Pain Research: Not Minding That It Hurts

How well can we adapt to pain in the long run? Since pain is such a source of disutility, it’s important for us to learn as much as we can about managing or reducing its impact on our lives. One researcher studying the issue is Dan Ariely, who has a rare perspective after suffering major burns at a young age. He describes some fascinating findings at the beginning of one of his TED Talks (before moving on to his research on cheating), but he devotes a whole chapter to adaptation in his recent book, The Upside of Irrationality.

I haven’t read the book quite yet, but Ariely has posted videos of himself discussing the first few chapters:

Besides being flat-out interesting, pain research could have public policy implications. The current laws tightly regulate the most effective drugs at treating chronic pain, and often discourage doctors (read: scare doctors away) from prescribing them. Earlier this year, Matt Yglesias referenced this kind of research to evaluate some of the costs and benefits of the war on drugs.

This is terrible. One of the most interesting findings from the happiness research literature is that human beings are remarkably good at adapting to all kinds of misfortunes. Chronic pain, however, is an exception. People either get effective treatment for their pain, or else they’re miserable. Adaptation is fairly minimum. The upshot is that from a real human welfare perspective, we ought to put a lot of weight on making sure that people with chronic pain get the best treatment possible. Minimizing addiction is a fine public policy goal, but the priority should be on making sure that people with legitimate needs can get medicine.

Policy decisions require us to weigh the interests of different segments of the population. If we’ve been underestimating the suffering of those in chronic pain, it might be best if we made a shift toward supporting them more and found other ways to offset our worries about addiction.

Another one of Ariely’s suggestions interested me – that events can change the associations we have with pain. I hadn’t given much thought to the dual nature of pain as a physical sensation and an emotional reaction to the sensation. I had always viewed it as a useful but necessarily unpleasant signal that someone is wrong with our bodies. Sure, it’s no fun to experience, but we need to know that we’re putting weight on a fractured bone, right? However, if it’s possible to have that physical alert without the mental anguish, we could get the best (well, the slightly better) of both worlds: notification of problems but not the accompanying distress. As Peter O’Toole said in Lawrence of Arabia: “The trick, William Potter, is not minding that it hurts.

There would be downsides, of course. Pain isn’t just an immediate reaction, it helps shape our future behavior. The emotional component to pain might be important in training ourselves to avoid harmful situations. If we “don’t mind that it hurts” we would probably be more prone to do stupid things.

At the moment, it’s fairly theoretical to me anyway. If we need to go through acute injuries to get to the tolerance Ariely has, count me out – it’s not worth it to me. But we need to understand suffering in order to reduce it, and research like Ariely’s will help.

(Sidenote: I hear Julia will have a chance to meet Dan Ariely at Burning Man this weekend. I couldn’t go because I’ll be on a business trip to Dragon*Con [I know, no sympathy for me] but I hope she has a fantastic time! I’m not envious or bitter at all… )