The Things I do for Science

Last month I did a strange thing. I participated in a scientific study evaluating how pain affects the brain which involved enduring the quaintly named ‘experimentally-induced pain’. This is code for putting my hand in a series of buckets of ice-cold water for three minutes at a time to see which areas of my brain lit up like a Christmas tree. In the most hard-core experiment the water was 5 degrees Celsius, the equivalent to holding my hand in a fridge.

The experiment took place in the lab of the ‘Human Pain Research Group’ at Salford Royal Hospital. I already knew of this group as there was a clinical trial involving a group of Breathworks volunteers many years ago, which evaluated the effects of Mindfulness-based Pain Management on brain function[1]. I didn’t take part in that trial, so this was my first visit to this group of scientists who carry out a continuous programme of brain scanning trials to better understand human pain.

The first task on arrival was to complete various pain and psychological questionnaires and get me rigged up to the machines. I’d seen pictures of people having EEG tests wearing what looked like old-fashioned bathing caps but had no idea what a complicated business it was getting it connected to the computer.

Tim, the genial scientist, spent a couple of hours painstakingly applying electroconductive gel through each of the dozens of electrodes positioned over my skull. He fiddled and tweaked, fiddled and tweaked and eventually the electrodes registered a good signal on the PC I was connected to. We were ready for the experiment to begin.

Tim now produced a bin of ice-cold water and placed it by my side. Oh dear. Looking ominous. He explained that I needed to immerse my hand in the water for up to three minutes and reassured me that I could remove my hand sooner if the pain became intolerable. This cheery advice from a man who runs ultra-marathons in his spare time. Given my competitive nature I mentally noted that I would rather keel over than be a defeated by some piffling freezing water.

The experiment had four stages involving two experiments with water at a (relatively) balmy 10 degrees Celsius and then two at a more bracing 5 degrees. At each temperature I would immerse my naked hand in the first round and then cover my hand in a cream for the second round. This cream might be a local anaesthetic, or it might be plain hand cream. I wasn’t to know of course, as the experiment was also examining placebo.

So off we went, and I bravely plunged my hand into the bucket. “No worries”, I thought. “Easy. Three minutes. Hah. That’s nothing” After about a minute the burn set in. After another minute I felt the pain shooting up my arm. Not so easy. It’s amazing how long three minutes can stretch out in a situation like this.

The experiment continued and the time came to up the ante and move onto the water at 5 degrees Celsius. This was awesomely challenging. I only lasted a minute in the first immersion before whipping my hand out when I decided the pain had become truly intolerable. But I managed to last three minutes in the next attempt which was interesting in itself – once I knew what to expect I was more able to manage my response, showing how anticipation and expectation colour the pain experience.

This leads me on to the most interesting aspect of the day from my point of view: it offered me the opportunity to try out different pain management strategies and to assess their effectiveness.

I tried distraction which was fairly effective (thinking of something else while my hand was in agony). I tried breathing with the pain rather than tensing my breath against it. This was more effective. But by far the most effective method was to relax into the pain as fully as possible. When I tried this approach, I consciously dropped my awareness down into my hand, relaxed my shoulder and body as fully as I could, and settled into the whole experience with the least amount of resistance I could manage. I felt the initial shock as my hand hit the cold water on immersion, I felt the way this transformed, surprisingly, into heat and burning sensations. I noticed the way numbness then set in. I was able to stay with the numbness fairly easily and would in fact have been able to tolerate more than three minutes (or so I like to think!)

What was distinctive about this approach was the experiencing of the direct sensations as they occurred and, in that direct experience, I was able to perceive how the sensations were not a single ‘agony’, or ‘freeze’ or ‘burn’. Rather they were a continual array of changing sensations and they became oddly fascinating when freed of the tendency to contract around them and turn them into an object of torture.

There was also a marked reduction in resistance and ‘pulling away’ from the unpleasant experience. As I softened towards it again and again it became a much simpler experience. Rather than the unholy alliance of sensation + resistance + horrified thoughts such “I can’t stand this” + breath holding and tension; it was simply unpleasant sensations continually changing + a (relatively) relaxed mind and body. I also directly understood that these sensations are ever only present one moment at a time and freeing them from the tyranny of past and future moments of pain was also liberating.

This approach is what we teach in Mindfulness-based Pain Management at Breathworks and I was relieved to discover that my experience of the experiment affirmed the effectiveness of our method.

At the end of the day I was tired but also strangely elated. I’d had the chance to really investigate the physical, mental and emotional components of the experience of pain and had learned that it can indeed be bearable if approached in a simple and immediate way.

The last activity was to attempt to wash all the electroconductive goo out of my hair in a sink in the corner of the room. This was largely unsuccessful so I drove back home with a pretty wild hair style which gave me some ideas of how to use styling gel in future.

Vidyamala Burch

[1] PSYCHOBIOLOGICAL CORRELATES OF IMPROVED MENTAL HEALTH IN PATIENTS WITH MUSCULOSKELETAL PAIN AFTER A MINDFULNESS-BASED PAIN MANAGEMENT PROGRAM. Brown & Jones (2013) Clin J Pain. 2013 Mar;29(3):233-44. doi: 10.1097/AJP.0b013e31824c5d9f.