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Scicurious

The good, bad and weird in physiology and neuroscience
Bethany Brookshire

Scicurious

People prefer to just get pain over with

Do you put off the pain that will come with your next dentist appointment? Or do you just want to get it over with?

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You have to get a root canal. You’ve been dreading it for weeks. Now it’s the week of the appointment and the thought is driving you crazy. You can almost feel the drill. Can’t it just be over with already?!

A new study shows that the dread of pain becomes worse the further the pain is in the future. Giles Story and a group of researchers from England and Japan conducted two experiments to examine how people anticipate pain. They first gave 25 participants the choice of receiving a series of painful shocks immediately or at some time in the future. That decision also affected the number of shocks the volunteers would receive. You can receive more pain now, and less pain later, or put it off and get less pain now, and more pain later. No matter what, the pain would happen.

In a paper published November 21 in PLOS Computational Biology, the researchers showed that people would rather suffer the pain now than later. Moreover, many people chose to suffer more electric shocks right away if it meant they could get it over with, rather than putting it off for only 15 minutes. In another experiment, 30 participants imagined an upcoming painful dentist appointment. Participants showed a preference for scheduling it right away, to get it over with, rather than wait up to 8 months.

By modeling the data  during both short and long waits, the authors were able to conclude that dread before pain increases exponentially as you get closer to the painful event. They call this model “Exponential Dread,” which is now the name of my new death metal band.

After all, the biggest moment of panic is right before the pain. Think of the Bond movie Goldfinger. James Bond is strapped to a gold plate with a laser headed for his privates. At first, Bond exhibits his usual sangfroid, trading quips with the villain. But as the laser gets closer and closer, Bond’s fear begins to mount. Sweat stands out on his brow and he strains away from the laser. The villain capitalizes on exponential dread to get Bond to spill the beans (or at least, Bond pretends to spill the beans. You’ll have to watch the movie for the rest).

Maybe we’d all do the same if we had a laser headed for our nether regions. But in real life, not everyone actually behaves the same way. The results varied widely: 28 percent of the participants had no preference at all when they received shocks. All they were after was less pain. So whatever choice it took to get fewer shocks, that was their choice. Almost half, 48 percent, of participants preferred to get it over with, but 16 percent actually preferred to put it off. Maybe the desire to get it over with isn’t quite so universal. A larger sample could probably tell us more.

And of course, this second experiment was a hypothetical scenario. People were asked to imagine that dentist’s drill. But does the dread of pain change how people behave in real life? It did in the experimental scenario where people waited 15 minutes or less, and where real pain was involved. I’d be interested to see if the same holds true for real-life dental scenarios, where things have to be planned months in advance. Do people try to schedule real dentist appointments sooner when they know they will be painful?

It also makes me wonder, does dread have any impact on perceived pain? Would people rate something as being more painful if they had to wait for it as opposed to if they got it right away?

And why should the dread of pain, and the exponential dread of pain in the future, exist anyway? The authors hypothesize that it could be a form of stimulus substitution, where the cues associated with the pain evoke some of the feeling associated with the pain itself, such as fear. They also hypothesize that as the pain comes closer, you become less and less certain that you’ll be able to deal with it.

I actually wonder if dread of pain is more important than that. After all, pain is something to be avoided. Perhaps exponential dread is a useful thing, to give us the motivation to find a way out of the pain. After all, if you know it’s coming, you might be better able to avoid it.

Perhaps another series of experiments could tell us more about why we dread pain, what it does to our pain experience and how it changes our behavior. In the meantime, think of your own thoughts on pain. Do you want to put off that dentist appointment? Do you just want to get it over with? Or maybe you just want the doc to give you a sedative first.

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