PAIN REPSONSE

When defining pain, the first thing we consider is the sensory experience of pain: Where does it hurt? What causes the pain? Is the pain a burning or shooting sensation or something completely different?

The sensory response is, however, not sufficient. A feeling is also assigned to the pain – a feeling, which is often supported verbally: “Ouch! That hurts!”

The body and the mind are connected which becomes most apparent to us as our bodies encounter the outside world.

How you experience pain may, furthermore, be affected by a number of different factors, e.g., your personality, family relations, as well as sociocultural environment (Cordier 2). A parent’s reaction to their child falling and hurting their knee, may affect the child’s experience of how much the injury hurts. Different learning mechanisms may, therefore, explain how your experience of pain and your behaviour are connected.

When discussing learning processes, most people will visualize a child, learning basic language- and motoric skills, e.g., learning to walk or speak. Cognitive learning is, especially in infancy, closely related to the body, but how adults learn can also be affected by biological factors such as hunger, fatigue or (physical) pain. In relation to pain, your mentality is important in regard to aggravate or improve your condition.

The focal point in the pain process is your own experience of the pain you feel. By attributing a negative emotion to the pain; fear or anxiety, you risk (unconsciously) changing behaviour to compensate for the pain, which is common in larger injuries. An example could be starting to walk differently or using the right hand in stead of the left.

How you handle pain, by changed behaviour or mentality, can affect the chronification of pain – meaning it does not go away. The learning mechanisms, which are relevant in connection to pain are: classical- and operant conditioning, extinction, habituation, and sensitization.

involves association of  an involentary response to a stimulus (e.g., a sound). Here, the story of Pavlov’s dogs may ring a bell to some people? If you are curious about conditioning and psychological- and physical behaviour in regard to chronic pain treatment, click here!

involves association between voluntary behavior with an either negative or positive conseqeunce as an amplifier. A chronic pain-patient may adapt to a certain new behaviour to “spare” the troubled area, which can cause the pain to aggravate the injury further or cause the pain to become chronic.

can be apllied to both classic or operant conditioning of learned behaviour, simply by removing the consequence. A chronic pain-patient may learn to see physical exercise as a positive thing rather than linked to pain experiences. This can be done through treatment, which is based on physical activity, even though the patient might associate exercise with pain.

is a form of non-associatave learing where a response to a repeated stimulus dimingshes. It is behaviour, which have become a “habit”. If you change your ring tone on your mobile, at first, the sound might catch your attention but after some time, you will not notice it. We can compare this to chronic pain-patients who feel pain when performing physical activities. As time goes by, the patient may see physical activity as a form of punishment or consequence, because even the slightest movement is connected to pain.

affects your pain experience. Sensitization refers to a gradually increased and non-controlled response to pain. Some people, who suffer from chronic pain, will experience a gradually low pain threshold as a result of sensitization. If you want to learn more of sensitization in the nervous system, please click here: What is Chronic Pain?

The five mechanisms are not relevant for all patients; however, they can impact whether and when a pain becomes chronic (meaning it lasts more than three months).

Assigning positive consequences (caring, empathy, self-control) or removing negative consequences (e.g., adapting a new behavioural habit) following a painful experience, can affect the chronification process of the pain. In other words, your reaction to pain becomes the very cause of the pain. On the other hand, we know the reaction can be modulated, e.g., through healthy, physical activity or brain exercise such as neurofeedback.