Study subjects were asked to perform two tasks. In the first task, subjects were instructed to imagine situations which correspond to particular words. In a second task, subjects were reading words, but they were distracted by brain teasers. In both cases there was observed a clear activation of the pain matrix in the brain by the pain-associated words.

Evolutionarily speaking, it is to our advantage to keep within us engrams of painful experiences, so that we might not blunder into another similarly painful situation. However, the results of this study appear to demonstrate that "mere" verbal stimuli are enough to cause changes in the brain that are difficult to explain, and pain that is certainly not trivial.

A provocative question thus arises, particularly for those proponents of a multi-modality approach to the chronic pain patient that incorporates psychological counseling: Is there a threat to the heretofore respected role of verbal confrontation with pain for chronic pain patients? We encourage pain sufferers to express themselves, to purge themselves as it were of the stiff upper lip many such patients insist on presenting to the world. There is a real possibility that these supposedly therapeutic conversations actually intensify the activity of the pain matrix in the brain, resulting in an intensification of the pain experience. Obviously, more study needs to be done.

Words can hurt. Words can alter the activity of the brain. Words must be chosen carefully.