Thoughts on the Possible Application of Ideas on Pain Perception to Other Senses and Experiences

Mild trigger warning: some discussion of eating disorders.

One of the main things I have learned in reading about modern pain research is that pain relates to your brain’s opinion on what is happening to your body and whether or not you should be doing anything about it. You can have a horribly bad injury and feel no pain if your brain doesn’t think that that pain would help you in some way, and you can feel an incredible amount of pain without any injury if your brain thinks that that pain is protecting you in some way.

My favorite story about this comes from a book called “Painful Yarns” by Lorimer Moseley (a wonderful book that I highly recommend that relates a number of stories clinicians and patients can use as examples of or metaphors for how pain works). It’s a true story about a man who came into the emergency room with a hammer through his neck, experiencing no apparent pain, but who then, in the process of joking around about the hammer through his neck, banged his knee on a table, and started yelling about the pain in his knee.

There is a certain sense in which I have found that it sometimes makes sense to think of pain like a hallucination. Pain can have little or nothing in common with the volume of danger signals you may be receiving from your tissues. Phantom limb pain, for example, is obviously not the result of physical tissue injury. It is, in a way, a hallucination.

JT Eberhard has written before about getting visual hallucinations as a result of having an eating disorder. It strikes me that, if I assume similar types of preprocessing happen with the physical perception of pain and the visual perception of the world, this type of hallucination makes a lot of sense from a “Your brain is trying to protect you” perspective. Cultural contexts and conditioning can have a significant impact on pain, and I see no reason to suppose they might not have a parallel impact on things like visual hallucination. If your brain has learned to perceive any weight gain as a massive threat to your well-being, then visual hallucinations that exaggerate weight and weight gain might be, from the perspective of your brain, a sensible protective mechanism against any chance of any actual weight gain.

Just to be clear: I’m not saying the hallucinations would be in any way actually good. I am saying that your brain might employ them as a protective mechanism. Very big difference. I assume very similar things about my chronic pain: I assume that my brain “thinks” that creating this pain is protecting me in some way, even if the reality is that it makes my life unambiguously worse and does not actually provide any useful protection from anything.

One of the things that seems to help when I’m dealing with back pain is to concentrate on the fact that I know it isn’t providing me any useful information, and doesn’t reflect any actual threat to my tissues. Doing this regularly over an extended period of time has seemed, in the past, to have an ameliorating effect. I largely attribute the couple of months were I was having little-to-no back pain to a long period of doing that regularly. Pain is a product of the brain, and while generally your brain does its own thing, there are times when, if you are deliberate and patient, you can have some success talking it into or out of things.

This is all a long way of saying that I have started thinking about more and more of my experiences through the lens of what my brain’s opinion might be.

Yesterday, I was feeling a little insecure, and worrying about things it didn’t really make sense to worry about. Over the last month or so, one of the things that I have found myself being occasionally insecure about is not getting timely responses to texts. If I’m exchanging texts, and I say something and then don’t get a response for a while, I start to worry that I have, without realizing it, said something that offended someone. The fear doesn’t make a lot of sense, particularly in light of the fact that I, myself, am not always particularly good at responding to texts in a timely manner. In thinking about how I might stop being anxious about this, an idea occurred to me: could I treat this anxiety in a way that parallels the way I sometimes treat my pain? If my anxiety about texting is constructed out of a perceived threat to my well-being, could the same type of self-talk have a similar ameliorating effect on it?

I have come to believe more and more, lately, that all of the ways I perceive the world undergo so much extra-conscious preprocessing that it makes no sense to think of any of them as even remotely resembling a direct, raw feed of incoming data. I have come to think of them more and more as powerfully subject to context and to my brain’s opinion on what is going on around me. I am beginning to wonder, more and more often, how many aspects of my perception of the world might, correspondingly, be subject to the same types of influence that my pain seems (at least occasionally) to be.

Food for thought. I intend to try thinking about my insecurities from this angle more often, to see if it helps. I think it might end up being a very useful perspective to take.