The Complexity of Pain

Although I have written on chronic pain in a previous blog, it is such a complex topic that it deserves another look at (and possibly more in the future). In this blog I will discuss some of the complexities of pain and how it relates to psychology.

Pain can be defined as “An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage” (International Association for the Study of Pain, 2021). This definition means that: pain has a sensory component and an emotional component.

            From the Body to the Brain

Nociception is the process of transduction and transmitting a signal from a noxious input (Marchand, 2024). In other words, it involved the perception and neural signal of a painful stimulus. However, this is not yet pain. For example, touching something hot with one’s hand involves receptors in the skin, encoding this ‘message’ and then sending this message electrically and chemically. However, it is not pain yet.

This signal travels from nerves in our bodies into the central nervous system (the spine and up to the brain). This is referred to as the ascending pathway (Yousuf et al., 2022) Once this signal reaches the brain, it is still not yet experienced as pain. This signal is sent to various areas of the brain. It then travels along what is known as the descending pathway, involving areas of the brain associated with emotion and higher cognitive functions. The signal is modulated/altered by the descending pathway through our life experience, emotions, memories, motivations and more (Day & Thorn, 2022; Khera & Rangasamy, 2021; Yousuf et al., 2022). This is finally when pain is experienced.

What Does it Mean That Pain is Modulated?

Pain is a unique, subjective experience and is affected by biological, psychological and social factors (IASP, 2021; Marchand, 2024; Richter, 2023). This means our experience of pain can be changed depending on our unique biological, psychological and social factors. For example, running a few kilometres will cause me pain. However, for some individuals, running a marathon is not experienced as painful.

So, Why Is This So Interesting and What Are the Implications?

If we understand pain as having a biological, psychological and social component, we are able to change the experience by changing the variables (Marchand, 2024; Richter, 2023). I am not saying we can stop it completely; however, the overall experience can be altered through certain therapies (Marchand, 2024; Richter, 2023)

Pain is such a subjective and demanding experience.

Pain is so fascinating and complex and this is only the tip of the iceberg.

I find pain incredibly interesting. Should you wish to learn more or book a session, I am available at Thrive Psychology.

• Steve

References:

Day, M. A., & Thorn, B. E. (2022). Psychological interventions: A focus on cognitive‐behavioral therapy. In M. E. Lynch, K. D. Craid & P. H. Peng (Eds.), Clinical pain management: A practical guide (272-281). John Wiley & Sons Ltd.

International Association for the Study of Pain. (2021). https://www.iasp-pain.org/resources/terminology/

Khera, T., & Rangasamy, V. (2021). Cognition and pain: A review. Frontiers in psychology, 12, 673962.

Marchand, S. (2024). The pain phenomenon. Springer Nature.

Richter, J. (2023). Unlearn Pain: The successful techniques and exercises of psychological pain management. Springer.

Yousuf, M. S., Basbaum, A. I., & Price, T. J. (2022). Basic mechanisms and pathophysiology. In M. E. Lynch, K. D. Craid & P. H. Peng (Eds.), Clinical pain management: A practical guide (25-39). John Wiley & Sons Ltd.