Tuesday, December 02, 2008

Neuroscience: Where does it hurt? How?

This conference on pain neuroimaging and the law has set itself a difficult goal:

The issue of the existence or extent of pain comes up hundreds of thousands of times each year in the United States legal system, through personal injury suits, disability determinations, and workers compensation. Current methods of detecting pain are well short of perfect. The science of pain is being revolutionized by neuroimaging technologies, which may in turn have important implications for the law. The goal of this conference is to explore whether and how neuroimaging can help the law deal with claims about individuals’ pain.
My sense is that neuroimaging can help somewhat, but only somewhat.

When I first learned about Mario Beauregard's studies of people in a state of deep mystical contemplation, which we discuss in The Spiritual Brain, I asked him, "How do you know they aren't just faking it?"

He replied, "Oh, that would be no problem. Then they would generate plenty of beta waves but no theta waves, typical of deep meditation."

My guess is that, in the same way, neuroimaging technologies could help identify situations where people are simply faking an injury. (Like the legendary insurance disability claimant who is filmed playing rugby .... )

But many real life situations are much more complex. Some people magnify pain, some diminish it. Some choose to ignore pain. Some cope with it much more effectively than others. For some people, pain brings sympathetic attention, and for others it doesn't.

That was brought home to me when I was having a baby in 1973.

True to my upbringing, I remained silent about any discomfort during labour. But I was horrified to hear a woman down the hall shrieking something like "Jesus!" "Mary!" "Jesus!" "Mary!"

"Can't anything be done for her?", I asked my nurse, "Will she die? Will the baby die?"

"You mustn't worry," the nurse reassured me. "She is going to be fine and the baby will be fine too. In her culture, it is okay to scream like that."

That wise nurse did not assess pain or discomfort merely by the level of self-expression because that varies with culture.

Similarly, if you think that a shooting pain is a mere discomfort, you will experience it differently than if you think that it warns of an impending heart attack.

There is brute fact, to be sure, but there is also interpretation of the fact. The human experience of pain includes both.

Hat tip: Stephanie West Allen at Brains on Purpose

See also:

Finally, an idea! (which recounts a very interesting experiment on pain)

Neuroscience: Making sense of uncontrollable itching

Commentator Dinesh D'Souza on stuff he didn't know - like the power of the placebo effect

Placebo effect: Your mind's role in your health