美国国家公共电台 NPR Can You Reshape Your Brain's Response To Pain?

 

STEVE INSKEEP, HOST:

About 50 million Americans suffer from chronic¹ pain. We typically think of pain as coming from an injury or an illness. But there can be another source. Studies show repeated exposure to trauma², anxiety or depression, especially in childhood, can leave a physical imprint³ on the brain. This makes some people more vulnerable to feeling physically⁴ hurt. NPR's Patti Neighmond reports.

PATTI NEIGHMOND, BYLINE⁵: Jeannine is 37 years old and lives in Burbank, Calif. She's suffered pain from head to toe since she was a child. We're not using her last name for reasons of privacy. Over the years, Jeannine's gone to dozens of doctors. X-rays and MRIs found no physical damage. She changed her diet, wore belts to correct her posture⁶ and exercised to strengthen muscles. Nothing helped.

JEANNINE: Lightning bolts kind of going up from my shoulders through my neck to my head. Then I also get this, like, grinding pain in my hips⁷, where I feel like I can't walk anymore. It's just very painful to walk.

NEIGHMOND: She was eventually diagnosed with fibromyalgia, a disorder⁸ characterized by widespread pain throughout the body. The cause is unknown. Then, about eight months ago, a friend suggested a new type of therapy - emotional awareness⁹ and expression therapy. And Jeannine started writing in a daily journal.

JEANNINE: That paragraph I wanted to share with you here...

NEIGHMOND: In her journal, she looked backwards¹⁰ at the past when her health problems began.

JEANNINE: I wrote down all the different health symptoms I've had throughout my life, pain-wise, but also other things.

NEIGHMOND: Things that caused her distress¹¹. For Jeannine, who grew up in an abusive household, there was a lot to write down.

JEANNINE: If I was dressed in a way that my dad thought was too provocative¹², like, it wasn't anything for him to call me a whore, like, just say, well, you look like a whore today. Like, it just wasn't a - and he'd call my mother that too.

NEIGHMOND: And the aggression¹³ was also physical.

JEANNINE: Pushing, shoving, hitting and certainly a lot of belts in childhood, so spanking¹⁴, you know.

NEIGHMOND: It didn't take much therapy for Jeannine to make a startling discovery. The backaches, stomachaches and headaches she suffered in childhood came around the same time as the hitting and the yelling. As a young adult, she moved out of the house. The abuse stopped, but the pain didn't. Psychologist Mark Lumley at Wayne State University in Detroit says this is the case for a number of chronic pain patients.

MARK LUMLEY: There's a growing number of studies that have followed people prospectively¹⁵ over the course of years trying to predict who develops chronic pain. And they show clearly that difficult life experiences, adverse¹⁶ experiences in childhood are later predictors of chronic pain and widespread pain years later.

NEIGHMOND: So how does this happen? Amy Arnsten is a neuroscientist at Yale Medical School. Under healthy conditions, she says, higher circuits in a part of the brain, the prefrontal cortex, can regulate whether individuals feel pain and how much pain they feel.

AMY ARNSTEN: But these higher brain circuits atrophy¹⁷ when we're exposed to chronic stress, especially stressors where we feel uncontrolled and frightened.

NEIGHMOND: In other words, things like fear, depression or anxiety can weaken these circuits. And if the circuits aren't working properly, then Arnsten says people can feel more prolonged pain long after a physical injury has healed. And without proper regulation, the brain can also generate pain when there's no other physical damage.

ARNSTEN: The brain actually has pathways where it can go down and control our body and actually create a pain response.

NEIGHMOND: And Arnsten says this pain is real. It can happen to adults too. But when it starts in childhood, psychologist Lumley says it can set in motion a lifetime of chronic pain.

LUMLEY: Most people don't necessarily outgrow¹⁸ so easily some of those difficult early childhood experiences. And even though one's life might look good now, people still remain haunted as memories of or thoughts about family come to the fore¹⁹.

NEIGHMOND: This is what happened to Jeannine at a specific time every day during the week.

JEANNINE: Literally²⁰ on the drive home, I would start getting pain. And so then you think, well, maybe it's because it's your long commute²¹. You know, you are in the car for 45 minutes to an hour. Maybe it's your chair. So I had lumbar support. I had, like, heating elements.

NEIGHMOND: But in therapy, she realized it wasn't the car or the commute. It was going home.

JEANNINE: Nothing bad is meeting me here on the drive home. But when I was younger, you know, walking home, getting home was like, ugh, I got to go back there again. And it was just a dreadful feeling of now I have to go back to that environment. My house never felt like a safe place for me.

NEIGHMOND: The idea that there was a connection between her pain today and the trauma she suffered during childhood just sounded, she says, kind of crazy.

JEANNINE: To me, it just doesn't sound logical. You never - you think about pain like something hits you, something hurts, that it's physical. It's not like something hits you emotionally, and then something hurts.

NEIGHMOND: But in fact...

JEANNINE: In fact, it - that is the way it happens.

NEIGHMOND: With emotional awareness and expression therapy, Jeannine learned how to confront what had happened to her as a child. Psychologist Mark Lumley and colleagues developed the therapy. He says it helps patients face emotions like anger, sadness or loss of love that they may have suppressed at the time of abuse.

LUMLEY: And part of facing it means talking about it, giving it some expression with your words and your face and your body.

NEIGHMOND: Because when you face it, you feel more in control. And you can actually repair the weakened pathways in the brain and make them strong again. Jeannine's psychologist Laura Payne says it wasn't easy.

LAURA PAYNE: It got very tough, and the pain got a lot worse. And it became more persistent²². And she continued. We just continued to push through with doing all the things that she, you know, was supposed to be doing and engaging in what she would typically avoid. And we kind of got past that. But it was a hard time.

INSKEEP: Now, this is a new therapy. And so far, the evidence of its effectiveness is largely based on one study. More research with larger studies is needed to truly gauge²³ its worth. But Jeannine said the therapy worked for her, her pain is way down. And some days, she says, she has no pain at all. Patti Neighmond, NPR News.

(SOUNDBITE OF KILN'S "AIRPLANESHADOWS")

1 chronic   

adj.(疾病)长期未愈的，慢性的；极坏的

参考例句：

• Famine differs from chronic malnutrition.饥荒不同于慢性营养不良。
• Chronic poisoning may lead to death from inanition.慢性中毒也可能由虚弱导致死亡。

2 trauma   

n.外伤，精神创伤

参考例句：

• Counselling is helping him work through this trauma.心理辅导正帮助他面对痛苦。
• The phobia may have its root in a childhood trauma.恐惧症可能源于童年时期的创伤。

3 imprint   

n.印痕，痕迹；深刻的印象；vt.压印，牢记

参考例句：

• That dictionary is published under the Longman imprint.那本词典以朗曼公司的名义出版。
• Her speech left its imprint on me.她的演讲给我留下了深刻印象。

4 physically   

adj.物质上，体格上，身体上，按自然规律

参考例句：

• He was out of sorts physically,as well as disordered mentally.他浑身不舒服，心绪也很乱。
• Every time I think about it I feel physically sick.一想起那件事我就感到极恶心。

5 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

6 posture   

n.姿势，姿态，心态，态度；v.作出某种姿势

参考例句：

• The government adopted an uncompromising posture on the issue of independence.政府在独立这一问题上采取了毫不妥协的态度。
• He tore off his coat and assumed a fighting posture.他脱掉上衣，摆出一副打架的架势。

7 hips   

abbr.high impact polystyrene 高冲击强度聚苯乙烯，耐冲性聚苯乙烯n.臀部( hip的名词复数 )；[建筑学]屋脊；臀围（尺寸）；臀部…的

参考例句：

• She stood with her hands on her hips. 她双手叉腰站着。
• They wiggled their hips to the sound of pop music. 他们随着流行音乐的声音摇晃着臀部。 来自《简明英汉词典》

8 disorder   

n.紊乱，混乱；骚动，骚乱；疾病，失调

参考例句：

• When returning back,he discovered the room to be in disorder.回家后，他发现屋子里乱七八糟。
• It contained a vast number of letters in great disorder.里面七零八落地装着许多信件。

9 awareness   

n.意识，觉悟，懂事，明智

参考例句：

• There is a general awareness that smoking is harmful.人们普遍认识到吸烟有害健康。
• Environmental awareness has increased over the years.这些年来人们的环境意识增强了。

10 backwards   

adv.往回地，向原处，倒，相反，前后倒置地

参考例句：

• He turned on the light and began to pace backwards and forwards.他打开电灯并开始走来走去。
• All the girls fell over backwards to get the party ready.姑娘们迫不及待地为聚会做准备。

11 distress   

n.苦恼，痛苦，不舒适；不幸；vt.使悲痛

参考例句：

• Nothing could alleviate his distress.什么都不能减轻他的痛苦。
• Please don't distress yourself.请你不要忧愁了。

12 provocative   

adj.挑衅的，煽动的，刺激的，挑逗的

参考例句：

• She wore a very provocative dress.她穿了一件非常性感的裙子。
• His provocative words only fueled the argument further.他的挑衅性讲话只能使争论进一步激化。

13 aggression   

n.进攻，侵略，侵犯，侵害

参考例句：

• So long as we are firmly united, we need fear no aggression.只要我们紧密地团结，就不必惧怕外来侵略。
• Her view is that aggression is part of human nature.她认为攻击性是人类本性的一部份。

14 spanking   

adj.强烈的，疾行的；n.打屁股

参考例句：

• The boat is spanking along on the river.船在小河疾驶。
• He heard a horse approaching at a spanking trot.他听到一匹马正在疾步驰近。

15 prospectively   

adv.预期； 前瞻性； 潜在； 可能

参考例句：

• Methods: Twenty-four cases with JAS were prospectively analyzed and followed up. 方法对24例JAS进行前瞻性分析及随访研究。 来自互联网
• Our study appears to be the only one a prospectively randomized investigation of 2 different surgeries. 我们的研究似乎是仅有的一个对2种术式前瞻性随机性研究。 来自互联网

16 adverse   

adj.不利的；有害的；敌对的，不友好的

参考例句：

• He is adverse to going abroad.他反对出国。
• The improper use of medicine could lead to severe adverse reactions.用药不当会产生严重的不良反应。

17 atrophy   

n./v.萎缩，虚脱，衰退

参考例句：

• Patients exercised their atrophied limbs in the swimming pool.病人们在泳池里锻炼萎缩的四肢。
• Many hoped he would renew the country's atrophied political system.很多人都期望他能使该国萎靡的政治体系振作起来。

18 outgrow   

vt.长大得使…不再适用；成长得不再要

参考例句：

• The little girl will outgrow her fear of pet animals.小女孩慢慢长大后就不会在怕宠物了。
• Children who walk in their sleep usually outgrow the habit.梦游的孩子通常在长大后这个习惯自然消失。

19 fore   

adv.在前面；adj.先前的；在前部的；n.前部

参考例句：

• Your seat is in the fore part of the aircraft.你的座位在飞机的前部。
• I have the gift of fore knowledge.我能够未卜先知。

20 literally   

adv.照字面意义，逐字地；确实

参考例句：

• He translated the passage literally.他逐字逐句地翻译这段文字。
• Sometimes she would not sit down till she was literally faint.有时候，她不走到真正要昏厥了，决不肯坐下来。

21 commute   

vi.乘车上下班；vt.减(刑)；折合；n.上下班交通

参考例句：

• I spend much less time on my commute to work now.我现在工作的往返时间要节省好多。
• Most office workers commute from the suburbs.很多公司的职员都是从郊外来上班的。

22 persistent   

adj.坚持不懈的，执意的；持续的

参考例句：

• Albert had a persistent headache that lasted for three days.艾伯特连续头痛了三天。
• She felt embarrassed by his persistent attentions.他不时地向她大献殷勤，使她很难为情。

23 gauge   

v.精确计量；估计；n.标准度量；计量器

参考例句：

• Can you gauge what her reaction is likely to be?你能揣测她的反应可能是什么吗？
• It's difficult to gauge one's character.要判断一个人的品格是很困难的。