Have you ever been accused of feeling too much or too little as it relates to pain? Have you ever been called “a tough guy” or “a faker” or “a hypochondriac” while experiencing pain? Unfortunately one can assume the answers to these questions somewhat rely on one’s gender. It is probably of little surprise to people that men and women experience pain in different ways. That being said, I’ll be using this paper as an opportunity to evaluate why this is the case.
Women are typically seen as weak, or as possessing low pain tolerances, while men are considered to have “thicker skin.” These beliefs are a result of the gender constructions within our society. Due to the reinforcement of these social constructions, men and women begin to identify with the characteristics assigned to them. Women report experiencing pain to a more severe degree than an equivalent pain stimuli inflicted upon men. But how can simple beliefs and constructions lead to an actual alteration of one’s physical experience? In order to answer the question I will be applying Barrett’s prediction-based theory of pain to this real world application. Using Barrett’s theory I will explain how and why men and women experience the pain in different ways. My hopes in writing this paper, is to enlighten you not only to the power of our personal concepts and brain predictions, but also to the power of gender norms created by society, that are subconsciously digested.
Since there are several components needed to answer the previously stated question, I will follow the argument structure below to guide my logic:
P1:If men and women experience pain differently, then these differences prove the prediction-based theory of pain to be true.
P2: Men and women do experience pain differently.
C: Therefore the prediction-based theory of pain is true.
Obviously, there are many concepts we must grasp in order to follow this argument which is why I’ll be defining key terms throughout the paper. I will also propose counter arguments to Barrett’s. These counter arguments will attempt to discount Barrett’s views of pain, by regarding pain as a simple process rather than an experience. My hope is by understanding the counter-argument you will gain a stronger understanding of the prediction based theory which we will be following.
I want to begin by clearly defining and explaining Barrett’s prediction-based theory of pain. It’s important to understand the meaning of a construction, before explaining the entirety of the theory. A construction is defined as “an act or way of putting parts together to form or build something” (Dictionary.com). Barrett will argue that people form constructions of pain based on their basic concepts. These constructions impact the way people live their lives. In this paper we will be analyzing the way these constructions contribute to people’s prediction of pain – making pain an individual experience.
Barrett’s perspective considers pain to be an experience, rather than simply an occurrence. Dictionary.com defines an experience as “a particular instance of personally encountering or undergoing something.” It’s worth noting the definition specifies the instance is a personal one. This aligns with the construction component, since constructions are individual to a person. Barrett believes this “experience” of pain is influenced by whether or not an individual’s brain predicts danger to be imminent. If one were to predict danger as imminent, they would likely predict pain to follow the sensed danger. This expectation of pain leads one to experience pain as more severe, than someone who did not predict danger or pain (p.205) These predictions stem from one’s personal constructions. This implies individuals’ encounter pain not just due to physical damage, but also due to their unique predictions of damage.
Not all scientists agree with this Barrett’s theory of pain. In the past, scientists have believed that the brain “simply receives and represents nociceptive sensations and voila”(p. 205) causing one to feel pain. Nociception is simply “a process that takes place when one’s nervous system sends sensory input to his/her brain in response to an injury, bodily tissue damage, or chemical irritation” (p.205) This counter argument undermines Barrett’s view of pain as a series of complex inner workings within a predictive brain, by deeming the nociceptive sensation the sole influencer of pain.
Barrett responds to this argument by saying the nociceptive process is only activated through predictions, meaning people use these sensory inputs to construct instances of pain. This construction of pain derives from preexisting concepts of pain. The notion of construction coincides with Barrett’s “construction of emotions” theory.
Barrett further validates her theory by providing an example of a person receiving a shot at a doctors office. Prior to the shot taking place, the brain constructs pain by making predictions of how the needle will feel as it presses into his/her arm. These constructions are likely rooted in the person’s past experiences of getting shots. Nociceptive input from the body enters the scene once the shot is actually performed. It is only then, that the person is able to correct or give meaning to their predictions based on the sensation endured. If the shot did not hurt as badly as he/she predicted, he/she may make a mental note of this and alter his/her concept. In the process of one altering their concept, they will also be altering their future predictions of shots. (p.206)
Barrett reiterates the implications of the prediction-based theory through this example by explaining the predictions one makes prior to the shot can stimulate pain causing the person to actually feel that pain. I will discuss this concept in more depth later, for now let’s gather an understanding of the differences between men and women’s experiences of pain, in order to apply the prediction based theory to a real world example.
To begin, I want to present some experimental findings to prove a gap to exist between men and women’s experiences of pain. In an experimental study of pain, noxious stimuli were applied to both genders (Bradbury, 2053). Once applied, participants were asked to make judgments concerning the presence/ absence and intensity of pain. Males generally reported lower subjective ratings of pain severity and showed higher pain tolerance than women (Riley et al.,1998). In addition to this study, in 1993, Bendelow conducted a qualitative study on the association between gender and pain perception. To no surprise, Bendelow found people’s perception of pain were influenced by gender stereotypes enforced during their youth. Men recall being discouraged from expressing emotions and were encouraged to be stoic when experiencing pain. On the contrary, women participants recalled communicating about pain and engaging in interpersonal and communal strategies for dealing with pain. The differences in perceptions amongst genders, directly influence both genders constructions of pain. Since these constructions are based on preexisting concepts of pain, you can see how impactful physiological, social and cultural factors may be in creating a divide between the genders’ experiences.
So, we now understand pain is an experience constructed by an individual based on their previous concepts and predictions, but how exactly does this explain men’s higher threshold and tolerance to experimentally induced pain, over women? The answer to this question lies in a phenomenon Barrett introduces on p.206 called the “nocebo effect.” Recall the example of the person receiving a shot. Since they predicted pain caused from the shot, that pain was actually stimulated causing the person to feel it. The same logic applies here.
Given cultural messages and norms perpetuating women as weak and men as strong, both genders, typically unknowingly, align their experiences of pain to match these stereotypes. Since women are viewed as weak or less tolerant, their basic concepts of pain are altered to fit this view. This alteration of concepts impact the way women construct pain and in turn predict it. Likewise, men are less likely to predict danger as imminent given the reinforcement of their strength. As a result, women rate pain more severe than men, because their predictions of pain have actually affected their nociceptive input. Men who are told to suppress the pain because they are strong, likely predict a less severe pain, causing them to actually experience a less intense stimuli. These findings support Barrett’s beliefs of the prediction based theory and therefore the nocebo effect, because they demonstrate how expected pain may affect brain regions that process nociception. These predictions are powerful enough to change the activity of nociception.
With this application, we can validate Barrett’s the prediction based theory and therefore the nocebo effect. Given this validation, it is clear, pain is a result of a whole-brain construction rather than just a neurological process. If one believes they’ll feel less pain, their beliefs will influence their predictions and tune down their nociceptive input so they do feel less pain. We saw this to be true for men, while we found the opposite outcome for women. These beliefs are constructed from preexisting concepts unique to the individual. The differences experienced among men and women speak to the strength of the messages our concepts are unconsciously influenced by. These concepts influence men and women’s constructions and in turn their predictions of pain. Knowing the magnitude of these implications, I’ll conclude by asking the question: How can we use these findings to change the dissonance between men and women’s felt experiences of pain? Is change even necessary?
Work Cited:
Bradbury, J. (2003). Why do men and women feel and react to pain differently? The Lancet, 361(9374), 2052-3.
Steinmayer, K. M. (2006). An embodied approach to gender in the construction of pain in everyday life (Order No. 3204986). Available from ProQuest Central; ProQuest Dissertations & Theses A&I. (305350867).
Shared by: Laura Labate
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