It has been my experience that the single most powerful and indeed essential element in these interactions (and patient outcomes) is the “buy in” part, Howard. The engagement of the patient, where belief must enduringly trump skepticism and doubt, is the deal maker/breaker. After often years of disappointment and disillusionment, this can be a very tough sell! I think that the way you, in Unlearn Your Pain (and Alan Gordon, in “The Way Out”) emphasize how belief (ie Trust The Program), is the key, and you have both expressed that eloquently. Expectation of improvement or resolution leverages the placebo effect and sets the stage for neural circuit re-wiring. Expectation of improvement will also vanquish the nocebo effect. Because neural circuit disorder patients are often great skeptics, the pace of THEIR buy-in or acceptance of MBS (often by default, after nothing else would help) is often the rate limiting step in catalyzing and achieving lasting change.
It is not surprising to me ie intuitively obvious that provocative testing outcomes are proportional to patient buy in. Please send along a reference to that article you mentioned above.
I think it is very appropriate to offer up the list of hybrid diagnoses, beyond those that fit exclusively into the Mind or Body camps. Put another way, what chronic (and many acute) illness does not carry with it both mind and body components?
I wanted to add that the screening forms (Body Map, Lifetime Stressors, Lifetime ROS, Personality Traits) from our first week’s class seem to be very potent ways to gently introduce some new thinking to a “negotiable” patient and provide a ton of clues (red flags) to an astute practitioner.I look forward to learning more about how to proceed in the treatment realm. Very exciting! Best regards, Murray