Being with Pain
While they do exist, individuals who lack the capacity to feel physical pain are rare. One might
relish the thought of never having to endure another excruciating headache but, ironically, these
same individuals do not live long. Pain, while unpleasant, is a necessary signal of threat that is
crucial to our ability to avoid harm’s way. But why must we suffer in the presence of pain? Would it
not be enough to have a warning system that simply alerted us? Interestingly, some 2500 years
ago it was suggested that, indeed, the acute aspect of pain, upon which we’re dependent for
survival, does not necessarily have to be associated with suffering. This teaching is attributed to
the Buddha, who spoke about the first and second arrows of pain; the former being the warning
signal and the later the unnecessary suffering bestowed upon the individual as a result of their
untrained mind
It could be argued that in fact Buddhism has pain to thank for its existence.
Allegedly, it was the Buddha’s realization that all beings suffer that led him to seek a solution. The
result was a series of practices and theories that are still widely used today and which have
purportedly evolved to fit the needs of those suffering throughout the ages.
Buddhism seems to be in the midst of another transition, where traditional ideas are making their
way West and being scrutinized under the lens of science. The scientific study of pain is certainly
not new but has only gained a head of steam in the past two decades. This has coincided with the
advent of brain imaging techniques such as MRI, which have allowed scientists to see that pain is
more complicated than once thought. Rather than a single center in the brain receiving signals
from hurt body parts, an intricate network of interconnected regions underlies our experience of
pain. The precise role each area plays is still a matter of some debate. It has only been in the past
five years that studies have started to investigate
how
meditative practice may impact pain
As
we will see, although the story is far from complete, it echoes the words the Buddha said centuries
ago. Over the next few pages I’ll distil the current state of scientific knowledge concerning
meditation-related pain reduction. In doing so, the link between pain and compassion, from a
scientific perspective, should also become clear.
Pain in the Brain
The experience of pain is far from the simple burning or stabbing feeling it seems to be when
touching a hot stove or pinching one’s finger. It is believed that the experience can be dissociated
into several dimensions
The sensory-discriminative dimension allows us to locate the sensation
on the body and perceive its strength or intensity. The affective-motivational dimension of pain
relates more to the way the offending stimulus makes you feel. That is, pain is nearly always
associated with an emotional response. Lastly, there are cognitive-evaluative aspects of pain
perception, which are less experiential in nature and more involved in shaping or modulating the
experience. For example, anxiety of an upcoming painful stimulus is known to influence how it is
eventually perceived
In the brain, activity in a large number of regions underlies our experience
of pain, some of which are visible in
Generally, the sensory-discriminative aspect of pain
is believed to be processed by primary and secondary somatosensory cortices (SI, SII), the
thalamus (Thal) and parts of the insula (INS) where brain activity corresponds to participants’
ratings of how intense the stimulus was
The affective-motivational dimension of pain is thought
to be processed in the anterior cingulate cortex (ACC) and different parts of the INS, where ratings
of pain unpleasantness are often found to correspond with brain activity levels
It should be
noted that these distinctions are certainly not absolute and, further, that these regions do much
more than respond to painful situations, having known roles in general processes such as attention
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