Cover Image: September 2009 Scientific American Magazine See Inside

MIND on Pain: The Psychology of Pain [Preview]

Our expectations, mood and perspective on pain powerfully influence how much something actually hurts—and the decisions we make every day














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In Brief

  • Most people think of pain as resulting from physical injury or disease, but psychological factors play a huge role in pain perception. Pain is intimately tied to brain functions that govern behavior and decision making, including expectation, attention and learning.
  • Recent investigations are unraveling how factors such as expectation of reward or punishment, fear, stress and mood alter perceived pain intensity and affect our choices.
  • Scientists are not only revealing just how far pain reaches into our psyches but are also using their findings to devise ways of better controlling pain and hastening recovery from painful injuries.

Several years ago an elderly man came into the emergency room at Cook County Hospital in Chicago with a large, painful abscess (boil) on the back of his neck. When I told him he needed a minor procedure to lance the boil and drain it, he became ashen, asking, “Doc, is this going to hurt?” I told him that if at any time the treatment hurt too much, he could tell me to stop—and I would. I opened the boil with a very sharp scalpel. He did not make a sound for some time. “When are you going to start?” he finally asked. “It’s done,” I said. “How did you do that?” he replied. “I didn’t feel anything.”

Most people think of pain as resulting from physical injury or disease, but psychological factors play a huge role in pain perception. In the case of my elderly patient, my reassurance that the treatment would not significantly worsen his pain—because he could stop me if it did—produced an analgesic effect. In addition, reducing the man’s fear enabled him to look forward to pain relief instead, and that positive expectation also eased his pain.


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  1. 1. Rosemary McKenzie-Ferguson 02:29 AM 10/11/09

    Pain is such a personal concept it is real but can never be shared with anyone, it can not be touched or looked at, it is impossible to pick it up or put it down, pain is just there. It can be described in many ways or it is impossible to describe. I live with pain, I acknowledge it in my daily life,I know the restrictions I am meant to live within and I know that there will be moments when it will be impossible to do anything except breathe with the pain to be able to endure it, other days the pain is just an unwelcome guest in my body that I tolerate. For the most part I work with the pain instead of working against it, I rest when it is required to do so, but the one thing I refuse point blank is to allow the pain to dominate my life to such an extent that it runs me. The only concession I give the pain is that on the days that it does overwhelm me that I take heed and rest, the rest of the time the pain must not impede my progress. Sounds simple, but it is anything but simple, what it is isa determined outlook on life an understanding that I am more than the pain that is within me and adesire to ensure that others around me understand that once the decision is made to beat peace with pain, to learn the signs and to accept the down times life is a lot easier for myself and for everyone around me. Yours in service, Rosemary McKenzie-Ferguson Work Injured Resource Connection Adelaide South Australia

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  2. 2. egypts 02:49 PM 3/9/10

    i think what they are trying to say is if you make an effort to help someone, it can save them pain, reduce, or not even cause pain, i think its all about reassuarance and communication

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  3. 3. egypts 03:18 PM 3/9/10

    i think what they are trying to say is if you make an effort to help someone, it can save them pain, reduce, or not even cause pain, i think its all about reassuarance and communication

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