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. 2024 Apr 19:5:1346053.
doi: 10.3389/fpain.2024.1346053. eCollection 2024.

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

Maya Armstrong  1 , Joel Castellanos  2 , Devon Christie  3
Affiliations

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

Maya Armstrong et al. Front Pain Res (Lausanne). .

Abstract

Despite research advances and urgent calls by national and global health organizations, clinical outcomes for millions of people suffering with chronic pain remain poor. We suggest bringing the lens of complexity science to this problem, conceptualizing chronic pain as an emergent property of a complex biopsychosocial system. We frame pain-related physiology, neuroscience, developmental psychology, learning, and epigenetics as components and mini-systems that interact together and with changing socioenvironmental conditions, as an overarching complex system that gives rise to the emergent phenomenon of chronic pain. We postulate that the behavior of complex systems may help to explain persistence of chronic pain despite current treatments. From this perspective, chronic pain may benefit from therapies that can be both disruptive and adaptive at higher orders within the complex system. We explore psychedelic-assisted therapies and how these may overlap with and complement mindfulness-based approaches to this end. Both mindfulness and psychedelic therapies have been shown to have transdiagnostic value, due in part to disruptive effects on rigid cognitive, emotional, and behavioral patterns as well their ability to promote neuroplasticity. Psychedelic therapies may hold unique promise for the management of chronic pain.

Keywords: biopsychosocial; chronic pain; complexity; mindfulness; neuroplasticity; psychedelics; systems theory.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Proposed schematic representing interacting components and mini-systems. Central arrows represent multidirectional interactions among internal components. As incoming data are processed, their influence and interpretation are affected by many system components, including others not depicted in this simple graphic. The brain's predictive processes are depicted as the dashed line encircling the other components, because these predictive processes not only affect interpretation of internal signals but also perception of and attention to incoming data from the environment.
Figure 2
Figure 2
Proposed mechanisms for acute and long-term effects of psychedelic and mindfulness therapies on chronic pain syndromes. Adapted from Heuschkel and Kuypers: Frontiers in Psychiatry 2020 Mar 31, 11:224; DOI: 10.3389/fpsyt.2020.00224.
See this image and copyright information in PMC

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