Many, many years ago, I had a puppy who needed abdominal surgery. This was at about the same time that my father, a very stoic man, was dealing with cancer and the attendant abdominal surgery. What was fascinating was to see the psychologic dynamic play out — or, in the case of the dog, who had an IQ somewhere below 20, the complete absence of any psychologic dynamic play out

With my father, there was the worry about the surgery itself, the worry about the surgery's effectiveness, the worry about logistics (post-operative care, etc.) and, even for my stoic father, the worry about pain management. Recovery was long and awful. He was bedridden for the first 24 hours (until they forced him out of bed), and he suffered really terrible pain.

The dog had a slightly different experience. When we took her to the vet, you could see her assembling her limited brain cells to ask herself, "Gee, where I am?" This completely untroubled curiousity was followed by a two hour surgery. When we picked her up later that same day, she trotted out under her own steam. She seemed almost completely unaware of the four inch scar traversing her little abdomen. Her recovery was virtually instantaneous.
I am not, of course, comparing my Dad's cancer surgery to a dog's, nor his intelligence to the dog's, nor am I saying that human and dog physiology are sufficiently the same to compare pain reactions. However, I've never been able to shake the feeling that the dog's speedy recovery was because, prior to the surgery, she had no fear, and after the surgery, she'd already forgotten the experience. This meant that any pain she suffered took place in whichever "here and now" she happened to be occupying at any given time. Her feelings were layered with all sorts of emotional responses, such as fear, worry, depression and the memory of past pain.

My sort of intuitive sense about my Dad's and the dog's differing experiences got a little scientific boost today. It turns out that anticipating pain worsens it, and that some people suffer more badly from anticipation than others — so badly, in fact, that they make counterintuitive decisions that can lead to even more pain:

Anyone who's ever taken a preschooler to the doctor knows they often cry more before the shot than afterward. Now researchers using brain scans to unravel the biology of dread have an explanation: For some people, anticipating pain is truly as bad as experiencing it.

How bad? Among people who volunteered to receive electric shocks, almost a third opted for a stronger zap if they could just get it over with, instead of having to wait.

More importantly, the research found that how much attention the brain pays to expected pain determines whether someone is an "extreme dreader" — suggesting that simple diversions could alleviate the misery.


"We were interested in the dark side of the equation," explained Dr. Gregory Berns of Emory University, who led the new study.

"Dread often makes us make bad decisions."

Standard economic theory says that people should postpone bad outcomes for as long as possible, because something might happen in the interim to change improve the outlook.

In real life, the "just get it over with" reaction is more likely, said Berns, a professor of psychiatry and behavioral sciences. He offers a personal example: He usually pays credit card bills as soon as they arrive instead of waiting until they're due, even though "it doesn't make any sense economically."


The MRI scans showed that a brain network that governs how much pain people feel became active even before they were shocked, particularly the parts of this "pain matrix" that are linked to attention — but not brain regions involving fear and anxiety. The more dread bothered someone, the more attention the pain-sensing parts of the brain were paying to the wait.

In other words, the mere information that you're about to feel pain "seems to be a source of misery," George Lowenstein, a specialist in economics and psychology at Carnegie Mellon University, wrote in an accompanying review of the work.

I'm a wuss, but also a procrastinator. Those two qualities combined would, no doubt, have skewed their test results something awful.

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