Hmm. The notion that concentrating on pain makes it worse seems to contradict the finding that mindfulness meditation, which mostly involves concentrating on your feelings, increases pain tolerance even while it thickens the areas related to pain-related processing. E.g. Grant et al. (2010)
Zen meditation has been associated with low sensitivity on both the affective and the sensory dimensions of pain. Given reports of gray matter differences in meditators as well as between chronic pain patients and controls, the present study investigated whether differences in brain morphometry are associated with the low pain sensitivity observed in Zen practitioners. Structural MRI scans were performed and the temperature required to produce moderate pain was assessed in 17 meditators and 18 controls. Meditators had significantly lower pain sensitivity than controls. Assessed across all subjects, lower pain sensitivity was associated with thicker cortex in affective, pain-related brain regions including the anterior cingulate cortex, bilateral parahippocampal gyrus and anterior insula. Comparing groups, meditators were found to have thicker cortex in the dorsal anterior cingulate and bilaterally in secondary somatosensory cortex. More years of meditation experience was associated with thicker gray matter in the anterior cingulate, and hours of experience predicted more gray matter bilaterally in the lower leg area of the primary somatosensory cortex as well as the hand area in the right hemisphere. Results generally suggest that pain sensitivity is related to cortical thickness in pain-related brain regions and that the lower sensitivity observed in meditators may be the product of alterations to brain morphometry from long-term practice.
(For more on mindfulness meditation reducing the effects of pain, see e.g. here, here, here, or here).
On the other hand, mindfulness is a very specific way of paying attention to something—a non-judgemental approach where the unpleasant feelings are just observed as they appear and disappear. It seems reasonable to assume that other ways of focusing on pain might indeed make it worse.
Good question, and both your last paragraph and gregv’s answer are on the right track.
Mindfulness meditation is, above all else, training of attentional control. You choose what to focus at, and how to focus on it. Therefore, instead of focusing on “ohcrapithurtsithurtsithurts” (which would make the pain worse), someone with great deal of meditation experience can easily focus on other thoughts, or on how irrelevant the pain is (which trains the brain to make it irrelevant).
Or at least that’s the theory. Pain is a very complicated mechanism, and many caveats apply.
A side note on cortical thickness: IMHO, it is one of the most useless measures in neuroscience. Ok, fine, it can be a good preliminary note, along the lines of “this area here should be looked at in more detail,” but it doesn’t provide much more information beyond that. You can get increases in thickness due to outgrowth of the neuropil, or ingrowth of axonal inputs from the outside—and these in turn reflect an increase in excitatory or inhibitory or modulatory inputs (or some combination of the three). So in the end, you don’t really have any idea what’s really going on.
My guess is that the cortical thickening reflects an increase in the number of inhibitory synapses. The area gets larger because people get better at suppressing the activity within it.
This can also serve as an illustration of one limit (among many) of fMRI in general. fMRI (in most cases) measures blood flow/oxygenation increases in an area, which is related to neural activity. Neurons fire, they need energy, signals go out to increase blood supply. Area “lights up” on the scanner.
However, what kind of activity are you talking about? Activity of excitatory neurons, which activate an area, requires energy and oxygen, hence blood flow, hence it “lights up.” Activity of inhibitory neurons, acting to shut down or attenuate the actual functional activity of an area, also requires energy, which requires increases in blood flow, which makes the area “light up.” A bright spot therefore can mean “this area is somehow involved in the process I’m looking at,” but it doesn’t tell you if it needs to be activated or deactivated for the function to proceed. As you can imagine, this severely limits interpretation.
Right, I think it depends on how the “mindfulness” is directed. One teacher (Eckhart Tolle) suggests concentrating attention on (sorry for fuzzy terminology) internal energy in your limbs and a general sense of well-being. When pain impinges on this meditation, you notice and try to redirect your attention.
Hmm. The notion that concentrating on pain makes it worse seems to contradict the finding that mindfulness meditation, which mostly involves concentrating on your feelings, increases pain tolerance even while it thickens the areas related to pain-related processing. E.g. Grant et al. (2010)
(For more on mindfulness meditation reducing the effects of pain, see e.g. here, here, here, or here).
On the other hand, mindfulness is a very specific way of paying attention to something—a non-judgemental approach where the unpleasant feelings are just observed as they appear and disappear. It seems reasonable to assume that other ways of focusing on pain might indeed make it worse.
Good question, and both your last paragraph and gregv’s answer are on the right track.
Mindfulness meditation is, above all else, training of attentional control. You choose what to focus at, and how to focus on it. Therefore, instead of focusing on “ohcrapithurtsithurtsithurts” (which would make the pain worse), someone with great deal of meditation experience can easily focus on other thoughts, or on how irrelevant the pain is (which trains the brain to make it irrelevant).
Or at least that’s the theory. Pain is a very complicated mechanism, and many caveats apply.
A side note on cortical thickness: IMHO, it is one of the most useless measures in neuroscience. Ok, fine, it can be a good preliminary note, along the lines of “this area here should be looked at in more detail,” but it doesn’t provide much more information beyond that. You can get increases in thickness due to outgrowth of the neuropil, or ingrowth of axonal inputs from the outside—and these in turn reflect an increase in excitatory or inhibitory or modulatory inputs (or some combination of the three). So in the end, you don’t really have any idea what’s really going on.
My guess is that the cortical thickening reflects an increase in the number of inhibitory synapses. The area gets larger because people get better at suppressing the activity within it.
This can also serve as an illustration of one limit (among many) of fMRI in general. fMRI (in most cases) measures blood flow/oxygenation increases in an area, which is related to neural activity. Neurons fire, they need energy, signals go out to increase blood supply. Area “lights up” on the scanner.
However, what kind of activity are you talking about? Activity of excitatory neurons, which activate an area, requires energy and oxygen, hence blood flow, hence it “lights up.” Activity of inhibitory neurons, acting to shut down or attenuate the actual functional activity of an area, also requires energy, which requires increases in blood flow, which makes the area “light up.” A bright spot therefore can mean “this area is somehow involved in the process I’m looking at,” but it doesn’t tell you if it needs to be activated or deactivated for the function to proceed. As you can imagine, this severely limits interpretation.
Right, I think it depends on how the “mindfulness” is directed. One teacher (Eckhart Tolle) suggests concentrating attention on (sorry for fuzzy terminology) internal energy in your limbs and a general sense of well-being. When pain impinges on this meditation, you notice and try to redirect your attention.