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Pain: Actual and Perceived

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About twenty years ago I got out of a car, pushed the lock down, and promptly shut my left thumb in the door. I pulled my thumb out of the closed door as it was locked. At first it did not hurt at all. I thought that it would be fine, then about seven to ten seconds later I sat down, a throbbing pain emerging from the point of impact. I then got up and thought I should immediately find a way to reduce the circulation to my thumb. I pushed the button on a water fountain, and started to let the cold water run over the thumbnail. Immediately, a piercing and electric-like pain ran from the base of my thumb and directly out the end of my thumb. I no longer felt anything other than the pain of having slammed my thumb into the car door. I cried out from the excruciating pain, and felt as though I would never feel alright again. This pain did subside into a throbbing pain for the next several days, displaying pain attenuation or adaptive (Breedlove, Watson, & Roseenzweig, 2010). I could not hold anything in my left hand using my opposable thumb. Ultimately the thumbnail separated from my thumb, and the new one, to this day, has a couple ridges down it from where I damaged it those many years ago. I can recall the pain so well that I have learned my lesson and keep my hands very clear from the entry of any door: home, cabinet, or automobile using the perception of a potential of pain as a deterrent to carelessness (Breedlove, et al. 2010).

Pain: Perceived and Felt
This week I read the text book and other articles regarding pain, and that 20 year old injury popped back into my working memory. The truth of my thumb was actual sensation of pain for most of the two weeks (and more) while the thumb and thumbnail was healing. There were also moments of perceived pain, in which I did not actually feel any pain, but instead was expecting something to hurt so I changed a behavior to avoid the pain. The bandage that was on my thumb was as painful for the first two days as the initial cold water running over the injury, however after that I did not feel the bandage on my thumb, anymore. My body adapted to the pain so that the initial searing pain was not a constant sensation (Breedlove, et al., 2010).

Difference Between Perceived and Sensation of Pain
The most crucial difference between perception and sensation of pain is the relativity of them. Studies indicate that different people can handle different levels of pain, while there are even those who do not feel pain at all (Breedlove, Watson, & Rosenzweig, 2010). If one perceives something to be painful, for example a man watching one of those “Funniest Home Videos” segments where everyone is being hit in the groin, I wonder how many grab their own and sympathize with the perception of the pain? A study by Osborne (2008) proposes that one may feel pain that others experience through witnessing the act of the painful event. The pain in the observer is in the same place as that of the person who actually experiences the pain, although not as intense as the actually felt pain (Osborne, 2011).

Perceived Pain
Has anyone ever seen a child fall down? How did the adults around the child react? Then, how did the child react to the adults’ reactions? If a child falls down and does not truly get hurt, they may laugh it off until they see overly concerned looks on the faces of adults, or many run to the aid of the child. This child may then change from being alright to crying because he believes that he must be hurt because the adults are all reacting in such a way (Noffsinger, Pfefferbaum, Pfefferbaum, Sherrib, & Norris, 2012).

Potential Costs of Perceived Pain
Potential costs of pain perception include the child above, he perceives that he has been hurt. This cost comes in the form of future response to the same type of event (Noffsinger, et al., 2012). They may increase their sensitivity to pain in future episodes and not truly understand painful events.

Another problem can become perceived but nonexistent pain. A person may “feel” that they are in pain when they are not really hurting at all. The mind is a complex organ and in such, a person may begin to feel pain when they do not really have any—hypochondriac syndromes are an example of a negative ‘cost’ of perceived pain (Sirri, Grandi, & Fava, 2008).

Benefits of Perceived Pain
Benefits of pain perception are easier to explain. If a person is around a campfire and they can feel the warmth, they are less likely to stick their hand into the fire, because they are likely to get burned. A person who jumps off a cliff may hit their head on rocks, so they would avoid the fire and jumping off the cliff (Breedlove, et al., 2010).

Another benefit of pain perception comes from my introductory statement. I know that it hurts to slam your thumb in a door from previous experience, so now I perceive that there is the potential for pain, and I modified my behavior to reduce the potential of having that pain again.

References

Breedlove, S. M., Watson, N. V., & Rosenzweig, M. R. (2010). Biological psychology: An introduction to behavioral, cognitive, and clinical neuroscience. (6th ed.). Sunderland, MA: Sinauer Associates, Inc.

Osborne, J. (2011). Pain generated by observation of others in pain. University of Birmingham. Retrieved from http://etheses.bham.ac.uk/1753/1/Osborn11PhD.pdf

Noffsinger, M. A., Pfefferbaum, B., Pfefferbaum, R. L., Sherrib, K., & Norris, F. H. (2012). The burden of disaster: Part 1. Challenges and opportunities within a child’s social ecology. International Journal of Emergency Mental Health 14(1), 3 – 13. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed?term=child%20response%20to%20adult%20...

Sirri, L., Grandi, S., & Fava, G. A. (2008). The illness attitude scales. A clinimetric index for assessing hypochondriacal fears and beliefs. Psychotherapy and Psychosomatics 77(6), doi: 10.1159/000151387

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