Since writing my post, ‘A patient’s understanding of pain’, I have continued to learn more about pain.  I have further considered my own persistent pain situation in the light of that learning, and in light of my continued everyday living with pain.

In order to fully understand this post, I invite you to first read my original post about my understanding of pain, which you can access HERE.

In that post I wrote ‘My simple understanding of my pain’, which was largely based on the predictive processing model,  the Mature Organism Model and dispositionalism.  Since writing that post I have read and learnt more about causation and dispositionalism, and have now revised my simple understanding of pain to that below:

My improved simple understanding of 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 sciatic nerve (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 sciatic nerve, 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 sciatic nerve (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 is produced.  

If not, then pain is produced to alert me to do something to stop the irritation on the sciatic nerve continuing.

Changes in the novel mix of my dispositional levels, and my sciatic nerve 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 sciatic nerve irritation and also external factors, eg temperature, finances and work conditions, as 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 sciatic nerve.  Improving one factor only is unlikely to bring about sufficient change.



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Last modified: 12/09/2022