Explain pain book

Hi, does anyone know the book: Explain pain by Dr David S. Butler and Prof G. Lorimer Moseley?

Would you recommend it? Was it really helpful for you?

Thanks.

 

I found Butler & Moseley really helpful. Whether I would recommend it depends on what is causing a person's TMS, as I explain below.

Butler and Moseley started out as traditional physical therapists but have moved well beyond that. Moseley went on to earn a Ph.D. in pain science, did a stint as a research fellow in neuroscience at Oxford in the UK, and is now a leading researcher and author of professional journal articles on the neuroscience of pain. He now sees patients only one day a week (or is it half a day per week?). Butler went on to earn a Ph.D. in education "to further his professional love of devising ways to take the complex ‘gifts’ of neuroscience to students, clinicians and sufferers in ways that can change their lives."

Butler and Moseley have three books in their Explain Pain series (plus some related books I won't mention). Explain Pain (2nd ed. 2013) is the book I would recommend. It explains the neuroscience of pain in a way that an intelligent lay person can readily understand. I think understanding the neuroscience of pain can greatly help a person to accept that his or her pain is psychological, not structural, and is not a sign that his or her body is injured or about to be injured--which meshes well with Sarno's approach. Explain Pain Handbook: Protectometer (2015) was written, I think, mainly for patients of physical therapists who follow the Butler and Moseley model. It is pretty short and, in my opinion, contains too little neuroscience information to stand alone. I like Explain Pain Supercharged (2017), but it is not for the faint of heart because one chapter takes a really deep dive into neuroscience. Moseley quips that Butler has read that chapter five times and "almost gets it." Besides, I think the other chapters of Explain Pain Supercharged cannot be understand without first reading Explain Pain (2nd ed. 2013). However, Supercharged does contain a lot of information I found both interesting and useful.

To give you the flavor of Explain Pain, second edition, this is from the introduction:

"We believe that all pain experiences are normal and are an excellent, though, unpleasant, response to what your brain judges to be a threatening situation. We believe that even if problems do exist in your joints, muscles, ligaments, nerves, immune system or anywhere else, it won't hurt if your brain thinks you are not in danger. In exactly the same way, even if no problems whatsoever exist in your body tissues, nerves, or immune system, it will still hurt if your brain thinks you are in danger. It is as simple and as difficult as that. This book will try to explain this for you."
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What an insightful point: "It is as simple and as difficult as that." From later in the same book: "The point is that pain depends on many different factors and it is the brain that decides whether something hurts or not, 100% of the time, with NO exceptions."

To relate this to Sarno's approach, he tells the story in Healing Back Pain of the mother who stopped her fifteen-month old from having temper tantrums by splashing cold water in his face. She only had to do it once, and he never had another tantrum. Sarno wrote: "At the ripe age of fifteen months he had learned the technique of repression. He had been programed to repress anger because it produced very unpleasant consequences, and he would carry that dubious talent with him throughout his life." The cold and wet on the child's skin might have been unpleasant, but what was "very unpleasant" was that his mother did it. That disrupted the security of his attachment relationship with his mother, which Bowlby and Ainsworth have taught us is so important. At the ripe age of fifteen months, the child learned that anger was dangerous to attachment relationships, and he would carry that dubious talent with him for the rest of his life. In adulthood if he represses anger at his wife about something, his brain will think he is in danger of attachment trauma and cause pain somewhere in his body.

Notice that while Butler and Moseley say pain comes from the brain 100% of the time, they also say pain "depends on many different factors." Many different factors affect whether your brain thinks you are in danger. Repressed anger, which you learned in childhood is dangerous to attachment relationships because otherwise you would not repress it later in life, is just one of many possible factors. Sarno does a good job of focusing on repressed anger, while Butler and Moseley do a good job of focusing attention on other possible factors that can cause your brain to think you are in danger and of explaining why you then end up with pain.

For a person whose TMS is due to repressed anger, sticking with Sarno and working on being attuned to his or her repressed anger might be more productive than Butler and Moseley. For someone who has achieved some success in overcoming TMS due to repressed anger but still has pain, I think Butler and Moseley could be a platform for even more success. For a person who has had no success with Sarno's approach, who knows--maybe Butler and Moseley will be what he or she needs. Like Sarno, they have had much success in treating patients--which is not to say that Sarno or they have a success rate of 100%.

 

Hi Duggit, wow that is a really elaborate review. Thank you so much!

I think I will buy the book now. I am a curious person who wants to understand things .

After reading and rereading Sarno I have come to the conclusion that there is more to pain than just repressed emotions (for me at least), so I will keep reading and researching.

 

Thank you for posting this book review. I have ordered this same book from Amazon. Pretty sure I have never spent $68 for a book in my life…anyways I have a special interest in his work as a physical therapist we are working with studied David Butler and Lorimer Mosely’s work in Australia. He is very intuitive too. I am trying to focus on the fact that we are grateful he is not recommending surgery and does not appear to counteract what we know about TMS with his language. For instance, he does not believe in “chronic” pain but describes it as “unresolved” pain. Do you agree with that? We learned about TMS 4 years ago and have tried to do the “work” yet still have major and career altering flare ups.

 

Yes, even though I do not recall ever seeing or hearing Moseley and Butler use the term "unresolved." What they do say is that the language clinicians use in talking to patients about their pain (and that patients use in their self talk) can affect their recovery. I think the word "chronic" connotes permanence, while the word "unresolved" connotes impermanence (because the pain can be resolved). If you regard your pain as chronic, or even just maybe chronic, that will impede your recovery. If you regard your pain as resolvable, that can help your recovery. Ultimately, you need to not regard the pain as an indicator of tissue damage or disease. Here is a link to a short video by Moseley about reconceptualizing your pain that is titled Tame the Beast: It's Time to Rethink Your Persistent Pain:

https://www.tamethebeast.org/ (Tame the Beast)

 

Dr. Dan Ratner describes it as "consistent acute pain", which to me is the most accurate description. We generate those signals through our moment to moment thoughts. From a high level it looks like a "chronic" situation but when you notice chinks in the armor , those chinks become "chunks" of time and we see that it's not actually "chronic", but variable and inconsistent and triggered learned pain.