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How to Control Your Sense of Pain & Pleasure

Episode 32 Aug 9, 2021 2h 12m 21 insights
This episode I discuss our sense of pain and pleasure: where and how they each arise in our mind and body and various ways to control their intensity. I discuss the science of behavioral tools like acupuncture and hypnosis and directed pressure, including the neural circuits they each activate to modulate our experience of pain or pleasure. I also discuss whole body pain, pain "syndromes" and novel pain relief compounds such as Acetyl-L-Carnitine, SAMe and Agmatine. I discuss neuroplasticity of the pain system and the key role that visual perception plays in pain modulation. Finally, I address the link between dopamine, serotonin, and oxytocin, with arousal, pleasure and pain. As always, both basic science and various protocols are described. Note: The description of the dorsal root ganglia (DRGs) was intentionally simplified and does not include mention of dorsal horn spinal relay neurons, etc. For an excellent full text review of this anatomy and circuits for touch sensing, please see: https://bit.ly/3jH9CPf Read the full show notes for this episode at hubermanlab.com.
Actionable Insights

1. Use Intermittent Reward Schedules

To maintain high motivation and energy, occasionally and randomly remove expected rewards for your efforts. This keeps the dopamine system tuned for anticipation and sustained pursuit of goals, rather than habituation to constant reward.

2. Practice Self-Hypnosis for Pain

Utilize self-hypnosis for 10-15 minutes a few times a week, or even 1 minute daily, to reinterpret painful events and achieve significant relief from chronic pain. The free Reverie.com app offers guided self-hypnosis scripts for this purpose.

3. Enter Cold Water Quickly

When engaging in cold water exposure (e.g., ice bath, cold shower), enter quickly and submerge up to your neck, including shoulders, and potentially your face. This minimizes the relative temperature drops sensed by cold receptors, making the experience less uncomfortable.

4. Optimal Pain Anticipation Timing

If a painful stimulus is anticipated, aim for a warning period of 20-40 seconds in advance to reduce the subjective experience of pain. This allows for mental preparation without the heightened anxiety caused by warnings that are too short or too long.

5. Apply Pressure for Pain Relief

To alleviate pain from an injury (provided it doesn’t worsen the wound), rub the affected area or apply pressure above or below the site. This activates A-fibers that release GABA, a neurotransmitter that inhibits C-fibers carrying pain signals, thus providing relief.

6. Manage Pleasure for Motivation

To sustain pleasure and motivation long-term, avoid over-rewarding yourself or others for every accomplishment. Occasionally and randomly remove expected rewards to keep the dopamine system properly tuned and prevent a decrease in the ability to experience future pleasure.

7. Understand Arousal and Sensitivity

Recognize that heightened states of arousal increase both your ability to experience pleasure and your tolerance/threshold for pain. This principle applies particularly to highly sensitive body areas like the lips, face, feet, and genitals.

8. Build Pain Threshold Safely

Increase your pain threshold safely through practices like ice baths, ensuring no tissue damage occurs. Leverage top-down modulation by consciously telling yourself the experience is beneficial or a chosen challenge, or by distracting yourself.

9. Leverage Obsessive Love for Pain

To buffer against pain, leverage the dopamine-rich state of obsessive love or infatuation by thinking about your partner. This mental state can modulate pain perception through brain stem interactions with the immune system, increasing resilience.

10. Enter Heat Gradually

When exposing yourself to heat, such as in a sauna, move into it gradually. Heat receptors respond to absolute temperature changes, and a slow transition allows your body to acclimate more safely and comfortably.

11. Visual Context Impacts Pain

Be aware that what you see and how you interpret an injury or event profoundly influences your subjective experience of pain. Your visual perception can dramatically alter the intensity of pain felt.

12. Mirror Box for Phantom Pain

For phantom limb pain, consider using a mirror box to create the visual illusion of the missing limb. Moving the intact limb to a relaxed position can reduce phantom pain by leveraging the visual system’s influence on perception.

13. Acupuncture for Leg/Foot Pain

Consider low-intensity electroacupuncture applied to the legs and feet for pain relief and potential wound healing. This specific stimulation can activate anti-inflammatory neural circuits.

14. Acetyl L-Carnitine for Nerves

Consider oral acetyl L-carnitine supplementation (1-4 grams/day) for chronic whole-body pain or certain acute pain conditions. Evidence suggests it can reduce pain symptoms and improve peripheral nerve health.

15. Agmatine and SAMe for Pain

Explore Agmatine and SAMe (or its precursor 5-MTHF) as non-prescription options for various types of pain, such as osteoarthritis or injury-related pain. Note that SAMe may take up to a month to show its pain-relieving effects.

16. 5-MTHF to Increase SAMe

Instead of direct SAMe supplementation, consider taking 5-methyltetrahydrofolate (5-MTHF) to increase endogenous SAMe levels. This molecule is a precursor necessary for the body to produce SAMe.

17. Low-Dose Naltrexone for Fibromyalgia

If experiencing fibromyalgia or chronic whole-body pain, consult a doctor about low-dose naltrexone. This prescription drug has shown success in treating certain forms of fibromyalgia by blocking TOL4 receptors on glia.

18. Pet Animals With the Grain

When petting animals, stroke their fur in the direction it naturally lies, as this is typically perceived as more pleasurable. This is due to specific neural pathways that respond to the direction of touch.

19. Supplement with Athletic Greens

Take Athletic Greens once or twice daily to cover basic nutritional needs, address potential deficiencies, and support gut microbiome health with its vitamins, minerals, and probiotics. A special offer is available at athleticgreens.com/Huberman.

20. Hydrate with Element Electrolytes

Ensure proper hydration and electrolyte balance by dissolving one packet of Element in 16-32 ounces of water first thing in the morning and during physical exercise. Adequate sodium, magnesium, and potassium are vital for optimal brain and body function.

21. Use Waking Up App for Rest

Utilize the Waking Up app for meditation, mindfulness, Yoga Nidra, or Non-Sleep Deep Rest (NSDR) protocols. Even short 10-minute sessions can significantly restore cognitive and physical energy.