How to Hack Your Brain When You're in Pain by Amy Baxter

How to Hack Your Brain When You're in Pain by Amy Baxter | TED September 6, 2023

Amy Baxter’s TED talk argues that pain is not simply a signal traveling from an injured body part to the brain. Pain is an experience created by the nervous system and influenced by sensation, previous experiences, fear, attention, meaning, expectation, and our sense of control. This helps explain why we can sometimes feel the pain we expect to feel: an unexplained symptom that we fear is cancer may feel increasingly severe, while the same sensation can become less threatening once we learn it is harmless; similarly, contact from a bully can hurt more than comparable contact from a friend because the brain assigns a different meaning and level of threat to it. Baxter therefore suggests that reducing fear, increasing control, and deliberately directing attention elsewhere can turn down some of the brain processes that amplify pain.

Misconceptions:"I honestly thought that opioids turned off some pain switch. They turn on our reward system. So some people feel amazing, but most people just still feel pain, but don't care."

The talk also challenges a major misconception about opioids: Baxter argues that they should not be thought of as simply turning off a “pain switch.” Opioids act on pain-processing systems but also strongly activate the brain’s reward circuitry. In her description, many people may therefore continue to experience pain while becoming less distressed or concerned about it, while some experience powerful feelings of well-being. This distinction matters because pursuing the unrealistic goal of becoming completely “pain-free” can encourage repeated medication escalation without addressing the many other components of pain. Opioids can have an important medical role in selected circumstances, but they also carry serious risks, including tolerance, dependence, overdose, and opioid-use disorder. The safer goal presented in the talk is therefore not necessarily eliminating every painful sensation, but becoming more comfortable, more functional, and more capable of controlling the response to pain.

The practical message is that coping with pain is a skill that can be practiced before severe pain occurs. Techniques such as cold, appropriate vibration, movement, distraction, slow breathing, meditation, and reducing fear can be layered together to influence different components of the pain experience. Five minutes of meditation during an extreme pain episode is unlikely to suddenly eliminate the pain, but practicing for five minutes every day can build the attention, breathing, relaxation, and emotional-regulation skills needed when pain becomes intense. The objective is to become better able to notice pain without immediately becoming overwhelmed by it, reduce the fear and distress surrounding it, and maintain as much normal activity as possible. In this framework, the person learns to respond to pain with practiced tools first, rather than automatically responding to increasing pain with increasing opioid medication.