You Can Learn to Expect Pain, Even Without Experiencing Pain
When you expect more pain, you feel more pain.
Posted Dec 08, 2015
One of my kids got allergy shots when he was younger. Each week, we would drive to a clinic, and sit in the waiting room. When we first started going, he hated getting shots. As we waited, the anxiety about the upcoming shot would get worse. When we got into the clinic, he would tense up and then yell as he got the shot.
After several months of this, we had a visit with the doctor, who spent several minutes telling my son that the more he feared the shot, the worse it was going to feel. Gradually, he relaxed about getting the shots, and by the end we would get in and out of the clinic without any fear or expression of pain.
This story suggests that just anticipating pain can lead to an increased feeling of pain. In this story, of course, it is hard to tell whether the anticipation of the pain was a result of the small amount of pain my son experienced when getting the shots, or whether it was the result of a conceptual fear of the needle and shot.
Research on pain suggests that you can clearly learn to fear pain after experiencing it. A paper by Marieke Jepma and Tor Wager in the November, 2015 issue of Psychological Science explores the effects of learning to anticipate pain purely conceptually.
The researchers first trained people to expect pain without having them experience pain. Participants saw various simple geometric shapes that were going to be predictors of heat that would either be comfortable or painful. They would see a shape, and first predict how much heat they would get following that shape using a thermometer scale. After that, they were told how much they would actually get following that shape. They performed this prediction task until they could reliably predict which shapes predicted high heat and which shapes predicted low heat.
Then, participants were shown a shape and a moderately painful amount of heat was applied to their inner arm. The heat was either 47 degrees Celsius (about 117 degrees Fahrenheit) or 48 degrees Celsius (about 118 degrees Fahrenheit). They rated how painful the heat felt.
People were sensitive to the difference in the two levels of heat. They rated the 48 degree heat as more painful than the 47 degree heat. In addition, they rated the pain they experienced as more severe when it followed a shape that predicted high heat than when it followed a shape that predicted low heat.
The researchers also measured skin conductance responses throughout the study. Skin conductance measures small changes in the amount of sweat you release and is related to your level of psychological arousal. Participants had higher skin conductance responses following shapes that they learned would predict high heat than to shapes they learned would predict low heat. This amount of skin conductance predicted their later pain ratings.
These results suggest that there is a conceptual component to the experience of pain. When people learn to expect pain, they get aroused and fearful. That arousal causes them to experience more pain when they are in the presence of something painful.
This work also helps us to understand one reason why people can learn to moderate their experience of pain by decreasing their fear of pain. If you learn to expect that something will not be that painful, you will actually experience lower levels of pain than if you expect it to be painful.
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