Faking or Malingering or Exaggerated Pain Behavior

‘Faking’ or ‘Malingering’ or ‘Exaggerated Pain Behaviour’ | HealthSkills Blog – 2008

It’s amazing how often health providers get asked directly or indirectly whether someone experiencing pain is ‘faking’ it.

The short answer is the most accurate – we can’t tell. We’re not lie detectors, there is no ‘gold standard’ to work out whether someone is pretending or not, and the question is based on erroneous thinking about pain and pain behaviour.

pain is not the same as pain behaviour –

This is a truism because pain is something that happens to a person and pain behavior is the person’s reaction, some involuntary, some voluntary.

Pain is real when empathy is present

Pain is real to patient and provider when empathy is present – Sept 2018 – by Beth Hogans

“Of pain you could wish only one thing: that it should stop.
Nothing in the world was so bad as physical pain.
In the face of pain there are no heroes.”

― George Orwell, 1984

Biologically, pain is a sophisticated aspect of sentient corporeal existence: evolved to defend living beings from inadvertent harm, pain results in decreased biological fitness both in excess and deficit.

Empathetic Response to Chronic Pain

A Spouse’s Response to a Patient’s Pain – By Cheryl Zigrand – October 05, 2017

Though this article is almost a year old, it points out that empathy is still a healing force, despite its recent demonization for supposedly promoting a patient’s “catastrophizing“.

While it may be common sense that everyday interpersonal experiences play a role in the link between close relationships and physical health, few studies have been able to make any firm conclusions. Recently, however, researchers set out to close the gap in what is known about how spouses’ responses may or may not affect long-term physical functioning.

The research team, based at Penn State University, examined the association between the expression of pain made by patients with knee osteoarthritis and how their spouses responded to it, and changes in the patients’ physical function over 18 months.  

Why I’m fed up with being positive

Why I’m fed up with being positive – November 21, 2017 – by Linda Gask

So many people in the world now seem to be in pursuit of happiness.

I find the current vogue for dishonestly reframing everything in a positive way really irritating. We are not allowed to have problems any more only strengths.

The disconnect between this attitude and what pain patients are living is appalling.  

Failing health of the United States

Failing health of the United States | The BMJ – BMJ – Feb 2018  “The role of challenging life conditions and the policies behind them.” by Steven H Woolf, director, and Laudan Aron, senior fellow

The subtitle says it all: our country doesn’t know how to handle “challenging life conditions” because we’ve been the “land of plenty” for so long.

But with surging income inequality, the number of people living in poverty is on a relentless climb. With the previously existing economic and social safety nets dismantled, what is to become of us?  

The Bystander Effect | PatientSafe Network

The Bystander Effect | PatientSafe Network

Bystander Effect:
the greater the number of people present,
the less likely people are to help.

The bystander effect was first demonstrated following the murder of Kitty Genovese in 1964. The New York Times published a report conveying a scene of indifference from neighbors who failed to come to Genovese’s aid, claiming 38 witnesses saw or heard the attack and did nothing.

Psychologists launched a series of experiments resulting in one of the strongest and most replicable effects in social psychology. 

FInancial Involvement Inhibits Trust

Homo Economicus Belief Inhibits Trust – PLoS One – 2013 Oct – Free PMC Article

As a foundational concept in economics, the homo economicus assumption regards humans as rational and self-interested actors.

In contrast, trust requires individuals to believe partners’ benevolence and unselfishness.

The present three experiments demonstrated that the direct exposure to homo economicus belief can weaken trust.  And economic situations like profit calculation can also activate individuals’ homo economicus belief and inhibit their trust.

It seems that people’s increasing homo economicus belief may serve as one cause of the worldwide decline of trust. 

Intelligent people more likely to trust others

Surprisingly, This Type of People Are More Trusting – PsyBlog  Mar 2014

Intelligent people are more likely to trust others, according to a new analysis of US public opinion poll data. This may be because more intelligent people are better judges of character.

The researchers focused on the idea of generalised trust: not trust of close friends and family, but of other unknown members of society.

They found that people who were more trusting were also happier and had higher levels of physical health.

It’s smart to trust

Winning Pain Relief Engages Endogenous Pain Inhibition

Doubling Your Payoff: Winning Pain Relief Engages Endogenous Pain Inhibition | eNeuro

When in pain, pain relief is much sought after, particularly for individuals with chronic pain

the seeking of pain relief in a motivated state might increase the experience of pain relief when obtained.

I find it almost impossible to believe there is a way of seeking pain relief that isn’t motivated. Perhaps they are referring to people who take opioids just to get high?  

Overconfident And Self-Deluded

The Advantage of Being Overconfident And Self-Deluded – PsyBlog

This is a sad reflection on our society, and it explains why the most strident voices are given more credence than quiet logic.

Overconfidence and self-delusion can lead to higher social status, research finds.This might help explain why many leaders seem so overconfident.

Of course there are disadvantages to overconfidence as well, but these may be outweighed by the advantages.