Post No.: 0226
Pain is an alarm signal telling us that something is not right or is potentially about to be not right. For example, we feel pain after we get cut and bleed or after we collapse from a breakdown (something isn’t right so we should attend to it), but we can also feel pain when we exert a lot of force on a limb even if it’s not currently injured or when we face enormous mental stresses even though we’re still standing (something is potentially about to be not right if it goes much further/longer so we should take precaution and ease off before any damage is done).
There is no true objective test or measure for pain because pain is a ‘hypothetical construct’ and cannot be observed directly – it can only be measured via people self-reporting their own state. There is no known fair, ethical and objective test of pain to compare one person’s pain threshold to another person’s. For example, the pain felt from having one’s bare arm submerged in a bucket of icy water depends on the adiposity of one’s arm (i.e. how much fat, which is an insulator of heat, is around one’s hands, wrists and arms), or a person could be physically numb in the fingers due to nerve damage hence she/he isn’t necessarily mentally tough but just isn’t physically feeling any sensation through her/his fingers (which is not necessarily an advantage e.g. getting burnt without knowing it). We’re interested in what someone is feeling inside their mind, not what’s happening to their skin, muscles or bones.
Different people may have different numbers of active pain receptors in their mouths and tongues for sensing capsaicin, and anyone can slowly build up their tolerance to chilli heat the more they consume chillies; and so the person who is crying the most when eating spicy food might actually be the mentally toughest because she/he’s the one who’s actually experiencing the physical pain sensations! Electric shocks from electroshock weapons or ‘stun guns’, such as Tasers, have also been claimed to work better on those with more muscle mass because they work by neuromuscular incapacitation. So we cannot be sure what someone is really feeling inside their own brain by virtue of what’s happening to something somewhere on the rest of their body. We cannot really know accurately what level of pain a person is really feeling inside her/his own mind without being her/him – we know ourselves that sometimes a paper cut hurts or annoys us a lot and sometimes the same injury doesn’t. A few people even have an incredibly rare disorder that means they don’t feel any pain at all, which again has its pros and cons – probably mainly cons because pain evolved to help an organism’s survival. An ice bucket test can be used to compare within participants though (i.e. the same person under one condition and then under another condition).
There’s also no ethical way to truly test the raw mental strength of individuals by subjecting participants to torture. In a lab experiment or any situation where one can voluntarily withdraw from a test or exercise at any time – just psychologically knowing that one can withdraw under one’s own decision is a massive psychological relief that isn’t afforded to real-life situations of torture or psychological pain. Knowing or guessing that there are medics on immediate standby who have a duty to care about one’s welfare is also a great psychological relief, as are knowing details like what’s going to likely happen (e.g. either via research of past participants or being ethically told in advance), how long it’ll all last (e.g. a maximum of 4 weeks for the entire challenge) and maybe understanding that one chose to participate in an exercise without coercion in the first place. The loss of freedom, the complete uncertainty and the often psychological loneliness of real-life torture cannot be ethically replicated in lab experiments.
So it’s impossible to be objective about something that is subjective like reporting or comparing the sensation of pain between different people e.g. what’s an ‘average’ or ‘normal’ level of pain? One person’s ‘5’ on a scale of 1 to 10 is personal and cannot be compared to someone else’s ‘5’ in a like-for-like sense. The ‘worst pain ever conceivable’, or ‘10’ on the scale, is, for most people at least, only an imagined experience, so maybe their imagination doesn’t go far enough? Or maybe it goes too far since reaching a certain level would send one unconscious (or dead) and unable to consciously experience that level at all?
Our memories of past, internal, subjective states are also potentially fallible because memories are often fallible, and other transient situational factors can affect our current perception of pain too (e.g. the sports team one supports has just won a critical match, and so one’s knee pain temporarily seems less annoying because one is being pleasantly distracted).
Our current psychological emotions and perspectives can affect how deeply we feel actual physical bodily sensations or injuries. We can even completely imagine pain, via anticipating or exaggerating normal sensations, that has completely no basis on our (non-brain) physical bodily state (e.g. because our brains have been conditioned to anticipate pain whenever there’s a particular stimulus, such as if your chair collapsed every time a clock chimed, and then you hear a clock chime; or when we have great affective empathy with someone, then we hear a story about them bruising their head after a nasty fall, which may even cause us to physically flinch as if we tripped over and hurt ourselves). Meow.
Anticipating pain (e.g. when a needle is about to be injected into oneself) will tend to increase one’s experience of pain, and vice-versa. Stress amplifies the perception of any pain. It seems to present a contradictory facet of psychology research though because one may think that happiness is the difference between one’s expectations of an experience and the actual experience, hence expecting a lot of pain but then the pain not being as bad as one thought should make one feel happier about it all – but a lot of strong physiological processes happen within us when we’re anticipating a lot of pain, that make us feel tense and stressful, increase our heart rate and blood pressure and ultimately trigger our fuzzy ‘fight or flight’ responses.
Pain is therefore all in the mind – but this is not to say that pain isn’t real or to blame people for their own pains if they feel them (all emotions and feelings exist in the mind after all, and they make up our own reality). We cannot deny people’s feelings if they truly feel them. Shall we deny that a person is in love just because it’s all in her/his mind? Well, ‘mental’ is ‘physical’ after all i.e. the brain and all brain processes, emotions and feelings are ultimately physical processes operating in a physical world according to physical laws. Pain medications work physically on the nervous system, such as by blocking receptors. All that is ‘mental’ is ultimately ‘physical’ (including all cognition and consciousness) but not all that is ‘physical’ is ‘mental’ i.e. it doesn’t mean that if we can think it then we can make absolutely anything physically true in the world, apart from maybe within the confines of our own personal imagination.
Yet knowing it only exists in the mind can help one to approach pain management or even possibly total recovery from a chronic pain through cognitive behavioural therapies or the retraining of the brain, rather than e.g. falsely believing that one’s external body part is (still) life-threateningly injured when it isn’t, such as with cases of phantom limb pain. If an internal or external body part is still injured though, such as bleeding, then one should obviously primarily aim to heal the injured part rather than train one’s mind to try to ignore the injury.
Some pains that are believed to be (non-brain) physical can therefore be completely mental in source. For instance, many people who believe their back pain is physical, when it primarily isn’t, can avoid doing any hard physical activities, which only serves to make their backs even weaker and in turn more prone to true physical injuries, thus reinforcing their false beliefs – but knowing that the pain is more in the mind or anticipatory than on the body or realised can direct them towards the actual steps that’ll lead to a full recovery i.e. to disobey this ‘false alarm’ or over-sensitive ‘anticipatory/precautionary pain’ and go use your back more to make it gradually stronger and thus less prone to further real back injuries.
Since pain doesn’t just warn us when something might go wrong, which can sometimes produce false alarms, but when something has already gone wrong – dealing with a pain won’t necessarily mean dealing with the root problem or cause of that pain if the root problem is truly (non-brain) physical though. This would be akin to trying to switch off the car dashboard engine warning light, which won’t actually deal with the problem with the engine if there really is a problem with the engine, and where continuing driving would make the engine worse and harder to later repair, and carrying on driving dangerous. So one must, in the mid to long-term at least, deal with the ongoing root cause of a pain rather than seek ways to foolhardily ‘suck it up’.
To dampen the feeling of pain (apart from using methods that actually deal with the root cause of a pain where possible) – one could distract oneself from it (e.g. through hypnosis, listening to music or playing an engrossing video game). Swearing is an innate and effective way to reduce the effects of an acute pain (e.g. if you ****ing stub your toe!) Meditation can also work very well to reduce the effects of both acute and chronic pain if one has had a chance to practise it for a while – depending on the type of meditation used, it can work by training you to accept the pain but not be so bothered about it, which is a mindfulness technique, or to ‘Zen out’ and think of other things during a painful moment, which is in essence a distraction technique. Drugs, like alcohol, can of course dull pain. Read Post No.: 0213 for information about placebos too. Again, this isn’t to say that pain is to be ignored – physical sources need proper physical care, and mental sources need an identification of the root cause and practising a change of cognitive perspectives and/or changing one’s lifestyle.
The pain or irritation of a splinter may be exacerbated by psychologically drawing attention to it all of the time, but this won’t mean there isn’t a true physical injury component to it (i.e. the splinter). So invisible disabilities or hidden internal problems such as anxiety or irritable bowel syndrome may be exacerbated psychologically, but it doesn’t mean there isn’t a true physical component to them, be it somewhere in or on the rest of the body or within the brain itself.
Nevertheless – although it doesn’t necessarily mean stress is the root cause – stress can itself create pain or will exacerbate any existing pain, thus stress management (e.g. adequate nutrition, rest, exercise, leisure, mindfulness) will help, in conjunction with trying to solve (or learning to accept, if it cannot be reasonably changed) the root problem(s).
In conclusion, pain is in the mind but the mind is real and therefore pain is real too. If one can identify and realistically deal with the root source of one’s pain then one should tackle this root cause, or if this isn’t possible or the pain is overly precautionary then one can practise ways to cope with the pain or train to gradually get physically stronger.
Meow! Do, however, please consult your doctor first, especially before attempting to self-medicate for a long-term pain.