# The different models of pain ##### Untangling Pain --- ![](https://youtu.be/j-JFi-EIkQY) --- ## tl;dr **Biomedical model** - Doctors often look for something physical when it comes to pain - This is important, but it’s just *one* part of it - Especially with chronic pain, physical causes are often ruled out **Pain is multifactorial** - Pain is never just one thing - Physical causes are just one part of the story - Many clients have had test after test, but nothing is found - It doesn’t mean it’s all in your head **Biopsychosocial model** - Developed to reflect multiple factors contributing to pain - Helped me massively in understanding pain and helping clients - It’s important not to focus only on one area **My journey** - I started in the biological/biomechanical side - Moved to focus too much on the psychosocial side - Realized both are essential - Massage, exercise, thoughts, beliefs - all of it matters **Adding the spiritual side** - Came across a paper in 2017: Are We Ready for a True Biopsychosocial Spiritual Model? - Spiritual is open and fluid - connection to true self - It’s the part that brings joy and meaning - Clients weren’t just in pain - they were disconnected from what they love **Complexity of pain** - Everyone is different - Sometimes bio is more important, sometimes psycho or social - We must look at the whole person **Puzzle pieces** - Bio, psycho, social, spiritual - all are pieces of the pain puzzle - You need to figure out what your puzzle looks like **Mentioned** - [Are We Ready for a True Biopsychosocial–Spiritual Model? The Many Meanings of “Spiritual” - PMC](https://pmc.ncbi.nlm.nih.gov/articles/PMC5750603/) --- ## Transcript Before we get into the meaty part of this training, I want to just go through, I've spoken about the word biopsychosocial. and spiritual model of pain, and I want to explain a little bit of where my thinking has come from and how it's evolved. The biological or the biomedical model of pain is something that you might have come across, and basically it's what? A lot of doctors still do when it comes to pain, they are looking for something physical. And this is really important, by the way, this is not me knocking it by any means. This is a really important part, but it's basically looking at just one part of pain. And we know now that pain is it's completely complex and again, it is multifactorial, there's so many other factors and the biological side is just one area, so yes, there may be something wrong with, the tissues or the ligaments or, the bones or whatever it is, could be with the hormones or stress response or anything like that. Especially when it comes to chronic pain though, these tend to have been ruled out a lot and these don't tend to have been found to be an issue, the physical side, so this is when you're left with it. So there's nothing that they found physically wrong with me, but I'm still in pain, so what, why is that not being explained? I'm hoping that this training is going to explain exactly why you can still have pain, even if it's not just biological. So the problem with the biological model of pain is that, pain is seen as being something that is physical or biological. And again, like I said, it's outdated. It's never just one thing. It's never just biological. Physical causes are just one part of the story. So the reason I wanted to put this in is if you are in pain and you have been Given the all clear in terms of they've done tests after tests And believe me, I'm laughing because this is what I'm finding with a lot of clients Especially over the years that they've had all these tests done and there's nothing physically wrong with them and then thinking well Is it all in my head? No It's not. It could be that actually that the actual ways you've been tested are wrong anyway or not strong enough or not good enough. We are still very much in our infancy when it comes to learning about pain. But there are so many different pieces of the puzzle, and this is just one part of it. Over the years, the biological model of pain has been replaced with the biopsychosocial model of pain. Us as therapists and coaches, we're starting to see more use of this model. So we're starting to realize that actually it might not be something physical that we can see, but There are other reasons for pain being there in the first place. There's a number of different factors that we need to look at. So the biopsychosocial model of pain was developed. Now the problem with this And this is something I'm talking about personally, is that at the beginning of my career, I started with just the biological side and the biomedical side and the biomechanics side, and thinking, that it was just something physical, and When I came across the biopsychosocial model of pain, I started to realize, oh my god, it's there's so much more to it. And what I actually found was that I would rule things out with a biological and make sure there wasn't anything serious, and then I would focus specifically on the psycho and social model of pain. Now, that wasn't good either, because actually, for the biological or the biomedical side, actually, using massage and exercise can help massively. So when I went completely away from that, I wasn't helping anybody either, or not at least the best way I could. So I was focusing more on the psychosocial side helping them understand their thoughts and their feelings and their beliefs around pain and the support network and pain science. But then I was going away from the biological. And that was a problem as well. What I'm trying to say is there's so many different aspects when it comes to pain and trying to understand all of these together is what we really need. With the biological the biopsychosocial model of pain, When I learned about that, it helped me, it did help me massively when working with clients, and with my own pain. And it also helped with regards to, especially when I started to understand and use those aspects together and not just favoring one. And I began to understand my own biases. And I knew I needed to see more of the bigger picture, so the biopsychosocial model is brilliant, and I love it. I think it's really important. But I just felt there was something else missing when I was talking to clients. And In around about 2017, I came across a paper the paper was called, Are We Ready for a True Biopsychosocial Spiritual Model? The Many Meanings of Spiritual. So in it, they're talking about that spiritual is an open and fluid concept, and it can refer to many different things. And I realized that it was this side that was missing from so many different areas. I've talked about this spiritual side when we talk about perimenopause and I believe that the spiritual side is what is missing when we talk about perimenopause. And I believe there is a need for the spiritual side when working with pain too. As the paper said, the word spiritual can refer to many different things, it's not just, it's not just woo stuff. For me, my take on it is the spiritual side is a connection to our true self. The things that bring us joy, the part that makes that it's that deeper part. It's that part that makes us person as opposed to a thing. And this is what I was finding with so many different clients, they were coming to me with pain. And actually The problem wasn't the pain, the problem was that they weren't able to do the things that they love to do. And that's what this spiritual side is trying to bring in, so this is why I want to introduce this spiritual side as well as the biopsychosocial model. It's important for me to explain that Everyone is different. Now that I have adjusted and have become more confident in the fact that pain is complex. I've gone through that biomedical or biological or biomechanical aspect and then moved away the pain science and the psychosocial part. I'm realizing now that it's so much more complex than that. On this image, you can see each person is different, so sometimes the biological side is a bigger factor than the psychosocial part, or, for somebody else, it may be the psychological part that is more of a factor than the biological side. So again, we're trying to put these we're trying to appreciate that it's not just one thing and for each person, it's completely different. We need to understand the person. Ourselves as a whole thing, and understand where these all fit in. The biological, psychological, social, spiritual, we can think of these as puzzle pieces of pain as well as their sort of subtopics that we're gonna cover because you need to know which pieces of the puzzle are relevant to you and figure out what your actual pain puzzle looks like. --- Next lesson → [[Untangling Pain – Module 2 Lesson 03|next lesson]] %% - [[The Biomedical Model of Pain]] - [[Pain Is Not Just Biological]] - [[Introduction to the Biopsychosocial Model of pain]] - [[My Journey with the Biopsychosocial model of pain]] - [[How the Biopsychosocial model Helped Me and My Clients]] - [[Discovering the Spiritual Side of the Biopsychosocial model of pain]] - [[Understanding the Complexity of Pain]] - [[The Puzzle of Pain]]