Trigger warning: This episode deals with the topic of suicide.

Dan and I have an interesting and important discussion that bridges the gap between patients’ clear and obvious frustrations with how different versions of “it’s in your head” affect them and providers’ lack of awareness around the issue. How can this be the case? And how does being told pain is in your head possibly increase suicidal thoughts by 500-1200%? We explain how it occurs and compare it to what we’d accept from other therapies.

Chronic pain patients have a 25% likelihood of suicidal thoughts in the last 2 weeks. If how we explain pain increases that risk in as few as 5% of patients, we might need to think of another explanation.

If you are a patient who has had suicidal ideation recently, please reach out to one of the below suicide support lines in the show notes. We need you.

Resources:

www.iniyh.com/newsletter

Suicide support lines:

Australia - Lifeline 13 11 14 or call 000

USA & Canada - Suicide Crisis and Lifeline 988, or The Crisis text line 741 741

United Kingdom -Suicide Prevention Helpline 0800 689 5652 or Emergency services on 999 or the NHS on 111

Finland - MIELI Crisis Helpline 09 2525 0116

Timestamps:

0:00 Official Intro

00:17 Intro

02:30 Dan's side

05:04 Iatrogenic Psychological Harm

08:28 Young vs Older Patients

09:57 Chronic Fatigue Syndrom

13:16 Obvious to patients, not to providers

16:26 Illness Behavior

21:38 The harm - suicide risk

22:08 Patrick Ryan

27:37 Matthew Burke

31:19 Somatic symptoms and hopelessness

34:03 Bring it together

40:33 Pain Neuroscience

45:09 Wrap Up

47:28 Disclaimer