The contribution of new technological breakthroughs to the neuroscientific research of pain communication
Pain is a universal experience of human distress but paradoxically eminently private. One can infer the level of pain in others based on varying sources of information making it difficult to accurately and systematically evaluate the actual experience of a person in pain. Yet, this is one of many difficult tasks healthcare professionals face every day. Assessing pain in others is further hindered by the fact that caregivers are humans, and humans cannot easily remain indifferent to other people's distress, and tend to avoid it. From the patient's point of view, available means of pain expression can be reduced, but they can also be voluntarily restricted when facing for instance distrustful professionals. From the healthcare professional's point of view, facing pain on a continual basis and communicating one's understanding and empathy can be difficult. Ultimately, beyond the individual feeling pain and another individual decoding the pain message, the patient-caregiver interaction itself crystallizes the complex phenomenon of pain communication. In this chapter, we discuss the perception of pain and its communication from the perspective of neuroscience. Firstly, we briefly review recent imaging studies on the cerebral responses to pain and pain in others. We point out neuroimaging evidence showing the varying involvement of regions of the "pain matrix" in the process of other's pain perception (also called pain empathy). Secondly, we discuss current neurocognitive models which provide a first step towards understanding pain communication at the level of the central nervous system, although they fall short at characterizing the interactive mechanisms underlying this complex process, as the traditional one-brain approach used to date has focused on either the observer or the person in pain. We also review more recent neuroimaging studies on the phenomena of interpersonal synchrony. We argue that examining both individuals of a dyad together, and their interactions, is becoming necessary to address pain communication fully. Finally, we present new perspectives in the study of pain communication through the field of affective computing, which is making steady progress towards designing machines capable of detecting and reacting to behavioural and physiological markers of human emotions, including pain. We propose that the use of avatars offers a highly controllable experimental set-up to explore the mechanism underlying pain empathy and pain communication from both the patient's and the caregiver's perspective, as well as their interactions. Beyond designing intelligent and empathic tools to detect patients' experiences, these research initiatives may help promote empathic behaviour and thus meet the challenge of preserving our humanness in the contexts of pain and suffering.
Meugnot, A. , Jackson, P. L. (2016)., The contribution of new technological breakthroughs to the neuroscientific research of pain communication, in S. Van Rysewyk (ed.), Meanings of pain, Dordrecht, Springer, pp. 87-106.
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