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Not afraid to be contrary

Not afraid to be contrary

Photographer:Fotograaf: Joey Roberts/Simone Golob

Johan Vlaeyen inspired by Wilbert Fordyce

He was a pioneer in the field of chronic pain. His name is Wilbert Fordyce and he was a clinical psychologist, whose ideas still stand. Johan Vlaeyen, professor of Psychology, owes a great deal to him.

When Johan Vlaeyen (1957, Brussels) graduated from the VUB in Brussels as a clinical psychologist in 1981, he faced the so-called citizen’s service, an alternative for anyone who did not want to do military service because of a conscientious objection. Vlaeyen ended up working in a psychiatric centre where he came in contact with real patients for the first time. It was there that he, as an inexperienced young lad of 20, treated a patient with chronic pain: this would become the topic in which he was to specialise later. But the most important tip that he received in the psychiatric centre was to apply for a grant with the Belgian American Educational Foundation and use it to go to the US.

That is what he did, successfully: Vlaeyen received funds to do a work placement for a year at the multidisciplinary pain centre in Seattle, at the time the most advanced institute in this field in the world. “Every patient that came in, was seen by at least four different specialists. They had anaesthesiologists, psychologists, neurologists, orthopaedic surgeons, and social workers. For someone who had an interest in chronic pain, like me, this was the place to be.”

And not in the least because of clinical psychologist Wilbert Fordyce (1923-2009). “A charismatic man who was ahead of his time, " says Vlaeyen. "His book Behavioural methods for chronic pain and illness (1976) has become a basic book and is still relevant today. It was published again two years ago, as a posthumous mark of honour. With one difference, every chapter was complemented by comments from two experts [including Vlaeyen]. Everything that he preached back in the nineteen-seventies, appears to work today.”

He was one of the first to recommend exercise to patients who suffered from chronic pain, instead of resting. He saw that these patients were mainly afraid; afraid to move because they thought the pain would worsen, and maybe the precursor of something more serious, such as paralysis. They then become more and more careful, are afraid to walk, and end up in a wheelchair. All this has little to do with motor skills and a lot with fear.

“Fordyce was a powerful personality and not afraid to be contrary. At a certain moment, he wrote a report with rather controversial recommendations, at the request of the government. People with chronic pain who were unable to work, should - as far as he was concerned - be put to work. In that way, many of them would discover that they were overprotecting themselves.”

Amidst all the turmoil at congresses, Fordyce remained calm at all times, never angry, always listing his arguments. “Tragically, he became deaf towards the end of his life. He couldn’t hear the questions properly from people in the audience at meetings so someone had to write them down for him. Proper communication became difficult. You knew that he had good arguments, but he could no longer get them across.” 

In his further professional life Vlaeyen kept in contact with Fordyce from time to time, but he owes a great deal to him. “I incorporated a lot of his ideas in my work. Just before his death, I published an article in the Clinical Journal of Pain on tailor-made pain treatment. He immediately sent me an e-mail with the short message: ‘I’m proud of you’. I was moved by that.”

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