I’ve just watched an episode of Horizon on BBC Two, called ‘The Secret World of Pain’, and a few days ago another BBC Science programme called ‘Pleasure and Pain’, with Dr. Michael Mosley, the last in a series on the brain and the mind.
The whole subject of pain is an enormously complex one, which scientists are only just getting to grips with, and it’s one that is extremely pertinent to both martial artists and everybody else too.
The Genetic Link
The Horizon programme began by introducing us to three generations of one particular Italian family who live in Tuscany. Each generation has an odd response to particular stimuli which most of us would perceive as pain. For years scientists have been studying those rare individuals who, for one reason or another poorly understood till recently, and still not completely so, do not feel pain. Because this particular family exhibit this trait across several generations, there was a strong indication that this may be genetically linked – and so it has proved. By comparing their genetic make-up to the mass of us who represent the norm, one British scientist was able to isolate a specific gene which, mutated in a certain way, gives rise to a syndrome which will probably be named after this family.
The discovery of this gene may lead to the ‘holy grail’ of analgesia (pain control through medication) by allowing scientists to develop drugs that will alter the functioning of this gene key to the experience of pain without attendant side effects, which all other forms currently have.
My interest in the subject is both general and specific. To begin with, as a martial artist I have had to develop a relationship with pain – pain is our oldest survival mechanism; it tells us when something is wrong in the immediate sense and warns us to avoid that which caused it in the future.
However, in the course of martial arts training we are exhorted to ignore pain and to function through it. Now this can be quite legitimate – indeed it is the beginning of the development of an attribute or character trait that is much prized by warrior groups across cultures and throughout the ages, namely fortitude or stoicism. It’s important however, that we are able to make a distinction; while encouraging our students to continue through what we might, more properly, term ‘discomfort’ – a natural by-product of pushing ourselves to the point where development, or a ‘training effect’ takes place, we and they must remain mindful of what is merely transient and that which indicates significant damage is taking place.
And it’s here that it all becomes very difficult. The ‘training effect’ I mentioned a few moments ago is a degree of stress to a muscle, experienced when we do one more press-up, repetition of a kick, or bicep-curl than our bodies are telling us we are capable of. It is sometimes called ‘training to failure’, often defined by a fitness instructor when explaining the ideal number of ‘reps’ to a client, as the limit of where we can perform an action without losing an approximation of ideal form. And it is, technically, damage! A muscle is stimulated to begin the process of repair (i.e. development or growth) because the strain we have just put it under has led to tiny tears in the tissue.
Pain and Perception
Now, judging the difference between that ‘acceptable’ level of minor damage in the name of development, and realising something more serious and potentially permanent is going on is a matter of perception.
Here, I think, is where it all gets really interesting – PAIN – as a ‘thing’, or as an objective phenomenon – DOES NOT EXIST! Sensory perceptions are relayed to the brain via various neurons (nerve cells), and it is the mind that translates those stimuli into a composite experience which it then labels with a value judgement.
Interestingly, it is not possible to remember pain – you can remember the experience of pain, that is, the emotional response to pain, but not the sensation itself. It is an entirely transitory perception based upon the firing of specific neurons and interpreted through complex, interactive brain mechanisms and processes we don’t yet fully understand.
Fear – which is a factor in this process – is likewise an entirely subjective experience. The classic illustration of this is the rollercoaster or other extreme theme-park ride. I am a ‘wuss’ – I do not like to be frightened and I am allergic to pain – theme park rides are anathema to me! However, if you placed me next to someone who loves roller-coasters, and wired us both up to appropriate sensors, you would find that we are having the same objective experience; the same brain-chemicals are being released in each of us, but one of us (me) labels the experience terrifying, while the other (my niece, for example) finds it exciting and exhilarating!
Just waiting for the Pain!
A medical scientist, based at Oxford University, is conducting experiments with volunteers, where she places them in a scanner and then subjects them to a controlled burning sensation. To begin with she shows them a yellow triangle shape, and then triggers the stimulus at a low level. She then asks them for a subjective assessment of the level of pain, on a scale from 1 to 10. The average response for this is a 3.
Having done this a number of times, she then shows them a yellow square shape, and this time triggers a more severe stimulus – the average perception of which is a 7 on the same scale. Next, she shows them the yellow square shape, and triggers the same low level stimulus once more – conditioning however, has made the subjects associate the yellow square with a higher level of pain, and they now report on average a severity of 5! Association has driven up the perceived level of pain by 2 points on the scale, confirming that anticipation is one of the drivers of our subjective experience of pain.
Experience plays a strong part in this; you can always tell the black-belt student in a grappling class – they’re the ones who tap out long before the lock is properly on and the really excruciating pain kicks in! One of the strands of research into pain, featured in the Horizon programme, looks at the development of premature babies.
Children born significantly prematurely often have to undergo a number of medical procedures. Part of the monitoring involved requires fairly frequent blood-tests, and these are performed by a ‘pin-prick’, usually delivered to the heel of the infant. By placing a skull-cap containing electrodes to measure brain activity on a number of babies heads, it was discovered that the brains of those who were more premature and had more medical problems as a result, reacted much more strongly to the pin-prick stimuli.
A young lady of 16 years of age – who it was later revealed was herself born prematurely – suffers from a syndrome of debilitating pain, which manifests itself randomly, but frequently. She has had to endure this for years following a minor injury from which she subsequently recovered fully, and which would seemingly have no reason to continue to cause her the suffering she bears years on. Medical scientists in Bath are working with her on the many methods they have developed for pain management, and admirably she is determined to live a full life.
Another young woman, an installation artist, suffered a stroke very young – it paralysed her down her left side, but she made a ‘complete’ physical recovery. Despite this, she lives with a serious level of chronic pain, and notwithstanding a very brave exterior, she is unable to be as physically active as she would naturally be otherwise. One of the theories being investigated is that part of the motor cortex adapts as it does in many cases of brain injury, but in this instance in a negative fashion. It seems that in the re-routing of some of those neurons that control motor function, an undue stress is being created, and the neurons which formerly would have controlled some of the fine motor-control of the fingers on her left hand are being damaged in an odd way.
Scientists at the University of Liverpool are trialling an interesting method of intervention, called Transverse Magnetic Stimulation (I hope I got that right!?). Essentially, having conducted an MRI (Magnetic Resonance Imaging – that’s the kind of scanning that allows us to map which parts of the brain are stimulated by various physical and mental activities), in order to locate where the neuron damage has occurred, they were able to fire many tiny pulses of magnetic energy at the affected area. This seemed to ‘degauss’ the affected neurons, allowing these neurons to control the muscles they were supposed to, and formerly did, producing a temporary reduction in pain for this courageous young woman. The scientists involved believe this indicates they can effect a more permanent ‘re-education’ of her neurons with a last improvement as a result.
What all of this indicates, is that the nervous system of not only babies and young children, but even adults remains plastic to some degree, so that some damage can indeed be reversed.
Context is all!
Two young men were also featured in the Horizon programme. One, due to an accident while cleaning out his heating boiler in his basement, got his arm trapped. He couldn’t make anyone hear him for more than 24 hours, and so in desperation he cut off his own arm – an experience paralleled by the film just out, “127 Hours” based on the true story of a climber, Aron Ralston, who had his arm trapped, and likewise had to cut it off to escape.
What was fascinating about the young man in the programme was that he himself was amazed by how little pain he experienced! After 12 hours, he decided that no-one was going to hear him and therefore save him. He was engaged to be married and he was not going to die in his basement. He has made an amazing recovery and he expresses optimism about the future. Aron Ralston gave similar responses when asked how he could bring himself to do such a thing, and what his subjective experience of the event was.
The other young American man featured had suffered serious burns – 2nd and 3rd degree – over various parts of his body as a result of a motorcycle crash. As part of his recovery, he had to undergo daily re-dressings of his burns. Each time his burns are changed, much of the new skin growing back is pulled off in the changing. He also has to undergo physical therapy, and the act of having his legs stretched to encourage the development of suppleness in his newly grown skin is plainly extremely painful.
Realising that observing his own raw flesh as part of the dressing change is an ‘anchor’ for that anticipation of pain, making it subjectively worse, his doctor has begun experimenting with a headset that immerses him in a virtual reality game while he is undergoing his physiotherapy. The distraction of the fast-paced game is effective in lessening the discomfort he is feeling, and is a further proof that our mental and emotional state has the power to heighten or lessen pain – even from objective damage!
For approximately 36 years now, I have experienced fluctuating levels of chronic pain as a result of knee injuries incurred playing rugby, making my continuing daily practice of martial arts at best uncomfortable. I often say that I gave up Rugby, as being too dangerous, deciding to concentrate on nice, controllable risks like knife-fighting!
Additionally, I developed rheumatoid arthritis a couple of years ago – I don’t want to make too big a deal of this, as several people I know have the same condition and to a much greater degree of severity! My brother-in-law for one, really suffers from the condition – and never complains – and my wife’s best friend has had it for at least 15 years now, and it hasn’t stopped her becoming and functioning as a high-level adept of Yoga, which she teaches actively regardless.
Like everyone else with this condition, I have good days and bad days, but I am fortunate in one regard – I have studied Pain Control methods as part of my interest in Meditation, Hypnosis, Autogenics and various methods of Creative Visualisation and Stress control since my mid-teens.
One of the methods I have studied, sometimes called Suggestopedia, is a system from Bulgaria, developed in the 1970’s by a psychiatrist, called Georgi Lozanov. Dr. Lozanov was running a pain control clinic for patients suffering from chronic pain conditions, and he developed breathing and visualisation techniques based on Raja Yoga to help his patients cope. Interestingly, there was a tradition of commonly studying Raja Yoga in Bulgaria – I would imagine that this derived from a gypsy – or Romany – tradition, as anthropologists believe that they are the original Aryans, a tribal group who migrated originally to Europe from northern India.
Dr. Lozanov found to his surprise that teaching these techniques to his patients led to a fascinating side effect, that of heightened memory capacity. He later developed it with particular reference to language-learning, and a report by UNESCO cites it as being capable of teaching a language 3 to 5 times faster. Mixing and matching techniques from this system, Autogenics and a number of meditation and self-hypnosis techniques, I have found extremely effective for pain control – some years ago I underwent root canal surgery without any anaesthetic or pain, and have since repeatedly had dental surgery without recourse to drugs.
I have routinely included visualisation techniques for my martial arts students – as well as many other clients – for much of my teaching career and have found them to be advantageous to the learning process. If you sign up to my email list, you will receive notice of when my new Pain Control, Visualisation for Martial Artists, Creative Visualisation and Meditation CDs become available.
©John Mellon M.A., and The Martial Arts University, 2011. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to John Mellon M.A. and The Martial Arts University with appropriate and specific direction to the original content.