I have been preaching my VOMIT poster for almost 10 years now.

The only aim of the poster is to help inform patients of common and normative finding seen on medical imaging of different parts of the body. The intention of sharing that information is to help assure them that the findings on their imaging results are common and not necessarily associated with pain. The most important goal is to help them become less fearful of their condition and hopefully more confident in participating is various physical activities. HOWEVER…

There may sometimes be a negative flip side to this intervention. By telling individuals in pain that everyone has DDD and 70% of us have disc bulges and half of us have rotator cuff tears, and etc. we may be perceived as being dismissive of their pain and their condition. This perception may backfire and result in the patient losing trust is us.

As important as sharing imaging facts may be, two things remain true for those in pain.

  1. People want to be heard
  2. People want to be validated

To maximize your therapeutic alliance and make the patient feel heard and validated. You may use phrases such as…

“I’m sorry to hear that you’ve had to go through all that”

“It must be very difficult for you”

“Your condition is obviously impacting your life”

Before jumping into pain science education and going through the information on the VOMIT poster, it is always wise to simply ask them, “Would it be okay if I shared with you some information about normal x-ray & MRI findings?”

I’ve yet to have a patient who ever said “no”. However by getting their consent, they have allowed you to share information that may be contradicting their current beliefs and perhaps what they may have been told by other health care providers.

The psychology is that when you ask for consent and they say “yes”, they perceive that they are in control. When they feel in control, they are more likely to be accepting of the information being provided. After all, they said “yes” and it was not forced upon them.

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