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I wonder that in our talk about the social and culture influence on pain, if the influence is on the reporting of pain or the actual experience of it. This also seems to get at the idea of personal state on pain. If you are told that something is really going to hurt and the pain is focus on you are going to be more aware of the pain as a central aspect. Maybe if the pain is not focus upon as such a major aspect a person may simple focus on other parts of the experience (or not focus on any part of it). An example I thought of from my own experience is with allergy shots—when the nurse simply gives me a shot without warning while we’re chatting, I don’t notice it. However, if she says something like ‘just a little prick’, I’m much more aware of the pain of a shot. The same nociceptors should be activated, but my state is different. With culture influence on pain, I wonder if it is also a case that the state of the person’s thoughts about the pain are different based on both the context and what other people tell them. I am sure there are also reporting differences, but it doesn’t seem like that would be the only explanation for differences.

A person’s state and its influence on pain is particularly interesting in the sense of Stress-Induced Analgesia (basically in extremely stressful/traumatic situation, people don’t feel the pain until later). While it makes sense that this happens through downward regulation, it is still just a really interesting concept to think about. I’ve seen people with severed limbs experiencing pain, but not nearly at the level that you would expect them to be at. Your body is in so much shock that the pain just isn’t real. My point in saying this, I guess, is that as people have pointed out earlier, it is important to realize that pain is not just nociception and that there is no 1-to-1 correlation between stimuli and the experience of pain. I am studying pain in animal models now (and will be continuing to in the future) and this lack of direct correlation is always on my mind.

People also touched on earlier about the reading about when the man said he didn’t have pain when the doctors thought that he should (and dispensing the pain medicine based on what they thought he should be experiencing). While, as I’ve said, it is certainly possible that he is not feeling the pain because of stress-induced analgesia or other reasons (though his bodily responses suggest otherwise), your body can still feel the pain even if your mind does not. In this case I think it was right for the doctors to dispense a higher dose of medicine, because even if he doesn’t feel it, the negative effects on your body from going through the trauma should be protected against. Physicians now often used localized anesthetic during procedures as well as generalized anesthesia because of this possibility. If you body feels the pain, regardless of what your mind remembers/experiences, it can be harder to recover from injuries and cause a decreased pain threshold for you. If his reporting of no pain was simply a reporting difference, the body should still be protected against. In this case the physician should know how much pain the patient should be experiencing and how much damage that could do to his body, and because of this, I find that the physician and nurse were correct in dispensing higher pain medicine for this man.