opioids and non-steroidal anti-inflammatory drugs (NSAIDS)
🔹Anti-depressants and anti-convulsants
🔸Muscle relaxants and topical agents
🔹Injection therapy
🔸Surgeries and implantable devices
🔹Psychological treatments
🔸Exercise therapy
🔹Alternative and complementary medicine
🔸Dietary interventions (*not included in my research)

⚠️ Research shows that none of the treatments, on their own, are sufficient to decrease the pain or to have a significant effect on the physical and psychological aspect for the majority of patients suffering from chronic pain. For this reason, special attention should be given to the effectiveness of combining various treatments. This is where the importance of the bio-psycho-social approach is emphasized to both treat and manage chronic pain.

✅ Part 3

🔸Individuals with chronic pain often experience multiple painful areas in their body. Psychological distress and disability is proportional to the number of painful conditions.
🔹There are many challenges present for both patients and healthcare providers when it comes to dealing with chronic pain.
🔸Many health professionals focus only on the biological factors that can contribute to the painful conditions in their patients.
🔹Health professional need to be up-to-date with current pain science and the multi-factory influences that a person may have on their pain.
🔸Cultural and relational barriers can prevent individuals from expressing how they feel.
🔹The multidisciplinary approach must be considered for patients who suffered for a long time and who present a significant case of psycho-cognitive-emotional distress.

✅ International Association for the Study of Pain (IASP)

The IASP defines pain as “an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.”

The following key points were added recently by the IASP to further elaborate on the meaning and experience of pain:

🔸Pain is always a personal experience that is influenced to varying degrees by biological, psychological, and social factors.
🔹Pain and nociception are different phenomena. Pain cannot be inferred solely from activity in sensory neurons.
🔸Through their life experiences, individuals learn the concept of pain.
🔹A person’s report of an experience as pain should be respected.
🔸Although pain usually serves an adaptive role, it may have adverse effects on function and social and psychological well-being.
🔹Verbal description is only one of several behaviors to express pain; inability to communicate does not negate the possibility that a human or an animal experiences pain.

❇️ Stay tuned for part 5.

01/18/2021

CHRONIC PAIN - part 3 (of 5)

👉 Part 1 introduced the subject of pain, the characteristics of chronic pain, and the BPS (bio-psycho-social) approach to treatment and management.

👉 Part 2 discussed treatment interventions and emphasized the importance of the BPS approach for treatment and management of chronic pain.

👉 In part 3 we will look at some challenges that patients and healthcare providers face when dealing with chronic pain.

🛑 Challenges:

✅ Several barriers arise in the therapeutic environment that hinder the effective treatment of chronic pain. The majority of patients with chronic pain have pain in multiple areas of the body (Carnes, 2011). There is a linear correlation between the number of pain sites and the degree of psychological distress and disability present (Carnes, 2011). This raises the importance of incorporating the BPS approach when dealing with individuals with chronic pain.

✅ The first barrier is related to the attitude of the healthcare professional towards the patient. Patients complain that health care practitioners are not interested in listening to them or understanding their pain, but rather focusing on diagnosis and therapy. Patients perceive that their pain is often trivialized and do not feel the support they seek in order to justify the severity and the adverse effects of their pain (Upshur et al., 2011).

✅ On the other hand, primary care practitioners often experience frustration when caring for patients with chronic pain because they cannot cure or significantly relieve them. Improving patient-centered communication skills, including demonstrating empathy and encouraging shared decision-making can help reduce the burden of negative emotions (Matthias et al., 2010).

✅ Secondly, many healthcare professionals still tend to focus solely on biological causes of pain rather than considering the BPS effects of the condition and its influence on the symptoms perceived in the patient. Unlike in the medical environment where consultations are often very short, healthcare professionals who have the opportunity to spend more time with their patients may delve deeper into the cognitive and emotional factors associated with the experience of pain. This does not substitute professional psychological interventions, however it opens the door to begin a dialogue.

✅ Thirdly, many health professionals might simply not be well informed with current pain science either because they did not have an extensive curriculum related to the subject of pain during their education or they simply did not follow up-to-date continuing education content on pain. This will become essential in order to ensure a quality of intervention for patients suffering from chronic pain. If healthcare professionals are not able to investigate the effect of their patient's experience of pain, this can be considered a deficiency in their training (IOM, 2011).

✅ With regard to pain, for often cultural reasons, some patients will not elaborate on their experience of it (Narayan, 2010). See below for some barriers preventing pain from being expressed.

🛑 Cultural barriers preventing pain from being expressed:

🔹a belief that pain has a divine purpose and should be endured as an expression of faith;
🔹resignation to pain as something that cannot be alleviated;
🔹concern that complaining about pain will be regarded as a sign of moral or physical weakness;
🔹fear that pain will be regarded as completely psychological and hence not “real”;
🔹confidence that pain is a single, limited mechanism that will not disrupt other aspects of health or quality of life;
🔹an aversion to drugs—especially medications commonly used to relieve pain that may be addictive—coupled with the belief that these drugs are likely to be prescribed;
🔹linguistic differences that may confound the description of pain.

🛑 Relational barriers between therapist and patient preventing pain to be expressed:

🔹expectation that pain management is outside the professional’s scope of practice;
🔹suspicion that the professional is uninterested in pain—a suspicion that may reflect the professional’s time pressures, lack of competence in pain treatment, or biases against or unfamiliarity with certain demographic groups of patients;
🔹discomfort in communicating with the professional about sensitive topics or a belief that the professional will respond only to extreme expressions of pain;
🔹previous negative experience with clinicians who trivialized pain, a belief that nothing can be done about the pain, or a desire for the professional to concentrate on an underlying disease;
🔹limited communication skills.

✳️ Conclusion

🔸 Individuals with chronic pain often experience multiple painful areas in their body. Psychological distress and disability is proportional to the number of painful locations.

🔸 There are many challenges present for both patients and healthcare providers when it comes to dealing with chronic pain.

🔸 Many health professionals focus only on biological factors that can contribute to the painful conditions in their patients.

🔸 Health professional need to be up-to-date with current pain science and the multi-factory BPS influences that a person may have on their pain.

🔸 Cultural and relational barriers can prevent individuals from expressing how they feel.

🔸 The multidisciplinary approach must be considered for patients who suffered for a long time and who present a significant case of psycho-cognitive-emotional distress.

📚 References:

♦️Carnes, D. (2011). Patterns of chronic pain in the population. International Journal of Osteopathic Medicine 14, 81-85.

♦️Upshur, C. C., G. Bacigalupe, and R. Luckmann. (2010). “They don’t want anything to do with you”: Patient views of primary care management of chronic pain. Pain Medicine 11(12):1791-1798.

♦️Matthias, M. S., A. L. Parpart, K. A. Nyland, M. A. Huffman, D. L. Stubbs, C. Sargent, and M. J. Bair. (2010). The patient-provider relationship in chronic pain care: Providers’ perspectives. Pain Medicine 11(11):1688-1697.

♦️Narayan, M. C. (2010). Culture’s effects on pain assessment and management. American Journal of Nursing 110(4):38-47.

♦️IOM (Institute of Medicine). (2011). Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. Washington, DC: The National Academies Press.

❇️ Stay tuned for part 4 - we will summarize everything! 🤓