The importance of context: When relative relief renders pain pleasant, is the title of an article recently published in the leading international medical journal, Pain. British and Norwegian researchers examined how context can influence the experience of any event. For instance, the thought that “it could be worse” can improve feelings towards a present misfortune. They measured hedonic (pleasant) feelings, brain activation patterns, and skin conductance (which indicates stress, since increased sweating increases electrical skin conductance; this phenomenon is also used in biofeedback). 16 healthy volunteers experienced moderate pain in two different contexts. In the “relative relief context,” moderate pain represented the best outcome, since the alternative outcome was intense pain. However, in the control context, moderate pain represented the worst outcome and elicited negative hedonic feelings. The context manipulation resulted in a “hedonic flip,” such that moderate pain elicited positive hedonics in the relative relief context. Somewhat surprisingly, moderate pain was even rated as pleasant in this context, despite being reported as painful in the control context. This “hedonic flip” was confirmed by skin conductance and brain activation patterns on MRI scans. When moderate pain was perceived as pleasant, skin conductance and activity in certain parts of the brain were significantly reduced, relative to the control moderate stimulus. “Pleasant pain” also increased activity in reward and pain relieving brain centers. The context manipulation also significantly increased connections between reward circuitry and the pain relieving centers.
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