Neuroscience has done much to help us understand what occurs in the brain of the addict, and now it also offers us a better understanding of what occurs for family members, specifically as it relates to enabling behavior. The brain is wired to react empathetically to someone in pain in order to warn others of danger and elicit help. Functional MRI scans show that when watching someone undergo electric shock, the observer's brain lights up in the same areas in which the brain of the person in pain lights up.(Bufalari, Ilaria et al. (2007) Empathy for Pain and Touch in the Human Somatosensory cortex. Cerebral Cortex. 17:2553-2561)
One doesn't have to witness the painful experience for the brain to react, simply seeing a person act as if he or she is in pain causes the brain to light up. When the person in pain is a family member, the reaction to his or her pain is exponentially stronger.
In another study, when researchers delivered electric shocks to people with chronic pain, they found that in the presence of a solicitous spouse, pain levels and brain activity increased substantially. This study suggests that even though well-intentioned, when a caring person is present, the pain is reinforced.(Flor, Herta et al. (2002) Conditioning: Learning that Pain Can Elecit Reward. Presented at Society for Neuroscience Annual Meeting, Orlando, FL. Nov. 2-7, 2002)
Lessons for family members are:
You are suffering as you witness your family member suffer, but your concerned and doting manner causes more pain in the very person you want to help.
This research implies that family connections may well be the biological basis for enabling a loved one in chronic pain.
Treatment implications involve developing a sense of equilibrium despite another's experience of pain.