My ‘background’ levels may vary day to day, or sometimes hour by hour or minute by minute. The complexity of this depends on so many factors, including my genetics, life experiences, natural dispositions, and what is going on during that period of my life, and in particular on that day! It is the complexity that is almost acting as a ‘predictor’ for my pain.
As well as learning a little about causation and dispositionalism, Matt has taught me a little about the role of predictive processing in pain. This has helped me to better understand how the nerve signals being generated from my nerve root, often spuriously, might be being processed in me to give me an experience of pain.
Fundamentally the predictive processing model of pain considers peripheral sensitisation, and looks at how anxiety, emotion, expectation and attention may change and impact pain. I have written a little about predictive processing within this article HERE.
Combining my thoughts on predictive processing, and causation and dispositionalism, and with the help of Matt, I have come up with the following description which has helped me to understand my pain.
A simple understanding of MY pain
I have in my mind/body a ‘model’ (predictive model) which informs me as to whether to give an experience of pain or not, in a variety of circumstances, based on presenting factors.
When a part of my body, in this case my damaged S1 nerve root (which may be being irritated by, for example, position, load or temperature), emits an ‘impulse’, then my predictive model considers this factor, along with other factors, to evaluate whether to give an experience of pain or not. These factors include my current novel mix of the levels of my traits.
I have a number of personal traits, or dispositions, which vary over time. For example, I have a tendency, or disposition, towards anxiety and poor sleep. I am naturally positive and have high resilience.
I experience interaction between these dispositions. For example, my sleep is likely to be worse when I am anxious, and my resilience is likely to be reduced when I am sleep deprived.
Some of these dispositions have a stronger influence than others on my presentation, for example anxiety and poor sleep have a greater impact on me than positivity.
I am also affected by external factors. For example, my anxiety will increase if I experience work place bullying or an unexpected household bill, and my positivity will increase whilst experiencing success.
I have an ever-changing novel mix of the levels of my dispositions. At a ‘good time’, my anxiety might be low, my positivity high and I might have had good sleep. At a ‘bad time’, my anxiety may be high, my resilience low and my sleep poor.
My predictive model ‘knows’ what combination of dispositional levels and other factors, including the impulse from my S1 nerve root, are likely to be ‘ok’ and don’t need a response of pain.
If the combination of factors at a moment in time, including the ‘impulse’ from my S1 nerve root (which is likely for me to be a dominant factor), matches the predictive model of being ‘ok’, then no action is taken, and no pain emerges.
If not, then pain emerges to alert me to do something to stop the irritation on the S1 nerve root continuing.
Changes in the novel mix of my dispositional levels, and my S1 nerve root impulse, may, or may not, be sufficient to change whether I experience pain or not.
My experiences inform my predictive model. These experiences might result in the predictive model being changed.
In order to improve my pain situation, then I would need to work on optimising my personal factors, eg anxiety, sleep, resilience and positivity, my physical factors, eg S1 nerve root irritation and also external factors, eg temperature, finances and work conditions. This is because my predictive model takes the combination of these factors into account when deciding whether to give me a pain experience following an impulse from my S1 nerve root. Improving one factor only is unlikely to bring about sufficient change.