Transcript

Tim Beames (00:01):
Welcome to another Pain Podcast – this is the Painful Truths edition. I’m your host today, Tim Beames, co-founder of Le Pub Scientifique. Joining me is Bart van Buchem. Bart, hello! We could use a few more pleasantries for a change, couldn’t we?

Bart (00:16):
Hello, everyone! I’m here – great to join you.

Tim (00:28):
It’s such a comfortable day, isn’t it? Lovely weather here in the UK, and I know it’s the same over in the Netherlands. We’re feeling good today. So, we thought we’d talk about misinformation – how we counter it and how we undo unhelpful messages. As specialist pain clinicians and educators, it’s something we deal with frequently. Just the other day, I was listening to a patient’s experience, and as the story unfolded, I kept hearing snippets of really unhelpful information.

Tim (01:30):
Whether it was the way a clinician shared the information or how the patient interpreted it doesn’t matter. The point is, the patient came away with disappointing and confusing messages, particularly about the causes of their pain. It was completely different from what we had discussed, and I felt disappointed, frustrated, even a bit annoyed. I’m sure many clinicians feel the same.

Bart (02:10):
Yes, definitely. The longer someone has been in pain, the more misinformation they seem to gather. Over time, some people learn to filter out the nonsense, but many are still left with unhelpful advice, often from well-meaning friends saying, “You should try this,” or “Have you considered that?” It can be overwhelming, and eventually, they start rejecting all suggestions, including ours.

Tim (03:10):
That’s a great point. It’s very different when someone is dealing with their first episode of back pain – they’re keen to find out what’s wrong and fix it. But when pain has been there for years, it’s unrealistic to believe a simple solution has been missed.

Bart (03:40):
Exactly. After years of chronic pain, it sounds almost ridiculous to hear, “This is the fix!” Patients aren’t naive; they know it’s unlikely, and they become sceptical. But I understand why patients latch onto these explanations, especially if it’s the only thing they can grasp, like blaming a specific muscle. More complex factors like lifestyle or hormonal influences don’t always resonate immediately.

Tim (04:30):
Yes, it’s about the framework of knowledge that patients build up over time from different sources. It’s not their fault they hold onto this information – it’s just what they’ve gathered. As clinicians, we might find it unhelpful, but we can’t just dismiss it without offering something better.

Bart (05:10):
Exactly. Telling a patient their belief is wrong without providing an alternative can leave them in uncertainty, which can be just as damaging. I prefer to ask questions like, “How much do you believe this explanation?” It helps them reflect and opens up a dialogue.

Tim (06:00):
And it’s about recognising what type of thinker they are – convergent thinkers look for a clear right or wrong answer, while divergent thinkers are open to multiple perspectives. We need to adapt our approach based on this.

Bart (06:50):
Yes, and we have a responsibility to replace any unhelpful beliefs with something that feels safe. If we don’t, they might revert to old, familiar explanations that make sense to them, even if they’re not helpful.

Tim (07:30):
I had a patient recently who blamed her pain on gardening – something she loves. Instead of telling her to stop gardening, I asked her how often she could garden without pain. It helped her realise the activity wasn’t always the problem; it was about finding a balance.

Bart (08:20):
Exactly. It’s about challenging their beliefs gently, not invalidating their experiences. Sometimes, it’s driven by emotional responses, and we need to help them see the bigger picture.

Tim (09:00):
Yes, it ties into negativity bias – we tend to remember the bad experiences more than the good ones. We need to help patients notice the positive moments too.

Bart (09:40):
Absolutely. It’s about creating a safe space for them to explore new ideas without feeling judged. Trust is essential.

Tim (10:10):
Trust is key. We need to be patient, compassionate, and supportive, especially when they’re dealing with something as stressful as chronic pain.

Bart (10:50):
Yes, and if we, as clinicians, are uncomfortable with uncertainty, it can make the patient more anxious. We need to show that it’s okay not to have all the answers – it’s about figuring it out together.

Tim (11:20):
I think that’s a great place to wrap up. We’ve talked about misinformation, its impact on patients, and how important it is to handle it carefully. Instead of dismissing their beliefs, we should provide a supportive environment for them to explore alternatives.

Bart (11:50):
Yes, and remember, as clinicians, we’re always learning too. We don’t have all the answers, but we can be there to support our patients through the process.

Tim (12:20):
Exactly. If you enjoyed this episode, please like and share it. Visit lepubscientifique.com and follow us on social media for more discussions like this. We want to help both people in pain and the clinicians who work with them. Thanks for joining us, and we’ll see you in the next episode.

Bart (12:40):
Thanks for listening, everyone. Ciao!

Tim (12:50):
Take care. See you next time!