In the May issue of the journal Cerebral Cortex, a group from the National Institute for Physiological Sciences in Okazaki, Japan reported interesting results from a study in which “pain centers” in the brain were shown to be activated by WITNESSING pain afflicted to others. If you see someone being poked with a sharp needle in a (fake) movie, your brain responds as if YOU’VE been poked, and your brain responds as if YOU hurt. (I can almost see you wincing, as you read this!)

IT HURTS, WHEN YOU THINK IT SHOULD. If I flash a red light each time I burn your skin, you’ll learn that the red light means “pain”. If I flash a green light each time I just warm your skin a little without burning it, you’ll understand that the green light means “no pain”. It turns out that once you have learned those associations, you are VERY easy to fool. Now, a red light can hurt like hell, even when a stimulus just warms your skin a little. Perhaps more importantly for therapeutics, now an green light DOESN’T hurt, even on occasional instances in which I trick you, and burn your hide.

The brain powerfully modulates pain, as a function of the context in which an injury arises, and as a function of your ongoing expectations about “how much it SHOULD hurt”. If thugs beat me up in an alley, I might feel little pain when I realize that I am damn lucky that the beating is over, and I have survived it. On the other hand, it might hurt like hell once it sinks in that I’m going to be unemployed for weeks, with no food on the table for my family.

Understanding that the intensity of the pain that you feel is substantially determined by YOUR INTERPRETATION of the context and predicted consequences in which it arises, and understanding that pain can grow through learning, and persist even when the source of the pain is no longer evident are important considerations to reflect upon, for your personal pain management. The stoics among us have figured this out, to some extent by just deciding (and don’t we wish WE could!) NOT to hurt.