Closer to pain

The close proximity of threat: altered distance perception in the anticipation of pain

Great new paper from Abby Tabor et al (with a list of authors representing some real heavy hitters in the field as well as the next generation of heavy hitters), it’s open access at the link above and very much worth a read.

Some highlights:

“Pain is an experience that powerfully influences the way we interact with our environment. What is less clear is the influence that pain has on the way we perceive our environment. We investigated the effect that the anticipation of experimental pain (THREAT) and its relief (RELIEF) has on the visual perception of space”

Conventionally, pain research focuses on behavior, subject affect, physiology as well as cognition (Mcmahon et al., 2013). Yet, as an experience that affects the way we interact with our environment, little is known about the influence that pain has on the way we construct the perceptions of our environment.”

“We hypothesized that pain-evoking stimuli would be perceived as closer to the body than otherwise identical pain-relieving stimuli; our results support this hypothesis.

“Pain-evoking stimuli are perceived as closer to the body than otherwise identical pain-relieving stimuli. This finding supports the notion that our perceptions are inferences, constructed in relation to our prior encounters, and relevant incoming information.”

The implications of this study are quite profound – pain, by its very nature, alters the way a person experiences their body, these findings suggest that pain can also shape our perception and experience of the world around us.

With our clinical hats on, and respecting the novelty and newness of this research,  we might consider whether a flight of stairs looks steeper when you have chronic ankle pain, or whether a shelf looks out of reach when you have shoulder pain. Do cars appear closer after a nasty whiplash? Does a dropped object on the floor appear differently if you have had 10 years of chronic low back pain? What happens to the world on the left if your neck can only turn to the right?

We love it when scientists make clinicians think.

– Tim Cocks and David Butler

noigroup.com

protectometer.com

6 Responses to “Closer to pain”

  1. EG Physio

    Hiya,

    Is there an objective reality? That’s where we’re headed with this type of dangerous research! You guys know that! Shame on you!

    When I look at a leaf, I see a sort of green, flat, leafy-shape thing. When a chameleon looks at a leaf with his crazy, 360-degree, independently swiveling eyes, he sees something entirely different. How can the leaf possibly have an objective reality when both the chameleon and I see it differently? Because the chameleon can navigate a leaf perfectly well, you know.

    Physicists tell us that leaves don’t exist except as a particular arrangements of swirling energy. The mind creates the leaf…. as well it creates the body, and we know it creates pain. Now it seems it creates our physical environment too. That’s everything, isn’t it?

    Moseley showed us that people with chronic back pain don’t even register the body part! So does the back even exist for such a person? I tend to think it does exist in this case, but that the mind is practising what it does so well – aversion to pain.

    How to relate this to the clinic? Forget about careful physical examinations for starters. Forget about detailed histories. Forget about choosing a particular physical technique to use. None of it matters. None of it makes the slightest bit of difference to the client. All one needs to know is: 1) are there any red flags? 2) where is the pain? and 3) How long has it been there? That’s it. Then work out some way in which you might be able alter the client’s perception. Lots of ways. Read through the old blog posts.

    EG

    Reply
    • timcocks0noi

      Hi EG
      Great stuff isn’t it. We’re heading into some serious shiraz territory with questions about how a chameleon might experience a leaf!

      Reply
  2. davidboltononoi

    Yummy food for thought. My own personal experience very much supports the findings. On bad days mountains seem higher…..
    DB London ⛅️

    Reply
    • timcocks0noi

      That one word ‘seem’ carries a lot of weight with it don’t you think? To me, it emphasises the importance of an individuals private, lived world – what something ‘seems’ to *me* does’t matter when i am sitting with a person experiencing trouble and pain in their world.

      Reply
  3. Graham Yates-Osteopath

    Its interesting to see the philosophy of embodied cognition becoming utilised in a therapeutic way.The idea that we sense,think and then act has been questioned and the neuro feedback loops mean that our actions in the world influence our thinking and ultimately our senses.
    If a mouse comes across a tower of metre high steps it cannot climb, it will not have relevance to it as it cannot explore it.To a human however it can explore the steps and climb thereby informing the senses and our thinking about the tower.
    I have become hooked on Brain Science Podcasts and there are great interviews with leaders in embodied cognition philosophy-Alva Noe and Evan Thomson,Laurence Shapiro and Arthur Glenberg.Well worth checking out.

    Reply
    • timcocks0noi

      Hi Graham
      Thanks for dropping by and taking the time to comment. Those are all cracking BSP episodes. There’s some really exciting work being done at the meeting point of philosophy of mind, cognitive science and pain at the moment – Abby is definitely one to keep an eye on and I know that Mick Thacker has some interesting stuff in the works too.

      Reply

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