Not too long ago was I doing some research on chronic pain. I found that for both the 116 million Americans and for each doctor involved, receiving proper treatment and drugs can be a long and frustrating process. Chronic pain is becoming more and more problematic as it almost impossible to objectively measure. In an article that I found in New York Times, based off a research article, researchers went about treating chronic pain a little differently. Their hypothesis? What if pain was all in your head? The original article titled, Control over brain activation and pain learned by using real time functional MRI, tested to see whether chronic patients could learn to alleviate their pain using pain reduction techniques while also viewing the localized area of the brain that responds to pain, in real time.
Subjects with chronic pain were given the task to decrease already existing pain. All subjects were taught the same reduction or enhancement techniques (Attention, Stimulus quality, Stimulus severity, Control). All participants, except those in the control condition, were under the f.M.R.I. machine and were able to view a representation of their rostral anterior cingulated cortex (rACC), the area of the brain that activates in accordance to the awareness of pain. Healthy participants were asked, while presently viewing the representation of their own rACC region, to either increase their pain, or decrease pain by implementing learned techniques. Chronic patients, however, were asked to use the techniques solely for the purpose of reducing pain.
Chronic patients who applied reduction techniques reported an average decrease in pain by 64 percent. Healthy subjects also reported a significant difference in their ability to modulate pain, that being either increasing pain or decreasing pain. What was then the big take home message? Pain is a perception of the mind. By using f.M.R.I. and viewing one’s own rACC in motion, you can use strategies such as, positive imagining, distractions, and control techniques, to essentially manipulate how the brain perceives pain, and therefore alter the severity of one’s own physiological response.
Though this research provides positive results, what then happens to those patients who don’t have the financial means to undergo such procedures? Secondly, if the techniques only work for those under the machine then what happens in day to day life when the machine isn’t readily available?
Link to research article: www.pnas.org/content/102/51/18626.short
Link to New York Times article: www.nytimes.com/2006/05/14/magazine.14pain.htm
On Psychology and Neuroscience 
It is encouraging to hear that chronic pain can be reduced using techniques other than drugs. Although drug treatment can be highly effective for chronic pain, pain killers can often be addictive, causing patients to want to continue using them after treatment. Another common problem is that individuals that were prescribed pain killers will keep left over pills from their treatment in the house and give them to others for less severe pain. Using pain reduction techniques eliminates problems like these. Seeing if these techniques could be equally effective without the patients seeing a representation of their rACC would provide more hope for the effectiveness of these techniques.
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If pain is largely in ones mind, how can we take this into account when considering babies crying in response to supposed pain? Say a small child hits his/her head, or receives a shot at a doctors office and starts to cry, how are they experiencing this “painful” stimulus? They presumably do not have mature enough cognitions for pain to be a perception of the mind. Why might they be crying?
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This was a really interesting article, but I think there’s still a long way to go before we can know if pain is really perception. Subjectively, whenever I’m in pain if I think about something else to distract myself, I feel the pain less. Does that mean the pain isn’t real/just perception? I think it could mean I’m just not paying as much attention to it so I don’t notice it. We have sensory neurons that must sense some form of pain/discomfort, so I think an interesting follow up experiment could examine whether or not the sensory neurons themselves, or the subjective experience of the messages they’re sending to the brain, is the ultimate cause of pain.
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My cross country coach always claimed pain was an illusion of the mind, but when your legs feel like lead and your lungs feel like they are about to collapse, it is hard to believe that it is only controlled by the mind. I am glad to hear that methods other than drugs have been found to successfully decrease chronic pain. There are many problems and possible dangers with drugs, such as addiction. I wonder what are the possible repercussions of this new method. Is it possible to get addicted to this new method and not be able to function without the machine. I know this sounds like an extreme but as technology becomes less expensive and more people are able to afford this treatment it may become an issue.
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I see a link between this study and very old (and often philosophical) methods to address or study human experiences of suffering. To paraphrase a Buddhist philosophy, pain is real but suffering is optional. I think that the techniques above alleviate the suffering part of the pain because tthat’s what I see as the perception component. Pain as a biological process is just cells reacting to damage. Suffering is the interpretation of that sensation and if we can change the interpretation of other sensations (cognitive therapy), why not pain?
Regarding the possible baby exception: I’d argue that they lack the communicative and mental faculties to translate pain or other discomfort into any response other than crying.
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