Pain, Is it all in your mind?: Silje Endersen Reme at TEDxNHH 77,980 views •Nov 22, 2012 470 56 Share Save TEDx Talks 24.2M subscribers Silje Endresen Reme's talks about the common phenomenon of back pain; why some people develop chronic pain and disability while others don't, and what psychology has to do with it. Silje is a PhD. from Uni Health, Uni Research, Bergen & Harvard School of Public Health, Boston. In the spirit of ideas worth spreading, TEDx is a program of local, self-organized events that bring people together to share a TED-like experience. At a TEDx event, TEDTalks video and live speakers combine to spark deep discussion and connection in a small group. These local, self-organized events are branded TEDx, where x = independently organized TED event. The TED Conference provides general guidance for the TEDx program, but individual TEDx events are self-organized.* (*Subject to certain rules and regulations) Category Science & Technology comments 69 Comments Default profile photo Add a public comment... Pete S. Pete S. 6 years ago I realised I fear pain and avoid it. The problem with this is that i avoid life due to this. 13 Richard 4SHORT Richard 4SHORT 2 years ago I'm laying in bed with a bad back. I fell asleep and dreamt that I was getting out of bed. The pain woke me up and i am still in bed (???) 8 Maine D Maine D 6 months ago Walking helps relieve my back pain, sitting and lying down for too long makes it worse 2 Karyn Jennings420 Karyn Jennings420 1 month ago @Maine D agree if I lie on my back it makes my lower back worse.💯💚✌ Georgie Oldfield Georgie Oldfield 5 years ago I'm surprised this talk hasn't been seen by more people because awareness of this concept is definitely growing at last. Having worked in the field of stress-induced chronic pain for the past 8 years, finally the studies mentioned here are coming to light and there is more openness than there was. The interest in the brain and the mind in chronic pain has meant that more studies are being published. As well as the studies mentioned in the talk there is also evidence of a strong link between chronic pain and adverse childhood experiences, which clearly shows that we need to look further than the area the pain is felt to find the answer. Great talk Silje. 17 chrisrobinson82 chrisrobinson82 2 years ago "And the million dollar question. Is the pain all in the mind? Yes of course where else could it be" What was the point in saying this? Obviously it's in the brain. I am not going to walk to the shops to collect my pain - it's in my brain! 5 FishbowlSoulSwimming FishbowlSoulSwimming 5 years ago Great talk! Reinforces Dr. John Sarno's theories and treatment modalities for chronic pain. 11 Chuck W Chuck W 3 years ago "A worker goes from healthy and relatively handsome" did she really say that? 😳 2 Cerys InPain Cerys InPain 5 years ago I don't understand extrapolating from 1/3 of the sample to form the backbone of this theory of "pain is in the mind". No doubt psychosocial factors influence pain perception. However, researchers often fail to recognize how this approach is actively used by medicine and society to belittle persons in severe pain. Creating unattainable expectations and continuing derogatory assessments results in a self-fulfilling prophecy about the importance of psychosocial factors as patients are pushed into depression, anxiety, and isolation because their physical pain is dismissed as a secondary problem. 12 GorillaGuerilla GorillaGuerilla 4 years ago There are many nuances to this. Are there doctors and social workers who don't yet fully understand what this actually means, yes there is - but that's why it's important to get social workers involved in more of the research. Another nuance is miscommunication - where doctors/therapists etc., are saying one thing, but the patient is interpretating it another way... If I talk to a colleague about how pain is biopsychosocial and can best be described simple as an output from the brain, my colleague will usually understand what it is I mean by it, but a patient might hear, "it's in my brain/head - they say it isn't real" - even thou that is in no way what's being said! So we have to get better at explaining what it is we mean by it! When we as professionals talk about pain as an 'illusion' it doesn't mean the same thing as it does to most people unfamiliar with the proffesions of physiotherapy, medicine and other health providers! Chuck W Chuck W 3 years ago +GorillaGuerilla it's a chicken and egg thing. An underlying condition that is not obvious. Stress causes everything to tighten. Pain increases. Mild depression sets in. Stress is increased, etc... When the patient says that chronic pain isn't the main problem you have to understand that chronic pain is stigmatized. 1 Mox Cacaphony Mox Cacaphony 2 years ago (edited) Cerys InPain I've dealt with nerve damage & chronic pain for 2 years now. Being in so much pain disables me from doing more activities with family & friends, makes it difficult to clean my own house, & takes more time out from pursuing my passion-music. The situation cultivates depression, thus making it an uphill battle to get relief. This talk may be true for some individuals who do not confront their psychosocial issues, but notice she completely excludes cases where someone has an injury or illness that will unavoidably manifest serious pain. This is cherry picking at it's worst, to the detriment of those of us who struggle with real pain & the battle against a medical system that seems designed to discredit us. She even admitted she chose to focus on certain groups over others to bolster her study. This is madness. 3 RebelMnk RebelMnk 8 months ago My god the best videos always have poor sound quality! 2 John John 6 years ago Amazing stuff. But why so few views?!! This can potential help so many people! 2 Scott Aronin Scott Aronin 5 years ago Very good stuff. I would add though, that the implication/statement that for most back pain, as an example, the medical field doesn't usually find viable causes, isn't exactly so. At least it's not so in the US. There are usually xrays and often MRIs and most adults, at least over 40, will show some spinal joint/disc degeneration. BUT the reason the treatments statistically have quite modest success is precisely what the presenter is discussing- the deviations found on imaging are often not the cause, or whole cause, of the pain. In the US, I'd say most doctors are not aligned with the research and understanding discussed here (yet) and many patients experience treatments, including surgeries, that don't relieve their pain. They should explore work like this, imo. Thanks for this research and talk! 3 GorillaGuerilla GorillaGuerilla 4 years ago The thing is, if you took out a major sample of the population and put them through X-Ray, MRI etc., you would find a group who by the conditions present should be in a lot of pain, but isn't... 3 Chuck W Chuck W 3 years ago +GorillaGuerilla True, but there is yet to be much in the way of good evidenced based studies. There is no shortage of people who could be studied, but no one is asking us. Dr. Timothy Whiting Dr. Timothy Whiting 2 years ago What questionnaires did you use to get info on their stress, depression, hopefulness, catastrophising etc ? Just wondering how I can incorporate this into clinical practice. Thanks 2 SteveVi0lence SteveVi0lence 1 year ago We're you able to to obtain a copy of them? crazy greek crazy greek 3 years ago can't hear anything only when I turn everything off even electric. wtf. 1 KOBD 613 BODYBUILDING KOBD 613 BODYBUILDING 1 year ago I work in the field of vocational rehabilitation and from my observations this is very accurate. I believe the same trend pertains to MTBI's Steelheader08 Steelheader08 6 years ago ...And SMART! McBirdsong McBirdsong 3 years ago Very interesting! Backs up a lot of the ideas of Dr. Sarno. I'd be curious to hear her opinion on him. 1 Lo Ve Lo Ve 1 year ago You need to increse the Audio... 1 tdreamgmail tdreamgmail 7 years ago This was posted 2 days ago. And yes she's hot! montereydentist montereydentist 6 years ago I think most of pain is mental. Sometimes if I'm in pain and get distracted, I forget about the pain. 1 Jon Eisen Jon Eisen 10 months ago (edited) The Disconnect on this thesis is that just because "modern medicine" cannot find a "cause" or an "abnormal" image for pain, then it must be psychological. Would it occur to any "modern, scientific" doctor that maybe their modern medicine hasn't caught up to all the workings of our bodies? Basically, this could be the equivalent of the Flat Earth thesis...since we can only see so far, the earth looks flat, so we accept that that is the way things exist...discounting the possibility that processes are taking place in the nerves and / or brain that causes actually pain that our current technology cannot detect. - It always amazes me that physicians tend to conveniently forget that science and discovery move forward, making many of their past practices archaic and wrongheaded. - Bloodletting, anyone? (pass me the vioxx, please) 1 مصطفى العبيدي مصطفى العبيدي 6 years ago Why is it so hard to concentrate? 1 Richard Reeves 3 years ago TMS emotional release can cure back pain permanently 3 Saavycupcake 1 year ago Wow. This would make a world of difference for doctors to check for. Darn, I’m in the yellow group. ValhalaFiveSix 3 years ago She needs to speak up, Can't hear her. 4 Francine Bales Francine Bales 7 months ago actually i experience the worst pain about 4 years ago my guts got twisted or something ...and while i was waiting for the ambulance i though i could never control that with my mind when i got to the hospital they pump me full of drugs and i was so grateful there is a limit to what your body can take 1 Mohamed Karawan Mohamed Karawan 6 years ago excellent - - - i like it alot keldra alpine keldra alpine 3 years ago PANTS! 2 I hope your happy Ferreira I hope your happy Ferreira 1 year ago Degenerative disc disease, bone on bone... also diagnosed with Multiple Sclerosis 12 years ago. MRI's of back and brain showing damage that cannot be fixed. I can pretty much detect if I have pain or otherwise. I wish more than anything I didn't have Multiple sclerosis, a chronic disease that affects the central nervous system, including the brain, spinal cord and optic nerves. This video was back in 2012, I'm texting in December of 2018. SO much more information has come out about pain and how to address it. Pain is REAL...NOT imaginary! Those who suffer with it day to day know. 5 Rich M Rich M 6 years ago I think it is all in their heads. Eric E Eric E 2 years ago (edited) Funny that I came upon this video... I pinched the little finger on my right hand a couple weeks ago. Just before watching this upload, I had pulled the blackened nail off my finger with a pair of pliers. Pain really is all in the mind. In my experience, it's amazing how quickly we can forget how much something "hurts." Frank Olm Frank Olm 2 years ago Volume is way too low Thokko Thokko 6 years ago This talk is nothing new as we all know that stress and anxiety is dangerous for your health. Andy Smith Andy Smith 10 months ago Great presentation of an extremely complex (and fascinating) topic. Awareness of the psychosocial aspects of chronic pain is increasing in the medical community, although it is not even close to being routine for most healthcare professionals to screen and address this in most settings (at least here in Sweden). Patient awareness and acceptance is often a hurdle, but this is in part due to the emphasis on the biomedical model used in mainstream medicine. It is a challenge to convey this to many patients, without implying that their pain is “imagined”. I find that explaining the neurological and endocrinological changes that can occur with chronic pain to be more accepting to most sufferers - ie neural sensitisation and HPA axis response can be a good starting point before discussing other issues such as adverse childhood events and stress-related pain (thank you Georgie Oldfield for your excellent course!),. Although of course, we are all individuals and a “one size fits all” approach is seldom the best way. Offering flexible and holistic treatment plans, that include diet, sleep, physical activity and stress probably offer a good foundation. Henk Poley Henk Poley 6 years ago A recent publication ( doi:10.1007/s00586-013-2675-y ) had success in treating back pain with antibiotics against acne bacteria, which can invade the cartilage of the spine. Lila Dove Lila Dove 3 years ago "Lyme disease AND co-infections, are now at epidemic levels, with a minimum estimate of 300,000 new cases a year in the U.S.A. alone. The saddest thing is, the MAJORITY do not know they are infected, while doctors misdiagnose them! Lower back pain is one the most common symptoms in untreated advanced Lyme. Lyme damages the synovial tissue in joints, and this doe NOT show on MRI's, CT scans, X-ray with contrast, and other diagnostics! Pain becomes a 24/7 issue with adanced Lyme nd co-infections, and the pain is real. You would hurt too, having spirochetes literally drilling their way through the body - they do not stay in the blood strream. 6 Greg Abrams Greg Abrams 2 months ago (edited) It’s interesting to see that after a long arc away from the notion of psychosomatic disorders, science is finally taking another look. Psychologists tried for years to sweep this concept under the carpet due to its Freudian/Jungian baggage, but fMRI and other study methodologies have brought it back into focus again. Of course the mind influences the body—and vice versa! Chuck W Chuck W 3 years ago Thank God mine shows up all over on an MRI. 2 Alexander Maxhall Alexander Maxhall 5 years ago Fantastisk presentasjon. Du gjør meg stolt. :) Takk for arbeidet og spredningen av dette budskapet/vitenskapen. 3 Glen h Glen h 1 month ago Duh it's in the brain!? Yes pain signals travel to the brain and we therefore "feel" it. I get it. I'm always in pain with failed back and bad knees and elbows from years of football abuse. I like horse racing and in the final stretch, my mind often wanders off my pain and I "forget" my pain for moments but it is not gone. Same thing when it is 2am and all is quiet and my pain gets worse because outside stimuli is muted so yes I get it! However, pain is at times horrible and i wake up when I roll over onto my back when I sleep and i happen to use a pain med called buprenorphine. I bought into the "in your mind and opiates make it worse" notion and tried for a whole year not being on medications but it did not work in the long run. Opioid medication has improved my function and quality of life and it sickens me when I read BS like Sarno's book that back pain is all in one's head-try my life for a day and meditate your way out of pain. Good luck! Rajeshwar Sharma Rajeshwar Sharma 1 year ago Pain and painful emotions are stored in the memory and are holographically retrieved to accentuate the present pain. In addition intense brain waves from ongoing issues and stressors add to these. Thus the resultant brain activity gives rise to pain. Mar Mar 1 year ago "our experience of pain depends on how we interpret it" wow. What about really bad pain? like being burned? Is it really based mostly on fear? 4 Jay Rich Jay Rich 3 years ago U just did the right test and exams u could've saved that person from getting full blown thyroid issues! But why should u?! There's no money no profit in that u wait till the person get a full blown thyroid or get diabetic or even ca before u try to treat! Because u Reaper's END Reaper's END 5 months ago So going to the dr. for pain is unnecessary. Marijuana used for pain is just an excuse for people to get high. Extreme trauma requiring pain medication management is a lie. All according to this SATANIC society's separation of tounge. Jay Rich Jay Rich 3 years ago Know that if u try to fix the problem before it starts you won't get rich! So u wait till the last minute till it's too late then u treat the problem just till the person died that way there's more money more profit into your Pickett as well as our fucking government's pocket!!! Go Salman Khan Alokozay Salman Khan Alokozay 1 year ago Every chronic disease is caused by chronic inflammation and every chronic inflammation is caused by gut dysbiosis the rest is bulshit Christine Sutherland Christine Sutherland 2 years ago The speaker is confusing correlation with causation, and also overstates the worth of CBT (which is what she's talking about), which meta-analysis shows is not effective for chronic pain. Chronic pain involves central sensitisation, mediated via the amygdala region of the brain, and is best approached via MDR, a method for switching off pain signalling permanently. There must be a twin focus of treatment, focussing on both direct and indirect triggers to pain signalling. 5 مصطفى العبيدي مصطفى العبيدي 6 years ago I honestly think all the smart ones should know this from experience by now :) Might sounds crazy, but I can really block pain or even protect myself from flu of fever using this methode. 1 doutzen177 doutzen177 6 years ago Of course - your worries, small and big - that you do not deal with - will show in your body, first as light symptoms as a mild headache and stomachache - then if not dealt with - it will most likely develop into more serious conditions. This is no news at all. However, a lot of people are not aware of this, so to them, this is big news. If people would consider how they feel more important than a lot of other stuff they find 'important' - the world would look quite different. davisx2002 davisx2002 3 years ago I live in a blue collar town and it seems like every one I know has back pain. I know one dude who sells 60 mg morphine tablets that he gets from a family doctor for lower back muscle injury. He makes 200 dollars a day tax free by selling his prescription drugs that his insurance pays for. Many people are fucking dishonest, lazy, doctor enabled junkies. This skews the numbers. 2 Chuck W Chuck W 3 years ago Incentivize back to work? Show them a photo of a big cardboard box under a freeway overpass.