The Response to Pain: A Study in Contrasts

The problem is, pain is anything but straightforward. How is it, for example, that almost identical injuries can produce widely varying experiences of pain? In some cultures — those that practise scarification, for example (decorative incisions in the skin) — pain tolerance seems to be unusually high, especially compared to North American culture, in which every minor headache seems to require an immediate analgesic.

Ronald Melzack and Patrick D. Wall cite a particularly telling example of pain tolerance in 'The Challenge of Pain — the 'hook-swinging ritual' practised in parts of India: At a certain time of year, a man is chosen to represent the power of the gods to bless the children and the crops. The chosen man has steel hooks shoved under his skin and muscles on both sides of his back; the hooks are then attached by strong ropes to the top of a special cart, and the cart is hauled from village to village. At the climax of the ceremony in each village, the celebrant actually swings free, hanging only from the hooks embedded in his back, to bless the children and crops. Melzack and Wall reported that, 'Astonishingly, there is no evidence that the man is in pain during the ritual; rather, he appears to be in a 'state of exaltation'.'

Yet as foreign to our experience as such examples would appear, they're not without equivalents in 'soft' cultures like our, where the experience of pain can vary widely, from person to person--and particularly in special circumstances. In his 1988 book, 'The Mind,' Richard M. Restak recalls the British Army's landing at Anzio in Italy in 1943. Hundreds of soldiers were severely wounded, but three-quarters of them refused morphine. Afterward, the surgeon in charge questioned civilians with similar though far less severe wounds. To his surprise, some 80 per cent of the civilians requested morphine for their pain. The surgeon was left to conclude that pain really isn't a state of the body--it's a state of mind.

And what of pain felt--for which there is not even any flesh in which to experience it? Dr. Melzack recalls a seminal encounter in his career, with a patient named Mrs. Hull, who had lost a leg but still complained of severe pain in the missing limb. 'It's one thing to read about phantom-limb pain,' Melzack reported, 'but when you actually talk to someone who describes how a red-hot poker is being driven through her toes — and there's nothing there — it's a shock.'

It also makes the Cartesian model of pain look woefully inadequate. Melzack studied sensory experience in animals for his Ph.D. in psychology at McGill University and had already concluded that no Cartesian 'I hurt, therefore I am' formulation would do justice to the complexity of pain. In 1959, shortly after his encounter with Mrs. Hull, he met Patrick Wall, a British physiologist, at the Massachusetts Institute of Technology, where both were working. It was a meeting of minds. They became friends and co-researchers and, in 1965, published a paper in Science magazine that outlined what became known as 'the gate-control theory of pain.'

This page was last reviewed/updated on : 02/23/2008