the main convergence between these syndroms is a particular memory development, accompanied with pain or fear, expressed as a fragmentation of sensory snapshots (visual, auditory, olfactory) from the original scene, or bodily distributed painful sensations. A mode of information processing perhaps akin to the one accompanying emergency situations, but deprived of relevant feedback action possibility.
I have pondered on the comparisons of chronic pain and PTSD. Our sense of agency is affected significantly as we grasp to gain some control of our lives. There can be different circumstances surrounding the trauma, and it seems the sense of agency has a major part to play in this. Agency is formed, as you have highlighted Francoise, by the subjective awareness through memory, sensory snapshots etc and controlling one's own volitional actions in the world. PTSD and chronic pain remove that from the sufferer. As David Biro eloquently puts it in his book listening to pain: 'Once we determine the reasons for the crisis, we are in a better position to find a solution.'
Thank you Paul for your answer. My question was aimed at discussing diverse perspectives allowing to find more general principles across "neurosciences", from the cellular-molecular to the system and infividual levels.
Behind the chronic pain PTSD comparison was an interest for the vague (or too precise) concept of binding, i.e. whether it is possible to describe a common condition in which memory reactivations appear as unrelated fragments
Your answer suports the Harris proposition that pain results from an invalidated action hypothesis. Not simply one that requires correction, but one that invalidates further correction attempts, as in phantom pain or hand or elbow dystonias.
In my experience in case of chronic pain there are 2 groups:
- polyneuralgic patients: skin rolling test positive everywhere on the body (= nerve Under the skin = flight or fight situation = PTSD)
- chronic pain at one level with the rest of the body not painful => local problem to treat with neural prolotherapy according to John Lyftogt, classical blocs, trigger point release or surgery (in my experience pudendal nerve decompression).
Of course it is not always so clear but these 2 groups exists. In case of severe local pain the patient can move to the first group because of the stressful situation.
Keep me informed of your researchs.
Best regards
Jacques Beco m.d.
Liège University
As a sufferer from chronic pain for years before my sciatic nerve went numb. I had what I call a mental breakdown I was in fight or flight mode for three years. Having panic attacks and being suicidal. I also experienced loss of short term memory and hallucinations both visually and auditory. The Nice guidelines in the UK then for lower back pain was bed rest which meant I lost the use of my legs and had all sorts of other imaginary pains and ailments. All very similar to, my understanding as a non-medical person, PTSD.
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