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Goodbye, Cruel World

Rob Zacny | 12 May 2009 13:18
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Beecher's observations rendered the traditional model increasingly untenable and sparked a closer examination of the psychology of pain. In 1965, Melzack and Wall published "Pain Mechanisms: A New Theory" in Science, where they introduced the Gate Control Theory of pain (GCT). Their theory recognized the complex physiological and psychological factors that influence the experience of pain.

Two important and related factors are attention and distraction. This is where gaming enters the discussion. Crudely put, we have a limited amount of mental "bandwidth" available, and higher brain functions can sometimes take precedence over information coming in from the nervous system. In tests of distraction's effects on pain, people who concentrate on some moderately challenging intellectual task report reduced pain. Furthermore, functional MRI scans indicate that parts of the brain's "pain matrix" show decreased activity when subjects focus their attention elsewhere. A study by Michael Valet and collaborators at Technische Universit√§t M√ľnchen found that someone subjected to painful stimuli with no distracting task showed activation in 69.2 cubic centimeters of the brain. When participants were subjected to the same stimuli and given a distracting task, only 5.6 cubic centimeters showed full activation. Subjects also rated their pain as 16 percent less unpleasant when distracted.

We still don't completely understand why this happens, but there are a few things that are certain. One part of our brain, the anterior cingulate cortex (ACC), is involved in both cognition and pain perception. When we're focused on a mental task, it stimulates the periaqueductal gray matter (PAG), a part of the midbrain that plays an important role in controlling pain. When the PAG is stimulated, it "initiates a cascade of signaling events to stimulate the descending pain-modulation system and produce analgesia," write Dr. Jeffrey Gold and collaborators. Opioid receptors, as the name suggests, respond to chemicals like heroin and morphine, but our bodies also produce their own opioids. The result is that concentration raises the brain's defenses against pain, reducing the degree to which we experience it.


However it's not enough to simply command someone to "think about something else." Most people would love to think about something besides their discomfort, but a number of factors make us vulnerable. For instance, fear and anxiety can heighten the sensation. Anticipation is also detrimental, since it focuses your attention on the source of the pain. In other words, the feelings that many people inexorably associate with hospitals, doctors and medical procedures reliably make people feel worse. The trick, then, is to draw people's minds away from their circumstances. That's a trick at which games excel.

From personal experience, there have been many times when gaming has been less a leisure activity and more a retreat from pain. While spending a couple weeks recovering from knee surgery and undergoing some occasionally excruciating physical therapy, I found neither books nor movies were effective at helping me ignore the pain. A friend, however, was gracious enough to lend me his PlayStation and Final Fantasy IX, and through them I was able to shut out the pain in my leg, the machine that was strapped to it and my own frustration at being bed-ridden.

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