A definitional interlude

Pain was defined by committee as "an unpleasant sensory and emotional experience, associated with actual or potential tissue damage, or described in terms of such damage" [1]. I repeat this here, even though you will be familiar with it, because it is important to reflect on it from a psychological point of view.

First, it recognizes that pain is fundamentally an unpleasant or aversive experience. Pain is different from other sensations in which the emotional content can be considered an association to the primary sensory experience, occurring sequentially after the sensation. Instead pain is immediately emotional. Pain that is not aversive is not pain.

Second, it recognizes that pain is only loosely related to tissue damage. There is now ample evidence that the relationship between pain and damage is weak. Of course, they often occur together but the objective extent of physical damage is a poor predictor of pain report, and pain is a poor predictor of the extent of tissue damage. The intrapersonal, interpersonal, and contextual variability of pain reporting is where psychological explanations operate.

Third, it recognizes that pain is a communicative event that relies often on its description. This aspect of the definition has two elements. When in pain, people typically communicate it, verbally or non-verbally, intentionally and unintentionally. In addition, for those who are capable, people seek to make sense of the experience by symbolically representing it in language. Commonly, this language will revolve around descriptions of bodily damage and violence.

Missing from this definition is any attention to the function of pain, what it operates to achieve. Recently, I have argued that pain is fundamentally an affective-motoric event to be understood in a context of an evolved social warning system. In other words, pain functions to warn oneself, and others in one's group, of real or potential danger. This is not the space to expand this argument, which can be found elsewhere [2], but it is important to recognize that pain is fundamentally threatening: it alarms, it promotes avoidance and escape. Further, one learns, and is motivated to learn more about, what the cause of pain is and how to avoid it in the future. This functional account of pain is at the heart of an understanding of the cognitive, social and clinical psychologies of pain. From this perspective, pain is fundamentally an alarm system that imposes new behavioral priorities. Cognitively, it is an attentional interrupt that brings a forced disengagement with other thought processes, and imposes new thoughts and behaviors. Socially, its communication is shaped by social forces, and has consequences for other people in one's social group. Clinically, when we attempt to help people "cope" with pain nonpharma-cologically, we need to understand that we are often asking them to behave counterintuitively, and coun-terculturally, in ignoring a strong alarm.

Natural Pain Management

Natural Pain Management

Do You Suffer From Chronic Pain? Do You Feel Like You Might Be Addicted to Pain Killers For Life? Are You Trapped on a Merry-Go-Round of Escalating Pain Tolerance That Might Eventually Mean That No Pain Killer Treats Your Condition Anymore? Have you been prescribed pain killers with dangerous side effects?

Get My Free Ebook


Post a comment