Spouse's concern may worsen pain

ORLANDO, Fla. — Scientists have proved what so many have long suspected: The very presence of your solicitous spouse can be a pain.

By eavesdropping on electrical activity in the most private precincts of the mind, researchers investigating the effects of chronic pain discovered that a husband or wife can make the ache feel three times worse simply by being in the room.

All they had to do to make their spouses feel better, the neural probes revealed, was leave.

The new research, made public here yesterday at a meeting of 24,000 neuroscientists, offers the first clear neural evidence that social experiences can directly alter the way the brain responds to the kind of chronic pain experienced by more than 97 million people in the United States.

Chronic pain, the researchers concluded, can become embedded in the give-and-take of a relationship, even at the fundamental level of brain anatomy.

"For the first time, we have discovered that a social variable, namely the presence of a spouse, can influence the brain's response to pain," said neuropsychologist Herta Flor of the University of Heidelberg's Central Institute of Mental Health, who led the study team.

Presented during the annual meeting of the Society for Neuroscience, the work is part of a cascade of provocative insights into how experience can alter the structure and responses of the human brain.

Neurons and neural circuits are constantly remodeling themselves to accommodate the influence of experience, whether it is the stimulation of computer games, too much stress or the actions of an overly sympathetic helpmate, new research shows.

Indeed, the experience of surgery during infancy can alter the body's pain responses for a lifetime, researchers said yesterday.

Experimenting with laboratory mice, scientists at Haverford College in Pennsylvania determined that untreated pain at birth lessens sensitivity to pain later in life.

"Our research in mice suggests that an adult's pain sensitivity may be linked to past experiences with painful or stressful experiences, including those that occur very early in life," said Wendy Sternberg, whose laboratory conducted the experiments.

To better understand the interplay between chronic pain and the brain, Flor and her colleagues in Germany studied 20 couples in which one partner suffered from severe chronic back pain.

The researchers monitored the patient's brain activity with an array of electrodes that recorded the involuntary, physiological responses of nerve cells and synapses. They then gave the patients painful electric shocks to their aching backs and studied the brain's responses.

They found that some spouses measurably boosted the patient's neural pain responses just by sitting near them in the laboratory.

The sensors detected the heightened activity in a part of the brain called the anterior cingulate cortex, which is associated with the processing of pain.

The effect occurred only when the spouse was in the room and only when the painful shock was applied to the sore back, not to other parts of the body.

Surprisingly, perhaps, it was the most solicitous husbands and wives — those who clucked most lovingly over the spouses' discomfort — who triggered the pain.

The more the husbands or wives dwelt on their partners' pain, the worse it felt, the neural monitors showed.

"We found basically that when their spouses were in the room, they had an almost threefold increase in their response to pain," Flor said. "These patients also showed more overt signs of feeling pain, such as moaning."

Those spouses, however, who responded to complaints by changing the subject, by suggesting helpful but distracting activity, or by not dwelling too long on the pain, did not elevate the neural responses.

Through the feedback loops of a marriage or long partnership, the patient's pain has shaped the helping behavior of the solicitous spouse, who in turn has become a stimulus to provoke the pain.

"The solicitous spouse has become a cue for a more intense pain experience," Flora said. "When people pay too much attention to another's pain, it tends to reinforce that pain. We forget to reinforce those things that are not pain-related, like when a person smiles."

She suggested that treatment of chronic pain, therefore, ought to involve husband and wife together, so they can focus on things that counteract the pain.

"I am fascinated by this," said Allan Basbaum, an expert on the neurobiology of pain at the University of California, San Francisco. "It points out why persistent pain is so difficult to treat. The psychological environment in which you live can influence the experience of pain."