Translating the expression of pain in the face of uncertainty: The importance of human pain experiments for applied and clinical science

Abstract

This brief commentary attempts to provide a concise synthesis of social psychology experiments that inform an interpretation of clinical pain. From a social perspective the expression of pain is a complex phenomenon that is greater than the patient’s physiology. Numerous experiments show that pain is modulated by social and contextual factors. These experiments point to the role of the listener as a social agent that can modulate the patient’s expression. Within the clinical setting the patient’s pain experience can be understood as the uncertainty of physical damage and their expression as an attempt to reduce that uncertainty. How successfully this occurs is in part dependent on the empathetic reception of the provider. Chronic pain is a state that is challenging to effectively model in humans but may persist in patients due to an inability to receive effective empathetic reception at the critical time of need (at or near onset). Rather than focusing on pain’s alleviation future avenues of pain interventions may do well by turning attention to the most effective ways to impart a message that the patient will be “okay” in a genuinely empathetic manner.

Keywords: Pain, Social psychology, Uncertainty, Fear, Catastrophizing, Contextual modulation, Health, Medicine, Pain management

Core tip: The experience of pain has much to gain from a social psychology perspective where experiments modulate the patient’s context and affect their expression. Clinicians and providers should understand that listening sends powerful social cues back to the patient in terms of empathetic feedback. When this feedback is provided in a timely fashion (at or near the time of onset) and in combination with ruling out serious medical pathology a clinician can provide powerful signals that changes patient’s experience of pain.