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The Positive Consequences of Pain: A Biopsychosocial Approach
Abstract
Pain is mostly thought of as a problem-as debilitating or harmful. Despite its unpleasantness, however, under some conditions pain can be associated with positive consequences. In this review, we explore these positive biological, psychological, and social consequences of pain. We highlight three different domains in which pain may be considered to have positive consequences. First, pain facilitates pleasure by providing an important contrast for pleasurable experiences, increasing sensitivity to sensory input, and facilitating self-rewarding behavior. Second, pain augments self-regulation and enhancement by increasing cognitive control, reducing rumination, and demonstrating virtue. Third, pain promotes affiliation by arousing empathy from others, motivating social connection, and enhancing group formation. Drawing on evidence scattered across a range of academic fields, we provide for reflection on how pain is represented, generate insights into pain-seeking behavior, and draw attention to the role of painful experiences in maximizing positive outcomes.
... In other words, while one person might view pain as something strongly aversive (Vetterlein et al., 2022), another person might actively seek noxious stimuli for the anticipated reward of pain relief (vs. the mere escape from pain) or to reduce boredom (Vecchio & De Pascalis, 2021). Other examples of pain-related reward include the release of opioids in response to physical exertion, the sense of achievement after having endured pain and the perceived sensation contrast (Bastian et al., 2014;Dunkley et al., 2020;Leknes & Tracey, 2008;Newmahr, 2010;Vetterlein et al., 2022). These "inner tendencies towards pain and coping with pain, expressed by evaluations that might be of either positive or negative valence and might concern cognitive as well as affective approachers, both in objective and subjective measurements, with implications for the improvement of chronic pain prevention and therapy. ...
... Behind it might also be the notion that avoiding exertion and being cared for will accelerate healing and promote foreseeable pain relief (also cf. Bastian et al., 2014). This is somewhat supported by previous findings, suggesting that the more pain sensitive a person is, the more they are inclined to value the secondary gain that comes with pain (Vetterlein et al., 2022). ...
Background
The relatively stable individual differences reflected in Grey's revised reinforcement sensitivity theory (rRST), with foundations in neurophysiology and learning theory, appear particularly applicable to the study of pain. However, remarkably little research has been conducted in this area. In acute pain, activation of the behavioural approach system (BAS), the behavioural inhibition system (BIS) and the fight, flight, freezing system might depend on an individual's evaluation of pain. It was thus hypothesised that higher‐order interactions of rRST traits and pain attitudes affect pain responsiveness.
Methods
To investigate relationships between rRST traits and pain attitudes and to identify patterns between clusters of participants, we conducted a study in which N = 275 healthy participants filled in Reuter and Montag's rRST‐Q and the General Attitudes Towards Pain Inventory (GATPI). Experimental (pressure, electrical, thermal) and self‐report data of pain responsiveness were collected in a subsample ( N = 113).
Results
We found significant correlations between rRST‐Q and GATPI subscales of up to r = 0.34. Two clusters were identified, significantly differing in rRST‐Q and GATPI scores. Pain avoiders, characterized by high BIS, flight, freezing and negative pain attitudes, were found to be significantly more pain sensitive than pain approachers, characterized by high BAS, fight and positive pain attitudes. Moderate effects ( d = 0.56 to d = 0.70) were demonstrated in subjective and objective measures and across pain modalities.
Conclusions
The present study expands the scientific knowledge on factors influencing pain responsiveness. Future research is needed to confirm implications for chronic pain prevention and therapy, particularly concerning pain avoiders.
Significance
We have identified two clusters of participants, pain avoiders and pain approachers, that not only present differential patterns of revised reinforcement theory traits and general attitudes towards pain but also differ in their pain responsiveness. Pain avoiders appeared more pain sensitive compared to pain approachers, both in objective and subjective measurements, with implications for the improvement of chronic pain prevention and therapy.
... However, pain is not always negative. The primary function of pain is to act as a defense mechanism [5]. Pain indicates that something is wrong, causing a person to focus on its resolution. ...
Pain is an important innate defense mechanism that can dramatically alter a person’s quality of life. Understanding the microbiological and physiological effects of pain may be important in the pursuit of novel pain interventions. The three descriptors of pain recognized by the International Association for the Study of Pain are nociceptive, neuropathic, and nociplastic pain. Our review examined the current understanding of all three pain types, focusing on the key molecules involved in the manifestation of each type as well as physiological effects. Additionally, we compared the differences in painful and painless neuropathies and discussed the neuroimmune interaction involved in the manifestation of pain.
... Furthermore, an increasing number of recent studies began to indicate that negative experiences could benefit cooperation. Prior studies showed negative experiences could promote interpersonal relationships, such as empathy [15], trust [16], social bonding [17], helping behavior [18], and cooperative behavior [19]. These studies were conducted in a condition in which negative experiences were shared with others. ...
Cooperation is a fundamental ingredient of society. However, research on the effects of positive and negative experiences on cooperation remain largely inconsistent. Therefore, through two experiments, the present study examined the effects of positive and negative experiences on cooperative behavior, and the moderation effect of sharedness on this relationship. In Study 1, we directly compared positive and negative experiences in the same context. Seventy-four students participated the experiment (Mage = 19.88, SDage = 2.21). Results showed that participants reported higher levels of cooperative behavior in negative experiences than in positive experiences. In Study 2, we examined the moderation effect of sharedness on the relationship between positive/negative experiences and cooperative behavior. The result of the experiments involving 126 participants (Mage = 19.53, SDage = 1.14) showed a significant interaction effect between positive/negative experiences and sharedness on cooperative behavior. Participants exhibited higher level of cooperative behavior in shared negative experiences than in shared positive experiences, while there were no significant differences in cooperative behavior between unshared negative and positive experiences. These results suggested that shared negative experiences could facilitate cooperative behavior.
... Several studies have confirmed that the removal of pain significantly increases positive affect and reduces negative affect (Bastian, Jetten, Hornsey, & Leknes, 2014;Franklin, Puzia, et al., 2013;Gerber et al., 2014). Further, similar findings have been noted in laboratory-based investigations (Bresin & Gordon, 2013b;Franklin et al., 2010;Franklin, Lee, et al., 2013;Russ et al., 1992;Weinberg & Klonsky, 2012). ...
Non-suicidal self-injury (NSSI; e.g., harming oneself without the intent to die) is a leading health concern, and research indicates rates of NSSI are increasing. Despite the clear negative implications of NSSI, mechanisms that reinforce the continual engagement in these behaviors remain unclear. The Benefits and Barriers Model (Hooley & Franklin, 2017) proposes there are barriers that prevent most individuals from engaging in these deleterious behaviors; however, once these barriers are eroded, one becomes more likely to engage in NSSI. One such barrier is a positive association with the self. Self-criticism is generally understood as a trait lowering desire to avoid pain and bodily harm, thus decreasing the barrier of a positive self-view. Although a growing body of research supports self-criticism as an important construct in the understanding of self-harm, research is needed to clarify the role of trait versus state self-criticism in the initiation and maintenance of NSSI. The central aim of this study was to clarify the differential role of trait versus state self-criticism in the potential benefits and barriers to non-suicidal self-injury (NSSI). Participants (N = 168, ages 18-25) included individuals with (n = 78, 87.2% female) and without (n = 90, 57.8% female) histories of NSSI. These older adolescents participated in an online session in which they responded to self-report questionnaires that assessed trait self-criticism, depressive symptoms, and perceived benefits of NSSI and completed a self-injury implicit association task. Afterwards, they underwent an induction designed to elicit feelings of state self-criticism. They then again did the implicit association task and responded to questions regarding the perceived benefits of NSSI. Levels of state self-criticism were measured throughout their participation. Before ending their online session, all participants underwent a positive mood induction. Results suggest individuals with recent (past year) histories of NSSI are more reactive to state changes in self-criticism than those with past or no history of NSSI. Participants who were reactive to changes in state self-criticism evidenced a reduction in the barriers to NSSI assessed by implicit association tasks and increases in perceived benefits above and beyond trait self-criticism. Implications for treatment are discussed.
Christianity is the most widely practiced global religion. Christian philosophy and practices have recently gathered the interest of psychology researchers, especially in positive psychology. This chapter attempts to provide an overview of Christian theology and practices and their association with positive psychology. We discuss how the Christian worldview has contributed to understanding human nature, interpersonal relationships, and overall well-being. Several Christian practices such as congregational membership, volunteering services, prayer, and confession have been discussed for their positive physical and psychological impact. The chapter further presents the core concepts of positive psychology embedded in Christian teachings insinuating the Christian way of life. It draws parallels between Christian philosophy and the eudaemonic approach to happiness and shows how Christian theology supports the pursuit of purpose and meaning in life and interconnects love, forgiveness, and reconciliation. Besides, the chapter discusses empirical studies on Christian yoga, meditation, and other Christian-sensitive psychological interventions. In the end, it briefly covers Christianity in India, its origin, and various organizations that contribute to promoting overall health in society.KeywordsChristianityPositive psychologyMental healthWell-beingChristian psychology
Seeing others in pain can stimulate powerful socio-emotional responses. Does it also make us more moral? In two laboratory experiments, we examined the interplay between pain observation, self-reported guilt and shame, subjective perceptions of pain intensity, and subsequent honest behavior. Watching a confederate perform a moderately painful (vs. non-painful) task did not affect honest behavior in a subsequent die-roll task. Independent of pain observation, there was a positive relationship between self-reported guilt proneness and shame proneness and honesty. More specifically, individuals who are more prone to feeling guilt -and to a lesser extent shame- behaved more honestly. Furthermore, we found weak support for the hypothesis that greater perceived pain (rather than objective pain) is associated with less cheating. We call for further research in the interconnections between perceived pain, guilt, shame, and moral behavior.
This paper aims to problematize pregnancy and support the development of a safe alternative method of gestation. Our arguments engage with the health risks of gestation and childbirth, the value assigned to pregnancy, as well as social and medical attitudes toward women’s pain, especially in labor. We claim that the harm caused by pregnancy and childbirth provides a prima facie case in favor of prioritizing research on a method of extra corporeal gestation.
Pain is rarely suffered alone. In contemporary online contexts, publicly shared pain can command the collective attention of hundreds, even millions of people. We sought to explore the possibility that collectively attending to others' pain promotes affiliation among those with whom it is attended online and identify the mechanisms that mediate these effects. Across two experimental studies, utilizing independent group designs, physically dispersed undergraduate students attended to real‐world videos depicting either physical, social, or no‐pain online. In Study 1 (N = 74, 66.22% female, Mage = 25.31 years, SDage = 6.81 years), we found evidence for the phenomenon of pain collectively attended to online, with online videos depicting physical and social pain eliciting stronger perceptions of collective attention than the non‐painful online video. In Study 2 (Time 1: N = 185, 75.14% female, Mage = 22.62 years, SDage = 7.44 years; Time 2: N = 91, 72.53% female, Mage = 23.32, SDage = 8.19), we subsequently found collectively attending to others' physical and social pain online indirectly promoted cohesion, interpersonal closeness, and desire to affiliate among participants through perceived emotional synchrony. This pattern of indirect effects was found immediately after collective attention to painful online content (Time 1) and at 1‐week follow‐up (Time 2). Although preliminary, our findings increase practical understanding of how shared pain can be harnessed to bond physically dispersed individuals together online, the implications of which we discuss in the context of the COVID‐19 pandemic.
Emotion toward anticipated and actual outcomes acts as a vital signal on emotional decision-making, and the Iowa Gambling Task (IGT) can mimic this decision-making process. Pain can impair emotional decision-making behaviors because it captures attention and distracts from the task at hand. Alternatively, pain may facilitate emotional decision-making behaviors by prompting alertness and mobilizing cognitive resources to maximize rewards. The present study investigated the influence of ongoing pain on emotional decision-making behaviors using the IGT. Our study recruited two groups of participants and applied capsaicin (pain group) or control cream (control group) to their forearms. We then compared performances and selections between the pain and control groups. The results revealed that participants successfully learned the required adaptive selection strategy as the task progressed. The study observed a tendency toward optimal choices for both groups under the condition of frequent–small losses. However, we observed a disadvantageous preference for the control group, but not the pain group, when faced with choices with infrequent but large losses. The study implies that a distressing pain experience motivates individuals to adjust goal-directed behaviors to maximize their rewards in a task. Thus, the finding suggests that ongoing pain facilitates emotional decision-making behaviors.
According to a recent theory, anterior cingulate cortex is sensitive to response conflict, the coactivation of mutually incompatible responses. The present research develops this theory to provide a new account of the error-related negativity (ERN), a scalp potential observed following errors. Connectionist simulations of response conflict in an attentional task demonstrated that the ERN—its timing and sensitivity to task parameters—can be explained in terms of the conflict theory. A new experiment confirmed predictions of this theory regarding the ERN and a second scalp potential, the N2, that is proposed to reflect conflict monitoring on correct response trials. Further analysis of the simulation data indicated that errors can be detected reliably on the basis of post-error conflict. It is concluded that the ERN can be explained in terms of response conflict and that monitoring for conflict may provide a simple mechanism for detecting errors.
Pain interrupts and demands attention. The authors review evidence for how and why this interruption of attention is achieved. The interruptive function of pain depends on the relationship between pain-related characteristics (e.g., the threat value of pain) and the characteristics of the environmental demands (e.g., emotional arousal). A model of the interruptive function of pain is developed that holds that pain is selected for action from within complex affective and motivational environments to urge escape. The implications of this model for research and therapy are outlined with an emphasis on the redefinition of chronic pain as chronic interruption.
Using a process model of emotion, a distinction between antecedent-focused and response-focused emotion regulation is proposed. To test this distinction, 120 participants were shown a disgusting film while their experiential, behavioral, and physiological responses were recorded. Participants were told to either (a) think about the film in such a way that they would feel nothing (reappraisal, a form of antecedent-focused emotion regulation), (b) behave in such a way that someone watching them would not know they were feeling anything (suppression, a form of response-focused emotion regulation), or (c) watch the film (a control condition). Compared with the control condition, both reappraisal and suppression were effective in reducing emotion-expressive behavior. However, reappraisal decreased disgust experience, whereas suppression increased sympathetic activation. These results suggest that these 2 emotion regulatory processes may have different adaptive consequences.
The meaning people assign to physical sensations can have profound implications for their physical and psychological health. A predominant research question in somatic interpretation asks if it is more adaptive to distract one’s attention away from a potentially unpleasant sensation or to focus one’s attention on it. This question, however, has yielded equivocal answers. Many apparent ambiguities in this research can be traced to a failure to distinguish the content of a person’s attention from its mere direction or degree. A model of somatic interpretation is discussed, incorporating not only perceptual focus but also the attributions, goals, coping strategies, and prior hypotheses of the perceiver, thus delineating the psychobiological conditions under which various attentional strategies should be adaptive. In contrast to the prevailing concern with when and why somatic distraction doesn’t “work,” this conceptual analysis also considers when and why somatic attention does. Theoretical and methodological issues are discussed, as is the potential utility of somatic attention in cardiac rehabilitation and multiple sclerosis.
Social exclusion was manipulated by telling people that they would end up alone later in life or that other participants had rejected them. These manipulations caused participants to behave more aggressively. Excluded people issued a more negative job evaluation against someone who insulted them (Experiments 1 and 2). Excluded people also blasted a target with higher levels of aversive noise both when the target had insulted them (Experiment 4) and when the target was a neutral person and no interaction had occurred (Experiment 5). However, excluded people were not more aggressive toward someone who issued praise (Experiment 3). These responses were specific to social exclusion (as opposed to other misfortunes) and were not mediated by emotion.
Pleasure is fundamental to well-being and the quality of life, but until recently, was barely explored by science. Current research on pleasure has brought about ground-breaking developments on several fronts, and new data on pleasure and the brain have begun to converge from many disparate fields. The time is ripe to present these important findings in a single volume, and so Morten Kringelbach and Kent Berridge have brought together the leading researchers to provides a comprehensive review of our current scientific understanding of pleasure. The authors present their latest neuroscientific research into pleasure, describing studies on the brain’s role in pleasure and reward in animals and humans, including brain mechanisms, neuroimaging data, and psychological analyses, as well as how their findings have been applied to clinical problems, such as depression and other disorders of hedonic well-being. To clarify the differences between their views, the researchers also provide short answers to a set of fundamental questions about pleasure and its relation to the brain. This book is intended to serve as both a starting point for readers new to the field, and as a reference for more experienced graduate students and scientists from fields such as neuroscience, psychology, psychiatry, neurology, and neurosurgery.
