Physical pain is a universal human experience. And for many of us, it’s a constant one. Roughly 20 percent of American adults — some 50 million people — suffer from a form of chronic pain. For some, that means having terrible days from time to time. For others, it means a life of constant suffering. Either way, the depth and scale of pain in our society is a massive problem.
But what if much of how we understand pain — and how to treat it — is wrong?
Rachel Zoffness is a pain psychologist at the University of California, San Francisco, School of Medicine and the author of “The Pain Management Workbook.” We tend to think of pain as a purely biomechanical phenomenon, a physical sensation rooted solely in the body. But her core argument is that pain is also produced by the mind and deeply influenced by social context. It’s a simple-sounding argument with vast implications not only for how we experience pain but also for how we treat it. She points to numerous underused tools — aside from pills and surgeries — that can help lessen our pain.
We discuss Zoffness’s surprising definition of how pain serves as “the body’s warning signal”; how our mood, stress levels and social environment can amplify or dial down our pain levels; what phantom limb syndrome says about how the brain “makes pain”; how our emotions and trauma influence our pain levels; the crucial difference between “hurt” and “harm”; why studies on back pain have yielded such bewildering results about the sources of perceived pain; how to figure out and improve your personal “pain recipe”; the roots of our chronic pain crisis and how our health care system could be better set up to treat it; why she says, “If the brain can change, pain can change”; and more.
Mentioned:
“Neuroimaging of Pain” by Katherine T. Martucci and Sean C. Mackey
“Targeting Cortical Representations in the Treatment of Chronic Pain” by G. Lorimer Moseley and Herta Flor
“Psychological Pain Interventions and Neurophysiology” by Herta Flor
“Sham Surgery in Orthopedics” by Adriaan Louw, Ina Diener, César Fernández-de-las-Peñas and Emilio J. Puentedura
“Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations” by W. Brinjikji, P.H. Luetmer, B. Comstock et al.
“A Biological Substrate for Somatoform Disorders: Importance of Pathophysiology” by Joel E. Dimsdale and Robert Dantzer
“Undergraduate Medical Education on Pain Management across the Globe” by Nalini Vadivelu, Sukanya Mitra and Roberta L. Hines
“Lifestyle medicine for depression” by Jerome Sarris, Adrienne O’Neil, Carolyn E Coulson, Isaac Schweitzer and Michael Berk
Book Recommendations:
Why Zebras Don’t Get Ulcers by Robert M. Sapolsky
The Body Keeps the Score by Bessel van der Kolk
Pain by Patrick Wall
Thoughts? Guest suggestions? Email us at ezrakleinshow@nytimes.com.
You can find transcripts (posted midday) and more episodes of “The Ezra Klein Show” at nytimes.com/ezra-klein-podcast, and you can find Ezra on Twitter @ezraklein. Book recommendations from all our guests are listed at https://www.nytimes.com/article/ezra-klein-show-book-recs.
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