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The Pain Game

Not quite the blogpost I had planned for today, but clear thinking is impossible when you’re repeatedly curled up in foetal position for days on end. However, that little setback did put me in the perfect position to study the mind’s response to pain. Especially excruciating pain…

pain game - excruciating pain and how it affects the mind
Photo: Vincent Bozzo

A bout of enteritis brougth on some terrible and very painful cramps. They were only cramps, I kept telling myself. But even “only cramps” proved sufficient to hotwire my brain.

In short, my body threw a Happy Potter-style Cruciatus Curse on itself. This is what it did.

Waves of Agony

Pain caused by cramps hits in waves. The muscles contract, causing pain. Then they relax a fraction and the pain diminishes. The variations on this theme are endless:

  • A single wave may come on, peak and fade away in any period of time. Minutes are usual, but sometimes it does a hit and run in a matter of seconds.
  • A new wave may start before the previous one has ebbed away entirely. Depending on how much they overlap, the pain can seem practically continuous.
  • The intensity of waves can vary, too, depending on when they “crest”.

Pain can literally short-circuit your brain.

Your suffering depends greatly on that last point: intensity. The more intense the pain, the more it hinders you to function normally. “Well, duh.” Indeed, this makes perfect sense when you twist your ankle, break an arm or otherwise hurt yourself in a way hinders physical movement. But we tend to forget that pain can literally short-circuit your brain.

So how does that happen?

Four Steps To Meltdown

Agony is a subjective thing. What hurts one person might be a light sting to another. But regardless of how intense you deem your pain to be, it will fall into one of these four classifications:

  • Minimum pain – Discomfort only. Easily ignored.
  • Mild pain – Present, but easily pushed to the background.
  • Severe pain – You stop in mid-action, unable to think of anything but the pain and how to alleviate it.
  • Excruciating pain – Unbearable. Instinct takes over, resulting in unintelligible wailing and/or movements.

The first three stages cover a wide range. However severe your agony and however low your threshold of pain, chances are it rarely becomes excruciating. In fact, as long as you can come up with the word “excruciating” to describe what you’re feeling, you’re still well within Stage 3.

Why? Because at Stage 4, complex language is out the window, along with all other civilised behaviour.

Basic Instinct

When severe pain becomes excruciating, something snaps in our brain. This point is quite literally a breaking point: your behaviour changes dramatically from one moment to the next. You can tell yourself when it happens and when it stops – albeit in hindsight, because:

  • One moment you can utter complete sentences; the next you forget how to string words together. (Interestingly, curse words are the last to go.)
  • One moment you visualise and think in clear images; the next all your mind produces is abstract art.
  • One moment you are self-conscious and aware of others in your presence; the next you barely realise anyone is there, never mind care what they think of you.

And when the pain recedes just enough, everything snaps back into place.

When severe pain becomes excruciating, our brain reverts to our basic animal instincts.

The key to this strange breaking point lies in how our brains are structured.

Pain Game - Brain structure

The neocortex is what makes us human and capable of complex thought. The limbic system is the mammalian brain, which controls our emotions. Further down is the reptilian brain, which controls our response to fear and threats.

Normally, the neocortex has little problem overriding the instinctive responses of the limbic system. Yes, we get angry at that smug co-worker taking credit for our work, but we refrain from punching him in the face. Yes, we fall in love and feel attraction to that stranger on the subway, but we refrain from jumping them and tear their clothes off. Most of us do, anyway.

Extreme pain changes that game.

A little pain triggers a response from the mammalian and reptilian brains, but nothing the neocortex can’t override: we grin and bear it. But when the pain becomes too intense, the neocortex can no longer override the responses from the limbic system. Instead, the limbic system overrides the neocortex: we howl, we scream, we fail to control of our actions – in truth, we no longer try to control them. We just act any which way.

Puppets On A String

Thus I lay curled up on the bathroom floor in the middle of the night, crying and wailing like a beaten dog, begging for someone – anyone – to take away the pain.

Until it receded. The cramps subsided, my limbic system’s signals weakened and the human part of my brain took the wheel again. But not for long. The next wave hit and I was back in “mindless whimpering dog mode”. After less than a minute it subsided, but thus reprieve didn’t last, either, and soon I was howling again.

This continued for hours, my conscious mind switching on and off like a light. And me? During the dips between waves, I just lay on the stone-cold tiles and wondered at my strange reactions.

In the end, the brain is a funny thing. This biochemical electricity plant has evolved in such a way that we humans believe to be in charge of ourselves. But when the fat hits the fire, it also proves that we are barely even human at all.