Pain and Pleasure

Consider the word “pain”. It’s a common four-letter word, one of the few English words that contain no ambiguity. We all know its meaning and upon reading or saying it we can feel the word. Memory of past pains reside deep within our consciousness and often seeps into our subconscious like a viscous slime.

The word derives from the Greek “poine”, meaning “punishment”. Its monosyllabic structure suggests a meaning that is of basic relevance to Anglophones. Similar to other three or four letter verbs and nouns like “love”, “hate”, “fear”, “calm”, “sex” and “life”, the word represents a necessity of the human condition, an emotion or skill essential to our survival.

Pain is provoked. It is brought forth from an outside influence. A fallen rock breaks a limb and causes pain. A disease ravages your body making every joint and sinew throb in agony. An abusive parent delivers his blow and the pain will manifest in both body and mind. We’ve all experienced pain in some form or another. Its memory is something to shun and forget as best we can so we can live on.

Humans want to avoid pain, whether consciously or not. The avoidance of pain is a survival mechanism. We learned at a very early age what will cause pain and how to lessen the risk of experiencing it. Through our deep need to keep pain at bay, we stay away from those acts that will likely bring it on. We practice our balance to avoid a fall or learn how to properly handle sharp implements to avert cuts. Through our experiences with small traumas we learn the nature of pain and how to survive.

Our aversion to pain leads us to embrace its opposite, pleasure. The seeking out of pleasure is strategy for avoiding pain. Pleasure is found wherever pain is not. It’s found in the love of another or in the acquisition of a desire. Children find pleasure much easier than adults. The world is new to a child and pleasure can be found in the simplest of accomplishments. The completion of a drawing and the approving smile of his parents will bring immense pleasure to a child. However, as one ages the feeling of pleasure becomes much more difficult to obtain. The sources of pain never seem to diminish. On the contrary, the sources of pain become more abundant as one encounters new experiences.

Physical pain is easy to produce. It’s a reflex, an unconscious feeling. The pain center is in the thalamus, the most primitive part of the brain, the so-called reptilian brain. Its physiology is primarily electrochemical. A finger prick with a needle will excite pain receptors in the skin causing a cascade of electrochemical impulses to the thalamus. Motor and sensory nerves are subsequently stimulated causing pain and movement away from the offending source.

Pleasure is much more complex. It’s an emotional response to a complicated set of circumstances. It resides in the neocortex of the brain, the higher function center of the mammalian brain. The physiology of pleasure is not completely understood but seems to involve the neurotransmitter pathways of dopamine and endorphins. Neurotransmitters are complex molecules that open or close pathways into cortical neurons. Their presents or absences will direct neurons to fire or remain passive. Pleasure producing experiences are reasoned within the neocortex. The neocortex communicates with the hypothalamus in the reptilian brain where dopamine is released to facilitate nervous function. The intensity of the emotional response appears to be a function of the concentration of these neurotransmitters in the brain.

Psychological pain is the antithesis of pleasure. Although its physiology is likely as complex as that in pleasure, it has a strong analogy in physical pain. Psychological pain can be as intense as its physical partner as well as manifest into the physical form. Some forms of psychological pain, such as depression, are diagnosed by the reporting of chronic physical pain such as neck and back aches.

Pain whether it is the physical or psychological variety seems to be abundant and is common to all humans. Pleasure on the other hand, is something we all seek but never find in the desired quantity. However humans, being the curious creatures we are, have found ways to evoke pleasure other than the less reliable interpersonal methods. Instead of seeking external means to stimulate our brains into feelings of pleasure, we found ways to directly change our brain chemistry through the use of drugs.

The drunken stupor, the drug induced euphoria are manifestations of the pleasurable state of being. Alcohol was likely, but not necessarily, the first chemical found by humans to artificially bring pleasure. Ethanol, a form of alcohol, is a waste product of anaerobic (without oxygen) metabolism of some yeast. It’s easy to imagine some humans or pre humans stumbling upon a ditch of naturally fermenting cereal grains covered by debris so as to facilitate fermentation. They would have approached the ditch and moved the debris aside to get at the clean water. Since the mixture had been fermenting, it would have been free of bacteria and seemingly palatable. Their motivation for drinking the water would have been thirst but more than their thirst was quenched after imbibing.

The concentration of alcohol would have been low by modern standards but enough would have been ingested to provide them with a feeling of euphoria. The magic water made them feel better. It dulled some of their pain. Maybe before the wheel or tools or even fire, man discovered a way to evoke pleasure in a world fraught with pain and suffering.

From that day on man has sought the chemicals that could, temporarily at least, bring him some pleasure. He became embolden in his quest. Most natural analgesics and mind-altering chemicals are actually poisons. The correct dosage will bring pleasure, the wrong dose will being death. Regardless of the poison, they all work in similar ways. Alcohol is a neurological depressant. It affects the activity rate of various neurotransmitters manifesting in slower reaction times to stimulus and heightening the pain threshold. Opiates and barbiturates act in a similar fashion on different neurotransmitters but with the same pain relieving benefit.

Modern medicine has discovered the precise physiology of the pain producing pathways in the brain, both for physical and physiological pain. Synthetic analgesics are so abundant in our society that an entire row or more are dedicated to the sale of these chemicals in most pharmacies. The pharmacist’s counters are full of opiate derivatives, barbiturates, cox-2 inhibitors and antidepressants.

Four out of the top ten most widely prescribed drugs today are pain relievers of some form. Two are for physical pain and two for psychological pain. Almost 40% of Americans said in a 2006 government survey that they knew someone who was abusing painkillers. And it’s been estimated that about 20% of the US population have used a prescription drug for nonmedical reasons at least once in their life. The abuse of prescription painkillers may have surpassed the use of similarly powerful illicit drugs such as heroine and cocaine.

The abuse of painkillers is becoming epidemic. It can be argued that the use of painkillers goes well beyond their intended design and into the cause of pleasure seeking. The motivation of seeking pleasure is not, I argue, for that end in itself but in the elevation of pain. It is not pleasure we seek but it is pain we attempt to quell. When we use these drugs to feel pleasure we are actually using them to stop pain.

We are a culture of agliophobes. The sale of pain medication in the U.S. (OTC and prescription) is estimated at $11 billion. The US consumes 71% of the $13 billion antidepressant market ($9.2 billion). The alcohol industry generates $115 billion in sales from U.S. consumers. USDEA statistics report a rough estimate of $65 billion in the sale of illicit drugs in the year 2000. Americans spend on average about $918 per adult per year in the pursuit of pain avoidance.

$918 per year may not seem much but consider this figure in comparison to a USDA statistic for the purchase of food. The average American family of four spends just under $9000 per year on food. That’s $2250 per person. Americans spend 40% of their equivalent food budget on the alleviation of pain. That is a comparison worth thinking about.

Statistics can’t tell the whole story. Much of the expenditures for pharmaceuticals are for legitimate medical conditions. We don’t needlessly have to suffer with pain in this modern age thanks to the innovations of the pharmaceutical industry. But how much is spent on the pursuit of pleasure? Much more I think than on the surface for the alleviation of pain. When you consider all the “pleasurable” activities available, travel, entertainment, gambling, pornography and prostitution to name a few, the total bill is astronomical, I’m sure. Since I propose that the seeking of pleasure is motivated by the avoidance of pain you can see that much of our net incomes and behaviors are dedicated to chasing off pain.

In a strange juxtaposition, pain itself can be used in the battle against pain. The endurance of extreme physical exertion, the piercing of skin or body parts with studs, or the pathological habit of self-mutilation are all strategies employed by some people for pleasure seeking. The likely underlying mechanism for these activities is the production of endorphins (opiate-like neurotransmitters) by the hypothalamus. The pleasure felt is from the momentary alleviation of some deeper seated pain.

Pain is a crucial physiological response to potential harm, yet it can leave psychological scars that are sometimes greater than the physical assaults that caused it. We medicate ourselves as a result. We numb our psyches to pain’s onslaught. Nature has provided humans with the chemicals to combat physical and psychological pain. Modern painkillers and antidepressants are nothing more than derivatives of these naturally occurring remedies. Alcoholic beverages are made from the waste products of the same yeasts discovered eons ago. We rationalize our self-medication as a search for pleasure but in reality we are in a constant retreat from pain.

There was a saying that I recall from my youth, “It is only through pain that I know I’m alive”. This saying provides some insight into the position pain holds in the human condition. It is the primary measurement for life. It lets us know we’re in the universe and not standing apart from it. All interactions with the world have a painful component. Our eyes hurt when too much light passes through them. Our skin bruises when we fall onto solid ground. Our feelings are hurt when people we love are dishonest. To be human is to be in pain and to be human is to do all we can to avoid pain. It is the central dichotomy of the human condition. Pain is the pathway to pleasure and the cause of despair.


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