Saturday, February 19, 2011

Pain, the brain, and the power of expectation

012508 love hatePhoto credit: Me!

A recent study in the journal Science Translational Medicine has caught the interest of pain patients, physicians, and anyone interested in the complex interactions within the human brain. Bottom line: the effects of pain-killing medication can be boosted, or dramatically lowered, simply by manipulating expectations.

In the study, mild pain is administered to healthy people. The average study participant rated their initial pain at a 66. Without their knowledge, a potent painkiller was administered, and their rating went to 55. After they were told they were being given medication, the rating dropped to 39. The effects were just as strong in the opposite direction. With the painkillers still being administered, participants were told to expect pain, as the meds had been withdrawn. Their pain rating shot up to a 64.

As both a psychologist and a pain patient, I'm used to that stunned reaction that people get when they grapple with the somehow-amazing fact that the mind and the body are inseparable. After three decades of dealing with the complex rhythms of my own pain, I have a never-ending pool of empathy and understanding for my fellow sufferers. Like it or not, we're all part of a club, holders of a wealth of shared knowledge, imparters of well-wishes and comrades in battle. Any pain patient can tell you about the surging tides of pain management - the crests of hope and the cold-sea troughs of discouragement.

Healthy college students sense increased pain when their expectations are manipulated. Imagine what it's like for someone who has dealt with their pain for years and faced a series of discouraging attempts at relief. Hopelessness, those of us in the mental health business know, is a monster, capable of increasing suicide potential, ruining relationships, and hanging dark heavy weight on ordinarily functional people. The good news is that something as simple as hope can do the opposite.

Sometimes, in the face of any kind of pain, whether it's from a physical injury or a more intimate emotional scar, it's easy to forget that no one can manipulate our expectations more powerfully than we ourselves can.


  1. Fascinating study--this is something I've intuited, having experienced the darkness of depression and the journey out of it.

    I'm looking forward to reading more from you. :)

  2. @Corn Dog Mama - I think a lot of us with pain issues have known this on some level. It's interesting to see it quantified empirically, for sure. Thanks for reading!