How to Control Your Sense of Pain & Pleasure | Huberman Lab Podcast #32

Summary

• Skin is the largest sensory organ and has many functions, including detecting touch, temperature, and pressure, and experiencing pleasure and pain
• Motivation is related to fluctuations in the chemical dopamine, which is a molecule of motivation and anticipation
• Dopamine is released in anticipation of a reward and drops back to baseline when the reward is received
• To increase motivation and pleasure, it is important to set goals, break them down into smaller steps, and find ways to increase the anticipation of the reward
• To decrease pain, it is helpful to understand the role of the brain in creating and modifying pain perception, and to use techniques such as mindfulness and deep breathing to decrease the emotional component of pain
• There are also medications and natural supplements that can help to decrease pain and increase pleasure, although it is important to discuss these options with a healthcare provider.
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• Neurons in the skin collect information from the body and send it to the brain
• Different stimuli, such as light touch, cold, heat, and chemicals, can evoke electrical responses in neurons
• The brain interprets these electrical signals to create the sensation of pleasure or pain
• The somatosensory cortex in the neocortex of the brain is responsible for interpreting these signals and has a map of the body surface, called the homunculus
• The feet, hands, lips, face, and genitals have a disproportionately larger representation in the homunculus, indicating that they are more sensitive to touch
• The amygdala, a brain region associated with emotion, also plays a role in the perception of pleasure and pain
• The experience of pleasure or pain can be influenced by both physical and emotional factors.
• The dermatome is the way in which neurons connect to different parts of the body
• Herpes simplex 1 virus is present in 80-90% of people and is transmitted through non-sexual contact
• The herpes virus can cause the trigeminal nerve to become inflamed and cause tingling and pain in the affected dermatome
• Shingles is a common viral infection that causes a rash with a sharp boundary on the affected dermatome
• Allergic reactions can also affect the dermatome and show up as a rash with a clear boundary
• Physical pain can be worse in people with certain genes
• Emotional and psychological factors can affect the experience and perception of physical pain
• Advance warning of 20-40 seconds is optimal for preparing for a painful stimulus
• Pain threshold involves both the amount of stimulation needed to feel pain and the duration of the pain
• People experience the same stimuli differently in terms of pain
• Medical doctors also experience a range of subjective pain experiences
• Expectations and anxiety can impact a person's pain threshold
• Pleasure experiences also vary among individuals and can be influenced by expectations and anxiety
• Mindfulness techniques can be used to help manage pain and increase pleasure experiences
• Cold receptors in the skin respond to relative drops in temperature, not absolute temperature
• It is easier to tolerate cold water if you enter it quickly and fully submerge your body, including your neck and shoulders
• Activating the dive reflex (by fully submerging the face) can also increase tolerance of cold
• People's ability to tolerate cold varies greatly
• It is important to be cautious when entering cold bodies of water, as extreme cold can be dangerous
• Heat receptors in the skin also respond to relative increases in temperature, not absolute temperature
• Tolerance of heat varies greatly among people
• It is important to take caution in hot environments, as heat stroke and other heat-related illnesses can be serious and even deadly
• It is possible to acclimatize to both cold and heat over time
• Mindfulness and focus can help increase tolerance of both cold and heat
• It is important to listen to your body and not push beyond your limits when it comes to cold and heat exposure.
• Pain and the degree of physical damage to the body are not always correlated
• Perception of pain can be influenced by what we see and hear
• Chronic pain can be treated by leveraging the subjective and visual nature of pain
• The brain can change how it processes pain through neuroplasticity
• "Protocol 4" involves using visual cues to help the brain reinterpret pain signals
• Phantom limb pain can be treated using a mirror box
• The sensory innervation of the face, lips, genitals, and feet is denser than other parts of the body, leading to more intense experiences of pleasure and pain in these areas
• There are certain "pain syndromes," such as psychogenic fever and "psychosomatic" pain, in which the cause of the pain is psychological rather than physical
• The experience of pain is subjective and influenced by a person's beliefs, expectations, and emotions
• The pain experience is influenced by the activity of certain areas of the brain, such as the insula and the cingulate cortex
• The endocannabinoid system and its receptors play a role in pain perception
• The experience of pleasure and pain is influenced by the activity of neurotransmitters such as dopamine, serotonin, and norepinephrine
• The experience of pleasure and pain can be influenced by the activity of hormones such as oxytocin and cortisol
• Naproxen and similar drugs are effective for pain relief
• SAMe and agmatine have also been shown to be effective for pain relief under certain circumstances, but may take longer to take effect
• SAMe is sometimes replaced by a bioavailable alternative called 5-methyltetrahydrofolate or 5-MTHF
• It is important to do research and follow dosage guidelines when considering taking supplements or nutraceuticals
• The study "Keynan et al" published in 2010 in Pain Medicine looked at the safety and efficacy of dietary agmatine sulfate for treating lumbar-disc associated pain and found it to be safe and efficacious with limited side effects, but specific dosage regimens were necessary
• Mucuna pruriens is a tropical legume bean that contains L-DOPA, a precursor to dopamine
• Mucuna pruriens is sometimes taken as a supplement to increase dopamine levels, but it can cause side effects such as crashing and feeling bad
• The outside of Mucuna pruriens contains a compound that makes people itch, but this is usually removed when it is taken in supplement form
• Qiufu Ma's lab has studied how acupuncture can both alleviate and exacerbate pain, depending on the intensity and location of the treatment
• Electroacupuncture, a form of acupuncture that uses electrical current, can activate neural circuits and affect the sympathetic nervous system, the DMV and adrenal glands, and the release of NPY and adrenaline
• These findings may explain why some people experience relief from acupuncture while others do not
• Stage hypnosis involves controlling people's actions and behaviors through hypnosis
• Self hypnosis involves using hypnosis to modulate activity in the prefrontal cortex and related structures to achieve certain effects, such as pain relief
• The prefrontal cortex is involved in executive function, including decision making and interpretation of context
• Neuroimaging studies have shown that self hypnosis can change brain activity and alter subjective experiences
• Protocols 8 and 9 involve using hypnosis for pain relief and improving sleep, respectively
• The app reveri.com offers self hypnosis scripts and information on the science behind hypnosis
• Acupuncture and hypnosis can be combined with drug treatments if desired, and both are often covered by insurance
• The concept of hypnosis and the effects it can produce are supported by scientific data and research.
• Dopamine is a molecule associated with motivation, novelty expectation, and reward
• High levels of dopamine are present in the brain and body when people fall in love
• Dopamine can modulate the inflammation system by interacting with brainstem neurons that control the release of immune cells
• Dopamine can bind to receptor sites on certain brain areas, allowing for increased resilience and the transformation of pain into pleasure
• Pleasure and reproduction are related, with pleasure serving as a reward for behaviors that increase the chances of reproduction
• Serotonin and oxytocin are also involved in pleasure and bonding
• The touch system is designed to detect pleasure as well as pain, with certain nerve fibers and brain areas specifically dedicated to pleasure from touch
• The "cool" system for touch is activated by the release of endorphins, which can reduce pain and increase pleasure
• The "warm" system for touch is activated by the release of oxytocin, which can increase social bonding and trust
• Certain drugs like antidepressants can increase dopamine and serotonin levels to treat anhedonia (inability to experience pleasure) and depression
• Neuromodulators, such as PEA, can slightly increase the "tide" or baseline levels of dopamine and serotonin, making it easier for certain experiences to further increase dopamine
• Different experiences and the experience of pleasure use the same currency of dopamine and serotonin
• If dopamine and serotonin levels are too low, it may be difficult to experience pleasure
• Treatments that artificially increase dopamine and serotonin levels may have side effects
• The brain and body use common currencies (dopamine and serotonin) for different experiences
• Context and arousal can influence pleasure and dopamine release
• Dopamine is released in the brain when we work hard towards a reward, but its levels decrease when we receive the reward
• To maintain pleasure, we should engage in an intermittent reward schedule and remove the reward at random times
• This allows us to experience pleasure in a variety of contexts and maintain motivation
• To preserve our ability to experience pleasure, we should not over-reward ourselves or become too excited about rewards
• Dopamine is like a currency in the body, and the value of different currencies (including cryptocurrencies) is reflective of the dopamine in people
• In order to maintain the ability to experience pleasure, we should not constantly seek more dopamine through external rewards and should try to adjust down our expectations of reward
• This can be applied to various situations, such as student life, physical practices, receiving monetary rewards, teaching others, and leisure activities
• By following an intermittent reward schedule and adjusting down our expectations of reward, we can increase our ability to experience pleasure and maintain motivation.