I recently read “Self-regulatory deficits associated with unpracticed mindfulness strategies for coping with acute pain” by D. R. Evans. While mindfulness meditation has been shown to decrease pain perception, it turns out that it can actually be harmful in the short run. Using this strategy of self regulation is unfamiliar and strange to most people, and can deplete the will-power to resist temptation. For this reason, I think a more familiar pain-coping strategy might be better suited to addicts who are already struggling with self-regulation. This is why I am interested to find out if the addict’s addiction can become a mantra that will help addicts tolerate pain.
This article describes how reaction to pain can actually be conditioned, or trained. It uses the theory of classical conditioning, which was first described by Pavlov in his famous dog and bell experiment. An unconditioned stimulus, such as food, causes an unconditioned response, such as drooling in dogs. If a conditioned stimulus, such as the ringing of a bell, is paired with an unconditioned stimulus, then eventually the conditioned stimulus on its own will cause a conditioned response. In this case, the ringing of a bell will cause the dog to drool even though there is no biological reason for a dog to drool at the ringing of a bell.
This is important for the regulation of pain sensitivity. In humans, several types of stressors (unconditioned stimulus) result in an increased tolerance to pain (unconditioned response). These stressors include, well, stress. One example is intense physical activity (think of marathon runners who continue to run and soldiers who do not realize that they are wounded). In animals, even a novel situation can cause a reduction in pain levels. In humans, other stressors that result in reduced pain are loud noises, thermal stimulation, footshocks, and solving mental arithmetic problems and challenging memory tests. So math is good for something at least.
If an initially neutral stimulus is paired with one of these stressors, it could reduce pain by acting as a conditioned stimulus. The conditioned stimulus can be something in the environment. However, it is important to note that not all stressors make changes in pain sensitivity in the same direction. Some will cause less pain to be felt, others more.
As a way to relieve stress and escape from the struggles of everyday life, it is very possible that the substances of addiction are conditioned stimulus that have analgesic (pain relieving) properties. Withdrawal comes with very negative side effects and makes those trying to quit feel miserable. If an alcoholic who is craving a drink gives in to the temptation, he will be blissfully relieved of his withdrawal symptoms, even if it is only for a short time. Therefore, I think it is reasonable to hypothesize that the substance becomes associated with feeling good and pain-free, and becomes a conditioned stimulus. Maybe even the thought of the conditioned stimulus might have analgesic properties.
I recently read “Effect of Brief Mindfulness Intervention on Tolerance and Distress of Pain Induced by Cold-Pressor Task” written by Xinghua Liu.
This article tested short term mindfulness meditation against distraction intervention on pain tolerance and pain intensity. The mindfulness intervention included increasing awareness to bodily sensations and objectively accepting these experiences. Mindfulness is accepting the pain rather than avoiding or fighting it. The distraction intervention, which in most studies is completing hard math problems, was imagining a happy scene. A distraction from the pain can lessen it. Surprisingly, there was no significant difference in pain tolerance and intensity between subjects who used the mindfulness method and those who used the distraction method. I was worried that, because mindfulness is negatively correlated with cravings and addiction and it is positively correlated with increased pain tolerance, addicts, who are not naturally mindful, will have a decreased pain tolerance. This article shows, however, that there are different ways to tolerate pain, distraction being just as effective as mindfulness. Even if the guided imaginings of the addicts are nothing like the process of meditation, I am interested to see if the repeated thought process involving addictions is similar to the distraction technique. It might be good to have a control group that uses the distraction technique in my project.
Additionally, I think I will use the Cold pressor test mentioned in this article to measure pain. The equipment is two plastic containers. One is filled with warm water that is 37 degrees Celsius and the other with cold water and ice that is kept around 2 degrees Celsius. To prevent the participants’ hands from touching the ice directly, the ice is wrapped in plastic and tucked away in a bottom corner of the container. First, the participants place one of their hands in the warm container for two minutes to establish a baseline temperature. Next, the participants move that same hand to the container that is cold. They simply keep their hand in the water until they cannot handle the pain anymore, in which case they remove their hand from the water. To prevent any damage to the hand, the maximum time limit is 5 minutes, but the participants are not told this. Immediately after the procedure, the participants rate their pain experience. This seems like a simple and effective design, and an overall good way to test what I am trying to measure.