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Chronic pain as an emergent property of a complex system and the potential roles of psychedelic therapies

Summary

Chronic pain affects millions of people and is often resistant to current treatments. This paper suggests that chronic pain emerges from interconnected biological, psychological, and social factors working together as a complex system. The authors propose that psychedelic-assisted therapies could help by breaking rigid thought and behavior patterns that maintain pain, allowing the brain and mind to reorganize in healthier ways, similar to how mindfulness meditation works but potentially more dramatically.

Background

Chronic pain affects millions of people worldwide with poor clinical outcomes despite significant research efforts and calls for reform from global health organizations. Current pain management approaches have been slow to adopt biopsychosocial perspectives. This paper proposes viewing chronic pain through the lens of complexity science as an emergent property of interconnected biopsychosocial systems.

Objective

To conceptualize chronic pain as an emergent property of a complex system and explore how psychedelic-assisted therapies may help by disrupting rigid cognitive-emotional patterns while promoting neuroplasticity. The authors examine how psychedelic therapies might complement mindfulness-based approaches to chronic pain management.

Results

The paper identifies chronic pain as arising from interactions among multiple components including central sensitization, interoceptive dysfunction, altered brain network connectivity, stress-related epigenetic changes, and rigid belief patterns. Psychedelic therapies are proposed to work through entropy-increasing effects that destabilize entrenched cognitive patterns (decanalization), potentially allowing for new neural organization and therapeutic outcomes.

Conclusion

Chronic pain management may benefit from approaches that disrupt pathological rigidity in complex systems. Psychedelic-assisted therapies show promise as transformative interventions that, when combined with proper preparation and integration, may accomplish therapeutic changes that conventional approaches alone cannot achieve by relaxing overweighted priors and enabling belief updating.
  • Published in:Frontiers in Pain Research,
  • Study Type:Review,
  • Source: PMID: 38706873, DOI: 10.3389/fpain.2024.1346053
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