Tag: pain

A Modified Introduction to “Irrationally Yours:”

Jul 30

In 1984, as a 17-year-old high-school student in Israel, I was a member of a youth movement that focused on study, civic work and preparation for military service. Our graduation ceremonies often featured big fires, intended to dramatize our patriotic fervor. That year, some of our leaders had brought back military supplies to help make the blaze especially intense.

One Friday afternoon, as we began putting away these materials, there was an accident. Nobody knows exactly what happened, but a spark must have been struck somewhere. A large magnesium flare—the kind that the Israeli military uses to light up a battlefield—exploded right next to me. In a moment, I was engulfed by flames.

The fire nearly killed me. About 70% of my body was covered in third-degree burns. In a matter of seconds, my life had changed irreversibly. Looking back now, more than three decades later, I realize that my awful new situation had one unexpected and positive effect: It began my career as a serious observer of the peculiarities of human behavior.

The explosion marked the start of a three-year period of hospitalization and surgeries—first in the emergency department of Beilinson Hospital, then in Tel Hashomer Hospital, both near Tel Aviv. I’ll never forget the day, perhaps four months after my injury, when I first saw myself in a full-length mirror. Before the accident, I had been a decent-looking teenager. But that day, I saw something completely different. My eyes were pulled severely to the side. The right side of my mouth and my nose were both charred and distorted. So was my right ear.

Was this really me? It was hard to see, believe or accept. Why was I still here? What would my future be, looking like this?

The burns and their treatment caused me extreme pain over a long period—a kind of pain that is more intense and lasting than almost any other medical condition. But since I had little else to do and badly needed distraction, I began to notice and record things.

For example, every day, I had to have a soaking bath that involved removing my bandages and scraping off my dead skin and flesh. The nurses would rip off the dressings all at once, without a break. It was excruciating, but the nurses insisted that tearing the bandages off was the best way.

One day, one of the nurses allowed me a bit of control over the process, and I found the treatment somewhat more tolerable. This made me wonder if having more control over the process would be better in general, but given my helpless position, I had little influence over the way I was treated.

After years of treatment, I left the hospital and went to Tel Aviv University. I decided to study psychology. My harrowing years had left me deeply interested in understanding how we experience pain and in the experimental method.

So I carried out laboratory experiments on myself, my friends and volunteers, using moderate (and safe) physical pain induced by heat, cold water, pressure and loud sounds—even the psychological pain of losing money in the stock market—to probe for answers. I learned that there are better and worse ways to deliver pain—and that my nurses’ methods hadn’t been the best ones. (One should remove the bandages slowly, not rip them off, and one should start from the most painful parts, then move toward the least.) If my nurses, despite all their experience with burn victims, had erred in treating the patients they cared so much about, other professionals might also be misunderstanding the consequences of their behaviors and make poor decisions.

Soon, I found, my personal and professional lives had become intertwined. For years, I felt the burden of my scars: the unending pain, the odd-looking medical braces, the pressure bandages that covered me from head to toe, the feeling of having gone through some kind of weird door and of living separately from the day-to-day experiences of my previous self and other “normal” people. I’d become an observer of my own life, as if I were watching an experiment on someone else—and I looked anew at other people as well.

This new approach became central to my work. Remembering the placebos given instead of medications during some treatments, I conducted experiments to explore the effects of expectations on painful treatments. (They can dramatically change our experiences—and even the intensity of the pain we feel.) Remembering how it felt to be given difficult information in the hospital, I tried to figure out how best to break bad news to patients. (Slowly, and in steps.) I kept finding topics that crossed the personal/professional boundary, and over time, I learned more about my own decisions and the behavior of those around me.

I saw people who managed their suffering and triumphed, and I saw others who caved in to fear and terror. I tried to take apart mundane daily activities—about why we shop, drive, volunteer, interact with co-workers, take risks, fight and behave thoughtlessly. And I couldn’t help noticing the intricate fibers that entwine our romantic life. (Fortunately, I never lost my sense of humor.)

All these questions began to weave their way into my research. I grew increasingly adept at observing how people went about their daily lives, prone to wonder about human habits, eager to explore the reasons for our behavior and motivated to find ways to make us behave slightly better.

My accident happened more than 30 years ago, and if any good came out of it, maybe it is this: I like to believe that the disaster and its aftereffects made me better able to understand myself and others. Maybe I’m rationalizing. We human beings do that exceptionally well: By trying to see something awful in a more positive light, we’re able to make sense of it, or at least make it more tolerable.

After years of writing scholarly papers on these topics, I started writing about my research and its implications in a more conversational, less academic way. And perhaps because I described how my research grew out of my own struggles, many people started sharing their personal challenges with me. With experience (warning: second rationalization coming), I got better at answering their questions. And I would like to believe that my advice was even helpful sometimes.

Don’t get me wrong: I don’t think that my injury was worth it. I have spent every day of my adult years in varying degrees of pain. I have endured, over and over, the dysfunction of the medical system. I have been exposed to an astonishing number of medical procedures and odd human interactions. I am more comfortable in public these days, but my scars still make me feel out of place in most social circumstances.

But—whether I’m rationalizing or not—I did learn important lessons from my injury, my time in the hospital, the years that followed, the research that emerged from my ordeal, and the questions and challenges that people have shared with me over the years. These have become my microscope on life.


My latest book, Irrationally Yours, which is based on my Wall Street Journal column “Ask Ariely,” was recently published by HarperCollins. See this article on the WSJ here.

Men, Women, and Pain

Jan 28

If you’ve been to the doctor’s office recently with any kind of complaint, it’s likely you were asked to rate the pain you were experiencing on a scale from 0 to 10 (being the worst pain possible). Well, a group of researchers from the Stanford University School of Medicine recently analyzed the self-reported pain measurements from 11,000 medical records from 2007-2010 and discovered something surprising: women report greater levels of pain than men for the same injuries and ailments.

In The Upside of Irrationality, I briefly discussed a disagreement I had with a professor about the difference in pain tolerance between men and women. My professor, Ina Weiner, maintained the view that women have a higher tolerance in order to cope with childbirth, and she was unimpressed by the story I told about a woman I’d met in the burn unit who confided in me that the pain of her burns was far worse than what she experienced in childbirth. As you might expect, I decided to run a small experiment, and asked the men and women who passed by my cubicle (where I worked as a research assistant) to submerge a hand in hot water and keep it there until the pain became unbearable. Meanwhile, I timed them and recorded their gender.

The next day in class I was excited to describe my experiment and to report that the men who participated kept their hand in the hot water for much longer than the women.  Professor Weiner replied that all I’d proven was that men were stupider—after all, who would subject themselves to such pain just for my silly study? Naturally this took the wind out of my sails, and I left the subject alone after that.

But as it turns out, the women analyzed in this study reported more intense pain—an average of about 20% more—for equal-opportunity afflictions ranging from neck and back pain to viral Hepatitis. While the experience of pain and the way people report it is inevitably subjective (for instance, the presence of a concerned family member might lead someone to downplay their pain), it’s likely that the large number of people included in the analysis counterbalances social and individual differences.

And while I would never say “I told you so” to a former teacher, I do hope that this research might make its way somehow to Professor Weiner.

For the original paper, click here.

Pain decreases pain

Aug 15

In Chapter 6 of “The Upside of Irrationality” I wrote about the the process of adaptation, which is the process by which we get used to stuff — like pain, romantic partners, and new cars.

Some of the personal experiences and experiments I described were about how experiencing pain when I was hospitalized caused me (and others) to view pain differently and with a lower intensity.

A new study on back pain, showed the basic same results:

“This study of 396 adults with chronic back pain found that those with some lifetime adversity reported less physical impairment, disability, and heavy utilization of health care than those who had experienced either no adversity or a high level of adversity…… The data suggest that adversity-exposure also may protect against psychiatric disturbances that occur with chronic back pain…”

I am not suggesting that everyone goes and get some more experience in adversity — just to prepare ourselves in case something bad will take place in the future.  But, it is interesting to realize that negative experiences influence our adaptation, and this way also on our ability to deal more positively with new negative circumstances.

Dan

The Symbolic Power Of Money (by Alon Nir)

Jun 01

They say money can’t buy happiness. That might be true, but a new study suggests money holds more benefits in store than just the obvious ones. A clever set of experiments by Xinyue Zhou, Kathleen D. Vohs and Roy F. Baumeister suggest that simply handling money can dull physical and emotional pain.

Previous research has shown that social exclusion and physical pain share common underlying mechanisms. This is due to the way we evolved as social animals. In fact, a 2003 study (Eisenberger et al.) showed that the brain produces similar responses to social rejection as to physical pain. Other work (Vohs et al., 2006) revealed that thoughts of money convey feelings of self-sufficiency, thus soothing the uneasiness of social exclusion. Putting these findings together, Zhou et al. propose that money and physical pain are linked to one another, and they set out to examine this connection as well as the connection money has to social distress.

Three pairs of experiments were carried out on university students, looking to see if:

a. social exclusion and physical pain increase the desire for money
b. money can appease this pain, both physical and emotional
c. losing money intensifies these sensations. As it turns out from the study, the answer to all of these hypotheses is yes.

Since I liked the design of the study I’ll describe it succinctly as I introduce the findings. The impatient reader can skip the part in blue.

The first pair of experiments explored if the desire for money increases with social rejection and physical pain. Researchers let groups of four get acquainted with each other, and then split them to individual rooms. The subjects were then told that they were not picked by any of the others as partners for a dyad task, to stem feelings of social rejection (subjects in the control group were told everyone chose them). After this semi-cruel manipulation, the subjects’ desire for money was measured in three different measures (e.g. the sum they were willing to donate to an orphanage) and in all three the participants in the rejected condition expressed higher desire for money, compared to their ‘popular’ counterparts.

In the second experiment, half the subjects were primed to the idea of physical pain with word-completion tasks, while the other half was exposed to neutral concepts. Simply priming the notion of pain also increased the desire for money.

The next pair of experiments investigated if money can sooth pain. Subjects in the one condition were asked to count eighty $100 bills, in order to invoke the feeling of obtaining money, while the other subjects counted 80 pieces of paper (all this under the pretence of a finger-dexterity task). Then, one experiment had subject play ‘Cyberball’ – a computerized ball-tossing game with other players. The participants were lead to believe the players were human but in fact were a simple computer program. Subjects in the exclusion condition weren’t passed the ball and were effectively left out of the game by the other ‘players’. How tragic it must have been for some of them – it’s the grade school playground all over again. After the game ended participants were questioned about their experience, and – as you might have guessed it – those who counted money beforehand felt less social distress over being left out of the game, and maintained higher self-esteem than those who counted paper.

The other experiment of the pair is possibly the most interesting in the bunch. After that same money/paper counting exercise, the poor participants had to undergo a pain-sensitivity task (and all they got in return was partial course credit!). Zhou et al. used another approach – they put subjects’ hands in an immobilizing contraption and then poured hot water on their fingers. After this ‘pleasantness’, subjects rated how painful was this experience. The results indicate that simply counting money significantly reduced feelings of pain in the high-pain condition, and that it made participants feel stronger than those who counted paper.

The last pair of experiments used similar measures to show that thinking about losing money actually intensifies the sting of social rejection (Cyberball) and exacerbate physical pain (hot water again). Subjects in the money-losing condition indeed reported higher vulnerability in both cases.

To sum up, these experiments suggest that having financial resources diminishes pain, both physical pain and emotional pain caused by social rejection. Possibly the most interesting thing to pinpoint is that the method these findings were obtained indicates a general perception of money as a mean to alleviate pain and suffering. This is because money by itself had no value in the experiments as it could not “buy” any passes of the ball nor a release out of the hand constraints. It is also interesting to notice that merely thinking about having or losing money, without any actual change in resources, had the described effects since the experimenters didn’t award (or take) the subjects any money (neither as a part of the experiments nor for their participation).

This study springs several implications to mind. As for me, I wonder if there will ever come a day that a dentist appointment will kick off with a brief game of monopoly (one where the patient always accumulates great wealth) prior to the actual treatment. It just might alleviate the pain.

Reference: Zhou, X., Vohs, K., & Baumeister, R. (2009). The Symbolic Power of Money: Reminders of Money Alter Social Distress and Physical Pain Psychological Science.

The Psychology of Pain: "I didn’t mean it!"

Feb 10

There’s a phrase we hear all the time, and one that suggests something about our psychological makeup: we’re not just concerned with actions, but with their attendant mens rea – or lack thereof – as well. If it wasn’t intentional, then it’s not as painful.

And, as it turns out, that is quite literally true: Harvard researchers Kurt Gray and Daniel Wegner recently found that we experience greater pain when we perceive it to be deliberately inflicted, rather than by accident.

In their clever experiment, they had volunteers perform a variety of tasks, including an assessment of discomfort. This involved receiving electric shocks and then rating them on a 1 to 7 scale. When participants thought their “study partner” (who was actually a research accomplice) had selected the task for them to complete, they rated their perceived pain as higher (Mean ratings = 3.62) than when they were told the selection was computer-generated the pain was lower (Mean ratings = 3.00).

What’s more, deliberate pain was not just more acute, it also lasted longer: whereas participants rated the unintentional shocks less and less unpleasant as the experiment progressed, the intentional shocks remained just as painful.

So next time you are at the doctor try to think that he or she really cares about you.

A game to make burns hurt less

Nov 15

Burns are a particularly nasty and painful type of injury: the nerve endings are damaged, skin regrows tougher and tighter, and on top of this patients have to also deal with physical therapy.

A new game, called Snow World gets burn patients to play a 3D computer game in which move along a snowy path and fire snowballs at nonmoving target.  What are the effects of this game?  A recent report shows that patients playing the game report feeling less pain when playing, and more impressively also get a greater range of motion in their burnt limbs as their muscles relaxed. Finally, they also get less pain medication was also required, meaning patients were lucid for longer periods of time.

This is just great — and I wish I had this game when I was in hospital.  Maybe we can find games for other issues as well (eliminating the pain of social rejection, losing money in the stock market….).

   

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