Así, and to understand his hypothesis, he indicates that it all starts with many doctors dealing with this problem of unresolved symptoms, a percentage attributed to a considerable group of the population, «20% and rising.» «These are people who go to specialists because they have unexplained symptoms, with pain being one of them, to which experts give them various validated diagnostic labels such as migraine, fibromyalgia, tinnitus, vertigo, dizziness, or chronic pain, among others, because some are unclassifiable,» he notes.
He explains that from there, the expert doctor evaluates and cannot find a reason to explain why the patient has a headache, or why they have frequent migraine crises, to give a specific example. He also mentions that, many times, it is the specialist who lacks the ability to eliminate this ailment and solve the pain, despite labeling it, and encourages the patient to take a series of medications and live with the pain itself.
«The apparent effectiveness of therapies is based on the placebo effect, on expectations. Neurologists do not build valid theories and do what they have been taught to do, which is to prescribe anxiolytics, antidepressants, or analgesics like I used to until I changed,» warns this retired neurologist in this interview, acknowledging that he changed after reading a lot and observing his own reality of lower back pain as a result of surgery, among other pain-related episodes.
He warns that, «despite what the Academy says, Science advances,» and now it is known that the medical community «has no idea» how to work with the network of neurons: «We ignore everything about how consciousness is constructed in the organism, a mysterious domain. In the book, I use a metaphor of a movie, so that reality is made up of particles, atoms, molecules, and cells; and then there would be another reality, the perceptual one, which is what appears in consciousness. We assume that the latter is the direct expression of reality, but it is not. It is assumed that we all hear the same thing, with the same physical processes, for example, and it is probably true, but there is no way to verify it.»
THERE ARE INTERESTS AT PLAY
Dr. Goicoechea insists that the human brain «constructs a movie based on expert information,» and «this helps to realize that this movie has many interests at play.» He also warns that «the pain movie does not always reflect the real situation,» giving the example of a migraine crisis, a moment when nothing really happens in the head, but the movie is one of pain and sometimes vomiting for the person.
«The brain is a complex, creative system, and it generates an interpretation of reality based on the experience and information available that we have often been told, and what appears in consciousness is the expression of this story that is continuously being constructed,» he points out.
Therefore, this doctor argues that «we do not have the senses that allow us to see what is happening inside», but only the data of consciousness, the movie, which sometimes is consistent with what is happening, like when our head hurts after hitting it; although he warns that, in other instances, that pain does not correlate with reality. «It’s like a fiction movie that, after consulting with experts, they reinforce for us,» he adds.
He has been working with this hypothesis since the 90s, and many patients undergo the process of modifying the process and stop having migraines or reduce invalidity or dependence on drugs and the fear of living a normal life.
GENETIC AND HORMONAL FACTORS?
In the book, he mentions that, for example, many neurologists tell people with migraines that they have inherited the genes for this condition from a family member, and with a little agitation in their lifestyle (poor sleep, stress, diet, discouragement, hormonal or weather changes), they exceed the tolerance limit, and the person enters an uncontrolled process of neuronal activation, leading to all the symptoms.
Here, he disagrees with the idea of genetic factors, hormonal changes, stress, and psychoemotional factors, while stating that he does not use the term «somatize» as a possible trigger for many of these phenomena. He emphasizes that this approach does not consider the narrative, culture, indoctrination, or learning based on models coming from experts in its evaluation, reducing biology to molecules, and considering culture as something that disturbs or blurs research on migraines and other aforementioned labels.
In his opinion, the body is a complex biological system trying to survive, and biological evolution in our species is biocultural, so culture is part of biology and should always be considered in identifying the problem and proposing solutions. «Only by analyzing this narrative can the problem be identified and a solution proposed: to free it from all its cognitive, attentional, emotional, behavioral, and social affiliation components, automated and normalized,» adds Goicoechea.
«Official provisions are what orthodox neurology proposes, but in the case of migraines, I do not agree and rely on what biology says as basic processes. We are the only species that has migraines, for a reason, and what sets us apart is that we are the only species that have experts who believe that what they say is true, and that is closely linked to other interests, those of the pharmaceutical industry and not professionals.»
Consequently, we ask him what the magic formula is to forget about pain or at least alleviate it, and he points out that «there is no magic here,» but what we can do is embrace ignorance and empower the patient to start interpreting things from a different perspective. He says that this reinforcement of pain coping is starting to be done in many pain units, but in the field of migraines, there is still a long way to go. «It is necessary to correct attentional, impact, emotional, and behavioral habits; a job that involves several hours in the consultation, not so simple,» emphasizes this neurologist.
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FUENTE