Podcast Review -- Dolorology (PAIN) with Rachel Zoffness
In each episode of her podcast, Ologies with Alie Ward, Alie “asks smart people stupid questions and the answers might change your life.” Alie's episode on Dolorology (Pain) with Dr. Rachel Zoffness is no exception. Dr. Rachel Zoffness is a working pain psychologist, Assistant Clinical Professor at UCSF School of Medicine, on the Pain Education Faculty at Dartmouth, the Co-President of American Association of Pain Psychology, a Psychology Today columnist about pain, and the author of The Pain Management Workbook (see our book recommendations). Dolorology is the study of the nature and management of pain- or pain science. Together, Alie and Dr. Zoffness break down why and how pain comes to exist, why it is so challenging to measure and study, and why it is so deeply important to try to understand.
According to The Journal of Orthopedic and Sports Physical Therapy, pain is defined as “an unpleasant sensory and emotional experience associated with or resembling that associated with actual or potential tissue damage” (2020). Given pain is entirely invisible, treating it requires full reliance on the patient narrative. No two people experience pain identically. So tools such as the pain scale (i.e. “Rate your pain on a scale from 0-10, 0 being painless and 10 being excruciating”) are entirely subjective and often cause someone experiencing pain to downplay their symptoms. Pain is your body’s warning system, in existence to protect you and save your life, but it can malfunction. Our bodies remember painful experiences and the stimuli that caused them, and they want to protect us from experiencing that pain again, even if we aren’t in an actively threatening scenario. This, typically, is where chronic pain stems from. Pain is also not purely physical.. it is also deeply emotional and located in the brain, not the body. Pain lives in the middle of the biopsychosocial model; it is the intersection of our biological, psychological, and social experience, and therefore to treat any pain, we must recognize and treat all three.
Dr. Zoffness explains how pain works on a dial; different factors (stress, anxiety, mood, emotion, attention, etc.) can raise or lower that dial and change how we perceive pain. By altering these factors, events of pain can feel more or less painful in relation. This is incredibly enlightening for those of us experiencing chronic pain due to concussions or Post-Concussion Syndrome.
As someone who has personally been experiencing chronic pain for over ten years, this podcast shed light on a subject that felt very close to home for me. Alie and Dr. Zoffness do a remarkable job of putting those feelings that I have felt so alone in carrying perfectly into words, allowing me to feel seen and understood. They break down pain - understanding it, managing it - into digestible bits of critical information which definitely shifted the frameworks in which I envision and experience my own pain. They open space for the acknowledgment of how often chronic pain is ignored or misdiagnosed, and how mental health and physical health work hand in hand in how one experiences pain. By listening to this episode, I am more equipped with language I did not have before to describe my experience, gaining the knowledge needed to move into changing the way I view my experiences.
By addressing all aspects of pain - genetics, tissue damage, malfunction, sleep, diet, immune system, exercise, thoughts, feelings, trauma, memories, emotions, coping behaviors, socioeconomic status, access to care, support networks, social isolation; ALL of it - quality of life can dramatically shift. Definitely listen (perhaps more than once) to this incredible podcast to gain a deeper insight into pain... it might shift your mindset in a similar way that it did mine.