The mind games of pain

Confession: I love pain.

More precisely, my past year of study has left me fascinated by the ways psychological factors influence the experience of physical pain. So I had a field day with a recent Trends in Cognitive Sciences article that examines the ways sensory experiences beyond touch — especially visual and auditory experiences — can ramp up or tone down our pain.

What makes pain so fascinating is that it’s full of contradictions. On the one hand, recognizing pain is simple. You’re in pain when you feel it — end of story. On the other hand, you can experience constant pain without having obvious injuries, and figuring out why is anything but straightforward. Chronic pain is notoriously tricky to treat and widespread to boot. According to the National Institutes of Health, chronic pain is the most common cause of long-term disability in the US. And approximately 10 million people struggle with it every day in the UK. (Given the problem’s scope, care access issues are to be expected — just this week, the BBC reported that some chronic pain sufferers in Scotland have had to wait up to two years for proper treatment.)

So the nature of pain is not just an abstract mystery — it’s a major health care issue. The Trends article speaks to this problem by reviewing studies that probe the interplay between different kinds of sensory experience and attention in feelings of pain.

Across these studies, an overarching theme is that our pains can be shaped by whatever else is going on around us. Researchers have found that listening to jarring music or smelling nasty odors can intensify pain, whereas pleasing music and smells can do the opposite. Another study — which used a classic experimental set-up that makes people perceive an artificial limb as belonging to their own bodies — found that participants were quicker to feel pain when their fake limb turned red, compared to when it turned blue. In that case, the visual experience of color influenced the physical jolts of pain.

One way attention plays into all this is by triggering preparation in the brain for pain (sorry, there’s just no avoiding that rhyme). More specifically, directed attention — meaning a conscious decision to focus attention on something — has been found to enhance and even kick-start the experience of pain. For example, focusing on a part of your body where you might soon encounter painful stimuli can make the experience of that stimuli worse. When it comes to pain, then, preparation is not always a good thing. Expecting pain can increase or actually create it.

Altogether, I think these findings highlight just how much pain can reflect a state of mind. Not in the sense that those living with pain should be casually expected to control their experiences — telling people to fight their pain by not thinking about it sounds as effective as ordering them not to think of the color red (now you’re picturing red, right?).

What I mean is that given the evidence, it’s a good thing that healthcare practitioners are increasingly treating chronic pain as a psychological issue, on top of a physical one. The study of pain throws a big fat wrench into conceptions of mind and body as separate entities, forcing us to consider how mind and body work as one unit. No wonder I’m so taken with pain.


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