Pain: The Science of Suffering (Maps of the Mind) [Hardcover]

Patrick Wall (Author)

Book Description

ISBN-10: 0231120060 | ISBN-13: 978-0231120067 | Publication Date: August 15, 2000 | Edition: 1

Pain is one of medicine's greatest mysteries. When farmer John Mitson caught his hand in a baler, he cut off his trapped hand and carried it to a neighbor. "Sheer survival and logic" was how he described it. "And strangely, I didn't feel any pain." How can this be? We're taught that pain is a warning message to be heeded at all costs, yet it can switch off in the most agonizing circumstances or switch on for no apparent reason. Many scientists, philosophers, and laypeople imagine pain to operate like a rigid, simple signaling system, as if a particular injury generates a fixed amount of pain that simply gets transmitted to the brain; yet this mechanistic model is woefully lacking in the face of the surprising facts about what people and animals do and experience when their bodies are damaged.

Patrick Wall looks at these questions and sets his scientific account in a broad context, interweaving it with a wealth of fascinating and sometimes disturbing historical detail, such as famous characters who derived pleasure from pain, the unexpected reactions of injured people, the role of endorphins, and the power of placebo. He covers cures of pain, ranging from drugs and surgery, through relaxation techniques and exercise, to acupuncture, electrical nerve stimulation, and herbalism.

Pain involves our state of mind, our social mores and beliefs, and our personal experiences and expectations. Stepping beyond the famous neurologic gate-control theory for which he is known, Wall shows that pain is a matter of behavior and its manifestation differs among individuals, situations, and cultures. "The way we deal with pain is an expression of individuality."

Editorial Reviews

From Publishers Weekly

Wall (The Challenge of Pain), a professor of physiology at St. Thomas's Hospital Medical School (London), presents an alternative to the traditional theory of pain. Earlier theorists attributed painful sensations to nerve endings that transmitted a message from the spinal column to the brain. Drawing on the latest neurological research, Wall hypothesizes instead that when nerve endings are stimulated by painful sensations, the message is transmitted, but then, the brain analyzes this data to determine the appropriate motor response. One's response to the stimulus is, in part, based on personal history and expectations. According to Wall, this interconnectedness explains why people experience pain differently, and it also accounts for why a strong belief in the efficacy of a placebo may actually reduce an individual's pain. Although he doesn't examine specific conditionsAlike cancer and migrainesAin as much depth as Frank Vertosick does in Why We Hurt: The National History of Pain (Forecasts, May 29), Wall is a sympathetic and thorough writer: he describes the physiology of the nervous system; he explores, philosophically and scientifically, the history of pain and its treatment; and he suggests some improvements to popular medical approaches to pain management, explaining (in detail) the different ways in which pain can be eased. Postoperative patients, for example, deal with their pain better when they are able to regulate their analgesic medication (because control helps them overcome their feelings of physical helplessness). In this generally thoughtful text, Wall offers his belief in the benefit of narcotic medications for cancer patients in pain. B&w illus. (Aug.)
Copyright 2000 Reed Business Information, Inc.

From Library Journal

A British neuroscientist and physiologist who has written several books on pain, Wall provides a broad scientific account of the enigma of the brain and specifically its interpretation and use of pain. His book varies from Frank Vertosick's Why We Hurt (LJ 3/15/00) in that Wall fits facts, relevant data, and bizarre pain cases (abrupt injuries, torture, masochism) into an overall body-brain pain theory. Vertosick is a great storyteller who gives his text a more anthropological context. Divided into 11 sections, Wall's text investigates the philosophy of pain, whole body theories, obvious and mysterious causes of pain, and the placebo response to pain. He also provides practical if obvious advice on personal pain and its treatment. Wall is a sage neuroscientist who challenges younger pain researchers and the "new breed of clinicians" to create a contemporary picture of a "subtle multiplexed reactive system" we call the neurological response to pain. Recommended for academic libraries.DRebecca Cress-Ingebo, Fordham Health Sciences Lib., Wright State Univ., Dayton, OH
Copyright 2000 Reed Business Information, Inc.

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Product Details

• Hardcover: 192 pages
• Publisher: Columbia University Press; 1 edition (August 15, 2000)
• Language: English
• ISBN-10: 0231120060
• ISBN-13: 978-0231120067
• Product Dimensions: 9.2 x 6.1 x 0.7 inches
• Shipping Weight: 12.8 ounces (View shipping rates and policies)
• Average Customer Review: 4.8 out of 5 stars  See all reviews (5 customer reviews)
• Amazon Best Sellers Rank: #733,346 in Books (See Top 100 in Books)

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Most Helpful Customer Reviews

26 of 26 people found the following review helpful:

5.0 out of 5 stars Captivating study of a grim subject..., October 15, 2000

By 

Thomas J. Brucia "Tom B" (Houston, TX United States) - See all my reviews
(REAL NAME)   

This review is from: Pain: The Science of Suffering (Maps of the Mind) (Hardcover)

A word of advice: as the author states in the preface, this book is NOT a textbook, nor a do-it-yourself recipe book for pain relief. It is a work of communication for educated laymen "intended to give the readers the power of understanding processes in their own body." If the topic were not so grim, one could describe this work as "fascinating and fun." The topics he touches on range from studies of Yom Kippur War survivors to biofeedback training, from migraine auras to the sensitivity of babies to pain, from hand injuries to cannabis, and from nerve regeneration to the attention mechanism in ducklings and monkeys. The slim volume is filled with anecdote and humor, as well as with suffering. He reminds us that pain frequently occurs without physiological basis, and that pain sometimes fails to kick in when we are severely ill. ---- Dr. Patrick Wall (a British professor of physiology who started his career 40 years ago as a neuroscientist) is the author of several other books about pain. He unfortunately has first hand knowledge of pain. He is the victim of cancer. ---- This volume explains what we have learned in recent years about pain - and is honest about the vast amount of ignorance still to be conquered. After examining the corpus of knowledge - much of it gained in the last few decades -- in the first nine chapters, Dr. Wall brings together "all the phenomena we have discussed in the previous chapters and ask[s] what precisely is going on in someone who senses pain" in Chapter 10. His purpose: "a profound understanding one's own pain has itself a therapeutic effect and proposes a rationale for therapy." This is a fascinating summary of the status of knowledge to today. It is a work that invites re-reading.

21 of 21 people found the following review helpful:

5.0 out of 5 stars Pleasant Reading About Pain, August 21, 2000

By 

Donald Mitchell "Jesus Loves You!" (Thanks for Providing My Reviews over 109,000 Helpful Votes Globally) - See all my reviews
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This review is from: Pain: The Science of Suffering (Maps of the Mind) (Hardcover)

I was attracted to this book because earlier in my life I had experienced chronic pain for 8 years. The search for relief was ultimately successful, but the path to finding that relief was long and arduous. What I learned in the process didn't help me very much for being able to advise others, so I hoped this book would help.

I was pleasantly surprised to find that Pain contains more information about pain than all that I learned in my personal journey. "Any knowledge that brings patients into a clearer appreciation of their condition decreases their anxiety," says the author, Patrick Wall who is a pain researcher and was suffering from pain related to cancer while authoring the book.

Wall's basic point is that pain is related to many different parts of the brain and body, and is affected by our psychology. Little is known about many aspects of pain, and there is little focus on pain relief in medical training or medical research. Wall knows that the fear of pain is often worse than the pain, so he makes the subject amazingly pleasant. I expected to be depressed by reading the book, and felt elated instead as I learned more about the causes of pain.

The book starts up with case histories where people with severe injuries report no initial pain. The reason seems to be that they were still in a survival mode, and surviving concentrated their attention away from the wound and potential pain. Many frequent "mysteries" of pain are also explored like people who have lost limbs and feel pain in the lost part of the limb.

You will also learn about fascinating experiments to identify causes of pain and their relief. The book goes on to discuss the sources of pain, how treatments interact with those sources, and how placebo effects can reduce pain. For example, did you know that pessimistic people report more pain than others? As a result, I learned that it is normal to have some residual pain from my earlier experiences. I need not be concerned that full pain will return. That was a nice relief.

I suspect that you, too, will lose some of the unnecessary sources of your concerns about pain. And that will probably, in turn, reduce the pain you will experience in your future.

While that is happening, you should examine other areas of your life where you fear the worst. That could be a harmful misconception. Why not begin to expect the best instead? Think about it. There may be another placebo effect to help you there also.

14 of 14 people found the following review helpful:

5.0 out of 5 stars What a master has learned in a career, September 26, 2000

By 

Eric Chevlen (Youngstown, Ohio USA) - See all my reviews

This review is from: Pain: The Science of Suffering (Maps of the Mind) (Hardcover)

Who better to spend a few evenings with (metaphorically) than Patrick Wall, the man who literally, with Ronald Melzack, wrote the (text)book about pain?

Wall is now in the twilight of his still productive career. In this refreshing book, he gives an overview of what he has learned. He distinguishes among normal, i.e. biologically useful, and abnormal pain. He discusses at length the placebo response, showing fascinating data that it may be found even among animals.

His main point is that pain may be seen as a preparation for response, hence the essential role of attention in the experience.

This book is for the educated layman with a curiosity about the ubiquitous yet misunderstood phenomenon of pain. It will also be of considerable interest to the physician treating pain.