Acceptance, not distraction, is the way to deal with pain

You've got a painful visit to the dentist lined up and what do people advise you to do once you're there? Try to think of something nice, they always say. Imagine yourself lying on a lovely sandy beach. Not only can such advice be annoying, new research suggests it's also ineffective. You're much better off accepting the pain when it comes along and dealing with it.

That's according to Jenny McMullen and colleagues who tested the ability of student participants to cope with unpleasant electric shocks of increasing duration. The students were tested before and after receiving tuition in distraction or acceptance techniques.

To learn distraction, the students were asked to imagine how the first round of electric shocks had felt and to distract themselves from these feelings by imagining a pleasant scene. They were also asked to imagine that continuing with the electric shocks in the next part of the experiment was akin to crossing a swamp, and that the best way to get across was to think of pleasant images.

By contrast, the students taught acceptance were told to walk around the room, repeating to themselves 'I cannot walk'. The idea was to teach them that there is a disconnect between what they say to themselves - their thoughts - and what they actually do; that it is possible to continue enduring pain despite the thought that it is getting more uncomfortable. These students were also told to imagine the swamp metaphor, but in their version, the best way to get across was just to notice any unpleasant thoughts and feelings and carry them with them.

Only the distraction training was effective. In the second round of testing, the students taught acceptance were able to endure more electric shocks than they had in the first part of the experiment, but crucially, no such difference was observed for the students taught distraction.

Moreover, other students taught distraction or acceptance based only on very brief instruction, without use of metaphor or exercises, also showed no greater capacity to endure shocks.

"Of course, the current findings are restricted to a relatively artificial pain-induction task and a relatively small, non-clinical sample [16 people per condition], but the results do call for a careful and systematic analysis of how exercises and metaphors work in future analogue research," the researchers said.
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MCMULLEN, J., BARNESHOLMES, D., BARNESHOLMES, Y., STEWART, I., LUCIANO, C., COCHRANE, A. (2008). Acceptance versus distraction: Brief instructions, metaphors and exercises in increasing tolerance for self-delivered electric shocks. Behaviour Research and Therapy, 46(1), 122-129. DOI: 10.1016/j.brat.2007.09.002

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