Pain is whole person
What does this mean? Put simply, pain is experienced by the person and not by the bodily location or part. In the case of back pain for example, it is not the back that is in pain. Instead it is the person who experiences back pain. This is no different to thirst in as much as the mouth does not experience thirst and head off to get a drink. The person does.
Now, what does ‘whole’ refer to? Again this is a key point of understanding. There are no separations. We are whole. The lived experience, what it is like to be ‘you’ in any given moment, emerges from the meeting of thoughts, perceptions and actions (enactivism).
One of the reasons why considering the whole person is so important is because it is the person that we treat. Pain is poorly related to tissue state, but it is well related to the state of the person. It was Oliver Sacks, the famous neurologist and writer, who stated that it is as much about the person as the condition. He was a man of great compassion and insight.
Conditions in name are lists of signs and symptoms. They are brought to life by the whole person in a unique way with all his or her thoughts, feelings, emotions, expectations, hopes, priors and beliefs, each in a different environment and context. A huge number of variables exist within every unfolding moment. Listening to the narrative illustrates this, which is why deep listening is important.
The model that best represents the whole is the biopsychosocial (BPS) model. Truly using this approach means that the biology, psychology and sociology of pain are considered, in relation to each other. It is in the middle of these overlapping dimensions that the person’s experience sits. This is what we seek to improve, the lived experience.
When we focus on the person and what they want to achieve in their life, we can design a programme that encourages and supports them to take steps in that direction each day. This can only be achieved by thinking about the whole person.