Between the heavy mallet and the paving stone, my misplaced finger didn't stand a chance. But it wasn't the sight of the bloody, smashed-apart fingernail or split-open fingertip that first made clear my mistake. It was the pain. That searing, body-tensing, tears-in-the-eyes pain.
The basic function of pain is to interrupt whatever else is going on and draw our attention to the fact that something is wrong, that the body is facing or has already suffered some kind of damage. Sensory nerves, called nociceptors (i.e. danger receptors) detect elements capable of body-tissue damage, such as pressure or extreme heat. The nerves' signals are projected through the thalamus – a structure above the brain stem – to regions throughout the brain's outer cortex.
Neuroimaging studies suggest the regions activated by such signals, and that are clearly associated with the distress of pain, include the front-most section of the insular cortex – a region thought to be involved in monitoring and responding to changes in bodily states – as well a portion of the cingulate cortex near the middle of the brain.
Scientists have proposed that the pain-related role of this mid-cingulate region is to help quickly redirect our thoughts and actions toward eliminating the source of the pain, preventing further damage and caring for our injuries.
Well, I got the message. And while it was clear that my hammered finger was a minor injury in the grand scheme of things, I knew there would be at least an hour or two of throbbing discomfort ahead of me. What then? Sit back and suffer? Moan about the agony? Or perhaps find some way to minimize the discomfort?
Thankfully, the results of a growing number of studies indicate that we can exert a surprising level of control over the intensity of our painful experiences using relatively simple mental strategies. They work by altering patterns of activation in these key pain-related brain regions. Indeed, because pain levels depend on what is going on in these regions, it seems we can literally think our way out of considerable agony.
There are a couple of types of mental strategies you can employ.
Shifting attention – focusing our attention on something other than the source, or sensory experience, of pain – is one way to reduce activity in pain-related areas of the brain and thus reduce our experience of pain. This occurs because attention not only acts to enhance the level of neural activity corresponding to whatever we focus on, but it also acts to suppress activity in other brain regions that are not relevant or that might otherwise interfere with our ability to focus on the object of our choice.
Another effective strategy is to change the way you are thinking about a painful experience – to reappraise or reframe the situation in your mind. Thus, instead of feeling the pain sensation as something that is harming your body, you might instead come to view it as a feeling of something merely touching your body. Or instead of considering the pain in terms of how severe it is, you might consider how minor it is compared to a more intense experience. My smashed finger rates pretty low compared to what I've seen in hospital emergency rooms.
Recent research has shown that these different mental strategies work to reduce pain through different networks of brain regions. Shifting attention seems to work primarily through the recruitment of cortical areas primarily in the frontal and parietal lobes. Reappraisal appears to modify additional activity in subcortical structures such as the amygdala and thalamus.
Meditation offers another type of reappraisal. An essential element of many forms of meditation is the concept of mindfulness. Rather than shifting attention away from its source, a mindfulness approach involves focusing your awareness on the pain itself. However, instead of evaluating the pain in terms of how distressing and horrible it is, those who routinely practise meditation come to see it for what it is in an objective, non-emotional and less-reactive way. Recent neuroimaging studies have confirmed that this approach also results in diminished experience of pain, but does so through a decoupling of activity in regions associated with emotional reactivity.
Establishing these differences in how we can strategically control our brain's pain response may explain why one approach can work better for some people while the other approach works better for others. Some of us are better at controlling the focus of our attention, and others are better at reimagining the situations in which we find ourselves.
So the next time you find yourself grimacing in agony, remember that you can help yourself. And if one approach doesn't do the trick, don't hesitate to try the other.
Mark Fenske, co-author of The Winner's Brain: 8 Strategies Great Minds Use to Achieve Success, is a neuroscientist and associate professor at the University of Guelph.