In this episode of The Le Pub Scientifique Podcast, Tim Beames and Bart van Buchem tackle a phrase many clinicians fear saying out loud: “I don’t know.”

Working in pain care means working with complexity, variability, and uncertainty — yet clinicians often feel pressure to provide certainty, predictions, and clear answers. In this conversation, Tim and Bart explore why false certainty can quietly erode trust, and how learning to work honestly and skilfully with uncertainty can actually strengthen the therapeutic relationship.

They discuss:

• Why uncertainty is inevitable in pain — and not a sign of incompetence

• The difference between confidence and certainty

• How over-explaining or overselling treatment can backfire

• When “I don’t know” builds trust — and when it doesn’t

• Reframing patient questions like “What’s wrong with me?” into deeper needs such as safety, support, and direction

• How curiosity, exploration, and experience help both clinicians and patients live better with uncertainty

This episode is the first in a series exploring uncertainty, trust, and flexibility in clinical practice — especially relevant for clinicians working with persistent and complex pain.

If you value thoughtful, reflective conversations like this, you can join Le Pub Scientifique:

👉 Free membership — access selected podcasts, discussions, and community content 👉 Premium membership — full access to podcast archives, science sessions, clinical coaching series, and in-depth conversations with leading clinicians and researchers

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#PainPodcast #ClinicalReasoning #PainEducation #LePubScientifique

What happens when we try to apply predictive processing models to fibromyalgia? In this exploratory conversation, Tim Beames and Bart Van Buckem work through the clinical implications of understanding fibromyalgia through the lens of prediction, uncertainty, and sensitivity to difference.

They discuss why unpredictability is so costly in fibromyalgia, why "healthy activity" can backfire, and how systems become sensitized to even tiny changes. The conversation explores concepts like entropy, allostasis, expectation violations, and the challenge of creating difference without creating threat.

Bart brings healthy skepticism throughout, questioning the risks of mechanistic language and whether these models truly help in the clinic. Tim responds by translating theory into practical approaches: micro-variability, building baselines of safety, and pacing at a different timescale.

This is thinking-out-loud science. Two clinicians trying to bridge theoretical models with clinical complexity in fibromyalgia—a condition where traditional approaches often fall short.

Featuring: Tim Beames & Bart Van Buckem Duration: 39 minutes Level: All clinicians working with chronic pain

Note: This episode is followed by a refinement piece where Tim reflects on the limitations of this approach.

In this episode of The Pain Podcast, Tim Beames and Bart van Buchem explore a deceptively simple question: can assessment itself be therapeutic?

Drawing on clinical experience from both in-person and online practice, they unpack how physical examinations are never neutral acts. Every question asked, every movement explored, and every test performed can shape expectations, build trust, reduce threat — or sometimes unintentionally increase it.

Rather than viewing assessment as a box-ticking exercise, Tim and Bart discuss assessment as a shared process of sense-making. They explore:

• How validation, reassurance, and curiosity can emerge before any treatment begins

• The difference between testing and exploring

• Why over-testing can sometimes increase uncertainty or fear

• How assessments can update internal models and predictions about the body

• The role of safety, trust, and co-creation in early clinical encounters

If you enjoy conversations like this and want to go deeper into pain science, clinical reasoning, and real-world practice, you can join Le Pub Scientifique.

👉 Free membership gives you access to selected episodes, discussions, and community content 👉 Premium membership unlocks full podcast archives, science sessions, clinical coaching series, and in-depth discussions with leading clinicians and researchers

🔗 Join here: https://www.lepubscientifique.com/

#PainPodcast #ClinicalReasoning #PainEducation