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Douleur et Analgésie

, Volume 16, Issue 1, pp 43–54 | Cite as

Influence des processus émotionnels automatiques sur la perception de la douleur

  • A. Wunsch
  • L. Plaghki
Article

Résumé

Nos propos soutiennent une conception de la douleur en tant que produit final d’un processus perceptif complexe et global (le percept) au cours duquel le message nociceptif subit de nombreuses modulations centrales qui échappent à la conscience. En s’appuyant sur des exemples, nous verrons que, comme pour les autres modalités sensorielles, l’accès au stimulus qui déclenche la perception douloureuse, ainsi que le traitement de l’information dont celui-ci fait l’objet, sont influencés par de nombreux facteurs psychologiques (attentionnels, motivationnels, émotionnels, d’apprentissage, etc.). Nous étudierons, en particulier, l’impact des émotions sur la perception nociceptive. Une brève revue de la littérature sera complétée par des observations expérimentales originales qui traitent du cas particulier, encore mal connu, de l’influence des processus émotionnels inconscients sur le traitement de l’information nociceptive. Les expériences animales du conditionnement par la peur et les expériences humaines du conditionnent évaluatif, suggèrent que les caractéristiques affectives et sensorielles de la douleur pourrainent être encodées dans le système nerveux central d’une façon associative, non consciente et indélébile. Nos travaux ont montré que l’association répétée entre un stimulus nociceptif (le stimulus conditionné) et des stimulus inconditionnels (des images de valence émotionnelle positive ou négative), peut modifier la perception de ce stimulus nociceptif lorsqu’il est présenté ultérieurement dans un contexte émotionnellement neutre, et, que cet apprentissage est resté inconscient. En guise de conclusion, nous proposerons une définition des caractéristiques émotionnelles du système dédicacé au traitement de l’information nociceptive.

Summary

This review supports a conception of pain as the final outcome of a complex and global perceptive process (the percept) during which the nociceptive message is subjected to a large amount of central modulations escaping consciousness. Based on examples, we shall see that, as for other sensory modalities, access to the stimulus that triggers the painful percept, as wall as the processing of it, is influenced by a number of psychological factors (attention, motivation, emotion, learning, …). We shall examine, in particular, the impact of emotions on nociceptive perception. A brief review of the literature shall be extended by original experimental contributions, which concern the particular case, yet poorly understood, of the influence of unconscious emotional processes on the processing of nociceptive information. Animal experiments of fear conditioning and human experiments of evaluative conditioning suggest that the affective and sensorial characteristics of pain may be encoded in the central nervous system in a way that is associative, unconscious and indelible. Our experimental studies show that the repeated association between a nociceptive stimulus (the conditioned stimulus) and unconditioned stimuli (images of positive or negative emotional valence), may modify the perception of that nociceptive stimulus when it is presented subsequently in a neutral emotional context, and that this learning process remained unconscious. We shall conclude by proposing a definition of the emotional characteristics of the system dedicated to the processing of nociceptive information.

Mots-clés

Douleur émotion apprentissage inconscient conditionnement évaluatif perception 

Key-words

Pain affect unconscious learning multidimensional pain experience evaluative conditioning emotion perception 

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Authors and Affiliations

  1. 1.Cliniques Universitaires de Mort-GodinneUniversité catholique de LouvainYvoir
  2. 2.Cliniques universitaires Saint-LucUniversité catholique de LouvainBruxellesBelgium

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