<p>“My friend, the pain”: does altered body awareness affect the valence of pain descriptors?</p>

Abstract

Background: Pain is a marker of bodily status, that despite being aversive under most conditions, may also be perceived as a positive experience. However, how bodily states represent, define, and interpret pain signals, and how these processes might be reflected in common language, remains unclear. Methods: Qualitative and quantitative methods were used to explore the relationship between bodily awareness, pain reactions, and descriptions. A list of pain-related terms was generated from open-ended interviews with persons with spinal cord injury (SCI), and 138 participants (persons with SCI, health professionals, and a healthy control group) rated each descriptor as representative of pain on a gradated scale. A lexical decision task was used to test the strength of the automatic association of the word "pain" with positive and negative concepts. The behavioral results were related to body awareness, experience of pain, and exposure to pain, by comparing the three groups. Results: Higher positive and lower negative pain descriptors, as well as slower response times when categorizing pain as an unpleasant experience were found in the SCI group. The effect was not modulated by either the time since the injury or the present pain intensity, but it was linked to the level of subjective bodily awareness. Compared with the SCI group, health experts and non-experts both associated more quickly the word "pain" and unpleasant in the lexical decision task. However, while health professionals attributed positive linguistic qualities to pain, pain was exclusively associated with negative descriptors in healthy controls group. Conclusions: These findings are discussed in terms of their theoretical and clinical implications. An awareness of bodily signals prominently affects both the sensory and linguistic responses in persons with SCI. Pain should be evaluated more broadly to understand and, by extension, to manage, experiences beyond its adverse side.

Disconnected Body Representation: Neuroplasticity Following Spinal Cord Injury

“…Clinical treatments aiming to increase and preserve the use of the on-line and off-line experiences of body sensation, sense of ownership, and sense of agency should be based on remapping inputs to the affected body parts into the preserved body parts. In particular, taking advantage of peripheral multisensory integration processes could enhance the perceptual experience and chronic pain management [36,37,57], thus improving life quality.…”

A Therapeutic Matrix: Virtual Reality as a Clinical Tool for Spinal Cord Injury-Induced Neuropathic Pain

“…Such an effect could be due to the shifting of attentional pathways away from pain; importantly, the effect can be potentiated over time. Attention is already known as a modulating factor in the perception of pain [ 124 , 125 , 126 , 127 , 128 ], and the synergy between VR and hypnosis may exploit this effect and shift attention away from the body, producing an “unlearning” effect towards pain.…”

“…Attention modulates pain perception [ 72 , 124 , 125 , 126 , 127 , 128 , 129 ], and VR strongly modulates attention in turn by prompting a high level of engagement. Thus, an experience combining VR with hypnosis is believed to optimize the effect of illusion and the sense of presence, increasing the level of distraction from the painful body enough to provide relief [ 122 , 130 ].…”

Rebuilding Body–Brain Interaction from the Vagal Network in Spinal Cord Injuries

“…Finally, we want to emphasize the effect of this rehabilitation perspective on neuropathic or phantom pain in patients with SCI. The patients describe it as a way to restore a sense of the body, and a remaining link with it [10,113,114]. However, pain also exerts a relevant and highly disabling impact on these patients [114,115].…”