Trust the Doubters

Pain Science

Paul Ingraham from and Evie Martin from and

In this clip, Paul and Evie talk about the humbling effect of trying to help people who are in pain.

Paul thinks that while some clinicians making bold claims about the efficacy of their approaches, the “quiet majority are very humble” and he finds this heartening. At the same time, Evie wonders whether a general crisis in confidence amongst manual therapists may have negative consequences for patient outcomes as a whole.

They discuss the principle of “ignorance as bliss” amongst clinicians who are blind to their patients’ actual experience because they are “true believers” in their own methods. Evie (slightly mis)quotes the late Christopher Hitchens: “If you would just give up, if you will simply abandon your critical faculties, a world of idiotic bliss can be yours.”

Around 1.00 Paul: “There’s actually a very high self-awareness in the MT community that the problems we’re asked to solve are REALLY hard to solve… I think a LOT of professionals are well aware that…we do our best and we could very well be defeated. I find that heartening”.

Around 2.00: Is humility always a good thing? Might the clinician’s doubt and lack of confidence negatively impact patient outcomes?

Around 4.00: Paul: “You cannot try to help people in pain without being humbled”.
We discuss the phenomenon of patients being less-than-truthful with their therapists about their experience, and even trying to fool themselves. Patients “don’t want to believe that we’ve wasted our money. We don’t want to believe that we wasted a stupid amount of time…”

Paul: “I would rather be in the care of a HCP who is having an active nervous breakdown crisis of confidence… rather than a professional who is a blinkered true believer in their methods and can’t perceive it when they don’t work”.

Further recommended reading from

Overconfident Pain Diagnosis

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