The Culture of Pain

the-professor

This article was written for LiftBigEatBig.com by Professor Steven M. Platek, Ph.D. (AKA The Professor!) Steve is one of LBEB’s most loyal followers, and certainly the one with the most accolades. Steve wrote this article to showcase how physical and emotional pain are linked, and how suffering through pain with others can form unbreakable bonds.


I’ve been doing CrossFit for about 1.5 years. I love it. To an outsider CrossFit is some kind of cult for which you must drink the Kool-Aid. And, once you’ve drunk it, well you know the deal… There’s more to it than that and part of that derives from the definitional root of the word cult. Culture. Yes, there is a culture to crossfit that seems to an outsider very “cultish” in that freaky Waco, TX way. What I’d like to argue, and have done so before, is that it’s this very cult-like environment that makes athletes elite. It’s this cult of camaraderie that allows the ordinary Joe off the street to work so hard he pukes. And then come back for me. See cult-like camaraderie is greatly underestimated. If you don’t agree, just go google some information about famous cults and the types of things that followers have done in the name of the cult/leader. 

It’s quite baffling to the mind: killings, lynching, mass murdering, rapes, building structures (e.g. pyramids) that defy engineering of the time. This, I think, is because camaraderie actis on a part of the brain that is very much rewarded through social interaction of a similar vein. For example, if 1 person is out building a pyramid, we think they’re crazy. But if 100, 1000, 10,000 are doing it, they are doing it together. They are bleeding, sweating, encouraging – together. You might observe under such circumstance that individuals can work long hours, don’t complain as much, and seem to withstand variables (pain, weather) that goes against logic (or common sense). OK, that last part sounds a lot like CrossFit. The first time I did Fran I thought I was going to die afterward. I thought to myself, what the fuck did I get into? And, I thought to myself, I am never going to do that again. But, in those split seconds after the WOD was done, I received several fist bumps, hand shakes, “right ons”, “good jobs”, etc. It’s this camaraderie that makes up the meat of this short essay on how to kill the pain of a workout without taking NSAIDS, using ICE baths, or having to visit your local chiro/physio.

From my first experience with CrossFit I’d been thinking about the relationship between the CF model and pain, and particularly how the brain perceives that pain. From a neuroscientific perspective I think there is a lot to say about CrossFit’s effects on pain thresholds. Let me try to explain my thinking.

Pain is a bio/physiological ANDa psychological response, usually in response to cellular damage or insult[1] [2-6]. That is, cells are dying (or stretching or bursting or shrinking or not being oxygenated or, you get the idea) and that cues sensory neurons responsible for transmitting information about pain (usually called nociceptors[2]) to tell the brain that something bad has happened, and fast! The pathway from pain (e.g. stubbing a toe, slicing your hand) to brain is fast, efficient, and multi-faceted [3]. Fast and efficient, as you’d expect since pain, the perception of things hurting or not being normal, is our biology’s way of saying: “STOP! Now do something different, or at least do something that makes this pain go away!” When my hand hits that hot burner (I am quite clumsy in the kitchen) a very rapid set of neuronal signals tells my brain to automatically pull my hand back. A reflex [2]. However, there were other processes at work here. For example, my brain was very quickly making associations between warm red things, burners and stoves, and pain [7]. My brain was also evaluating the extent of the pain – did I need emergent care or just cold water and ice? All of this is happening at sub-second speed and for the most part it’s unconscious to us [6, 8, 9].

The Professor of Pain!
Interestingly, but not surprising[3], there are several “pathways” that are delivering the pain message to the brain, hence the multi-faceted part of this story. One pathway, the spinothalamic tract is responsible, in part, for generating the automatic aftermath of pain: reflexive retraction and covering up, or rubbing, of the injury site. The pain information also reaches cortical brain areas that allow us to consciously determine where the pain is located and generate behavioral responses in order to answer the question: What should we do about this pain? Without these basic[4] pain pathways we cannot “feel” pain correctly. There are several pathways because pain perception is important for a species survival, and ultimate reproductive efforts. It trains a species to stop doing stupid things that result in cellular or bodily damage. In some cases, people with damage to these pathways, or genetic conditions that render these pathways dysfunctional do not “feel” pain [10-12]. While that might seem appealing, consider standing in the snow barefoot. When your feet start to hurt from being too cold most of us go inside or put on footwear. People with congenital pain intolerance [10-12] would not have this perception and thus not go inside, resulting in frostbite and eventually death of cells in the limbs – maybe even amputation. Very maladaptive.

“Feeling” pain is like feeling the “burn”, being cut by a knife, feeling the impact of a punch, the pain associated with tearing your ACL, or the feeling of your feet literally freezing in the snow. Often we “feel” pain but do not respond immediately to it. For example, consider a young child who while running along side his parent falls and scrapes his knee. Many children pop right back up without much indication that they are injured and continue to run. That is, until they peer down at the knee and see red liquid oozing from the wound. Out of nowhere, it seems, tears and crying begin.[5] This is what we neuroscientists refer to as the “neural alarm system” [13]. It’s essentially the brain’s “Oh Shit!” response. It’s an interpretation of the pain, from either your own or another person’s perspective[6], irrespective of the actual amount of pain you might be experiencing. The injury is now interpreted as being important and demanding some response. For our little fella it’s: cry so mom or dad will pick me up and all things in the universe will be good again. For a chef, it’s wrap my fingers so I don’t bleed in the soup and have my restaurant closed down. And so forth. 

Quite fascinatingly, our “feeling” of pain in the physical realm (e.g., getting burned, cut, kicked, or punched) is tightly linked, neurologically, to our feeling pain in the social realm (being excluded, ostracized, socially rejected or plain made fun of) [13-15].  The kid who does not get picked for dodgeball experiences a sense of pain very similar to what he would feel if he were just hit in the face with a dodgeball. Sure there are some differences, but in both examples the neural alarm system would become activated. In the former case (not getting picked) all of the pain is in the social neural alarm system, with little, or no physical feelings of pain (although continued social exclusion can produce real physical symptomatology). See, humans have been highly social critters during our evolutionary history (~4+/- millions years) [16, 17]. Our brains have evolved to be social. We like groups. We’ve survived in groups. We like the feeling of team support. We like when our teammates slap our ass. We like camaraderie!And when our support system, our membership on a team, or our group membership, generally-speaking, is threatened our brains respond using the same exact systems as those used when we are physically injured. This occurs in order to motivate us to get back into the group. This time it does not mean pull hand from hot burner, but it means make a friend, work harder to get picked for dodgeball, or work to complete that WOD even if you’ll meet Pukie because your Box is cheering you on (you wouldn’t want to let them down, would you?).

Acetaminophen and Ibuprofen can reduce physical pain; camaraderie reduces social pain. Let’s take this one step further: if physical pain and social pain systems are so tightly linked, neurologically[13], then we might assume, or hypothesize, that medicines that reduce physical pain ought to also reduce social pain. Indeed, there is new scientific evidence suggesting that certain painkillers, and variations in genetic susceptibility to painkillers, can make someone feel less upset about being excluded from a social situation[18]. I think this is an amazing discovery! So when your kid is feeling low about being cut from the team, when you are feeling heart broken, or when the kids just don’t like playing with you any more: “take 2 and call me in the morning” might be an effective prescription! Similarly, the thing that reduces social pain – camaraderie– should be able to reduce physical pain. There is little scientific data on this idea, but I think we see this everyday in CrossFit through a highly cooperative and yet still competitive, friendly and very encouraging environment. Camaraderie, or being made to feel like you are part of a group that is supporting your goals (and a group that might have a larger purpose), can make you push through a WOD (or any challenge life throws at you: a fight, a war, an athletic competition) while effectively reducing the physical pain associated with the challenge at hand! CrossFit exemplifies this model. The “whiteboard” is not just a whiteboard, not just a dry erase board, and not just a place to jot down your score for a particular WOD. 

The whiteboard is more than this. The whiteboard is a prescriptive motivational tool. The whiteboard is our prescriptive medicine. The whiteboard helps reduce the impediments that stand in the way of us all forging ahead, faster, stronger, again and again, as Rx’d! The whiteboard is an extension of our social group, or if you prefer, a key piece of equipment among our cult.

References

1. CrossFit, What is fitness? CrossFit Journal, 2002. October (2002): p. 1-11.

2. Berston, G.G. and J.T. Cacioppo, The neuroevolution of motivation, in Handbook of motivational science, J.Y. Shah and W.L. Gardner, Editors. 2008, Guilford Press: New York.

3. Holden, A.V. and W. Winlow, eds. The neurobiology of pain. The Neurobiology of Pain. 1984, Manchester University Press: Manchester.

4. Merskey, H., An investigation of pain in psychological illness: DM Thesis. 1964, Oxford: Oxford University Press.

5. Raj, P.P., Taxonomy and classification of pain, in The handbook of chronic pain, S. Lreitler, D. Beltrutti, and A. Lamberti, Editors. 2007, Nova Science Publishers, Inc.: New York.

6. Woolf, C.J. and R.J. Mannion, Neuropathic pain: Aetiology, symptoms, mechanisms and management. Lancet, 1999. 353: p. 1959-1064.

7. Ploghaus, A., et al., Learning about pain: The neural substrate of the prediction error for aversive events. Proceedings of the National Academy of Sciences, 2000. 97(16): p. 9281-9286.

8. Coghill, R.C., J.G. McHaffie, and Y.-F. Yen, Neural correlates of interindividual differences in the subjects experience of pain. Proceedings of the National Academy of Sciences, 2003. 100(14): p. 8538-8542.

9. Treede, R., Cortical representation of pain: functional characterization of nociceptive areas near the lateral sulcus. Pain, 2009. 87(2): p. 113-119.

10. Cox, J.J., et al., An SCN9A channelopathy causes congenital inability to experience pain. Nature, 2006. 444(7121): p. 894-898.

11. Hornsby, J., Insensitivity to pain, congenital, with anhidrosis: CIPA. Community Outlook, 1986. 189.

12. Manfredi, M., et al., Congenital absence of pain. Archives of Neurology, 1981. 38(8): p. 507-511.

13. Eisenberger, N.I. and M.D. Lieberman, Why rejection hurts: a common neural alarm system for physical and social pain. Trends in Cognitive Science, 2004. 8(7): p. 294-300.

14. Krill, A.L. and S.M. Platek, In-group and out-group membership mediates anterior cingulate activation to social exclusion. Frontiers in Evolutionary Neuroscience, 2009. 1(1): p. 1-7.

15. Krill, A.L., S.M. Platek, and K. Wathne, Feeling of control during social exclusion are partly accounted for by empathizing personality. Personality and Individual Differences, 2008. 45: p. 684-688.

16. Baumeister, R.F. and M.R. Leary, The need to belong: Desire for interperonal attachments as a fundamental human motivation. Psychological Bulletin, 1995. 117: p. 497-529.

17. Kurzban, R. and M.R. Leary, Evolutionary origins of stigmatization: The functions of social exclusion. Psychological Bulletin, 2001. 127(2): p. 187-208.

18. Way, B.M., S.E. Taylor, and N.I. Eisenberger, Variation in the mu-opioid receptor gene (OPRM1( is associated with dispositional and neural snesitiy to social rejection. . Proceedings of the National Academy of Sciences, 2009. 106: p. 15079-15084.

Author Biography:

Steven M. Platek (Ph.D. Biological Psychology, The University at Albany, SUNY)is Associate Professor of Psychology in the School of Liberal Arts at Georgia Gwinnett College and Associate Researcher at The MARIARC imaging center of the University of Liverpool. Platek is director of the Evolutionary Cognitive Neuroscience Laboratory (ECNL), where he and his students have identified the unique neural substrates associated with self-referent phenotype matching (facial resemblance), self-face recognition, kin recognition, and attractiveness of female body morphology and male facial characteristics. He has published over 65 scholarly peer-reviewed articles, edited three academic volumes, is Editor-in-Chief of the journal Frontiers in Evolutionary Neuroscience, Co-Editor-in-Chief and Managing Editor of the journal Evolutionary Psychology, Editor of the Mind Section of the online magazine Evolution: This View of Life, Associate Editor of the journal Personality and Individual Differences, and is consulting editor for the journal Human Nature. He also serves on the editorial boards of The Journal of Social, Cultural and Evolutionary Psychology, The Open Ecology Journal, Scientific Research and Essays, The Open Neuroimaging Journal, The Open Evolution Journal, and The Journal of Scientific Psychology. A new focus for Platek and his team is to study the neurocognitive and psychological effects of various fitness-training regimens, particularly functional fitness vs. non-functional fitness movements. He and his wife Austen are also an avid CrossFitters and run CrossFit Gwinnett, a donation-based garage gym, out of their home in Georgia!


Steven M. Platek, Ph.D.

Associate Professor of Psychology

Psychology, The School of Liberal Arts

Georgia Gwinnett College

USA

404-734-1023

splatek@gmail.com

Acknowledgements: I’d like to thank Coaches Ben Davis and Kyle Maynard, and Brandon Brigman of No Excuses CrossFit for helpful comments on this idea.