Background & Aims
Persistent pain is a multifaceted, widespread, and insufficiently managed condition. It is poorly understood by those whom it affects directly and their support networks, but improving an individual’s understanding of their persisting pain provides a variety of clinically important benefits and improves pain-related behaviours. Whilst multisensory illusions have been used in research to understand aspects of body perception, we present them as a novel, accessible, engaging technique for discussing perceptions, such as pain, with patients, their families, and clinicians. Importantly, these illusions provide first-person experiences as a compelling mechanism to understand sensory-cognitive integration misperceptions (SCIMs) and they challenge beliefs about long-term perceptions of our own bodies. The aim of our project was to assess clinicians’ and patients’ acceptance of multisensory illusions as a tool to understand pain and promote multimodal management.
Methods
Several iterations of our toolkit in workshop format were demonstrated with different groups, including an array of clinicians and people with persistent pain, facilitating iterative development. A group of patient partners were invited to an early workshop to provide their insights on the suitability and acceptability of the workshop content and their feedback was valuable for the workshop development. The workshop involves demonstrating multisensory illusions to illustrate key pain concepts, using commonly available household objects to improve translation to clinical practice and the home. Twenty-nine clinicians and five patients completed anonymous feedback forms and rated the workshop in terms of understandability, relatability (to their patients/lives) likelihood of use (clinically/personally), and likelihood of recommendation (to clinicians and patients), alongside open-answer feedback responses about the workshop.
Results
All respondents agreed that they understood the key workshop concepts (‘pain buffer’, ‘reframing pain’, and ‘overall message’) and got ‘something positive’ out of the workshop. All patient respondents were able to relate the workshop to their experiences of pain and 27 out of 29 clinicians were able to relate the workshop to their patients’ experiences of pain. 28 out of 29 clinicians were ‘likely’ or ‘very likely’ to use the toolkit in their clinical practice, whilst four out of five patients were ‘very likely’ to use the toolkit in their lives. All clinicians reported they would recommend the workshop to both other healthcare professionals and people with persistent pain, whilst four out of five patients reported the same. The most impactful illusion was the multisensory Anne Boleyn illusion, which induces the instantaneous SCIM of having an additional (6th) finger.
Conclusions
Both healthcare professionals and people with persistent pain broadly accept, understand, relate to, and recommend the use of multisensory body illusions as a mechanism to explain pain and understand SCIMs. The most impactful illusions for this understanding are those which involve the participant’s own body, as opposed to those that do not allow a tangible physical experience (visual/auditory illusions). Hence, the Anne Boleyn illusion should be widely shared as an example of the brain combining sensory information and inducing SCIMs. Multiple clinicians spontaneously proposed use of this toolkit in Pain Management Programmes as a valuable addition to traditional educational methods. The workshop promotes empathy for people who experience bodies differently to how they look, which may hold relevance for numerous persistent pain conditions.
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