The Impact of Validation (and Invalidation) on Pain in Young People and Adults

Session Title: The Impact of Validation (and Invalidation) on Pain in Young People and Adults

Topic: EXPERIMENTAL (NON-CLINICAL) HUMAN STUDIES

Description of Workshop: One experience shared in nearly every story told by children and adults living with pain is that others did not believe them and denied their fundamental truth: their pain is real. This invalidation happens in every corner of society: in homes, schools, workplaces, and healthcare settings. This is especially true for minoritized and marginalized people (e.g., those who are queer, neurodivergent, racialized) who experience pain at disproportionately higher rates and are also far more likely to be invalidated, disbelieved, stigmatized, and denied pain relief. Such invalidation can have a significant and negative impact on the health and wellbeing of those individuals. Conversely, when someone’s pain experience is validated, this can have a powerful impact on their journey; it can impact cognitions, mood and behaviour, the perception of pain itself, and restore trust.
In this session, we present cutting edge empirical work identifying key interpersonal communications around validation and invalidation at different points in patients’ lifespan and their influence on socioemotional development, pain, and mental health. We start with findings from emerging longitudinal research examining (in)validation in videotaped interactions between 1.) parents and children (preschoolers; adolescents with chronic pain) while they reminisce together about past painful experiences and 2.) youth with chronic pain, caregivers, and clinicians during clinical encounters at a tertiary chronic pain clinic. Evidence for the role of (in)validation about pain experiences in the development of children’s empathy for another’s pain and their own clinical pain outcomes will be shared. A novel conceptual framework will be presented, providing compelling evidence to consider how validation of young children’s pain could be a modifiable social pathway to build children’s resilience against future chronic pain. Support for this framework is grounded in Linehan’s biosocial theory of emotion regulation. We will share the experiences of (in)validation from young people with juvenile idiopathic arthritis from across multiple social contexts, including the clinical encounter, while at school, and during peer-related activities. The impact of pain (in)validation on mental health, misdiagnosis, and family functioning for these young people will be discussed. Finally, we present evidence suggesting that immersive autobiographical memories of validating consultations in adults living with pain impact on recall capacity of health messages, while recounting memories of invalidating consultations increase self-reported interoception. These findings are interpreted in the context of known risk factors for exacerbation and maintaining pain, including fear, avoidance and hypervigilance.

Speakers