The Think System: How much can we control pain?

In the musical by Meredith Willson, The Music Man, the main character is a con artist named Harold Hill.  Trying to pass himself off as a band leader, he claims he’s developed a new system to learn music, known as "The Think System".  Instead of learning how to hold the instrument, and how to read notes, the musician simply thinks about the music, and the rest comes naturally.

Although there’s certainly some truth somewhere in Hill’s theory, most of us would recognize that there’s more to playing an instrument than just knowing a tune.

How much we can control our body just by thinking has always been a matter of debate.  Some people claim that they can do almost anything with pure willpower – though I suggest these people have yet to face the obstacles that most of the world faces.  Others say that there’s little proof for mental control of things like pain – that promoting such a thing will only lessen our motivation to find real treatments.

At Stanford School of Medicine, researchers are trying to find out just how much we can control chronic pain with the mind.  Now – a clarification.  They’re not trying to figure out if we can ignore the pain.  This is not "just get back to work and ignore the pain like I do".

Instead, they’re theorizing that we could be trained to actually make biological changes in the body to fight pain.

This is, of course, nothing new.  Biofeedback techniques are very common in migraine treatment, and have been very successful.

Here’s what the researchers at Stanford say:

We all consciously and unconsciously control our brain for every activity we initiate, every thought we have, and every emotion or sensation we experience.  Until recently, it has been unclear as to what extent we can learn to control brain activity—more specifically, the activity of specific brain regions–and what impact that control would have on us.  Well-defined regions of the brain are responsible for the perception of pain…

So researchers set out to see if patients could control a region of the brain known to impact pain (the rostral anterior cingulate cortex (rACC)), and if healthy patients and patients with chronic pain could use that control to actually make a difference.

Dr. Christopher deCharms developed software enabling patients to see their own brain activity almost instantly.  They used heat to expose a patient to pain (notice – we’re not talking about so-called "imaginary pain"), and then they gave patients suggestions about how to reduce the pain.

Remember, all this was related to seeing brain activity and learning to control it.  It wasn’t just about controlling pain with the tips from the researchers.

Compared to patients who didn’t have real time information about their brain activity, the patients had 23% more control over pain, and 38% control over pain "unpleasantness".  Meaning that this was not a placebo response.

Those with chronic pain (8 patients) also found they could decrease pain by 64%, showing that this research could have a very practical application – not just for those suffering from pain from something like a recent accident or surgery, but also those who have suffered chronic pain for years.

The researchers recognize, of course, that this was a very small study.  They also need to go to the next step – to discover how long the improvement lasts, and how this could be used to help constant pain.

This is not a cure for chronic pain, but it could help patients to significantly lower their pain without need for drugs.

More on the study:  Learned Volitional Control Over Brain fMRI Activation and Pain