The Surprising Science (and Non-Science)of Enduring Pain

The Science Of Pain Endurance

One of the most surprising truths about the biology of pain, is that pain does not happen in the body.

Now, before you ask for a complete refund, bear with me a moment. Just because pain feels like it’s in the body, it doesn’t mean that it is. Sensory perception and scientific truth don’t always line up.  It’s common knowledge that sciatic pain in the back of your leg doesn’t necessarily indicate a problem in the leg itself! By the same token, if you see a glowing aura around everything prior to a migraine, it doesn’t mean that your personal effects are actually glowing. 

The torrent of information carried within the nervous system and it’s cells can give rise to confusion over the true location of pain.

It’s only natural that we’ve always assumed pain happens down in the body. To our faculties of perception that’s exactly how it feels. It was however also natural that we assumed our earth was completely flat and the sun vaulted over the top of it once a day. Prior to the light of science being shone into the dark depths of reality for us, we often fall into cognitive traps laid by our limited sensory perception.

The truth of the pain matter is as follows… the pain we feel is created deep inside the brain – from where it is projected onto the body. 

The pain part of the brain is like a movie projector – it projects pain down into body parts that need to be ‘tended to’.  And just as there is no actual image on the projector screen in the movies,  there is no actual pain happening in the body. This analogy should help, but it has its limitations – because unlike the movie projector/screen, pain is a two way street. 

I said that pain happens in the brain, but I didn’t say the body wasn’t involved in the process, because of course it is. 

In order for pain to happen in the brain, there needs to be some incoming raw data from the body; which gets translated into ‘felt pain’. Science calls this raw data ‘nociception’. Nociception is the raw data the body generates when it is harmed. This raw data gives rise to the pain we feel, but only when the brain decides it’s necessary. If the brain doesn’t ‘tune in’ to it there is no pain at all.

If you touch a hot stove or hurt your back; nociceptor signals fire in your tissues. The nociceptive signals are sent as raw data to the brain. The brain reads that incoming raw data and translates it into finger pain or back pain, in an attempt to advise you of your mistake. Pretty simple, conceptually at least.

There are however times when things can get a little more squirly, and it is these moments that give the pain game away.

Have you ever cut or burned your finger and felt the pain an inch or more away from the injury? Or even in the wrong finger? Have you ever had a deep tissue massage or some acupuncture and felt the weird migrating ‘referred pain’ that happens during treatment? Perhaps you haven’t personally, but millions of us have. These examples are the brain slightly mis-interpreting the raw nociception that came up the spinal cord – so that you feel the pain in an unharmed part of the body.

If the brain fails to process the incoming raw data, there can be an injury with no pain whatsoever. This is why so many have reported delayed pain after being shot or stabbed unsuspectingly. The brain in shock failed to process the incoming data, so there was no pain… at first.

There are many other well known anomalies that highlight the true nature of pain. Phantom limb pain. Completely sane patients with headaches outside their head. Painless surgery under hypnosis. Painless religious ceremonies that involve stabbing ones self with kebab skewers. And many more examples besides.

Think of the raw nociception data generated by the body when it’s harmed is like radio waves. Radio waves are utterly silent, unless there’s a radio apparatus attuned into the signal. When the noise of the radio kicks in – it is all generated by the radios hardwear. Pain is generated within your brain’s hardwear – the nerve signals in the body are just like the silent invisible radio waves prior to them being received by a radio receiver! 

It’s pretty clear when you look at the true nature of pain that there is potentially scope for altering the way we manage our pain internally. If pain is really an artefact of the brain (and it is) the ‘laws’ of neuroplasticity and epigenetic influence may very well have some relevance on our journey towards a lessening of the vast physical suffering our species has always gone through. It is this deeper question of our immense suffering as a species that holds the real meaning here… far moreso than the science.

The  Human Dimension Of Pain Endurance

There’s a well known pain related spectrum that we are all part of. And it’s one that offers an important glimpse of the deep and complex nature of our pain. That spectrum is made of what we refer to as ‘pain thresholds’.

At one end of this spectrum – there are people who can endure unthinkable levels of physical punishment. ‘High pain thresholds’.

In the middle of the spectrum – there are people with reasonable pain tolerance. ‘Normal pain thresholds’.

And at the far end of the spectrum – there are people who are very sensitive to pain. ‘Low pain thresholds’.

 Normal healthy folk do all experience pain, there’s not really any question about that; because there data on rare genetic conditions that prevent people from experiencing pain indicate very clearly that you can’t stay healthy if you don’t have pain. What the differing thresholds reveal is variability in our brain function and psychology… our human experience. Our level of pain tolerance reflects how we process pain in our brains.

We are treading along an imaginary but still somehow very real line here. We are at the ethereal interface between what happens in our bodies cells and our psychology. The tendency would be to think of these 2 things separately – maybe on some level they are – and definitely on some level not. Either way, pain is not a simple on/off switch in the brain or in the body.

People with good pain tolerance tend to have a robust mindset around pain, and/or have experienced a lot of it (like experienced soldiers and athletes for example). These people manage pain well at the brain level. If you have had pain for a long time, it may have turned you into one of these!

At the other end, people with very low pain tolerance tend to be inexperienced with pain, and/or feel uncertain about the meaning of their pain. These people have often experienced very little discomfort in their lives, or alternatively have had a great deal of discomfort but failed to manage it resourcefully.  These people manage pain poorly at the brain level. 

The connection between our conditioning and how we handle pain it is not a simple one however, far from it.

Physical abuse early in life tends to polarise the pain threshold topic. Adults who were physically abused as children tend to land at the extreme ends of the spectrum; depending on how they learned to deal with what they went through. Some end up impervious to physical pain, others are are ultra sensitive 

It’s possible that not all pain thresholds come about just by chance conditioning and early childhood experience  however.

On 10 June 1963, U.S. press based in Saigon were informed that ‘something important’ would happen the following morning on the road outside the Cambodian embassy in Saigon. They were unsettled times, so in itself that was nothing unusual. But the event that followed created an emotional and psychological shockwave that was felt around the world.

The morning after the announcement, a handful of journalists turned up at the Cambodian Embassy. In due course a small procession appeared. It was lead by a sedan and followed by 350 monks and nuns marching in two phalanxes. The monks and nuns were carrying banners. They had come to protest.

At the intersection outside the embassy three monks emerged from the car. The first monk to emerge placed a cushion on the road. The second monk took a five gallon petrol can from the trunk of the car. The third monk made use of the cushion, using it to sit down in the lotus position. He continued to sit quietly as the monk holding the petrol can emptied the entire contents over his head. The sitting monk then gently thumbed his wooden prayer beads one last time, uttered a few words, struck a match, and dropped it on himself. 

After about 10 minutes the body toppled onto its back. Still in the lotus position. 

Once the heat had subsided enough to get close, a group of monks covered the man shaped block of charcoal with yellow robes. They then picked him up and struggled to fit him into the coffin and left.

The journalist who had shown up from The New York Times wrote “Flames were coming from a human being; his body was slowly withering and shriveling up, his head blackening and charring. In the air was the smell of burning human flesh. ‘I was too shocked to cry, too confused to take notes or ask questions, too bewildered to even think. As he burned he never moved a muscle, never uttered a sound, his complete composure was a sharp contrast to the wailing people around him.”

If you have ever wondered how much pain a human can endure – you now have your answer.

The monks name was Thích Quảng Đức and he was protesting the incumbent vietnamese government’s treatment of Buddhists… through ‘self-immolation’. And our basic assumption about his ability to tolerate pain should be that it was something that he cultivated over a lifetime of meditative practice. 

As well as posing sciency questions about the source of our ability to endure pain. Acts of extreme pain endurance like this reverberate within our collective imagination. Photographs of Thích Quảng Đức’s self-immolation made headline news across the entire world.  Communist China seized upon the image and distributed millions of copies, twisting it into a symbol of support for their own political agenda at the time. The Pulitzer award-winning photograph of Quảng Đức’s death became an icon in itself. And has been reproduced and referenced millions of times on merchandise, in films, television programs and music album covers.

Quảng Đức’s self-immolation didn’t just grab attention (as many extreme acts or protest do) either, it also had the intended specific effect. It was subsequently oberved to have been a turning point in the Vietnamese Buddhist crisis and a critical pivot point in the collapse of the South Vietnamese regime.

What are the limits of human pain endurance?

In reality though, the world need not have been so shocked by these events. Self immolation is an practice that has been undertaken by literally thousands of people in the modern era alone. Mostly buddhist and hindu monks.

To my mind, sitting in quiet dignity while every cell in your body turns to charcoal seems like an implausible feat. You are of course free to disagree, but before you do, try holding the tip of your finger in a small flame for 10 seconds with firm composure.

I manage pain for a living – bit I don’t know the first thing about the mechanics of how someone becomes willing to face that much pain. But knowing what I know about pain, as something that happens deep in the brain; it is hard not to entertain certain questions.

It’s not likely that Thich had a genetic insensitivity to pain. As far as we know he was a perfectly healthy 65 year old monk. There is also the fact of countless other instances of self immolation by buddhist monks. These clearly point to a practice rather than a freak genetic event.

In a sense the question of complete madness is neither here nor there. Whether a person reaches this level of stoicism by madness or by meditation; it still shows that it is possible for a mind to endure at this level.

In another sense, the question of madness vs meditation potentially matters a lot. Does dignified self immolation mean we (the clinically sane) have the potential to cultivate mind power to a point where we are that free? How much did he suffer? Did he have ability to switch pain off at will? Is it even possible to feel what we would feel and sit quietly?

Somewhere deep down we all want to be free of pain. Preferably by us not having any. But most of us will face scary pain at some point. Wouldn’t it be beautiful to be able to greet that without fear.

Can you and I learn to trip switches deep in our brain so that ‘raw nociception data’ doesn’t get converted into pain? That’s a life skill I for one would be keen on attaining. Although I confess the self immolation might not make it onto my list of party tricks. If it is a direction you choose to go in my job is to to make sure you can comfortable sit on your cushion in the lotus position, without a sore back and knees – prior to you merging with the Buddha as you purify yourself in the flames ;)

For me there is also a question of why one image of a burning monk would create such a profound and enduring impression on millions of people. Death and atrocity were very much routine throughout the 20th century after all.

Perhaps there is some wonder that someone could be that commited to a cause.  If you have ever thought it seemed like a hassle to sign an online petition, you’ll appreciate the commitment it takes to self immolate for a good cause. But I suspect there is more to our collective reaction than that. The pictures of Thich burning on the front of newspapers sent a seldom seen ripple of collective speechlessness across the western world.

Moments like these point again to that invisible transitional zone. Between the hard science of pain/and the profoundly un-sciency topic of human suffering.  Between what happens in our cells and what happens in our souls.

When JFK was shown the picture of Thich burning on the cover of a newspaper, his first response was reportedly “Jesus Chris”. He later said of the picture “No news picture in history has generated so much emotion around the world as that one’’. And yet another violent human death in the news was the most normal thing imaginable at that time in our recent past.

Quietly composed self immolation is a headline grabber because it heavily implies freedom – to our collective subconscious at least. Freedom from the physical struggle and suffering that come with being human. And that’s exactly what the gesture symbolises in buddhist monking circles. Caring about something bigger than yourself, enough that you are willing to sit serenely while your flesh is seared to the bone for it implies freedom from the baser physical parts of our humanity. 

The least buddhist and the most materially attached among us still seem to register this gesture of completely freedom on some level. That is why we clearly feel there is a very big difference between a monk quietly and willingly burning himself; and a monk being noisily and reluctantly burned by others.

The attention self immolation grabs, arises from our own deeper senses of the hold pain has over each of us. A hold that somehow steps over a line. This deeper sense of pain is not just a form of important biological feedback. This feeling about pain, is about something that constrains us – something that holds us back – something that scares us – something that makes life worse not better.

The ability to overcome fear and pain are ultimate expressions of strength. Especially so when they are faced as a sacrifice and not for personal gain. This points to the key traits of countless pop culture hero’s going back thousands of years. For good reason. There is something within us that see’s pains hold over us as being something limiting. So not only is there more to pain than simple nerve signals in the body – there is also more to pain than just the physical. 

The science of how the pain we experience is really generated within the body-mind is definitely interesting. Beyond simple fascination understanding may even prove to be a useful tool on the road to managing chronic pain better.

For me though it is the deeper human element that ignites my interest in this topic. Not the science itself -but what it might mean for my potential for leading a more fearless life.   If we can hack into our own brains pain centres the potential implications for how we engage with our bodies, with our fear, and even with death could be vast. We are all going to get sick, we are all going to get old, we are all going to suffer pain and loss. Is there a way we can learn to make this more okay?

I would argue that we don’t fear losing everything so much as we fear how it might feel. We don’t fear death so much as what it might feel to go through the process of dying. We dont fear pushing ourselves to the extremes of our endurance – we fear the pain we will experience as a result. For all these reasons and many more freedom from the hold physical and emotional pain have over us may be the deepest from of freedom that a human can express.