The Rest of the Story

I just read an article today.  First I'm going to tell you what is not interesting about it, then I'll get to the interesting part.

Thinking the Pain Away

By Ingrid Wickelgren
ScienceNOW Daily News
12 December 2005

Researchers have developed a potentially powerful new tool that allows patients to fight pain by literally thinking it away. Volunteers put inside a functional magnetic resonance imaging (fMRI) machine were able to control the activity of a brain region responsible for pain perception, suggesting that the technology may someday provide a drug- and side-effect-free way to calm troubled nerves. [...]

This is basically an enhanced form of biofeedback.  If people who are experiencing pain can see the level of activity in a certain pain center in the brain, they can learn to make that center less active, thus reducing the pain. The author mentions that the technique seems promising, except that the machines that make it possible cost two million dollars.  

The finding that patients can control pain with this kind of biofeedback is interesting, but the fact is, we already know that biofeedback works for other things, and it is not terribly surprising that this would work, too.

What provokes my curiosity is this:

By contrast, volunteers who were asked to change their rACC activity without fMRI feedback, or with sham feedback from another brain region or from another volunteer's rACC, could not effectively do so, and also failed to control their pain, the researchers report online this week in Proceedings of the National Academy of Sciences. "We feel this is very strong evidence that the real-time fMRI information was necessary for this effect," deCharms says.

What this means, assuming it turns out to be replicable, is that there is something critical, not just about the feedback process in general, but about the particular kind of feedback that patients get from fMRI.  It does not work if you simply tell people to think their pain away.  I guess that is obvious, because if it were possible, we'd all be doing it routinely.  So what is it about the fMRI feedback that makes it work?  

But that is not the interesting part; this is:

It is extremely common for the friends and family of patients to feel frustrated and perplexed, that the patient is "letting" the symptoms or the illness get the better of them.  To the bystanders, it seems that it should be possible for the patient to think their way out of the problem.  The bystanders, in their ignorance, assume that the patient must have some motive for not doing so.  

This attitude is somewhat understandable.  After all, if it were possible to think one's way out a problem, and one did not do so, then it would be reasonable to assume that there must be some reason.  For example, if you believe that it is possible to think yourself out of pain, or depression, or anxiety (to use three common examples), and you remain afflicted by the pain/depression/anxiety, then there would have to be a reason.  

What the fMRI study shows is that the reason people don't think their way out of the pain is that they can't (without a $2,000,000 machine, and the assistance of some highly trained specialists.)  Give them the resources, and they do it, just like you would expect.  This would sugget that it is not necessary, or helpful, to assume that there must be a hidden agenda.  It is really quite simple.  The reason they don't do it, is that they can't do it.