Special Interest Group - Philosophy & Ethics

Contact

To contact the Philosophy& Ethics Special Interest Group, please e-mail the BPS Secretariat : [email protected] who will forward your message to the SIG Secretary Maureen Tilford.

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About the group

Our origin lay in a conversation at the IASP Vienna conference in 1999 where, as usual on these occasions, we had been battered by science and the unremitting message from the drug industry that no effort or expense could be spared in the fight to defeat the evil of pain. There seemed to be little obvious relevance of much of this to the everyday realities of dealing with distressed human beings in the pain clinic, nor acknowledgement of the reality that we didn’t seem to be making much progress in winning the battle. So much of our time is spent on the practicalities of clinical pain medicine and keeping up with the science that we can rarely spare enough time to step back and reflect on our role as healers of suffering. It occurred to us that it might be useful to try to arrange some sort of meeting to reflect on what we were trying to achieve and should be realistically expecting to achieve, and how to accept and cope with our relative impotence in the face of so much unrelieved pain So in the summer of 2001 a group of us got together at Scargill House in the Yorkshire Dales to tackle some of these questions – not perhaps expecting to find answers but at least to share some of our perplexities and anxieties. This conference, entitled 'The Inevitability of Pain?' was intended as a 'one–off' but the need for a forum for further discussion was immediately apparent and has resulted in a series of annual gatherings. The core group was recognised in 2004 as a Special Interest Group of the British Pain Society.

The title of the SIG may give the impression that our deliberations are somewhat 'cerebral' and divorced from the realities of everyday clinical practice, but this would be a misleading picture. We have long struggled and failed to think of a better title and a more appropriate word than ‘philosophy’ with its implications of the academic study of knowledge, reality, and existence. The alternative definition: ‘a theory or attitude that acts as a guiding principle for behaviour’ might be less misleading but is still an inadequate guide to our activities and the sort of subjects we discuss. These may arguably be best identified by exclusion: exclusion of the usual content of scientific and clinical (in the sense of conventional interventionist and biomedical) meetings which rarely give space or opportunity for reflection. The range of subjects we have covered is huge, from the therapeutic benefits of knitting via the nature of healing to hypnosis! – and a list of the topics we have covered in the last 22 years in the ‘transcripts’ section below will give an idea of their extent. Readers may discern a tendency in recent years to focus on the inadequacies of conventional pain medicine and alternative approaches but this is by no means exclusive.

Although we have greatly benefitted from the guidance of philosophers, theologians and ethicists the participants are mostly those whose daily work is essentially clinical and practical. Their first priority is to try to relieve suffering. But as well as the limitations of our ability to achieve this there are many ethical and other dilemmas involved in the practice of pain medicine which give rise to uncertainty and anxiety. These meetings provide a unique opportunity to share doubts and problems and to learn from the insights of colleagues from around the world.

In recent years we have also benefitted from the participation of a few people who have themselves suffered from chronic pain, and the insights they have provided into their experience both of suffering and the sometimes unhelpful attitudes of health professionals and others. But some have also contributed valuable advice about the ways they have learned to lessen the dominance of pain over their lives and restore a measure of wellbeing.

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Meetings

Our meetings are different. Besides addressing topics not normally covered by major 'scientific' meetings, the programme is designed to maximise participation by the audience, and the remit of speakers is to stimulate rather than to inform debate which, both in full session and informal conversation, takes up a major proportion of our time.

Our annual three-day meetings are held at Rydal Hall in the Lake District and formerly alternated between here and Launde Abbey in Leicestershire. These are both diocesan retreat centres, although the meetings are not religious in content and open to those of all faiths and none. They are set in some of the loveliest landscapes in Britain and provide ideal surroundings for meetings of a reflective nature, as well as for the mental and physical recreation so much needed by people wearied by their daily work with human pain and distress. Time is set aside every afternoon for walking when - as well as in the pub in the evening! - we have many of the most fruitful conversations. (See 'Feedback' below for former participants' experiences of this)

Webinars

The Group hosts monthly webinars on a variety of issues and dilemmas encountered in the management of chronic pain, intended to explore key areas or challenges in everyday clinical practice. Delivered on Zoom and open to all, these popular and engaging webinars provide insight from leading subject matter experts and an opportunity to debate and discuss the topic.

The format is a 30-minute plenary talk by an authority on the evening's topic to stimulate 60 minutes of moderated discussion. These sessions have been very well attended and highly commended by those taking port. The meetings are free and open to non-members of the BPS, and it has been an unanticipated pleasure to welcome participants from all over the world!

Webinar Monday 9th December 2024

DR SARAH PARTRIDGE: 'Clinical Hypnosis Within Integrative Oncology'

Requests fo Zoom links fo our meetings can be directed to the secretary, Dr. Maureen Tilford [email protected].

See details and reviews of previous meetings.

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Transcripts

http://www.britishpainsociety.org/media/resources/files/Atkinson_November_2024.docxAll talks and discussion at our meetings are recorded and transcribed . You can download all previous transcripts, for free, here. Shortened versions of many talks have also been published in Pain News.

Annual Meetings

Webinars http://www.britishpainsociety.org/media/resources/files/Rydal_03_transcript.docx

2024 Revisiting pain Webinar April 2024

2024 Acupuncture for Chronic Pelvic Pain . Webinar October 2024

2024 On a Scale of One to Ten... a personal examination of the language of pain.http://www.britishpainsociety.org/media/resources/files/Atkinson_November_2024_5AQ7atA.docx Webinar |November 2024

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Photo album and recommended reading

Over the years members have taken countless photos to comemmorate our meetings and their beautiful surroundings. They have agreed to share some of them, which will be made available here.

Members have also formerly contributed to an e-mail circular of literature pertinent to the group's remit. We hope that including these links on this website will be a useful addition. The material can be accessed on this page.

Recommended books

A Whole New Life

Reynolds Price

An at times distressing but inspiring account of one man's struggle with and ulitimate triumph over appalling pain

Where Does It Hurt?: A memoir of life with chronic pain

Tim Atkinson

Part memoir, part medical investigation and part manifesto for non-medical cures, Tim Atkinson's candid and revealing memoir about his own, lived experience of pain will help start a conversation on this medical mystery. Why do some people continue to feel pain long after they've healed? How can people feel pain from limbs that have been amputated? And what makes people with horrific injuries sometimes insensitive to pain? The truth is that pain is far from straightforward, and most of what is now known about it has only recently been discovered. Part memoir, part medical investigation and part manifesto for non-medical cures, Tim Atkinson's candid and revealing memoir about his own, lived experience of pain will help start a conversation about this medical mystery.
But although “Where Does it Hurt?" is about life with chronic pain, it is anything but a misery memoir. There have been huge strides in pain science in the last five years and the plethora of pain books testifies to an insatiable market. But there is a need for a book by someone with their own story to tell, an "expert" as the world's leading pain scientist Professor Lorimer Moseley says. And after twenty years suffering constant pain from chronic arthritis Tim Atkinson is certainly that.
Chronic pain has been called 'the silent epidemic' and affects more than two fifths of the UK population. It has been declared a disease in its own right by the World Health Organisation. Tim Atkinson's account of a life lived with chronic pain and his attempts to kick a dangerous opioid addiction is a moving story of a personal struggle shot through with the latest science. And with a happy ending!

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Feedback

Some key feedback from past meetings is presented below – we would like to thank all those who have taken the time to reflect on the meetings and provide their very useful thoughts and insights. If you have attended any of our meetings, we would really value your thoughts on how we can improve and further our aims.

‘The whole meeting gave me a great deal of food for thought and I find myself reviewing my notes. I think the most interesting thing was the opportunity to be an outsider, as it were, to jump the fence and look at situations from a different standpoint. Doctors – not unnaturally – tend to regard cancer, for example, as primarily a medical situation and themselves as the primary agents in its treatment. But actually many patients do not think like that.’
‘I’m really glad I attended. If there’s a space, then I would be very interested in attending again.’
‘It was one of the most stimulating meetings I have attended for many years and gave us all an opportunity to escape from the “medical tramlines” in which most of us are trapped for most of the time. I came away with some new ideas, new thoughts and an intention to put some of them into action with respect to the developing countries programme.’
‘It is unique! I felt totally recharged by the week.’
‘… the most holistic group of mainstream practitioners that exists today.’
‘… such a refreshing change to any other educational meeting I've been to before. The setting was quite beautiful too. I'm looking forward to next year already.’
‘The Philosophy and Ethics SIG has become a real treasure within the Pain Society. … Long may it continue.’
‘This was again an excellent meeting well organised and executed! The subject was down to the point and relevant to everyday practice. It was very nice to see how over the progress of the meeting all speakers where able to connect with the previous content. Loads of learning points to take away!’
(From John Loeser. co-founder with John Bonica of IASP) This has been a fascinating experience for me and I greatly appreciate the invitation to join you. The chance to participate in less than formal presentations and discussions is relatively rare. I have been to plenty meetings in my life and heard many plenary lectures and attended workshops etc. but you have a lovely format that is very satisfying for people to participate in.
Ten out of ten. Embodying as well as advocating taking wellbeing and active self-care seriously. Interesting and impassioned people imparting thought-provoking and useful information and skills in a lovely environment.
I joined the Philosophy and Ethics retreat for the first time this year and was welcomed into a new family of friendly, passionate, informed and reflective thinkers. There was plenty of space (both geographically and chronologically) to share experiences and expertise, absorb new ideas, be creative, challenge assumptions and explore a diverse set of ways of thinking about pain. Each speaker was inspiring, spoke from their heart and drew on their own lived experiences of working with people experiencing pain and/or their own pain experiences. The welcome was genuine and the social time was a key part of the retreat - we ate, walked, talked, did Tai Chi and swam together - and the conversations between sessions were as valuable and illuminating as the scheduled sessions.
Best conference I have been to for years. Time to reflect, share and be with knowledge and people.
It is a wonderful; special interest group and the summer retreat has been fabulous
Inspiring, challenging and thought-provoking
“Rydal Hall” - the name of the location evoked anticipations of a murder mystery story, a guest found dead in the library at least. Luckily these fearful expectations turned out to be unfounded. The library contained theological literature behind bars, to be released on special request. Rydal Hall belongs to the diocese of Carlisle. Our stage has been blessed. The blessing seems to have worked. I had such a good time!

“Retreat” - the description of the event evoked anticipations of retreating for a while from the turbulences of daily worklife. And indeed, it turned out to be a retreat. The group was small enough to generate personal relationships and quickly the formal encounters blended with informal encounters (swimming, walking, visiting the neighbourhood) into a multisensory experience, intellectually and emotionally woven around pain in all its shapes and forms. I felt like one of the mythical blind people touching the pain elephant, busily conversing with my blind fellows. I left the retreat with new ideas, new names in my contact list and new ways to conceptualise pain in conversations with patients. And I will come back next year…."
I joined the Philosophy and Ethics retreat for the first time this year and was welcomed into a new family of friendly, passionate, informed and reflective thinkers. There was plenty of space (both geographically and chronologically) to share experiences and expertise, absorb new ideas, be creative, challenge assumptions and explore a diverse set of ways of thinking about pain. Each speaker was inspiring, spoke from their heart and drew on their own lived experiences of working with people experiencing pain and/or their own pain experiences. The welcome was genuine and the social time was a key part of the retreat - we ate, walked, talked, did Tai Chi and swam together - and the conversations between sessions were as valuable and illuminating as the scheduled sessions.
Where else but Rydal Hall in the company of the Philosophy and Ethics group could you truly explore the pluralist and holistic approach necessary to understand and respond to the demands of managing a lived experience of pain in the world? The Philosophy and Ethics meeting enables colleagues from science, medicine and the humanities to co-mingle with those who have such a lived experience, and to do so in a non-threatening, non-critical and supportive environment. Despite what at first sight might appear to be a disparate group of individuals presenting radically different interpretations encompassing perspectives of personal, social, visual, auditory, and contemporary cognitive neurobiological interpretations of pain, it was abundantly clear that each approach shared common themes contributing to the complexity of pain. Essential CPD!
I don’t think I have ever enjoyed intense conversations about pain as much as I did during those few days at Rydal Hall. What a fantastic model?!! Our days started with walks or swims in the warmest water I have experienced in the UK in Rydal waters (?lake?), followed by Tai Chi and breakfast. The body having been attended to the mind could focus on the kaleidoscope of diverse perspectives of pain presented. From basic science to lived experience via the arts, humanities and social sciences, I felt stimulated and engaged for a full three days exploring pain. I also felt moved by the emphasis on the challenges and complexities of experience of the care provider as much as the lived experience of pain and touched by the honesty which allowed for real processing and personal development. This was a meeting unlike any other I have been to and a memory I am still feeding off and learning from. What better way to nudge the brain into action than starting the day swimming with ducks and colleagues surrounded by hills?
I can see why this is called a retreat and not a conference: the whole experience was an inspiring mix of critical thinking, broad exploration and adventure. We explored humanities and their role in developing an understanding of pain, and their integration into clinical work; with challenging lectures on pain theories and modern cross-disciplinary roles as clinicians dedicate themselves to holding a whole-person practice for people experiencing pain. Heading down to the waters of Rydal before breakfast moved me on a personal level and gave me space to think and reflect on my practice and all the discussions we'd had over the days.The real friendships within the group helped me to feel welcome and safe to push out the boundaries of my own knowledge and thoughts. As a physiotherapist, I felt included, respected and welcomed which doesn't always happen at medical conferences. It was a wonderfully empowering experience to be in a room with people with a lived experience of persistent pain, medics and psychotherapists and others, sharing their experience, knowledge and wisdom generously and listening deeply to the perspective of others. I came back to practice feeling rejuvenated and ready to implement change.

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Pain, Suffering and Healing (Book)

Pain, Suffering and Healing: insights and understanding is a book published in 2011. It contains 11 essays by past speakers at our meetings on the issues of unsatisfactory relief of chronic pain, the inadequacy of scientific biomedicine in offering answers, and ethical problems arising in pain medicine. It is edited by Peter Wemyss-Gorman and has a foreword by John D Loeser.

Since the doctors who write here work largely in pain clinics, they often confront long-term pain that has not yielded to ordinary treatments. As they point out, these cases call for a much wider kind of thinking, a background conceptual map that must be very different from the blank division between mind and body that informs the accepted dualist approach. When the obvious physical remedies have already been tried, a new paradigm is needed – one that really takes on the person as a whole. As they show, understanding that person’s problems can sometimes directly relieve the pain. And, even where it does not, it may still make it possible to manage it more effectively.

- Mary Midgley, Moral Philosopher, book review Pain News 2012 10(1): 53.

Reference: Wemyss-Gorman P (ed). Pain, Suffering and Healing: Insights and Understanding. London: Radcliffe Publishing, 2011. The book is available in paperback (ISBN 978-1-84619-326-2).

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Innovative approaches to Chronic Pain: understanding the experience of pain and suffering and the role of healing.

Editor Peter Wemyss-Gorman. 2020

This book sets out to restore the concept of healing to its place within and beyond pain medicine, in chapters authored by keynote speakers to the British Pain Society's Philosophy and Ethics Special Interest Group. Exploring psychological, spiritual and creative approaches, contributors reflect on therapeutic avenues ranging from the deliberate use of the placebo response and the importance of a caring relationship between patient and practitioner, to the use of knitting as a therapeutic tool. Barriers to the flow of healing such as practitioners' careless use of language and cultural attitudes are identified and contrasted with the need to understand the first-person perspectives of people who are suffering. This book will provide hope and inspiration both to people who have become disillusioned with conventional medical approaches to the relief of their pain, and to health professionals sadly aware of the frequent inadequacy of their efforts to help them.

This valuable book addresses two key dilemmas. First, chronic pain is always more than a signal of tissue damage, which is why standard biomedical approaches fail. Second, multidisciplinary treatments (focused on a narrow band of the cognitive-behavioural spectrum) are not multidisciplinary enough. A holistic approach, by contrast, opens our understanding and treatments to the physical, mental, emotional, and social lived experience of chronic pain. It holds important resources for physicians, therapists, patients, family members, and anyone seeking a better way.

David B. Morris, author of The Culture of Pain, Illness and Culture in the Postmodern Age and Eros and Illness

Wemyss-Gorman P. (ed) Innnovative Approaches to Chronic Pain Jessica Kingsley Publishers Paperback / ISBN-13: 9781787751873

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Chair	Dr Tim Johnson
Secretary	Dr Maureen Tilford
Communications Officer	Betsan Corkhill
Web page editor	Dr Peter Wemyss-Gorman
Year Formed	2004
Number of Members	116

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