All posts by Genevieve Miller

Pain Sensitivity in Opiate Addicts

I recently read the article “Abnormal pain response in pain-sensitive opiate addicts after prolonged abstinence predicts increased drug craving” written by Ren Zhen-Yu.  This article is a great foundation for what I want to write my research proposal on.

In the article, the different intensities of cravings of opiate addicts was related with how much pain was felt.  Overall, the opiate addicts  in this study showed a shorter tolerance for pain than control subjects, which is one of the reasons I have decided to use alcoholics instead of opiate addicts in my study.  Opiate addicts can show either an increased tolerance to pain or a decreased tolerance to pain, depending on what stage of addiction the individual is in-development, maintenance, withdrawal periods, and periods of abstinence.  This could be because opiates have a specific receptor in the brain, since our bodies can actually produce certain opiates (endorphins).  Also, opiates such as morphine are used to treat pain directly.  Additionally, people who are at risk for opiate addiction might already be partially intolerant of pain.  They might choose to take opiates to relieve their pain.  Our bodies cannot naturally produce alcohol, and alcohol does not directly affect pain receptors, so I feel like alcoholism will be a better substance disorder for me to test than opiate addiction.

I like the descriptions of the participants that were involved in the study.  The opiate addicted participants had to be four months sober, could not be on any other psychoactive drugs except nicotine (so cigarettes are okay), any prescribed medicine, any medication for physical or mental disorders, and could not have a pain condition.  The control patients had to have no history of substance abuse, pain conditions, serious physical or mental disorders, and not be on medication.  To ensure this, a urine sample was taken to test for drugs.  They were collected through word of mouth and advertisement.  I feel like this will be a good model for me to follow.

A Cold pressor test (CPT) was used to test for tolerance to pain and pain intensity (sensory aspect) and distress (affective/emotional aspect).  I really like this quote that was used to describe the difference between pain intensity and distress. “To understand the difference between pain intensity and distress, think of listening to music on a radio. As I turn the volume up, I can ask you how loud the music is or I can ask you how pleasant or unpleasant the music is to listen to.  The intensity of pain is like the loudness of music. How pleasant or unpleasant the music is depends on how much you like or dislike the music, and the distress of pain depends on how much you dislike the sensation.”  These levels were measure using separate visual analogue scales VAS 0-100, 0 being “not at all intense” or “not at all unpleasant” and 100 being “the most intense pain imaginable” or “the most unpleasant pain imaginable.”  Again, this seems like a really good model for me to follow.

 

A Balancing Act

About the Author

Greg Downey is a professor and the head of the Anthropology Department at Macquarie University in Australia.  He completed his MA and PhD at the University of Chicago, focusing on how skill acquisition leads to biocultural modifications to the nervous system and body.  He spent several years in Brazil doing field research as an apprentice in capoeira, which led to his book chapter Balancing between Cultures:  Equilibrium in Capoeira.

anth_greg_downey_2014
Greg Downey

What is Capoeira?

Capoeira is a Brazilian martial art form that combines elements of fighting, dancing, rhythm, and music.  It is sometimes played as a game, a ritualized form of combat that is a constant flow of movement between the two opponents as they react to each other.  No matter what the reason, someone training in capoeira must have or develop a good sense of equilibrium, for this fighting form includes a great deal of flips and inverted postures such as a bananeira (handstand).  The dynamic flow of capoeira, where practitioners must focus on their opponent’s face, is in stark contrast to the static forms of gymnastics, where gymnasts use other visual cues to help them hold each pose perfectly.  The training methods used to obtain balance in these different styles highlights how the human equilibrium system can become enculturated.

Sense of Balance

Over the years, scholars have labeled the vestibular system in the inner ear as the organ of balance.  However, equilibrium is really more of a “sensory system” of many other sensations, such as vision, proprioception at ankles and joints, and pressure perception of feet, which helps maintain equilibrium.

My sense of balance is not all that great.  I don't know how many times I fell down while in the mangroves of Florida.
My sense of balance is not all that great. I don’t know how many times I fell down while in the mangroves of Florida.

Just knowing where you are in your environment will make you better balanced. It is an elaborate synthesis of conscious and unconscious perceptions and compensatory behaviors.  My compensatory behaviors aren’t always up to par, though.  I don’t seem to have a very good vestibulo-ocular reflex, because whenever I go jogging my field of vision bounces as I move, making me have to stare at the ground and possibly run into people. While some athletes have amazing equilibrium senses, I have a hard time walking without tripping.

The Brain in Balance

The plasticity of our equilibrium system allows for it to become encultured.  Not only can we find many solutions to a single balance problem, we can adaptively react to novel stimuli, such as the lack of gravity in space or Dr. George Stratton’s inverted glasses.  This plasticity leaves our equilibrium system open and flexible, allowing it to be trained into different arrangements.  However, long term extensive training, along with cultural and unconscious conditioning, are required to change someone’s equilibrium system.  One change that learning causes in the brain is the ability to ignore irrelevant sensory information and focus on what is important.  A gymnast may focus on a visual point, while one trained in capoeira may focus on proprioception.

Training Equilibrium

While training directly changes the body’s physical ability to move, more subtle influencers also occur.  Forms of training for skills involving equilibrium include social and cultural influences like coaching, aesthetic preference, and specific training drills.  Olympic gymnasts on the balance beam who are penalized for extraneous movements use small ankle based righting techniques, while an untrained individual is more likely to use larger hip movements.  In contrast to gymnasts, capoeira practitioners are not restricted by specific technique forms, and so utilize a wide range of righting behaviors such as curling the body or flailing the legs. While these techniques would be abhorrent to any gymnast, in capoeira it enables dynamic movement and different reaction patterns.  Training behaviors can also enable practitioners to cope with disorienting sensations, such as spinning at high speeds.

My brother and I posing at our dance studio back in the day.
My brother and I posing at our dance studio back in the day.

In my dance classes, we used the “spotting” technique, which involves focusing the head on one point while rotating the body.  This was supposed to help me maintain balance by substituting visual orientation for vestibular information. I can attest to this technique being a cultural factor that is not inherently learned, for after years of dance classes I still had trouble with pirouetting in a straight line.  I never quite got the hang of spotting, so my dance career did not go very far.

Inverted Balance

Balancing while inverted is undeniably harder than balancing right side up.  The upper body has to support the physical burden, the inverted form is more unstable, and the neural system has to cope with the head being upside down and closer to the ground.  To keep a handstand steady, gymnasts often focus on a visual anchor, a stable position on the floor in front of their hands.  Capoeira practitioners cannot utilize this technique.  They have to keep their eyes on their moving opponent while in a bananeira or even while flipping.  Instead of visual cues, they use righting behaviors to maintain balance.  The differences in these strategies makes it very hard to transfer balance ability between these two forms.  As a result, the two disciplines have distinct skill sets and perceptual-motor strategies.  The process of acquiring a sense of equilibrium is malleable and culture-specific.  The aesthetic preferences of a culture influences which movement forms are utilized, which then influences neurological development.  The nervous system is always training to best suit our needs.

My Thoughts

After reading this chapter, I would love to try capoeira myself.  I feel like that style of training the equilibrium system might actually be better suited to my predisposed make-up than the formal dance training I have had that relies on visual cues (or I could just be all around clumsy).  I have a bad vestibulo-ocular reflex, a hard time with the “spotting” technique, and to top it all off a horrible sense of vision in general.  One correlation I have to the flowing action-reaction equilibrium system of capoeira is my experience in white water kayaking.  I paddle down rapidly moving rivers, so there is no static visual anchor for me to focus on.  Instead, my body almost automatically responds to the motions of the current as I fight to maintain upright.  When I am inverted in the water, I rely heavily on proprioception so I can get my arms in the proper position to roll up.  In any case, capoeira seems like an amazing showcase of physical prowess.

Here is a video of some of the equilibrium challenges that face the members of the Alabama Kayak Club, courtesy of the Wasser Bruder (Water Brothers).

 

psych table
A section of the psychtable for this article.

Head Above Water

When I came to UA as a freshmen, the first club I joined was the Alabama Kayak Club.  I have always loved kayaking, and growing up I would often drag my kayak across the street to a channel leading into the Back Bay (I’m from Biloxi, MS, which is on the coast).  However, I soon learned that the club’s kayaking has nothing in common with my own experiences.  We do white water kayaking here. White water, which means going down a narrow river with tons of waves and currents that are just waiting to flip you over and drag you over the underwater rocks.  Meanwhile, the bay that I am used to paddling in is so tranquil that it appears more like a lake than part of the ocean.

I had always loved adventure and the outdoors and wanted to go white water kayaking, so this was a challenge that I was ready to face.  Through club practices, I slowly began to learn how to navigate the waters and roll up if I flipped over.  Soon, the dread terror I felt looking down a river became a bubbling of excitement as I prepared to soar down the churning water. AKC became like a family to me here.

AKC at one of the Locust Fork races.
AKC at one of the Locust Fork races.

We saw each other every week, had parties at the AKC house, and went on camping trips to the races (which sometimes got a little bit rowdy).  Kayakers across the state would come to these races, as I was introduced to the kayak culture.  The kayakers are usually men (and interestingly enough, almost all the members of AKC are male engineers) who love being outdoors, enjoy the rush of adrenaline from going down a particularly challenging rapid, are friendly, and prefer camping and kayaking to going to the beach.

What was I thinking, choosing a hobby that is so inherently dangerous?  The potential of accidents in the river, the discomfort of camping, and the prospect of being on the water while it was literally snowing were not enough to defer me from the adrenaline, comradeship, and beauty of kayaking, but why?  Here are the answer to Tinbergen’s 4 “why questions” that explain animal behavior.

Historical:  Kayaking is not a modern invention.  Throughout the ages, humans have seen different expanses of water and crafted suitable vessels that would allow them to cross.  The kayak itself was first used by the Inuit around 8000 years ago.  That’s a lot of time for this skill to evolve and be passed along.  For the Inuits, being able to kayak meant being able to provide food for your family and a quick method of travel.  These invaluable skills, and the processes that come along with them, would have been inherited through the generations.  While I do not have any Inuit in me, I do have Native American, and though Native Americans used canoes, most of the concept is the same.  I might have inherited a propensity to be on the water due to my Cherokee ancestors.

I practiced safety while swimming in rapids by diving into the Coosa river.
I practiced safety while swimming in rapids by diving into the Coosa river.

Additionally, scientists have found several genes that are linked to risk-taking behavior, such as white water kayaking.  As Americans, we have conquered the environmental dangers and stresses that still plague underdeveloped nations, so we have found other ways to express these risk-taking genes, including extreme sports like white water kayaking.  Most of America is composed of immigrants or the descendants of immigrants, who were more inclined to risky behavior as they had to leave the life the knew to come to an unknown land.  These risk-taking genes were probably passed on throughout the generations.

Proximal:  I’ve always been someone to go for adventurous, outdoorsy experiences in my travels, from hiking to skiing to scuba diving.  Something I had always wanted to learn how to do was white water kayak, but there was no where around for me to learn.  The thought of coursing down a river with the water rushing around me, not having to actually paddle to go anywhere (unlike flat water kayaking, which makes the arms extremely sore) seemed so thrilling to me.  When I was presented with the opportunity where I would not only be taught how to navigate the waters but also have an instant group of people who would go with me and act as a safety net, I jumped at the chance.  If I had not had a group of experts who were willing to teach me and go on rivers with me, I never would have been a white water kayaker.

A joint house-warming party for the president and the AKC awards.
A joint house-warming party for the president and the AKC awards.

Developmental:  This one is fairly straightforward.  I was new in Tuscaloosa, did not know many people, and was looking for acceptance from a peer group.  Humans are extremely social creatures, and college-age students in particular place an emphasis on friends and peer groups.

Part of the culture of college is forging connections with different people and being introduced to new ideas.  AKC provided me with an instant group of similarly minded students, and provided me with a means of relaxation after all the stresses of my studies.  I couldn’t do schoolwork 24/7, and kayaking each week was a welcome break.

Functional:   White water kayaking is a very physically and mentally demanding sport.  The mind has to be adaptable and able to make quick judgments in order to navigate rivers.  Depending on the speed of the rapids, there might only be seconds to properly set up the boat and hit the right line on the river to avoid flipping or running into rocks/fallen logs.

Besides mental capabilities, the evolution of the human body have allowed us the reflexes and physicality to stay upright on the river.  Muscle coordination is used to paddle.  In a sense the paddle becomes an extension of the arms, and you have to be aware of exactly where and how it is hitting the water.

A sense of balance, developed in the ear, is crucial, for the boats are extremely unstable and without proper adjustments of the body and weight in response to the current, a kayak will be immediately flipped.  Humans have a need to survive, and this survival instinct has helped me.  When I flipped over a huge expanse of rocks, the adrenaline kept me from panicking as I calmly put my body through the motions necessary to roll.  That was a huge accomplishment for me, and gave me a tremendous amount of confidence.  If I can remain calm while my head is being slammed by rocks and I am trapped upside down in the freezing water, I can do anything.

I flipped while attempting the slalom race at Mulberry; I couldn't roll at the time so I had to swim down the rapids
I flipped while attempting the slalom race at Mulberry; I couldn’t roll at the time so I had to swim down the rapids