What is Mental Defeat?

Mental defeat is defined as the perceived loss of autonomy in the face of uncontrollable, traumatic events. In the context of chronic pain this can be explained as a loss of identity and self in relation to repeated episodes of pain.

"It's defeat of the mind."

"The pain is taking over and you cannot cope with what you are supposed to do."

"Everything had beaten me and there's nothing I could do. I couldn't fight anymore."

"The pain belittles you as a person."

"It's like you're not a human being."

The concept of mental defeat has its origins in the study of post-traumatic stress disorder (PTSD), depression and suicide.

Mental Defeat in PTSD

In the context of PTSD, mental defeat signifies the "perceived loss of all autonomy" when confronted with uncontrollable traumatic events. Research has shown that individuals who experience a profound sense of defeat tend to exhibit more severe PTSD symptoms and respond less favourably to exposure treatments.

Perception of Defeat in Depression

In the realm of depression, defeat is conceptualised as "a sense of failed social struggle, loss, and reduced social rank." Depressed individuals often perceive themselves as trapped in a "subordinate" role, with the perception of defeat correlating with more severe depressive symptoms.

Defeat in relation to Suicide

In the field of suicide research, defeat plays a central role in influential models like the Cry of Pain Model and the Schematic Appraisal Model. Questionnaire-based studies have revealed that defeat statistically correlates with negative appraisals of social support, poor problem-solving abilities, and suicidality. Longitudinal evidence indicates that among young individuals reporting suicidality, a stronger sense of defeat is associated with a heightened risk of increasing suicidality over time, even when baseline symptoms of depression and suicidality are considered. Most recently, mental defeat has been implicated as a significant predictor of suicide risk or intent among patients with chronic pain. These findings collectively suggest that the concept of defeat has the potential to shed light on how symptom severity, distress, and disability evolve across various disorders.

Mental Defeat applied to the study of Chronic Pain

Recent research in health psychology has begun to apply the concept of mental defeat to the study of chronic pain, yielding interesting outcomes. Repetitive experiences of persistent pain are believed to serve as recurrent triggers for the experience of defeat. This in turn may activate negative self-appraisals concerning pain. Studies have demonstrated that people seeking specialist treatment for chronic pain experience significantly higher levels of mental defeat compared to people with chronic pain but not seeking specialist treatment, people with acute pain, pain-free individuals and patients seeking specialist treatment for anxiety disorders. Furthermore, recent research from our group has identified a consistent link between higher levels of mental defeat and an increased risk of suicide in people with chronic pain.