Sunday, November 15, 2009

Presence or Thoughts of Loved One Relieves Pain

Can the presence, or even mere thought, of a loved one help to reduce pain? It can, according to a new study by UCLA psychologists; however, there are some limitations to consider.

The study, appearing in the November 2009 issue of Psychological Science [Master et al. 2009], involved a group of women who received moderately painful heat stimuli to their forearms while they went through two different conditions. In one situation, each woman alternately held the hand of a boyfriend (with whom she had been in a good relationship for at least 6 months), the hand of a male stranger, and a squeeze ball. Researchers found that when holding their boyfriends' hands the women reported less physical pain than when holding a stranger's hand or a ball.

In a second situation, during the painful procedure the women viewed photographs of their boyfriends, a stranger, and a chair. "When the women were just looking at pictures of their partners, they actually reported less pain to the heat stimuli than when they were looking at pictures of an object or pictures of a stranger," said study coauthor Naomi Eisenberger, assistant professor of psychology and director of UCLA's Social and Affective Neuroscience Laboratory. "Thus, the mere reminder of one's partner through a simple photograph was capable of reducing pain.”

Commentary: The study authors suggest their findings demonstrate the importance of the social support provided by loved ones, particularly during stressful or painful experiences, and that this works even by proxy via photographs. However, it is important to note that, despite all the attention in the press devoted to this study, it involved merely 25 university coeds; so, while the outcomes appear to make good sense, the external validity of this research is questionable. Also, we wonder if a reverse effect might be encountered if the relationship with the loved one is strained — would the pain be worsened rather than relieved?

Furthermore, it is interesting to consider that this study may actually demonstrate the power of placebo effects; which some have defined as “positive clinical outcomes caused by a treatment [in this case, the physical or pictorial presence of a loved one] that is not attributable to its known physiological properties or mechanism of action” [Tilburt et al. 2008]. However, another viewpoint might be that inherently “psychological therapies” such as this — invoking mind-body mechanisms that relieve pain and suffering — have a legitimate place in pain management and are not merely inert placebos. In either case, the study authors suggest that the presence of a loved one, or even a photograph of the person, can help patients to cope with acute pain, at least to some extent.

> Master SL, Eisenberger NI, Taylor SE, Naliboff BD, et al. A picture's worth: partner photographs reduce experimentally induced pain. Psych Sci. 2009(Nov);20(11):1316-1318 (no abstract).
> Tilburt JC, Emanuel EJ, Kaptchuk TJ, Curlin FA, Miller FG. Prescribing “placebo treatments”: results of national survey of US internists and rheumatologists. BMJ. 2008(Oct 23);337:a1938(online) [see abstract].