Jennifer Haythornthwaite – a professor at Johns Hopkins University School of Medicine (Maryland, USA), plenary speaker at the IASP 2024 World Congress on Pain, and recipient of the John D. Loeser Award for Distinguished Lifetime Achievement in the Clinical Science of Pain – has been operating at the cross-section of psychology and biology for decades. While a prolific researcher and graduate advisor, she also serves as a mentoring consultant for vice deans at Johns Hopkins University School of Medicine.
To supplement her plenary lecture at the IASP 2024 World Congress on Pain, we’re sharing an interview we conducted with Jennifer at the 2023 North American Pain School. In her conversation with PRF-NAPS Correspondent Bukola Ibitoye (the University of British Columbia, Vancouver, Canada), Jennifer describes her introduction to the field of pain research, the formation of the United States Association for the Study of Pain, and how her research career has sparked interest in improving faculty mentor/mentee relationships.
You have had an impactful career as a pain researcher contributing to the understanding of pain catastrophizing, the influence of sleep disturbance on pain sensitivity, and other aspects of pain research. What inspired you to be a pain researcher?
I’m a clinical psychologist by training, and as a part of that training, I did an internship at a veterans’ hospital and learned about pain as a part of my rotations. One of the things that made an impression on me was how common [and debilitating] pain was. I would talk to people about the patients I would see at the veterans’ hospital who had an amputation or a spinal cord injury. They would be experiencing pain but there was no foot left after an amputation, or due to paralysis they had no sensation at the level that they were experiencing the pain. So they could not move the body part, but they had pain. It was such a puzzling and worrisome experience to hear about.
Then I was working in a service that was very focused on psychological interventions because this was in the early 1980s, and there was a huge push to stay away from opioid pain medication use for, particularly, chronic pain. So we were looking to try and provide alternatives, and to help veterans cope with their pain.
It resonated with me that this is something where I could [potentially] have a home as a clinician, as a researcher, and as somebody who wanted to have an impact. So that’s where it all started for me, in the veterans’ hospital, and working with somebody who I still regard as one of my mentors. That’s Bob Kerns. He taught me about mentoring.
At what stage in your career did you start focusing on pain research?
My dissertation research was on chest pain (angina) in cardiac patients. What happened was, I went to the Veterans Affairs Medical Center (VA) without a plan for a dissertation. I came up with the idea while I was on an internship, went back to school, and did my proposal. Then I went to Connecticut, collected my data through the VA, worked with Bob, learned about pain research, and finished my dissertation. So it was all kind of embroiled together as part of finishing up my degree, learning about pain through the VA, and finding an area that I wanted to research for my dissertation. And just all of those little things got rolled into one big thing.
What inspired you to start the United States Association for the Study of Pain (USASP), and how did you bring people together to sustain the association?
When the American Pain Society dissolved, I was very upset. Routinely, when I talk to young faculty and trainees about their career development, I say, “Find a group where you really feel you have the greatest common interest and become a part of that group, nurture those relationships because that will pay off throughout your career.” That’s what the American Pain Society was for me. It was a part of my life that helped me develop my career in pain and helped me in many ways – such as learning how to be a good presenter, having conversations with like-minded colleagues, as well as colleagues who challenged my ideas. It offered the opportunity for so much growth and development. The idea that the next generation wouldn’t have that broke my heart.
So the questions were: What do we do? Where do we find an existing professional society, or what do we do to make sure we have one? As I talked to people, I found out that Michael Gold was having the same conversations.
I knew Michael from lots of interactions and have a tremendous respect for him, and I knew that I could work well with him. So we had a series of conversations and decided to work together to take on some opportunities. There’s something called “Mr. Pig,” which is the Midwestern Regional Pain Interest Group. They were having a meeting, and they gave us time to speak about the need for a new association. We had conversations with a lot of the people attending the meeting about what they wanted from a professional society, and what were the options already.
Then we put together an organizing committee that was representative of various people from across the nation. We brought them together through monthly conference calls, and we talked a lot about what we wanted to do. Around that time, the auction for The Journal of Pain was scheduled to happen in December 2019. Michael, thankfully, pushed that we “rally the troops” and get people to donate money so that we could buy the journal on the auction block in the bankruptcy court. So we opened a GoFundMe page, and we got thousands of dollars.
Jerry Gebhart solicited money from past leaders in the pain community, and they wrote big checks. We got a lot of generosity from the pain community and put all that money together and created the United States Association for the Study of Pain. Also, we were able to successfully buy the journal, and that was our first act. Then the second act was, with the organizing committee, we wrote new bylaws so that we could take on members. Then in July 2020, those bylaws opened [and] the society [started] taking on members.
What advice would you give to those who might be interested in bringing people together to have a society like USASP in their own countries?
We had the advantage of the US being a very large country. We have a lot of money, and we have a lot of resources that have been available to us for many years. We’re very fortunate. It depends on the nature of the resources that a country has, and some countries do not have rich resources.
I would suggest that somebody who’s interested in starting a group like USASP should work on developing a group of people who share similar interests and come together for a journal club, or just casual dinners, where everybody compares notes or somebody presents a patient. As much as you can, you can also try to blend the people who are interested in research with the clinicians, because that is such a valuable opportunity for both sides: For the clinicians to learn what’s going on in research, and for the researchers to learn what’s going on in the clinical area.
You’re currently leading a program on graduate mentorship at Johns Hopkins. Can you tell us about this?
About six years ago, the National Institutes of Health (NIH) mandated that renewals of training programs in the National Institute of General Medical Sciences (NIGMS) require the T32 [Institutional Training Grant] renewals to include information about how they were going to assess the quality of their mentoring, provide evidence-based training for their faculty, and remove ineffective or poor-quality mentors. At Johns Hopkins, this was a big deal because it was a substantial change that was clearly required. We ended up putting together a committee and then a task force. I chaired the task force and worked with chairs, students, faculty, and program directors to come up with a plan on how to achieve this requirement. They decided that all the faculty would be required to do two things.
One requirement [was] that our faculty complete an online training module on mentoring at the University of Minnesota. The second [requirement was] the program I run, in which the faculty are required to participate in six hours of in-person workshops on mentoring skills. In these workshops, we cover four of the mentoring competencies: Effective communication, aligning expectations, fostering independence, and creating an inclusive culture.
How can other institutions develop similar programs?
I went to the University of Wisconsin and got their training on mentorship – [which] is eight one-hour workshops. Then I condensed it down and morphed it to fit the [Johns] Hopkins faculty, ran things by the students, and did a lot of groundwork before I started the mentorship program at John Hopkins. The University of Wisconsin has a nationally recognized center on mentor training. Anybody who’s interested in getting mentor training can go to CIMER at the University of Wisconsin.
How can the mentee-mentor relationship become worse, and how can that be prevented? Can you share a bad mentor-mentee scenario that you have encountered or heard about?
I’ll tell you an interesting story that captures problems from both sides of the equation. People who are being mentored at [Johns] Hopkins will tell me that they got bad advice, and I’ll hear the mentors say, “They don’t listen to me.” The mentees aren’t listening because the mentors aren’t listening – both parties aren’t listening.
I think communication is so foundational to a good, healthy mentoring relationship. You have to listen carefully to each other to understand the point of view before you can start making decisions, and truly understand expectations and make sure that they’re aligned.
Another issue is when mentees make promises they cannot keep – big mistake! A mentee says, “Yes, I’ll get X and Y done,” and they don’t even get X done, let alone X and Y. Or they’re repeatedly late in performing. It’s one thing to be late once in a while, but it’s a whole other thing to be late regularly. All that does is frustrate mentors, and they’re usually donating their time. They’re not paid to do this.
At Johns Hopkins, through this whole mentoring task force, we decided that mentoring graduate students is a privilege. Mentees have to take that seriously. Most people who go into academia, science, and research love to teach and train the next generation – they have a real devotion to passing it on. That devotion diminishes rapidly if somebody is not listening, coming in late, and they’re not respectful.
The same thing can happen on the other side if a mentor is traveling all the time, not attentive, and ignoring emails – that’s not a recipe for success. There are lots of ways things can go wrong, and lots of challenges for both mentors and mentees to repair, sort out, and move things forward.
How can mentees and mentors address these problems?
Mentees, in particular, can think about and communicate what their goals are. What do they want in the period that they’re working with their mentor? What are they looking for out of the relationship? They should try not to be bashful or shy about those goals and put them on the table, and try to make sure that they are heard and respected.
Mentors need to do as much as they can to help every mentee. They can ask questions like, “What is your path? Where do you want to go? What are your goals? What is your vision, your mission, and your sense of where you want to go?” Then help them develop that and free them up to pursue the things they need to develop the qualifications. For instance: If a mentee wants to go to a teaching university or a teaching college, they need teaching experience. They need an opportunity to get that practical experience and develop their teaching skills.
I’ve been reading this work by Carol Dweck, and she talks about mindsets, and she talks about a growth mindset versus a fixed mindset. I think in general, in academia, we have a growth mindset. I think the challenge – for both mentors and mentees – is to have a growth mindset in the mentoring relationship and around each person’s, especially the mentee’s, career development.
Bukola Ibitoye is a PhD candidate at the University of British Columbia, Canada. You can follow her on Twitter – @bukky_ibitoye.