Do we learn pain?

A 10 month old baby stands up for the first time and falls backward onto their butt – are they in pain?

It’s sort of like that old question – if a tree falls in the woods and no one is around to hear it, does it make a sound?

As an analogy, it’s actually a lot more like the first question than people may realize.

In the last blog I detailed how I don’t think we start our lives inherently knowing pain, but instead have nociception and fear – much like their older counterparts – but have not developed the concept and understanding of pain yet.

Let’s get real for a second, pain is confusing and everything I’m going to discuss is just conceptual and highly debatable.

That’s sort of what makes it interesting though because there is so much to learn on it and no absolutes.

Back to the point, does the baby have pain?

Babies are constantly learning, everything around them is new, their senses are improving each day and new experiences happen within the same environment constantly.

Observational learning is one of our primary forms of learning and it’s based around our interactions within our society/environments.

Each day we take in tons of information, most of it goes relatively unacknowledged, but that doesn’t mean it’s not absorbed.

Our mind cannot readily bring each thing to our active conscious, this would be highly inefficient, instead it decides what to acknowledge (we will get into Bayesian modeling in time).

Social learning is a theory that was first proposed by Albert Bandura who believed that most of human behavior is learned observationally through modeling – seeing how a behavior is done, forming an idea on the behavior, coding the behavior and then using that information to guide action in the future.

We acquire our attitudes around health from our parents and the other significant persons in our life through infancy and childhood.

This comes in many forms and has significant implications that are often not appreciated.

A few examples:

- How someone reacts when experiencing trauma

Their parent walks and stubs their toe and chooses to swear for coping.

- How someone reacts to others experiencing suffering

Their father consoles their mother who has fibromyalgia

- How someone reacts to them experiencing trauma

Their parents sees them fall and is concerned, holds and coddles them.

Each of these builds a component into what the person develops as a meaning for pain and what will become their representation of pain responses.

Whether or not that infant experiences pain is a lot like that tree example as it’s heavily dictated by whether not someone is there to acknowledge it.

Sound is perception that requires acknowledgment, otherwise it would just be sound waves and without interpretation.

From the infants first interactions with their parents, it begins to build relationships around experiences – it cries it gets soothed and fed.

If the infant goes through its life learning that a bop to the head during rolling equals concern & fear which leads to love & affection, then it will likely build that concept that a flop on the ground equals concern & fear.

In contrast, if the parents react to the child bopping its head during a roll with excitement for an attempted roll, the infant will believe it to be an entirely different experience.

This concept is compounded through an entire lifetime and world of experiences which form the infants concept of pain.

In coming blogs we will further explore this, particularly the concept of chronic pain and its relevancy on the offspring of those who are suffering.

References for more on what was discussed:

Hermann C. Modeling, Social Learning in Pain. Encyclopedia of Pain. 2007.

Stone AL, Walker LS. Adolescents’ observations of parent pain behaviors: preliminary measure validation and test of social learning theory in pediatric chronic pain. Journal of pediatric psychology. 2017;42(1):65-74.

Higgins KS, et al. Offspring of parents with chronic pain: a systematic review and meta-analysis of pain, health, psychological, and family outcomes. PAIN. 2015;156(11):2256-2266.

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