Living with Chronic Pain

Science Behind How Mindset Alters Pain Perceptions


Having the right mindset can allow a person to accomplish many amazing feats. Whether it’s something as mentally challenging as putting a man on the moon or physically daunting as completing grueling endurance events, the human mind can discover a way to accomplish it. Another marvel of the human mind is how it can alter the perception of pain.

Scientists have been fascinated with the concept of cognitive self-regulation, which is the practice of controlling different pain pathways. There are many instances of people altering their perceptions of pain. Athletes, soldiers in combat and prisoners of war have been known to use this technique when needed. Another group that can benefit from cognitive self-regulation are those suffering from chronic pain.

Two Pathways

In 2015, the groundbreaking study “Distinct Brain Systems Mediate the Effects of Nociceptive Input and Self-Regulation on Pain,” was published in the journal PLOS Biology. The lead author of the study, Choong-Wan Woo, announced in a press release: "We found that there are two different pathways in our brains that contribute to the pain experience.”

What they discovered is pain travels through two pathways. In the first pathway, nerves send messages to various areas of the brain (such as the anterior cingulate cortex) detailing the intensity of the pain. The second pathway manages the effects of cognitive regulation on pain perception. It is here that activity is increased in other brain regions such as the medial prefrontal cortex and nucleus accumbens. What makes this interesting is these brain regions are centers of motivation and emotion. They were not linked to perceptions of pain in the body.

Based on these studies, it is believed the second pathway is extremely important in understanding the emotional or psychological aspects of chronic pain.

In the study, painful heat stimuli was applied to the arms of participants. As the heat was applied, their brains were scanned with functional magnetic resonance imaging, or fMRI. During the first round of the experiment, participants were asked to clear their minds and not think of anything while the heat was applied. For the second scan, they were instructed to imagine the heat burning their skin. Not surprisingly, their perception of pain was increased. For the final experiment, participants were told to imagine the heat was pleasurable, (i.e. a sense of warmth on a bitterly cold day). This time, the perception of pain was significantly reduced.

Surprising Findings

When the brain scans and two pathways were analyzed, they were the same in all three scenarios. However, what surprised the researchers was how the second pathway changed in intensity depending on the cognitive self-regulation the participants used. When researchers analyzed these findings and referred to real-life examples of people who have endured pain (athletes and soldiers) they conclude that imagery and distraction are viable ways to regulate pain regulation.

In many instances, people expressed anxiety, worry, stress and other negative emotions about the pain they felt. Looking at the findings of the study, these feelings made the pain worse. Instead of worrying about how bad the pain will feel, individuals with chronic pain should try changing their mindset and way of thinking. By choosing a more positive tone, it’s possible they can decrease the intensity of the pain and decrease feelings of discomfort.

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