INVALIDATING PATIENTS WITH PSYCHOLOGICAL INNUENDO
GPs devote much of their clinical time to chronic pain. Back, joint, and musculoskeletal pain consistently rank among the top five reasons for visiting a doctor.1 One of the pitfalls in treating chronic pain is the tendency to over-psychologise, a practice I call psychological mislabelling.2 Psychological mislabelling occurs when anxiety, depression, and stress are routinely assumed to play a major role in cases of back pain, headache, fibromyalgia, and other poorly understood chronic conditions.
When we invoke the biopsychosocial model (BPSM) — particularly the psychological component — selectively in chronic pain, we are likely mislabelling. When we think of the BPSM only when confronted with patients we find difficult, inconsistent symptoms, or failed therapies, we perpetuate the misconceptions of a discredited …
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