The realization of how relative happiness is became very apparent to me some years ago when I was in the burn department.

One day a new patient came to the burn department — Miri, a teenage girl.  Miri was 17 and her boyfriend just informed her that he was leaving her for someone else.  As passionate as only teenagers can be, she went to the bathroom, slashed her wrists and poured bleach on them.  As luck had it, when she was brought into the emergency room, Dr. Batya Yafe was there, an amazing woman and specialist in both plastic surgery and microsurgery who was able to reconstruct Miri’s blood vessels and take care of the damaged skin on her wrists.

A few weeks later Miri was a functional teenager again, but with second degree burns on her wrists.  Relative to the rest of us, this was a relatively minor injury, but I am sure it was still very painful.  The first few weeks were a serious adjustment for her – switching from being an active teenager in love to a patient in the burn department surrounded by these awful smells and many people in tremendous agony is not easy for anyone and particularly not for an idealistic teenager.  The amazing thing was to see her a few weeks later and in the months to follow when she would come back to visit us.  She seemed like a new and altogether person.  She was happy, energetic, and with an appetite for life.

The scars that Miri carried on her wrists must have made her feel immensely different in the world outside the burn department, a constant reminder of her time spent in the burn department and the events that brought her there.  I also suspect that these scars acted as a permanent reminder of what could have been, and her relative fortune in life.  Was her newfound happiness related to the negative experience in the burn department?  I imagine that Miri’s injury and her weeks in the burn department adjusted her perspective on life.  Both the struggle she had with her burns, and the comparison to the other people in the burn department must have dwarfed her perceptions of her romantic trouble in comparison.

The burns on her wrists really helped Miri, and more generally I think that injuries that “work best” in giving people a new perspective on life are those that continuously act as a reminder of their relative happiness — even once the initial injury is over.  Miri’s wrists, or losing a leg, for example, are promising on these grounds because the loss can act as a permanent reminder. And so are deep burns (the superficial ones are not as good because they can disappear with time).  Lets be clear — I am not advocating burning people who are not very happy with their lives and letting them struggle with the pain and agony of burns, the slow recovery, and the comparison to other less fortunate individuals — but I do think that ironically such negative experiences can actually improve the outlook people have on life and their motivation for living.

So, as we plan for 2011 maybe we can find ways to be happy without any serious injuries.

Happy new year

Dan

A couple months ago, I wrote about a study showing that those who had experienced a little (but not too much) adversity were better at handling physical pain than their pain-free counterparts.

Now, a new study finds the same trend – but with mental health and wellbeing. It seems that both physical and mental resilience can be achieved through a healthy amount of adversity. When we face hard times, we adapt and build a callous that helps us take on future challenges.

Resilience is often considered a process that occurs in spite of adversity, but we might want to instead think of it as a phenomenon that appears because of adversity.  Indeed, we can become even more physically and mentally capable as a result of our misfortunes.

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

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.

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.

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….).

The nights in the burn department were always difficult, and many of the patients would regularly ask (beg) for more painkillers to help them fall sleep. One afternoon I overheard the doctors tell the nurses not to give a certain patient any more morphine. A few hours later, when the same patient started begging for painkillers I saw the nurse go to her room with an injection and a few seconds later the patient quietly went to sleep. When the nurse stopped by my room, I asked her about it and with a smile she told me that she had given the patient IV fluid.This was the first time I experienced (secondhand) the power of placebo. I am not sure if they ever treated me with the same method, but it is certainly possible.Years later I became even more impressed with placebos when I learned that a placebo for pain has a very clear physiology. When we expect to get pain relief, our brain secretes a substance that is very much like morphine and this substance makes the pain go away. This means that even if the injection contains no painkiller we can still get pain relief courtesy of our own brain.Yesterday we published a study in The Journal of the American Medical Association about placebos. In this study we showed that when people get more expensive painkillers (placebos in our case) they expect a lot and get a lot of pain relief, but when the price of these pills is discounted, the expectations are lowered and so is their efficacy. As it turns out, with painkillers, we sometimes get what we pay for.For a story in the NYT see this link