Abstract
While physical pain from noxious stimuli is understood in a rather well-defined and limited framework, an all-inclusive concept of how these physical events are translated into the feeling of pain is not yet within reach: this quest directly points to the fundaments of the mind/body relationship. With increasing “encephalization” of the pain system, neuronal mechanisms evolved to allow transition from pain being a purely physical phenomenon to the experience of psychic pain. Prefrontal cortical areas as well as subcortical areas such as the amygdala and cingulate gyrus contribute to the conscious awareness and affective and cognitive evaluation of pain and form part of the multimodal areas of the pain-processing network. The affective and sensory components of pain are closely related: psychological pain activates the same neuronal pathways as those involved in physical pain.
The brain has been said to actively “carve” the properties of pain as it evolves from an acute to a chronic condition. The dynamic changes involved in chronic pain occur at the molecular, synaptic, cellular, and network levels, leading to changes in body perception. How chronic pain affects reward-seeking behavior is a subject of considerable interest for understanding the relationship between pain, mood, and behavior.
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Notes
- 1.
“When I lost my daughter 12 years ago in a horrendous traffic accident, among her papers I found a poem that is now carved on her tombstone. The last stanza is particularly pertinent to the question of whether love can reduce the emotional pain of loss” (Panksepp 2003, ref. 21). “When your days are full of pain, And you don’t know what to do, Recall these words I tell you now—I will always care for you.”
- 2.
Joyful and sorrowful; thoughtful; longing and anxious; in constant anguish; sky-high rejoicing despairing to death; happy alone is the soul that loves (Goethe 1898).
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Steck, A., Steck, B. (2016). Pain and Mind-Body. In: Brain and Mind. Springer, Cham. https://doi.org/10.1007/978-3-319-21287-6_11
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