Thoughts on San Diego Pain Summit

I just attended the San Diego Pain Summit, which was a three-day conference featuring many excellent speakers, including Lorimer Moseley as the headliner. I had a fantastic time. The speakers provided a ton of interesting info, and Rajam Roose did an amazing job organizing the event. The best part was meeting many interesting, compassionate and fun people.

You may have heard some of the buzz about the conference on social media. The conference definitely had a very buzzy feel to it, kind of Woodstockish, as if something important was happening, and Mr. Jones didn't know what it was.

Following are some thoughts about the general vibe of the conference.

But first a quick story about my interaction with Lorimer Moseley.

He was sitting nearby so I introduced myself and thanked him for his great work. As I was returning to my seat he mentioned that he was halfway through reading my book. And that he thought it was good! (Thanks Alice Sanvito for providing/forcing it to him.) What a thrill!

A few minutes later he asked me for some of my dark chocolate, which left me wondering whether the book compliment was just a ploy to access a delicious treat. I reported my suspicions on Facebook, and then immediately showed Moseley my post. He cracked a smile, swallowed a bite of chocolate and said ... “Sucker!”

OK, back to my description of the vibe of the conference. There was a general feel of warm fuzziness, coupled with:

Humility and skepticism

This was a big theme with almost every speaker. Skepticism doesn't mean a cynical distrust of motive, or a tendency to deny obvious truths. It means a commitment to questioning beliefs, and making sure they are supported by sufficient evidence.

Lorimer Moseley started his talk by saying that science is difficult, that its purpose is to prevent you from fooling yourself, and that you are the easiest person to fool. Therefore, you're getting the scientific process right when you are trying to prove yourself wrong.

Jason Silvernail spoke about the importance of critically examining beliefs, and making sure they can be defended with solid evidence and reasoning.

Eric Kruger discussed pain treatment in the face of uncertainty as to its cause or cure.

And nearly every other speaker was quick to point out the complexity of pain, and the limits of our knowledge in treating it.

Among the attendees at the conference, I would guess that almost every one has experienced the pain of learning that one of their favorite treatment modalities is not supported by good evidence, or maybe even in conflict with evidence. That type of experience builds humility, curiosity and strength. It was great to be around so many intelligent and well-educated people talking about their desire to learn more, discussing past mistakes, and admitting they don’t know the answer to questions that are answered with smug confidence by people with far less knowledge. It made for many great conversations.

Empathy and compassion

Compassion means a feeling of wanting to help others in pain, and empathy means the capacity to understand another's feelings. Several speakers related the relevance of these qualities in creating therapeutic interactions with clients.

For example, Ravensara Travillian (coolest name ever) and Kara Barnett spoke about the importance of carefully listening to a client’s story about their pain. We often listen with the intention of forming a clever response, instead of simply gaining a full understanding of what the speaker is trying to communicate. This failure can prevent us from helping the client change pathological ideas that might be contributing to pain. It can also deny a client the opportunity to be understood, which can therapeutic.

The attendees to this event have a LOT of compassion and empathy for their clients. A biopsychosocial approach is not the path of least resistance in the world of therapy, nor is it the best way to maximize the bottom line. It doesn't create any simple algorithms for treatment, or promise any magic bullets for pain. And it doesn't always fit in easily with the desires of insurance companies, coworkers, or even clients. But it is the right thing to do, and I was inspired by everyone’s commitment to practicing with the highest level of integrity.

Optimism

Although almost every speaker acknowledged the challenges in treating persistent pain, they also expressed optimism about our ability to help people now, and to progress our ability to do so in the future.

One of the things we are learning about pain is that it can be in the nature of a habit. We all know that habits are hard to change. But it remains true that change is possible, and that our chances for creating it improve greatly with an attitude of self-efficacy, hope, and resourcefulness.

Community

I met many people who felt very energized and empowered by meeting others with an interest in learning more about pain. Some are working in environments where their colleagues have no interest in pain science, which can be alienating and depressing. So they seek out good conversations online. This is of course a great resource, but it lacks the extra dimension you get from talking with an actual real live person.

I am fortunate to know many like-minded therapists here in Seattle, and I get the chance to hang out with them on a regular basis. But it was still a special treat to meet for the first time many people that I had interacted with online for years. Most meetings were strangely like I imagined, and after a few days there was that uncanny feeling of accelerated familiarity. Plus there was beer.

But more important than beer (or is it?), is the fact that people from the pain science community got together in a way that might create energy to spread the word to more people. Thanks again to Rajam Roose, Lorimer Moseley, the speakers, and everyone else for creating this event.

Next Year

I am already looking forward to next year’s conference, when I will have the honor of giving a one-hour talk and also a half-day pre-conference workshop, each of which will have something to do with the Feldenkrais Method. And I better bring my A-game, because the list of speakers is .... kind of insanely good.

V.S Ramachandran is the tentative keynote speaker. Robert Sapolsky is a confirmed guest speaker. Other confirmed speakers include Michael Shacklock and Bronnie Lennox Thompson.

All we need now is Richard Dawkins, Stephen Hawking and the ghost of Carl Sagan. See you there!