Human emotional reactions to a painful stimulus. Emotional reactions: definition, types, essence, functions performed and their impact on a person

Health

You decided to peel potatoes and unexpectedly cut your finger. Or they burned themselves on a hot soldering iron, dropping it from the table onto their knees. And, of course, all this happened by accident. It is difficult to imagine a situation where people could deliberately cut themselves or get burned. And yet, such people exist. We are not talking about masochists who derive pleasure from pain. We are talking about people for whom such self-harm helps to overcome serious emotional distress. A new study confirms that some people experiencing so-called borderline psychopathy, are really capable of such inappropriate actions.

Emotional distress, unlike ordinary stress, is something that the body cannot quickly cope with using its own resources. People with borderline personality disorder experience extreme emotional distress., and they often simply do not have enough of the body’s own resources to cope with the consequences of stress. It is these people who may demonstrate a desire to cause physical harm to themselves.

"Hurt me!"

Inga Niedtfeld with my colleagues from University of Heidelberg, Germany, studied the effect of an emotional stimulus on people suffering from borderline personality disorder and on healthy people. Scientists conducted an experiment during which researchers showed subjects various images that evoked positive, negative and neutral emotions. Simultaneously with the demonstration of pictures, people were exposed to a so-called thermal stimulus.. In other words, they were hurt by applying hot objects to their skin. At the same time, the researchers took into account the fact that each individual has his own pain threshold; therefore, for each subject, the temperature of the thermal stimulus was different.

In people suffering from borderline personality disorder, increased activity of the so-called limbic system, which is a collection of a number of brain structures that are involved in regulating the functions of internal organs. In addition, it was noted increased activity of amygdala neurons, which is also associated with emotional changes. This was the reaction to visual stimuli. The thermal stimulus prevented the activation of neurons in the cerebellar amygdala. Moreover, this happened in both sick and healthy people - the emotional reaction was drowned out by pain.

"The results of this experiment support the hypothesis that painful stimuli slightly reduce emotional distress in people suffering from borderline personality disorder. They somehow suppress the activity of areas of the brain that are responsible for emotional experiences, explains John Krystal, editor-in-chief of a scientific publication "Biological Psychiatry". – Perhaps this helps sick people compensate for disturbances in the emotional control mechanism.".

The results of this study coincide with previous ones, which also documented emotional overactivity in people with borderline personality disorder. A comparison of the data leads to the conclusion that, Depending on their emotional state, such people react differently to thermal stimuli(their pain threshold increases), the researchers say. In fact, it is not the discovery itself that is important - people have known since time immemorial that emotional shocks make us more immune to pain– and the mechanism of interaction between painful and emotional stimuli.

Pain, caused not only from the outside, by external causes, but also by irritations coming from internal organs during certain diseases, gives rise to both instantaneous, short-term and longer-term functional disorders.

Establishing these reactions and determining their nature to painful stimuli can serve as a diagnostic sign of the disease causing this pain syndrome.

Painful stimulation has a strong effect on the higher nervous system and behavior of the animal. In the laboratory of I.P. Pavlov, in the process of experimentation, repeatedly observed a drop and sometimes a complete disappearance of conditioned reflexes in cases where the animal exhibited pronounced pain irritation.

The inhibition of conditioned reflexes under the influence of painful stimulation was later confirmed.

The excitability of the central nervous system decreases under the influence of painful stimuli. Painful stimuli have a noticeable effect on the activity of the sense organs. It was noted that even short-term painful stimulation increases the sensitivity of the tempo adaptation of the eye (S.M. Dionesov).

The reaction to painful stimulation has three forms (I.I. Rusetsky): a reaction to pain of low intensity - tachycardia, lability of the processes of expansion and narrowing of the lumen of blood vessels, shallow breathing; reaction to pain of moderate intensity - pronounced sympathetic arousal; reaction to severe pain - (shock type) with phenomena of inhibition of the centers of the autonomic nervous system. Vakhromeev and Sokolova, based on their experiments, came to the conclusion that painful stimulation excites both the sympathetic and parasympathetic nervous systems, and in each specific case the effect appears according to the more mobile department at the moment.

Pain causes a wide variety of changes in the body. Extremely active chemicals accumulate in the blood and tissue fluid, which are carried through the bloodstream throughout the body and act both directly and reflexively on the carotid sinocarotid zone. Chemical substances that accumulate during painful irritation in the nerve endings of the skin and in the cells of the central nervous system pass into the blood, tissue fluid and endocrine glands, stimulating or inhibiting them. The adrenal glands, cerebral appendage, thyroid and pancreas react first.

Painful stimulation has a noticeable effect on the activity of the circulatory system. At one time, in order to determine whether pain was being simulated, it was proposed to use pulse counting. However, painful stimulation does not always accelerate the activity of the heart; severe pain depresses her.

Pain in general and pain in the heart area in particular affects the cardiovascular system, causing an acceleration or slowdown of the pulse, up to complete cardiac arrest; weak pain leads to an increase in rhythm, and strong pain leads to a slowdown. At the same time, blood pressure changes both upward and downward.

With a certain strength and frequency of stimulation of afferent nerves, venous and spinal pressure increases.

According to Tinel, painful stimulation usually causes a vasodilator effect on the extremity exposed to irritation, and a vasoconstrictor effect on the opposite one. Special experiments have shown a decrease in blood circulation in some internal organs under the influence of pain. Changes in the cardiovascular system are explained by complex and numerous reflexes occurring at various levels and in various parts of the peripheral and central nervous system. Therefore, it is clear that painful irritation not only causes disorders in the cardiovascular system, but also affects the functions of many organs and systems, including metabolism. Thus, the onset of painful stimulation is well known. hyperkinetic reaction, expressed in convulsive contraction of individual chest muscles. One of the effects of painful stimulation is mydriasis. It was noted that the degree of pupil dilation increases as pain stimulation intensifies.

Numerous studies have also shown that under the influence of pain, the secretory function is inhibited and the motor function of the digestive organs is disrupted (often enhanced); Sweating is also disrupted, skin resistance to galvanic current changes, water and fat metabolism is disrupted, hyperglycemia appears,:

Painful stimulation, according to Cannon, mobilizes sugar from the carbohydrate depot - the liver. In this case, the increased secretion of adrenaline is of great importance for the occurrence of hyperglycemia.

Emotions arise under the influence of external influences or processes occurring in the body itself. Factors causing the emotional process can be divided into three classes:

1) factors that can cause emotion due to the body’s innate sensitivity to them; we will call them natural (unconditioned) emotional stimuli;

2) factors that have acquired the ability to evoke emotion due to the fact that they have become signals of important events for the subject;

3) factors that have acquired the ability to cause emotion due to the fact that they correspond to or contradict cognitive structures acquired through experience; these factors were called “collateral variables” by Berlyne (1967, p. 19).

Let's consider these factors.

Natural (unconditioned) emotional stimuli

A natural stimulant of emotions is any physical impact on the body that causes stimulation of receptors and certain changes in the biological balance of the body (homeostatic changes). Apparently, emotional processes can also be caused by certain specific configurations of stimuli, including certain situations. However, virtually nothing is known about these factors, at least when it comes to humans, and the assumptions that can be made about this are based on extrapolations from the results of animal studies and very unsystematic observations in humans.

Emotional meaning of sensory stimuli. As is known, human contact with the outside world begins with exposure to sensory stimuli on the receptors. These stimuli provide information about the properties of objects and events and at the same time cause changes of an affective nature. Both the magnitude and sign of these changes depend to a certain extent on the sensory modality, that is, on the type of analyzer with which the signal was received. In some modalities the emotional component is of secondary importance, in others it plays a dominant role. The French psychologist A. Pieron expressed this dependence in a special table, in which he arbitrarily determined cognitive and affective coefficients for certain types of sensory influences (Pieron, 1950). However, the figures given by Pieron are not based on any real measurements and represent only an abbreviated form of description intuitive assessment.

The affective component depends not only on the sensory modality, but also on the type of influence within this modality. Thus, as Titchener noted, achromatic colors (white and black) can rarely be pleasant or unpleasant, just like auditory noises and tones. Chromatic colors usually have a more pronounced affective meaning. As Heinrich writes, “Red, especially when highly saturated, is the color of strength and energy. With weaker intensity, its emotional tone decreases and acquires the character of seriousness and dignity. Purple has this character to an even greater extent, forming a transition to the calm mood of purple and blue. The color violet has features of sullen seriousness” (Heinrich, 1907).

Experimental data can be provided to confirm this kind of observation. Thus, it has been established that the red color causes stronger arousal than the blue color of the same brightness, and this is reflected, in particular, in an increase in systolic blood pressure, a decrease in the conductivity of the skin of the palm, a change in the breathing rhythm, depression of the alpha rhythm in the EEG, as well as in the reports of subjects obtained using a standardized methodology for studying emotions.

When discussing the question of the emotiogenicity of sensory stimuli, it is necessary to particularly focus on vestibular and kinesthetic effects. Kinaesthetic stimuli can have significant emotional overtones. Thus, in studies conducted by Kagan and Berkan, it was found that the opportunity to move can serve as a positive reinforcement for animals; Moreover, the effectiveness of this reinforcement depends on the degree of deprivation caused by keeping animals indoors.

Emotions caused by sensory stimulation can be both positive and negative. The sign of an emotion depends primarily on the quality of the stimuli. P. Young found that people of different ages react in very similar ways to certain odors. Thus, the correlation between ratings of 14 different odors made by subjects of three age groups (7–9 years, 10–13 and 18–24 years) ranged from 0.91 to 0.96, which indicates that the sign of emotions, caused by presented substances does not change significantly with increasing age (Young, 1967). It has also been established that the affective meaning of pure sound tones (that is, the ability to evoke emotions of a certain sign and intensity) depends on their pitch and strength. These dependencies can be expressed graphically. Such curves were presented by Guilford (based on data from Young) and were called “isohedons”; Thus, isohedons are lines representing the properties of stimuli that have identical affective meaning.

The role of stimulus intensity. The intensity of the stimulus is one of the significant factors determining its emotional meaning. Schnirla formulated a general position that determines the nature of the body's reaction. According to this author, “in the early stages of ontogenetic development, low-intensity stimulation tends to evoke approach reactions, and high-intensity stimulation tends to evoke withdrawal reactions from the source of influence” (Schneirla, 1959). To illustrate this thesis, the author gives many examples of the behavior of animals at different levels of phylogenetic development. A similar dependence can be established in humans.

The relationship between the strength of the stimulus and the emotional reaction it evokes was also noted by past psychologists. Wundt believed that a barely noticeable sensation has extremely little sensory coloring; As the intensity of the sensation increases, its positive sensory coloring increases, but, having reached a certain intensity, this positive coloring begins to decrease and, having passed through the zero point, becomes negative.

The curve presented by Wundt corresponds to the accumulated experimental data. As early as 1928, Engel studied the evaluation of sour, salty and bitter solutions of various concentrations and obtained a curve similar to the Wundt curve; in 1960, Pfaffmann obtained similar results while studying taste preferences in rats.

When discussing the intensity of a stimulus, one should also recall the effect of the suddenness of its appearance. Objects that appear unexpectedly and move quickly cause a negative reaction. Schnirla believes that this is precisely what can explain, in particular, the well-known effect described by Tinbergen, which consists in the fact that the same perceptual form can either cause or not cause a strong emotional reaction (flight) in young birds, depending on whether where it is being moved.

This effect can be explained by the fact that the shape of a figure when moving from left to right causes a more significant and faster change in excitation in the retina than when moving from right to left, and this leads to a rapid increase in internal excitation, causing a fear reaction.

The influence of the strength of irritation and the rate of its increase was also observed by E. Franus. In studies of fear reactions in young children, he found that such reactions are easily caused by relatively large, rapidly approaching animals that make loud noises (Franus, 1963).

The Role of Repetition and Internal States

The role of repetition. Changes in the emotional coloring of stimuli under the influence of their repetition have been the subject of many studies. Tolman, one of the first to study this problem, found that rats receiving food at both ends of a T-maze spontaneously changed the direction of their search when repeating trials. So, if the last time they turned left, then in the next trial they turn right, in the next trial they turn left, etc.

In further experiments, an attempt was made to determine whether this tendency to alternation was due to the processes that are responsible for the reception of stimuli, or to the processes that are responsible for the execution of reactions, in other words, whether it is due to “bored stimulation” or “boring actions.” The data obtained indicate the dominant influence of processes occurring in the sphere of perception. Experiments on rats showed that when stimuli change, animals do not tend to change their response (Glanzer, 1953).

The phenomenon of alternation is also inherent in people. Wingfield showed this with a very simple experiment. He asked subjects (students) to repeatedly light one of two light bulbs in front of them (without indicating which one). Under such conditions, the subjects lit alternately one or the other light bulb. If the bulbs were different colors, the tendency to alternate was more pronounced. Carsten investigated the phenomenon of satiation by asking subjects, for example, to draw lines for as long as they could. As repetitions progressed, signs appeared indicating resistance to further work, and the tendency to modify the shape of the lines increased (introducing variability in the stimuli). This tendency noticeably decreased when the principle of line grouping changed (the stimulus changed). All these data suggest that repetition of stimuli leads not only to an increase in the threshold of sensitivity (adaptation), but also to a change (decrease) in the attractiveness of the stimulus.

Repeating sensory stimuli does not always lead to such consequences. When the subject is still learning to perceive this kind of stimuli, repetition over a period of time leads to an increase in their attractiveness. This can explain the great attractiveness that simple sensory stimuli have for young children and which, as is known, decreases with age. It is likely that the emotional significance of negative stimuli also changes to some extent: under the influence of repetition, it also decreases.

Repetition may not affect the attractiveness of stimuli if they are separated by more or less significant intervals. Thus, the alternation effect was not observed in experimental animals if the trials in the experiment did not immediately follow each other. People who have been isolated for a long time (in a quiet chamber) experience an increase in sensitivity to color - it seems more saturated. This indicates a weakening of the satiety effect that occurs in people under normal conditions (many people remember that in childhood, colors seemed more vibrant and attractive to them).

Repeated repetition of the same stimuli over several days makes him emotionally neutral. This is indirectly evidenced by experiments conducted by Soltysik and his colleagues, in which the effect of a simple sound stimulus on cardiac activity in dogs was studied. Changes in cardiac activity can be considered as an autonomic component of an emotional reaction. These experiments showed that as the auditory stimulus is repeated, a systematic decrease in heart rate occurs - a cumulation of the extinction effect is observed (Soltysik et al., 1961). In adults, the emotional reaction to simple sounds is completely extinguished and therefore does not cause changes in the activity of the heart.

The described dependence explains, in particular, why a stimulus that is attractive to a small child is not attractive to an adult (for example, a brightly colored object, the sound of objects thrown on the floor, etc.). However, an adult can also be captivated by unusual color phenomena if they are observed rarely or for the first time (such as the aurora).

A change in the emotional significance of sensory stimuli can be not only temporary, but – under the influence of experience – even longer lasting. When first applied, sensory stimuli cause a nonspecific response throughout the body in the form of increased activation (arousal), the degree of which depends on the intensity of the stimuli. Under the influence of repetition, anticipatory schemes, “expectations, neural models of experienced events” are formed in the body (Pribram, 1967, p. 831). These models, which provide the possibility of a differentiated reflection of surrounding phenomena, represent standards with which incoming influences are “compared.” Actual stimuli evoke an emotional response until their representation in neural models becomes sufficiently strong. If incoming irritations fully correspond to internal standards - anticipatory schemes, or, as we will call them, attitudes - addiction occurs and, as a consequence, suppression of the emotional reaction. If the properties of the stimuli change, an emotional reaction occurs again. New properties, in turn, are included in the structure of the circuits, and after a number of repetitions, the new stimulus again loses its ability to evoke emotion.

As a result of this kind of process, a gradual depression of emotional sensitivity to most simple sensory stimuli occurs. To cause a response, these stimuli must either have unusual properties or appear in new configurations. These configurations, in turn, must become increasingly complex, and the differences between their elements increasingly subtle. In this way, in particular, aesthetic taste is formed.

The above analysis suggests that the source of stimulation that influences the emotional state of an individual is the physical environment; The simpler, more familiar, and less differentiated the environment, the less powerful it will be to evoke emotion.

It should be added that some stimuli retain their emotional significance despite repetition; in any case, sensitivity to them disappears much more slowly than to other stimuli; this applies primarily to those irritants that have a direct effect on the physical state of the body: for example, strong thermal effects (burn, cold), mechanical damage to tissue, a number of chemical irritants (some odors). This also applies to those stimuli that in phylogenetic development were associated with phenomena important for the individual or species (some taste stimuli, sexual stimuli).

Sensitivity to these stimuli, as well as to all others, changes depending on the state of the body and, above all, on the state of needs.

The role of internal states. The emotional significance of a stimulus can change under the influence of somatic factors. This is indicated, in particular, by observations of animals; for example, in animals surgically deprived of the adrenal glands, while maintaining the threshold of physiological sensitivity to salt, the threshold for its preference is significantly reduced, in other words, “interest” in salt increases. In experiments conducted by Young, it was found that food preference depends on diet and body needs (Young, 1961).

Pain sensitivity

Considering the above data, we can confidently say that each sensory stimulus has a certain emotional significance. In other words, it causes a state of pleasure or displeasure, changes in the level of activation and in the activity of internal organs; if it is strong enough, it can also cause organized activity in the form of, for example, grabbing, running away, attacking, etc. The emotional significance of the stimulus depends on its intensity, as well as on what receptors it is perceived - irritation of some receptors usually causes positive reactions, others - negative; sharp, sudden, strong irritation of any receptor causes a negative reaction (most often in the form of fear or rage). Moderate impacts usually produce positive emotions. The emotional significance of a sensory stimulus changes under the influence of experience, as well as depending on organic conditions; repetition leads to a decrease in the emotional significance of the stimulus (that is, habituation).

These statements are very general in nature, since they relate to various sensory stimuli, and primarily to those in which the cognitive (informational) component predominates. A more detailed characterization of the emotional features of these stimuli would require a special discussion of individual modalities, which is beyond the scope of this work. However, given the importance of pain as a source of emotions, we will consider here only this modality as an example.

Pain. Painful stimuli are one of the primary sources of the emotional process. Pain occurs when something internal or external causes irritation of specialized nerve fibers, the so-called type C fibers. These fibers are among the thinnest, and nerve impulses travel through them more slowly than through other fibers. This explains the fact that pain usually occurs somewhat later than other sensations.

The process caused by painful stimulation is very complex; Several points can be highlighted in it. First of all, it is known that the reaction to painful stimulation consists of two independent components: cognitive and emotional. The latter manifests itself in the form of the negative emotion of suffering. In some cases, it is possible to separate these components, as evidenced, in particular, by the following observation. There are patients who experience very severe chronic pain that cannot be relieved with medications. In such cases, surgery is sometimes used to relieve pain, which involves cutting the nerve pathways in the front of the brain (called a leucotomy). As a result of such an operation, you can sometimes observe an amazing effect. The person claims that he still knows that he is in pain, but now this knowledge does not bother him and he does not experience any suffering. In other words, the sensory (or cognitive) component of pain is retained, but its emotional component disappears. The cognitive component informs what exactly is damaged (albeit not very clearly), while the emotional component encourages the individual to avoid or eliminate the factor causing the damage.

People who lose sensitivity to pain due to illness are doomed to many injuries. Thus, children suffering from such a disease are constantly wounded or burned, because the loss of pain sensitivity deprives them of sufficient caution.

Different people have different emotional responses to pain. It is possible that this is due to the unequal sensitivity of the receptors.

Sensitivity to pain depends to some extent on the experience of the first days of life. This is evidenced by observations and experiments conducted on animals. Thus, in one experiment, cardboard tubes were placed on the lower and upper limbs of a newborn chimpanzee (named Rob). This excluded any irritation of these parts of the body, but did not interfere with movement. When the sensory responses of this chimpanzee were examined at the age of two and a half years, it turned out that they differed from the reactions of chimpanzees raised under normal conditions. In particular, amazing changes have occurred in the area of ​​pain sensitivity. While an ordinary chimpanzee reacted violently to a pin prick and immediately tried to remove the piercing object, Rob did not show a negative reaction, but rather tried to examine the instrument of influence.

The same thing was observed in dogs that, after birth, were kept in complete isolation for some time (in a small darkened and sound-proof cage). As adults, these dogs showed unusual reactions to painful stimuli. Thus, a burn or a pin prick made no impression on them; When they saw a lighted match, they approached and sniffed it. They repeated these actions repeatedly. It should be emphasized that a normal dog that has never seen fire behaves in this way only once and then begins to avoid it (Hebb, 1955, 1958).

Observations of this kind show that the reaction to pain, in addition to the moment of negative emotion or suffering, contains another moment associated with it - the element of fear acquired in experience. The individual often finds himself in a situation in which a little pain is a precursor to more severe pain. Mild pain as a result of damage can subsequently become significant due to a tumor, pain in the abdominal area can develop into a severe pain attack, etc. Such experience leads to the fact that most people perceive pain not only as an actual irritation, but also as a signal of something even worse, as an indicator whose emotional component is added to the purely pain factor.

It has been found that the reaction to pain can be significantly weakened if the fear factor is eliminated. This is, in particular, what prenatal psychotherapy is aimed at. As evidenced by reports from clinics in different countries, such psychotherapy significantly reduces the intensity of pain in women in labor.

With appropriate treatment, the pain response can be reduced or even eliminated. This procedure consists of turning a painful stimulus into a signal that foretells something useful for the body. This was first established in experiments conducted by M. N. Erofeeva in the laboratory of I. P. Pavlov.

The dog, placed in a special rack, received irritation with an electric current, which initially caused a violent defensive reaction. Each stimulus was followed by food reinforcement. Repeated repetition of this combination of stimuli gradually turned the painful effect into a signal for receiving food. As a result of this, signs of a defensive reaction in the dog began to disappear; irritation from the current began to cause a food reaction (secretion of saliva, turning the head in the direction from which the food was supplied, etc.). Ultimately, even a strong electric current, which led to damage to the skin of the animal, did not cause a pain reaction, but only caused signs of interest in food. However, very severe pain caused by direct irritation of the nerve endings located in the periosteum eliminates the possibility of such a restructuring of reactions, remaining a strong negative irritant.

Changes in pain responses have not only been observed in animal experiments. It has been found, for example, that with the help of appropriate training it is possible to reduce the reaction to pain from an injection in preschool children; You can even get the child to willingly agree to the injection. The researchers who obtained this result used a method similar to that used by M. N. Erofeeva in Pavlov’s laboratory. The experience was as follows. First of all, the children were told that they would receive the toy they were interested in if they agreed to the injection. At the same time, the researchers tried to ensure that the promised object was really very attractive to the child and, in addition, that the desire to receive the toy arose before the fear of the injection. Thus, the child’s attention was concentrated on the pleasant event awaiting him. Under these conditions, the injection was perceived as a stage of approaching pleasure and received a completely different meaning: it became a signal of something positive and thereby acquired the character of a positive impact.

Thus, although pain usually causes negative emotional processes, under the influence of life experience the features of these processes can undergo significant transformations.

Irritations that are generated by processes occurring in the body itself also have a strong emotional effect. These irritations are caused by 1) natural fluctuations in biological balance caused by the life process itself, 2) the activity of internal organs and muscles, 3) pathological changes occurring in the body, and 4) functional changes associated with the introduction of certain substances into the body. Let's look at each of these factors separately.

Factors that cause a strong emotional reaction. Changes in homeostatic balance

Changes in homeostatic balance. Fluctuations in biological equilibrium are the source of states traditionally called drives. Their mention when discussing emotions is due to two reasons: firstly, in higher animals homeostatic changes acquire the character of incentives (that is, they determine the direction of actions) only at later stages of development (under the influence of experience and exercise), whereas at earlier stages they have almost exclusively emotional in nature; secondly, each impulse contains a distinct emotional component, which at certain stages of the action of the impulse (for example, at the stage of satisfaction) acquires a dominant meaning.

The main sources of emotions include changes in homeostatic balance associated with:

• with a deficiency of certain nutrients, which is signaled by chemical changes in the blood and stomach contractions, although the latter component is not necessary;
• with changes in osmotic pressure in tissues, which creates a condition called "thirst";
• with a change in the partial pressure of oxygen and carbon dioxide content in the blood, expressed in a feeling of suffocation;
• with the course of the menstrual cycle and the process of secretion of sex hormones, leading to changes in sexual arousal;
• with a state of fullness of the intestines or bladder, perceived as an urge to defecate or urinate, or vague abdominal pain.

Emotions associated with these factors in the initial period of life are of a non-specific nature; they are not represented in the subject’s consciousness (which is still in the embryonic stage of development) and do not yet cause almost any specific changes in behavior. The main effect of any arousal during this period comes down to a general increase in activation with a negative sign (undifferentiated displeasure). As learning occurs, certain types of excitation are associated with certain patterns of action, which leads to their separation into a separate mechanism of motivation. Thus, from the vague experience of anxiety and excitement, more and more specific feelings of hunger and thirst gradually emerge. In a later period, sexual emotion is highlighted and detailed.

Homeostatic changes usually occur cyclically: detection of deficiency - achievement of satisfaction. The first link of this cycle usually causes negative emotions and an increase in activation (and later also a specific state of motivation), while the second – a decrease in activation and positive emotions.

The action of internal stimuli associated with homeostatic changes causes a state of readiness, which is expressed in an increase in general emotional sensitivity. If there are no objects in the environment with the help of which it would be possible to eliminate the disturbance of homeostatic equilibrium (satisfy the impulse), as well as signals indicating exactly where to look for such objects, a specialized impulse reaction does not arise. In this case, there is a significant increase in activation - a general excitation or state of tension occurs; such states are usually described as “vague desire”, “inexplicable melancholy” or “strange restlessness”, etc. In these cases, the tendency to negative reactions increases: irritability, nervousness, tension, etc.

Some impulses (for example, hunger or sex) contribute to the emergence of strong emotions of an aggressive nature. From observations of animals it is known that male sex hormones contribute to the appearance of aggressive reactions. The effect of hunger on the occurrence of negative emotions may be due to the fact that biochemical changes in the blood cause disruption of the normal activity of cellular ensembles, thereby contributing to the disorganization of cortical processes, which can cause negative emotions. It is quite possible that this influence is associated with the action of not only biochemical, but also nervous factors - strong stimulation of food centers can cause changes in the nonspecific (reticular) activating system, which in turn leads to disruption of the activity of the cortex.

The emotional changes caused by a lack of food were the subject of special study in a well-known experiment with a group of volunteer subjects who fasted for several months. They experienced, in particular, depression, irritability, and loss of sexual interests. And in everyday life, a hungry person often shows increased aggressiveness and a tendency to anger; Sexual deprivation may also be a reason for increased aggressive tendencies.

Some motivations are cyclical. Thus, hunger manifests itself with some regularity. In this regard, distinct cyclical mood changes may occur, which is especially noticeable in children.

According to some data, the strength of sexual urge in women is also cyclical, and this appears to be related to the menstrual cycle. However, this opinion is not shared by all researchers. Some of them believe that fluctuations in sexual excitability are associated not so much with fluctuations of a biological nature, but with fluctuations in fear of a possible pregnancy, depending on the phases of the monthly cycle. However, it is undeniable that more general changes in mood and activation levels occur depending on the monthly cycle.

Muscle and nervous activity. As is known, nervous activity leads to increased fatigue: this condition is characterized by both changes in the activity of internal organs and a number of mental changes, for example, weakening of interests (motivation), increased irritability, etc.

The occurrence of emotions is also associated with muscle activity. Doing hard, backbreaking work is a source of strong negative emotions, while doing work that matches the body's capabilities causes positive feelings. Every significant effort requires a harmonious coordination of the various functions of the body: blood circulation, breathing, the secretion of certain substances, the metabolic rate must be adapted to the actions performed. If the corresponding systems function normally, a person has a feeling of strength, vigor, cheerfulness, otherwise there is poor health, depressed mood, dissatisfaction, etc.

This relationship explains the often observed differences in the mood of young and old people. A young healthy body in itself is a source of causeless joy, a surge of strength, etc., while dysfunction of an aging body can be the cause of dissatisfaction, bad mood, grumpiness, etc.

Factors that cause a strong emotional reaction. Pathological changes and action of pharmacological agents

Pathological changes. Pathological processes occurring in the body usually cause a deterioration in mood (due to a general disruption of the normal functions of the body), as well as a feeling of pain (when they are sufficiently localized). Deterioration in mood is one of the first signs of an onset of illness. In such cases, there is an increase in irritability, poor health, anxiety, and loss of interests. Sometimes an emotion acts as a specific sign of the disease that it accompanies. These diseases include heart disease and coronary artery disease. One of the typical manifestations of angina pectoris is paroxysmal anxiety. It seems to the patient that something terrible will happen soon; he experiences insurmountable fear. Anxiety sometimes reaches very strong levels. There is an opinion that impulses that excite fear centers are caused by insufficient oxygen supply to the heart muscle. This opinion, however, is not shared by everyone. In any case, very often the appearance of strong causeless anxiety (sometimes occurring in a dream) may indicate the onset of heart disease.

Anxiety is also one of the most characteristic signs of an overactive thyroid gland.

However, pathological processes cause not only negative emotions. Thus, for unknown reasons, during oxygen starvation, an elevated mood occurs immediately before loss of consciousness. This poses a serious danger, in particular for climbers and pilots, since good health and lack of anxiety do not at all contribute to the adoption of appropriate preventive measures.

Another example is the euphoric mood in patients suffering from organic brain damage. As Bilikevich writes: “Bolno is not preoccupied with anything, his thoughts are serene; he is satisfied and happy” (Bilikiewicz, 1960). These phenomena are observed in such serious diseases as progressive paralysis, epilepsy, chorea, and multiple sclerosis.

Action of pharmacological agents. Emotional processes can also arise under the influence of the introduction of certain substances into the body. In medical practice, for example, the so-called LSD-25 was used, a drug that causes symptoms of a psychotic nature in healthy people. In experiments it was found that under its influence numerous changes of an emotional nature can appear.

Some people develop euphoria, uncontrollable laughter, etc. This mood may later develop into a state of severe anxiety. It is not entirely clear, however, whether these reactions are a direct consequence of the use of a pharmacological agent; the fact is that LSD also causes significant changes in perceptual processes (hallucinatory type). These perceptual experiences can influence the experience of emotions. However, the strength and nature of the course of emotional reactions in these cases indicate that this remedy apparently also leads to direct stimulation of the centers of emotions.

The introduction of substances into the body that cause emotional processes (and not only for research purposes) is not a modern invention. Thus, in the early Middle Ages, some northern tribes had a custom called “walking with naked skin” (that is, without a shell - Berserk). This expression meant great, reckless courage, a fierce battle with the enemy. The ancient Norwegian sagas tell that there once lived giants who were called Berserkers. These people from time to time fell into a terrible frenzy, which doubled their strength, made them insensitive to pain, but deprived them of their reason: at such moments they behaved like wild animals. This state began with trembling, baring of teeth, convulsions, a rush of blood to the face and turned into rage. With a terrible bestial roar, they pounced on the enemy, gnawing and destroying everything that came in their way.

The behavior described is reminiscent of the behavior of animals in which the rage center in the diencephalon is irritated in experiments. Apparently, this behavior of people was caused by the action of some substance of plant origin. Many historical studies of customs, religious rites, etc. indicate that such a remedy was most likely mushrooms from the fly agaric genus. It is also known that among the Siberian peoples the custom of intoxication with the help of such mushrooms is widespread.

Influencing emotions by introducing certain substances is widely used in our time, with the only difference being that instead of poisonous mushrooms, drugs, and most often alcohol, are used.

General characteristics of natural emotional stimuli. Natural emotional stimuli are of great importance in the initial period of an individual’s life. On their basis, primary regulatory mechanisms, primary motivations and so-called emotional needs are formed. The formation of impulses occurs due to the fact that the excitation that arises as a result of a violation of the biological balance in the body is associated with images of objects with the help of which this excitation can be weakened, a program of actions that ensure the achievement of these objects, as well as with the image of the conditions that are necessary for the implementation these actions. Thanks to this, the isolation of functional units - motives - occurs. So, for example, the urge to hunger can be considered as a connection formed in ontogenesis between excitations coming from internal organs (primarily under the influence of stomach contractions and changes in the chemical composition of the blood), images of food, learned motor patterns for achieving food, as well as a whole system of associations relating to information about where and when food can be found, what signals its presence and what signals its absence. The basis for the qualitative differences between incentives is the differences in the operations through which they can be reduced.

The formation of emotional needs is associated with the action of exteroceptive emotiogenic stimuli. The latter cause states of strong arousal, positive or negative, which the individual learns to avoid or achieve. For example, painful or other harmful effects lead to the establishment of a connection between fear and certain factors that can cause or eliminate this fear (or pain). Emotionally positive influences, such as something warm and soft, are, as Harlow’s experiments show, a very important prerequisite for motivation that encourages establishing contacts with other individuals. It is quite possible that any type of sensory influence entails emotional reactions that influence the formation of more complex regulatory mechanisms. However, we currently have very little information about these mechanisms.

It is not entirely clear whether relatively simple sensory stimuli alone are unconditional emotiogenic factors, or whether they can also be certain configurations of stimuli. The possibility that certain configurations of stimuli may have the ability to arouse emotions is evidenced, for example, by experiments in which young chimpanzees, raised from birth in isolation from other individuals, were exposed to various stimulations. It turned out that a slide depicting the face of an angry male chimpanzee caused a fear reaction in the animals. It is possible that other configurations of sensory stimuli are capable of evoking emotions just as naturally. It is necessary, for example, to take into account the fact that such a complex system of stimuli, such as signals about the position of an individual in a group, can have an emotional impact. Reactions to this kind of situational factors are observed in higher herd animals (for example, dogs, monkeys), and it is possible that in some form they also appear in humans. Of course, this applies only to the most elementary relationships, such as “dominance - submission,” which are signaled by certain facial configurations and expressive movements.

Transformation of neutral stimuli into emotiogenic ones

Neutral stimuli can turn into emotiogenic ones if they acquire the function of signaling events that are important for the subject. This occurs as a result of the formation of conditioned emotional reflexes, as a result of generalization, as well as as a result of higher mental processes, thanks to which a person evaluates the meaning of situations. Before considering each of these processes in more detail, it should be emphasized that when using the concept of “neutral stimulus”, one can mean three types of phenomena.

Firstly, every sensory stimulus in which, due to repetition, the ability to evoke emotion has disappeared or is extremely weakened will be neutral.

Secondly, a neutral stimulus can be any configuration of sensory stimuli determined by objects and situation.

Third, sensory stimuli or their configurations may be neutral only with respect to one specific emotional process. In other words, a factor capable of causing a certain emotion (for example, food) can be completely neutral in relation to the emotion of fear and only as a result of the corresponding process acquire the ability to also cause this emotion.

Conditioning emotions (learning). Tadeusz Zakrzewski in his book cites the case of a pilot who, while flying a combat mission in a bomber during the Second World War, was shot down over the English Channel. He managed to escape and return to his unit, but from that moment on, every time he flew across the strait, he experienced severe anxiety, accompanied by pronounced somatic manifestations (sweating, trembling). After he crossed the strait, these manifestations disappeared (Zakrzewski, 1967, p. 49).

It is obvious that the basis of such phenomena is the process of formation of conditioned reflexes (learning).

The importance of this process for the emergence of emotional reactions was first identified about fifty years ago in an experiment conducted by Watson that has become a classic. The study was conducted on an eleven-month-old boy named Albert. The basis of the study was the observation that fear reactions in children can be easily evoked using a strong sound. The experiment proceeded as follows.

The boy was shown a white rat, with which he played repeatedly. As he reached out to pick up the rat, the experimenter struck a gong located behind the boy. There was a loud sound, the child shuddered and screamed in fright. Soon he received the cubes, calmed down and began to play. They showed him the rat again. This time the child’s reaction followed with some delay; he no longer reached out his hand so quickly and impatiently and only carefully touched the animal. At this moment, the gong rang again, which again caused a strong reaction of fear. After a few minutes, the child calmed down and started working on the blocks again. When the rat was brought in for the third time, the child's reaction was completely different. He showed every sign of fear at the mere sight of this animal. There was no longer any need to hit the gong. The child turned away from the rat and began to cry.

When Albert was shown the white rat again a month later, the fear response had not changed. There is reason to believe that it has become sustainable. As the author believes, it could have been preserved even until the end of life. Moreover, it was noticed that this reaction did not only occur at the sight of a white rat. And other, at least somewhat similar objects, such as a dog, cat, rabbit, guinea pig, fur coat and even a Santa Claus mask, caused a reaction of fear.

This experiment observes two very important processes that explain why people begin to react emotionally to initially neutral objects.

The first process is the formation of conditioned emotional reactions: neutral stimuli that precede or accompany the appearance of emotiogenic stimuli themselves acquire the ability to evoke emotions.

It cannot be said that in the experiment described (as in the Jones experiment discussed below), the neutral stimulus acquired conditional significance, since the stimuli used already had some emotional significance. In this case, the process of so-called alteration of the stimulus took place, which, as research from Konorsky’s school shows, proceeds somewhat differently than the conditioning of a truly neutral stimulus.

The second process is the generalization of emotional stimuli: indifferent stimuli, similar to stimuli that cause emotions, also acquire the ability to cause emotions.

Research on the formation of conditioned emotional reactions is carried out not only for scientific, but also for therapeutic purposes. Thus, this process is widely used as a psychotherapeutic tool.

One of these psychotherapeutic procedures is to develop a conditioned disgust reaction. For example, a patient for whom handbags and baby strollers were sexual fetishes (which put him in constant conflict with the law) was shown these objects and photographs of them just before he began violently vomiting from a previous injection of apomorphine. The author of this method, Raymond, ensured that these objects acquired the ability to evoke a strong feeling of disgust (Bandura, 1961). A similar procedure is used in the treatment of alcoholism.

Attempts have also been made to give positive emotional meaning to negative stimuli. One of the first such attempts is M. Jones's experiment, conceived as a continuation of Watson's experiment and conducted under his leadership, Jones tried to eliminate the strong fear that arose in the child she studied at the sight of a rabbit (Jones, 1924).

The procedure for developing a positive conditioned reflex in this case consisted in the fact that the stimulus that caused fear (rabbit) was shown and gradually brought closer in situations when the child experienced positive emotions, namely at the time of playing with other children who were not afraid of the rabbit, and later when getting your favorite treats. As a result of using this procedure, tolerance towards the rabbit gradually increased, which was subsequently replaced by a positive reaction.

It should be emphasized that imitation played a significant role in this experiment. Faces that have emotional value for other people cause a tendency to imitate (Bandura, Huston, 1961) and thereby contribute to the formation of new emotional relationships.

In the experiments of Peters and Jenkins, the procedure of positive reinforcement was used in relation to patients suffering from chronic schizophrenia. Given the limited possibility of social influence on such patients, a procedure based on primary reinforcement was applied to them (Bandura, 1961, p. 149). Patients in whom acute hunger was aroused through subcomatose injections performed various tasks, receiving food as a reward. After some time, the behavior of the experimenter directed towards them acquired reinforcing significance for the patients. Thus, through food reinforcement, certain actions of other people acquired positive emotional significance.

These and many other experiments (conducted mainly on animals) show that, due to the formation of conditioned reactions, initially neutral stimuli can become “attractive” (positive) and “repulsive” (negative). The main condition for emotional learning is the connection in time between the neutral stimulus and the reinforcing agent that causes the emotion.

Is this a sufficient condition? Some authors consider this doubtful. For example, Valentine failed to obtain the result described by Watson when he used binoculars instead of a rat as a neutral stimulus. At the moment when a strong whistle was heard, the girl he was studying did not react with fear, but only began to look in the direction from which the sound came. But after that she did not become afraid of binoculars. However, she discovered completely different behavior in relation to the caterpillar. When the girl saw her, she turned away and refused to touch her. When a strong whistle sounded while looking at the caterpillar, the child became frightened and cried loudly (Valentine, 1956, pp. 132–133).

Referring to other similar studies, Valentine expresses the opinion that as a result of the formation of a conditioned connection, only a stimulus that, from the very beginning, is capable of causing a certain degree of emotional arousal can become emotiogenic. A completely neutral stimulus cannot become a conditioned emotional stimulus.

We cannot completely agree with this opinion. First of all, the empirical argument to which Valentine refers is not entirely clear. As follows from its description, the reinforcing stimulus used (whistle) did not cause a pronounced fear reaction, that is, it did not actually perform the function of reinforcement. It is therefore not surprising that fear of binoculars could not be developed under these conditions. On the other hand, the caterpillar, for reasons that will be discussed later, immediately evoked a negative (albeit not very strong) emotional reaction.

However, the data Valentine cites is worth noting because it points to two important facts.

The first is the fact of facilitating the emotional reaction. Some stimuli, for one reason or another, become emotiogenic faster than others: a caterpillar caused fear more easily than binoculars. Conversely, some stimuli have difficulty becoming conditioned. Thus, in Jones’s experiment, the rabbit very slowly acquired the characteristics of a positive emotional stimulus; Apparently, the initial emotional reaction (fear) prevented the development of a new one. This suggests that stimuli that already have some emotional significance more easily acquire the characteristics of an emotiogenic stimulus if they are reinforced by a related emotion.

Secondly, the phenomenon of summation of emotions deserves attention. In the described case, the caterpillar and the whistle, when exposed simultaneously, caused an emotional reaction that each of these stimuli separately could not cause.

Conditioned emotional reactions have a number of characteristics that distinguish them from other conditioned reactions.

One difference concerns the effects of reinforcement. As Maurer points out, punishment has different effects on motor and emotional responses. If the punished movement shows a tendency to inhibition, then punishing the fear reaction only strengthens it (Mowrer, 1960, pp. 416–419). Thus, punishment may act as a reinforcer of emotional reactions.

However, Maurer's statement only applies to negative reactions. Positive emotional reactions obey the laws inherent in motor reactions: they are developed and consolidated under the influence of reward and disappear under the influence of punishment.

The second difference concerns the way emotional reactions arise. If new motor reactions (skills) are developed when they serve certain goals, that is, lead to obtaining a reward or avoiding punishment, new emotional reactions arise as a result of a mere coincidence in time - when a neutral stimulus precedes an emotional one or acts simultaneously with it (there same).

Another feature of emotional reactions is their resistance to extinction. Even with a small number of combinations they can be very stable. These data were obtained, in particular, in studies in which motor and autonomic reactions to a conditioned stimulus were simultaneously recorded (vegetative reactions can be considered as an indicator of emotion). Thus, a group of Polish researchers found that in the process of extinction of a motor conditioned reaction to a sound, movement disappears much earlier than the heart reaction. Autonomic reactions associated with emotional processes develop faster and fade away more slowly.

Emotional reactions are also difficult to differentiate. Therefore, they are rarely responses to any specific stimulus that portends something useful or harmful; on the contrary, they are often caused by a whole complex of stimuli that do not benefit the individual and do not threaten him in any way. This explains the peculiar irrationality of emotions that can sometimes be observed in everyday life.

The irrationality of emotions is also associated with the phenomenon of generalization. As a result of generalization, the individual reacts emotionally to objects and situations that have never brought him anything good or bad, but which are in some way similar to what some of his emotional experiences have already been associated with in the past.

Generalization of emotions

The scope of the emotional reaction depends on how broad the generalization was. From the research of Pavlov's school it is known that in the initial stages of acquiring experience, generalization has a very wide range - in the first phase of the development of a conditioned reflex, many phenomena, even faintly resembling a conditioned stimulus, are capable of causing a conditioned reaction. Pavlov called this phenomenon “primary generalization.” Later, under the influence of new experience, the limits of generalization narrow.

Something similar is observed when studying the process of generalization of emotions. Thus, in the experiments of Watson and Jones mentioned above, after children developed emotional reactions to certain animals (rat and rabbit), the same reactions began to be caused by many other objects that were somewhat reminiscent of the original object of the reaction: other animals, soft, fur objects, etc.

Generalization extends not only to similar objects, but also to those objects that appeared simultaneously with the source of the emotion. In other words, emotions are associated with the entire situation as a whole.

The ease of formation of “conditioned emotional reflexes”, the obvious tendency of emotions to establish connections with different elements of the situation, as well as the difficulties in developing differentiated reactions explain the fact that emotional reactions in humans are extremely vague, “diffuse” in nature. Emotions “color” any situation in which a person finds himself. Due to the similarity of situations, their emotional significance is “mixed”, partially changing, as a result of which new, special forms of emotions arise. Any new situation already has a certain emotional “tone” for a person, depending on what emotions he experienced in similar conditions.

At the initial stages of human development, the generalization of emotional reactions occurs on the basis of the physical similarity of stimuli and their proximity in time. Later, as development progresses, a new basis for generalization arises—semantic similarity.

The idea that generalization occurs on the basis of semantic similarity has long been expressed, though using different terminology, by psychoanalytic researchers. They argued that the emotional attitude towards a certain object is transferred to other objects of similar meaning. One of Freud's fundamental theses, the “primary choice of object” proposition, is based on this kind of premise.

According to Freud, objects or persons who first satisfied the child’s libidinal drive in childhood become, as it were, models to which an adult later focuses. So, a mother, for example, becomes the standard of a desirable woman. Freud did not mean physical properties; he rather emphasized the similarity of influences and relationships, that is, the similarity in content. Therefore, an adult is looking for in a woman not so much the color of his mother’s eyes or hair, but rather a certain attitude towards himself.

Regardless of whether this statement is true or not (and it undoubtedly needs many qualifications), it is indisputable that the generalization of emotions can occur not only on the basis of physical similarity. An illustration of this can be seen in the experiment conducted by Lacey, Smith, and Green (1964). The experimental procedure in which the subjects were students was as follows.

The subject sat comfortably in a chair. An electrode was attached to his left hand, in the place where the nerve passes close to the surface of the body, with the help of which the subject could be given a small electrical stimulation, causing, in addition to burning and pinching sensations, a sharp involuntary spasm of the forearm muscle. The subject, who was informed that the peculiarities of coordination of intellectual and motor activity were being studied, performed the following task: in response to each word given through the loudspeaker, he had to find and pronounce out loud as many words as possible (chain of associations). At the same time, he had to press the telegraph key at the most regular pace. After the stop signal, he had to stop both activities and wait until the next word was presented. From time to time, immediately after completing the chain of associations, the subject received an electric shock. The experimenter (unbeknownst to the subject) used a word list in which two words: “paper” and “cow” were repeated six times. One group of subjects received an electric shock each time after completing associations with the word “paper”, the other - with the word “cow”. Two autonomic reactions were simultaneously recorded: dilation of the blood vessels in the fingers and galvanic skin response.

What are the results of this experiment? First of all, it was discovered that individuals who received an electric shock after a chain of associations to the word “paper” soon began to develop a galvanic skin response to this word. This reaction to the word “cow” was absent in this group of subjects. The opposite effect was found in those who received an electric shock after associating the word “cow”: they had no reaction to the word “paper” and a clear reaction to the word “cow”.

Those for whom the significant word was “cow” had an emotional reaction to 8 other words, which were united by the fact that their meanings were in one way or another connected with the village (“plow”, “bread”, “chicken”, “rake” , “sheep”, tractor”, “peasant”). It should be emphasized that these words do not sound similar to the word “cow” (in the English language in which the study was conducted). It was also found that 22 out of 31 subjects could not indicate when they received an electric shock or when they experienced signs of anxiety. In other words, the reaction was unconscious. The subject did not know what he was afraid of; True, he knew that he was afraid of electric shock, but he did not know that fear arose in him when presented with certain words, including those that were not a signal for him to receive an electric shock.

Similar data were also obtained in many other experiments.

The question arises: what determines the breadth of generalization, in other words, what will and will not cause an emotional reaction?

One of the most important factors determining the limits of generalization is the strength of the stimulus used: the greater it is, the stronger the generalization. Thus, it has been established that when a stronger electric shock is used, wider generalization occurs than when a weaker one is used.

The limits of generalization also depend on susceptibility to a certain kind of emotional stimuli. Such susceptibility is determined by various factors, among which one of the main ones is spatial or temporal distance from an event that is significant for the subject. The dependence in question can be illustrated by the research of Epstein (Epstein, 1962). This author studied a group of 16 skydivers who were compared with a control group of 16 non-skydivers. With parachutists, the experiment was carried out two weeks before the jumps (or two weeks after them), as well as on the day of the jumps. The control group was studied according to the same scheme - twice with a two-week interval between tests. Both groups were given an association test containing words that caused anxiety, as well as words whose meaning was more or less related to the jumping situation. During the experiment, galvanic skin response was recorded. Words that caused anxiety were, for example, the following words: “dead”, “wounded”, “fear”, etc. As an example of four degrees of proximity of the meanings of words to the jumping situation, let us name the following: “music” (I), “sky” (II), “fall” (III), “parachute line” (IV).

It turned out that among paratroopers, the emotional reaction, measured in units of skin conductance (microsiemens), was greater, the closer the connection of the test word with the situation of parachute jumps. The situation was different with subjects in the control group. They reacted emotionally to words that caused anxiety, but words associated with the jumping situation did not cause an emotional reaction in them.

It should be emphasized that on the day of the jumps, the anxiety of the parachutists increased significantly. Words that did not cause anxiety when the day of the jumps were still far away, caused it on the day of the jumps. The average reaction value (in microsiemens) was as follows:

*) The average results of both studies are shown.

This study suggests that a person in an emotiogenic situation exhibits increased sensitivity to emotional stimuli. This is reflected in the fact that even those stimuli whose meaning has a very remote resemblance to the emotiogenic factor begin to evoke an emotional reaction.

This basically banal fact allows us to come to very important conclusions. In particular, it indicates that the occurrence of strong reactions to weak emotional stimuli can be considered as a symptom of the fact that the current situation is emotional for a given person.

One more point should be emphasized: the process of generalization is a very variable phenomenon, depending on the strength of emotions. This means that stimuli that are neutral in some situations are capable of causing emotional reactions in other situations. This, apparently, can explain the fact that an angry, or, as they usually say, “excited” person quickly becomes excited under the influence of even weak stimuli, for example, under the influence of words containing a very distant hint of possible criticism or disapproval. For the same reasons, with an increased level of sexual arousal, a person perceives as sexually attractive even those who, under other circumstances, would seem to him not worthy of any attention. The same can be said about other emotions.

Excessive strength of emotional arousal, and especially anxiety, can lead to pathological disorders. A person begins to experience fears of taking appropriate precautions in situations that objectively do not require it. A number of authors believe that these mechanisms can be used to explain the symptoms of some mental illnesses.

The dependence of generalization on the strength of emotions can be used to determine the strength of latent emotions. The wider the range of stimuli that evoke a certain emotion, the greater the strength of the corresponding latent emotion. This dependence was confirmed, in particular, in the research of I. Obukhovskaya, who showed that children with a high level of anxiety regarding failure refuse to complete tasks at those stages when there is not yet sufficient information about success or failure. The refusal reaction in this case is due to the generalization of the fear of failure, which arises at the very beginning of activity when faced with signals that are still very weakly associated with failure (see Obuchowska, 1965).

Assessing the meaning of situations

A person's emotional responses to novel or challenging situations that lack strong natural or conditioned emotional stimuli depend on how the situation is appraised or the meaning assigned to it. According to Lazarus, two main types of situation assessment (appraisal) can be distinguished: assessing it as threatening or favorable (Lazarus, 1968, p. 191). Assessment of the situation causes a tendency to perform appropriate adaptive actions (precisely a tendency, since these actions are not always carried out). In principle, adaptive actions can be carried out on the basis of exclusively cognitive mechanisms, without the participation of emotional processes. Emotions arise only when certain additional circumstances appear. Thus, negative emotions arise when an individual assesses a situation as dangerous, but does not have ready-made and sufficiently reliable, in his opinion, ways to resolve it, that is, when these methods have yet to be found and there is some uncertainty regarding this possibility.

Therefore, a threat in itself does not cause emotion; When crossing, for example, a busy street, we usually do not experience fear, although objectively it is quite dangerous. We do not experience fear because we know how to behave on the roadway and how to avoid danger. In the same way, people who are accustomed to working in dangerous conditions and have mastered the methods of eliminating the threat do not experience anxiety.

When a threatening situation evokes emotion, it can find expression in three main forms: fear, anger and sadness (feelings of depression). The nature of the emotion that arises depends on the assessment of the person's capabilities: if we believe that the situation is not too dangerous or if it is perceived as an obstacle to the satisfaction of needs, a tendency towards anger and attack is likely to arise. If the danger seems great, the tendency towards fear and avoidance prevails. Finally, if neither attack nor avoidance is possible, feelings of depression and withdrawal from active action may occur.

The emotional reaction to a favorable situation takes the form of joy, satisfaction, hope, etc. However, the presence of a favorable situation in itself is not enough for the emergence of positive emotions. Some additional conditions are necessary, but they are not yet well known. It is quite possible that positive emotions arise, in particular, when a favorable situation develops unexpectedly or after a period of uncertainty, or when, within a short period of time, there is a sharp transition from a state of threat to a state of security, etc.

The process of the emergence of negative and positive emotions, depending on a person’s assessment of the situation, was quite fully studied at different phases of parachute training, when some autonomic and muscular indicators were used as objective correlates of emotional reactions. As an example, let us cite data from a study of Soviet cosmonauts; the following reactions were recorded in these studies:

1. on the eve of the day for which the jumps were scheduled, if it was necessary to wait for the start of the action, there was an increase in emotional activation (anxiety, doubts) with accompanying vegetative manifestations (increased blood pressure, increased heart rate, increased muscle tension, difficulty falling asleep);

2. before the jump (critical moment) – increased heart rate to 140 beats per minute, dry mouth, increased arm strength (according to dynamometry);

3. after the parachute opens (the main source of danger disappears) - a joyful rise in mood;

4. after landing (reaching the goal) - for some time, activation increases (pulse up to 190), then it decreases: a decrease in arm strength, a slowdown in pulse, etc. (Gorbov, 1962; Khlebnikov, Lebedev, 1964).

Language plays an important role in assessing a situation. A person categorizes emerging situations and thereby classifies them. The very names that a person uses are associated with certain emotional mechanisms and, when assigning a certain situation to a certain class, evoke certain emotions. In many cases, when a person is faced with unfamiliar situations, he can use other people's assessments. Thus, information about the opinions of other people can lead to the formation of one’s own assessments.

Emotions arising under the influence of such information may change when directly confronted with the situation. This can be illustrated by the results of another part of the experiment by Lacey and his colleagues.

These authors, using the already described technique, conducted an experiment with another group of subjects who, before the experiment, were given additional information about which words would be reinforced with electric shock. This information noticeably changed the subjects' reactions. At the first presentation of a critical word (for some subjects the word was “cow”, for others it was “paper”), the warned subjects had a very strong reaction, which was not the case in the first group.

This is explained by the fact that the words “you will receive an electric shock” for most subjects had already been associated with the experience of pain in the past and therefore in themselves caused fear. By establishing a connection between these words and the word “paper” (or “cow”), it also acquired the ability to evoke fear. For this, a single comparison of it with an emotionally significant phrase was enough.

It is characteristic that as the presentation of the test word in combination with the electric shock was repeated, the warned subjects experienced a gradual fading of emotional reactions to this word. On the contrary, those subjects who were not warned and learned from experience became more and more afraid of him. This can be explained by the fact that the reaction to a verbal signal may be disproportionately large compared to the event it foretells. It is known that emotions caused by an assessment of a situation are often stronger than the emotions that arise during real contact with this situation. Thus, the Soviet researcher N. N. Malkova found that the anticipation of a painful injection causes a more significant increase in blood pressure than the injection itself.

We often encounter this phenomenon in everyday life. Thus, children who have committed their first crime in their lives are much more afraid of the police than children who have several criminal records.

A similar pattern was established when studying the emotional reactions of soldiers to different types of enemy combat weapons in real conditions of front-line life. At first, the strength of the emotional reaction was determined by the secondary properties of the weapon (for example, noise, suddenness of appearance) and the everyday ideas associated with them. Later, as experience accumulated, fear of this or that type of weapon began to depend on the actual danger that this weapon poses. So, at first, enemy aircraft caused great fear. Later, this reaction became weaker, as experience showed that the effectiveness of aircraft attacks on entrenched soldiers was relatively low. But the fear of mortar fire has increased significantly.

Change in the significance of an emotiogenic stimulus

The factor that has acquired the significance of an emotiogenic stimulus does not remain unchanged. Some changes may occur spontaneously over time. Others are the result of repetition of experiences associated with a given factor.

Over time, emotional reactions can either increase or decrease. The spontaneous increase in emotional response is called the “incubation effect.”

The phenomenon of incubation was first systematically observed in experiments conducted more than 50 years ago by Diven. This author investigated the process of developing conditioned emotional reactions to verbal stimuli, using the technique that Lacey and his colleagues later used, and established the fact of semantic generalization. His experiments also yielded another noteworthy fact, which was discovered when the experiments were repeated. Thus, with some subjects the second experiment was carried out immediately after the first, while with the rest it was carried out a day or two later. It turned out that the strength of the emotional reaction (as measured by the galvanic skin response) to the conditioned stimulus (the word “ovin”) was greater the next day than immediately after the first experiment. In other words, over time, the emotional response to the verbal stimulus increased. Similar facts were obtained by Gaitt in experiments on animals; He found that experimentally caused disturbances in the behavior of dogs not only did not disappear, but often deepened and expanded for many months after the end of the experiment.

As you can see, time is not always the “best healer”; Over time, a negative emotion may not only not weaken, but even intensify.

The phenomenon of incubation was also discovered in the study of Martha Mednik. Her experiment was not significantly different from Diven's. It turned out that the subjects, 24 hours after completing the process of forming conditioned emotional reactions, had a higher level of GSR than the experiment itself. Mednick also found that after 24 hours the process of extinction occurs faster (Mcdnick, 1957).

In everyday life, the phenomenon of incubation takes the form of “disappointment” in what caused pain, suffering, fear, etc. This attitude not only persists, but even intensifies over time. To prevent this, after a negative event you should repeat it again as soon as possible, ensuring a successful outcome this time. However, there is another danger associated with repetition. If repetition is performed under coercive conditions, emotional conflict may arise, causing an even greater increase in the negative emotional reaction.

The causes and mechanisms of the incubation phenomenon are still unknown. Perhaps a process similar to the “fatigue-rest” cycle takes place here: repetition of a reinforced conditioned stimulus leads, due to fatigue, to a weakening of its effect (the phenomenon of so-called consolation with reinforcement). After a break, due to the removal of fatigue, the reaction arises with renewed vigor. A similar phenomenon is observed in the process of intensive training of a skill; after a break, the action is performed better than at the end of the skill development process. This assumption is supported, in particular, by the fact that in Mednik’s experiment, during the last presentation of the stimulus, skin conductivity was lower than during the previous ones, that is, fatigue was observed.

The phenomenon of incubation resembles the phenomenon of reminiscence. Perhaps they are based on a similar mechanism.

Along with an increase in the strength of the emotional reaction, that is, along with the incubation effect, a weakening of the strength of the reaction is often observed over time. The question arises: does a stimulus spontaneously lose its emotional meaning if we do not encounter it for a long time? This seems unlikely; There is evidence indicating that the loss of emotional Meaning by a stimulus occurs as a result of extinction. It is likely that the connection between the neutral stimulus S and the emotional response E does not disappear spontaneously over time; for it to disappear, it is necessary that both S and E appear independently of each other. If S does not appear separately, its connection with E may not disappear.

The problem discussed here is a special case of a more general and as yet unsolved problem of erasing memory traces. At first glance, this seems self-evident: material that is not repeated is forgotten. However, it is not known why exactly it is forgotten: either because it was “not used,” or because the elements of the memorized structure later became components of other functional systems and, as a result, fell out of the original structure. In other words, forgetting can occur not so much because the connection between A and B was not repeated, but because during this time connections A–C and B–D were formed, which led to the exit of elements A and B from the primary functional formation. Thus, as Jenkins and Dallenbach argued, forgetting is a consequence of retroactive inhibition.

The hypothesis that retroactive inhibition underlies forgetting suggests some implications regarding the stability of S–E connections. If E is a strong negative emotion, then, apparently, there should be a tendency that counteracts the reproduction of elements associated with this emotion. Therefore, the individual will resist remembering S, will avoid everything that can be connected with S, and therefore S will not be able to form other connections besides the original one; As a result, the S–E relationship can persist for an unlimited time.

This kind of phenomenon is actually observed. Intense traumatic experiences rarely go away; most often they are isolated from other elements of experience and, repressed from consciousness, continue to exist for many years; events or situations containing S (or similar associations) can lead to the updating and updating of all the strong emotional reaction associated with them.

A traumatic emotional connection shows a tendency towards “encapsulation”, towards protection by “thick armor” from possible resumption. Such protection is ensured by the formation of the ability to avoid everything that may have even the most distant connection with the experience.

Extinguishing emotions

We can only add that the formation of such “encapsulated” foci influences the entire subsequent life and activity of the individual. Their disorganizing effect on the human psyche becomes especially obvious if such a focus is very extensive and concerns issues that are important for regulating the relationship between a person and his environment. This disorganizing effect is associated primarily with the emergence of a number of behavior patterns that make it possible to avoid the actualization of the “painful focus”; rationalization occurs, the formation of opposition, denial, etc., in other words, processes that Freud and the psychoanalytic school described as the consequences of emotional conflict and repression.

Thus, in one of the patients studied, the first sexual experience ended with a feeling of complete failure and humiliation, after which a strong tendency arose to “suppress” this experience. The patient actually managed to forget about him, to remove him from his “conscious self,” but this did not remain without consequences in his sexual sphere. Each sexual contact was accompanied by severe anxiety (due to the generalization of his traumatic experience), which caused him a functional disorder and general disorganization in the sphere of sexual life, and subsequently in other areas, one way or another connected with self-esteem.

If the emotion is not excessively strong, the barrier it creates will not be insurmountable and, as a result, individual components of the experience will be able to gradually form new connections, which will contribute to the disintegration of the original negative association.

Thus, in the light of the hypothesis we have accepted, the main condition for the loss of the meaning of an emotional stimulus by some factor is the process of extinction, that is, the manifestation of this factor without the emotion associated with it. This hypothesis allows us to explain this process using the laws of extinction.

As is known, extinction usually occurs gradually, and its effects are most pronounced at the beginning of the process.

However, this process is not sustainable. If it is interrupted for some time, then during the next test one can detect an increase in the ability of the stimulus to cause a reaction - the phenomenon of so-called spontaneous disinhibition. True, it does not lead to a complete restoration of the reaction force, although it can be quite large.

Let us take as an example the gradual weakening of a person’s passion for some other person. This process occurs mainly according to the laws of extinction: as a person analyzes his contacts with a given person, he notes a weakening of the emotional reaction to him. But after a break - when he did not touch on this topic for some time - an increase in emotional involvement is again observed (although usually this reaction is no longer so strong). This is due to the phenomenon of spontaneous recovery.

It should be noted that the subject may mistakenly interpret such an unexpected increase in passion as a sign that the previous feelings were “real”, that this person “can never be erased from memory”, that an evil fate hangs over the feeling, etc. If, in such a mental state, contact is renewed, that is, repeated reinforcement, the extinction effect may completely disappear and everything will repeat all over again. If a person is able to overcome the crisis and does not do anything that would cause reinforcement of the emotional reaction, then a further, even greater weakening of it will soon occur.

The process of extinction depends on the method of reinforcement of the emotion. If reinforcement occurs without disturbances, extinction is more “painful”, but faster. If the reinforcement was irregular, extinction occurs more slowly and is less effective.

Emotions can persist for a particularly long time, reach exceptionally great strength - clearly disproportionate to the significance of the stimulus - and lead to pathological symptoms when a person is exposed to opposite influences for a long time, if hope, fear, love, or humiliation are aroused in him. Such antagonistic “forces” have an enhancing effect on emotional processes.

This explains, in part, how difficult it is sometimes to break some unfortunate emotional ties in human relationships. People who are not suitable for each other and whose life together brings only conflicts and disappointments, nevertheless cannot separate, even in the absence of objective reasons connecting them (children, economic dependence, etc.), since the essence of their relationship is until now was the irregular receipt of positive reinforcements. Therefore, hope for improvement disappears extremely slowly, and even after the most difficult trials, these people still expect something from each other.

Avoidance response

As a result of systematic research, other factors on which the extinction process depends have been identified. One of them is the strength of the reinforcing stimulus, in this case the strength of the emotion. The stronger the emotion, the more difficult it is to extinguish the reaction.

Some emotional reactions are particularly difficult to extinguish. Such reactions include, in particular, anxiety, which contributes to the emergence of an avoidance reaction (an avoidance reaction is a reaction that occurs in an individual in response to a danger signal and which is designed to eliminate this danger, that is, to eliminate the effect of a negative stimulus). This is evidenced by some studies conducted on animals. In one of them, a dog was trained to jump over a barrier at the sound of a bell in order to avoid an electric shock, the signal of which was the bell. As the authors of this experiment, Solomon, Kamin and Winn, found, the dog performed this action 800 times without any signs of extinction.

How can we explain such an amazing persistence of the avoidance reaction? According to N. Miller (1960), it is due to the fact that the avoidance reaction is constantly reinforced, as it reduces fear. The bell causes fear, but the jump reduces it. Reducing fear, acting as a reinforcer, strengthens the connection. This assumption could, in some cases, explain the robustness of the relationship between the call and jump performance. However, it is still necessary to explain the connection between the sound signal and the emotion of fear. To clarify the latter, we should remember two facts: the inertia of emotional reactions (their less susceptible to the process of extinction compared to motor reactions), as well as Soltysik’s analysis of recurrent inhibitory stimuli.

According to Soltysik, extinction does not occur in cases where the so-called conditioned inhibitor is attached to the conditioned stimulus. Pavlov called a conditioned inhibitor a stimulus that signals that there will be no reinforcement. If such a stimulus was presented in combination with a conditioned stimulus, the conditioned response did not occur (hence the name “inhibition”).

As a result of the avoidance reaction, stimuli appear that acquire the characteristics of a conditioned inhibitor (since they carry information that there will be no reinforcement, in this case punishment), and the action of stimuli signaling punishment ceases. Therefore, if an individual, having received a danger signal, flees and actually avoids this danger, the stimuli associated with the avoidance reaction become a conditioned inhibitor. Since the conditioned inhibitor has been shown to preclude extinction, the inhibitory avoidance response prevents danger-signaling stimuli from losing their original meaning. The mentioned authors provide some experimental data confirming this idea. Thus, it is impossible to stop being afraid if you run away every time when there is a signal of danger.

Would the fear response go away otherwise? Clinical observations suggest that this does not always happen. Thus, the anxiety that arises in pilots in connection with the performance of certain tasks (for example, during high-altitude, night flights) sometimes continues to persist very stubbornly, despite the repeated repetition of this activity without any negative reinforcement; sometimes, as it repeats, the anxiety even intensifies. In relation to such cases, the explanation proposed by Soltysik is apparently unacceptable.

It can be assumed that the strong emotion of fear in itself is so unpleasant that it serves as reinforcement for the avoidance reaction. Elimination of this reaction would be possible if the conditioned signal appeared in a situation that precluded the occurrence of emotional reactions (for example, as a result of the use of pharmacological agents or special procedures leading to relaxation and elimination of anxiety). There are known cases of practical application of such procedures that led to successful results (Bandura, 1967, Eysenck, 1965).

It should be added that the persistence of the avoidance reaction observed in the experiments of Solomon and his colleagues mentioned above can be explained in a completely different way, without resorting to the mediating role of anxiety. Some authors believe that as a result of repetition, a strong associative connection is established between the signal and the corresponding actions, which persists even after the anxiety disappears. The latter occurs only when the avoidance reaction becomes impossible. In this case, the avoidance response would be an adaptive action, devoid of an emotional component. This interpretation is supported, in particular, by the fact that in a dog that has learned to effectively avoid electric shock, all signs of fear disappear.

Thus, the persistence of some reactions may be associated not so much with the difficulties of the process of extinguishing emotions, but with the strong consolidation of certain skills that arose in the past under the influence of emotions and subsequently lost their emotional character.

Pain. Pain sensitivity. Nociceptors. Pathways of pain sensitivity. Pain assessment. Gate of pain. Opiate peptides.

Pain defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage. Unlike other sensory modalities, pain is always subjectively unpleasant and serves not so much as a source of information about the surrounding world, but as a signal of damage or illness. Pain sensitivity encourages the cessation of contact with damaging environmental factors.

Pain receptors or nociceptors are free nerve endings located in the skin, mucous membranes, muscles, joints, periosteum and internal organs. Sensitive endings belong to either non-myelinated or thin myelinated fibers, which determines the speed of signal transmission in the central nervous system and gives rise to the distinction between early pain, short and acute, that occurs when impulses are carried out at a higher speed along the myelinated fibers, as well as late, dull and long-lasting pain, in case of signal transmission along non-pulp fibers. Nociceptors belong to multimodal receptors, since they can be activated by stimuli of different nature: mechanical (impact, cut, prick, pinch), thermal (action of hot or cold objects), chemical (change in the concentration of hydrogen ions, the action of histamine, bradykinin and a number of other biologically active substances) . Nociceptor sensitivity threshold high, so only sufficiently strong stimuli cause excitation of primary sensory neurons: for example, the pain sensitivity threshold for mechanical stimuli is approximately a thousand times higher than the threshold for tactile sensitivity.

The central processes of primary sensory neurons enter the spinal cord as part of the dorsal roots and form synapses with second-order neurons located in the dorsal horns of the spinal cord. The axons of second-order neurons move to the opposite side of the spinal cord, where they form the spinothalamic and spinoreticular tracts. Spinothalamic tract ends on the neurons of the inferior posterolateral nucleus of the thalamus, where convergence of the pathways of pain and tactile sensitivity occurs. The neurons of the thalamus form a projection onto the somatosensory cortex: this pathway provides conscious perception of pain, allows you to determine the intensity of the stimulus and its localization.

Fibers spinoreticular tract end on neurons of the reticular formation interacting with the medial nuclei of the thalamus. During painful stimulation, neurons of the medial nuclei of the thalamus have a modulating effect on large regions of the cortex and structures of the limbic system, which leads to an increase in human behavioral activity and is accompanied by emotional and autonomic reactions. If the spinothalamic pathway serves to determine the sensory qualities of pain, then the spinoreticular pathway is intended to play the role of a general alarm signal and have a general stimulating effect on a person.

Subjective pain rating determines the ratio of neural activity of both pathways and the activation of antinociceptive descending pathways dependent on it, which can change the nature of the conduction of signals from nociceptors. To the sensory system pain sensitivity an endogenous mechanism for its reduction is built in by regulating the threshold of synaptic switchings in the dorsal horns of the spinal cord (“ gate of pain"). The transmission of excitation at these synapses is influenced by descending fibers of gray matter neurons around the aqueduct, locus coeruleus and some nuclei of the median raphe. The mediators of these neurons (enkephalin, serotonin, norepinephrine) inhibit the activity of second-order neurons in the dorsal horns of the spinal cord, thereby reducing the conduction of afferent signals from nociceptors.

Analgesic (painkillers) have an effect opiate peptides (dynorphin, endorphins), synthesized by hypothalamic neurons, which have long processes that penetrate other parts of the brain. Opiate peptides attach to specific receptors of neurons of the limbic system and the medial region of the thalamus, their formation increases under certain emotional states, stress, prolonged physical activity, in pregnant women shortly before childbirth, as well as as a result of psychotherapeutic effects or acupuncture. As a result of increased education opiate peptides antinociceptive mechanisms are activated and the pain sensitivity threshold increases. The balance between the sensation of pain and its subjective assessment is established with the help of the frontal areas of the brain involved in the process of perception of painful stimuli. If the frontal lobes are damaged (for example, due to injury or tumor) pain threshold does not change and therefore the sensory component of pain perception remains unchanged, however, the subjective emotional assessment of pain becomes different: it begins to be perceived only as a sensory sensation, and not as suffering.

Introduction

Chapter 1 Theoretical and clinical aspects of pain

1.1 Features of pain sensitivity

1.2 Factors determining pain perception

Chapter 2 The influence of psychosocial factors on the course of the disease

2.1 Mental factors in chronic and acute pain

2.2 Impact of gender differences on pain perception

Chapter 3 The influence of the disease on the psyche and behavior of the individual

3.1 Emotional and behavioral aspects of pain perception

3.2 Influence of socio-constitutional factors

on the concept of illness

Conclusion

List of sources used

Introduction

The study of pain is one of the central problems of biology, medicine and psychology. Pain, one of the most common sensations, is characterized by a variety of manifestations. Many people know that the nature, severity, duration, localization and other characteristics of pain can be very different. Pain is always unpleasant, and a person strives to get rid of this feeling. At the same time, it turns out that pain is useful, as it signals problems that have arisen in the body. The ancient Greeks said that pain is "...the watchdog of health."

The feeling of pain warns the body about the harmful effects of mechanical, chemical, electrical and other factors. Pain not only notifies a person about trouble, but also forces the body to take a number of measures to eliminate the causes of pain. This happens reflexively. It is known that a reflex is the body’s response to the action of various stimuli. Indeed, as soon as a person touches something hot or very cold, sharp, etc., he immediately instinctively distances himself from the action of the harmful factor.

In the process of evolution of the organic world, pain turned into a danger signal and became an important biological factor ensuring the preservation of the life of the individual, and therefore the species. The occurrence of pain mobilizes the body's defenses to eliminate painful irritations and restore the normal functioning of organs and physiological systems.

Of all types of sensitivity, pain occupies a special place. While other types of sensitivity have a certain physical factor (thermal, tactile, electrical, etc.) as an adequate stimulus, pain signals such conditions of organs that require special complex adaptive reactions. There is no single universal stimulus for pain. As a general expression in the human mind, pain is caused by various factors in different organs.

Anokhin defined pain as a unique mental state of a person, caused by a combination of physiological processes of the central nervous system, brought to life by some super-strong or destructive irritation. In the works of domestic scientists Astvatsaturov and Orbeli, ideas about the general biological significance of pain are especially clearly formulated.

By its nature, pain is a subjective sensation, depending not only on the magnitude of the stimulus that causes it, but also on the mental, emotional reaction of the individual to pain.

The object of the study is people experiencing pain.

The subject of the study is changes in the emotional and personal characteristics of an individual with various manifestations of pain.

The purpose of the study is to examine the impact of pain on the psyche and behavior of the individual.

Consider the theoretical and clinical aspects of pain;

Determine the influence of psychosocial factors on the course of the disease;

Analyze the impact of the disease on the psyche and behavior of the individual.

Chapter 1 Theoretical and clinical aspects of pain

1.1 Features of pain sensitivity

The multifactorial nature of pain processes prevents researchers from even coming to a single definition. “Pain must be viewed as an integrative function of the body, which includes components such as consciousness, sensations, emotions, memory, motivation and behavioral reactions.” Pain is an unpleasant sensation or suffering caused by irritation of special nerve endings in damaged or already damaged tissues of the body. Apparently, the biological significance of pain is that it serves as a warning signal and forces a reduction in physical activity during injury or illness, which facilitates the healing process.

Pain is not only a signal, but also a protective device. People who have no sense of pain, which in rare cases can be a congenital defect or a consequence of a disease of the nervous system, are not able to avoid the influence of a damaging factor in time and may become a victim of accident, despite the fact that they constantly resort to precautionary measures, trying to protect themselves from burns, wounds, exposure to radiant energy, etc. These people are easy to recognize upon examination: they usually have numerous scars on their skin from burns, wounds, etc.

However, no matter how difficult it is for a person deprived of the feeling of pain, it is even more difficult for someone whose pain continues for a long time. Having first fulfilled its protective function, pain becomes the body’s worst enemy. It depletes strength, depresses the psyche, and disrupts the functions of various body systems. A person’s motor activity decreases, sleep, appetite, etc. are disturbed.

As you know, the feeling of pain in the human body is formed by the nervous system. The main parts of the nervous system are the brain, spinal cord, nerve trunks and their end devices (receptors), which convert the energy of external stimulation into nerve impulses.

The brain and spinal cord make up the central nervous system, and all other parts of the nervous system make up the peripheral nervous system. The brain is divided into hemispheres and the brain stem. The hemispheres are represented by white matter - nerve conductors and gray matter - nerve cells. Gray matter is located mainly on the surface of the hemispheres, forming the cerebral cortex. It is also found in the depths of the hemispheres in the form of separate clusters of cell groups. These are the so-called subcortical nodes. Among the latter, the visual hillocks (left and right) are of great importance in the formation of pain. They contain cells of all types of sensitivity of the body. In the brain stem, clusters of gray matter cells form the nuclei of the cranial nerves, from which various nerves begin that provide sensory and motor innervation to the head, face, oral cavity, pharynx, and larynx.

In the process of long-term adaptation of living beings to environmental conditions, special sensitive nerve endings have formed in the body, converting various types of energy that come from external and internal stimuli into nerve impulses. They are called receptors. Receptors differ in their structure and function. They are present in almost all tissues and organs. Some of them perceive tactile irritations (the feeling of touch, pressure, weight, etc.), others - thermal (the feeling of heat, cold, their combination), others - chemical (the action of various chemicals), etc. The simplest device have pain receptors. Painful sensations are perceived by the free endings of sensory nerve fibers. Pain receptors in the head do not differ in structure from pain receptors located in other areas of the body.

Pain receptors are distributed unevenly in different tissues and organs. Most of them are in the fingertips, face, and mucous membranes. The walls of blood vessels, tendons, meninges, and periosteum (the superficial lining of the bone) are significantly equipped with pain receptors.

Everyone knows how painful blows to the periosteum are, especially in those areas where it is not covered by soft tissue, for example, on the front surface of the shin. At the same time, operations on the bone itself are painless, since the bone does not contain pain receptors. There are few pain receptors in subcutaneous fat. The brain substance has no pain receptors, and neurosurgeons know that the brain can be cut without resorting to painkillers. Due to the fact that the membranes of the brain are sufficiently supplied with pain receptors, squeezing or stretching of the membranes causes pain of significant strength.

The activity of the cerebral cortex largely depends on a special formation of the nervous system, called the reticular formation of the brain stem, which can both activate and inhibit the activity of the cerebral cortex.

Pain sensitivity to extremely strong and destructive stimuli is associated with the occurrence of painful sensations that have a sharply negative emotional connotation, and vegetative reactions (increased breathing, dilation of the pupils, constriction of peripheral vessels, etc.). Painful sensations of various types can be caused by any damaging stimuli (temperature, mechanical, chemical, radiant energy, electric current).

Painful sensations are a stimulus for various defensive reactions, the main goal of which is to eliminate external or internal agents that cause pain. Pain sensitivity therefore has important biological significance.

Some believe that any extreme irritation or destruction of any receptor in the body can lead to pain. On the skin surface, the total number of pain points corresponding to the location of pain sensitivity receptors in the skin is 900,000 - 1,000,000 (up to 100-200 per 1 cm³).

Painful sensations are easily caused by a conditioned reflex. So, if you combine a bell with painful irritation of the skin, then after several combinations the isolated action of the bell begins to cause pain and characteristic autonomic reactions. Pain sensitivity is the most primitive, undifferentiated form of sensitivity. Painful sensations are very difficult to localize. Their localization becomes possible due to the accompanying tactile and other sensations.

Sensitivity to pain depends not only on the number of pain receptors, but also on age and gender. There is a dependence on the state of the psyche.

Anything that helps distract attention from painful stimulation reduces the sensation of pain. This explains the weakening or cessation of pain during periods of emotion, anger, and fear. A person who is passionate about something does not feel pain. For example, in the heat of battle, he may not notice a wound. And, conversely, in states of depression, physical fatigue, and nervous exhaustion, the sensation of pain increases.

Anticipation and fear increase pain; the same thing happens in the absence of distractions. This can also explain the increase in all types of pain at night.

Pain impulses, having been received by receptors, are then processed in a complex way along special sensitive fibers to various parts of the brain and ultimately reach the cells of the cerebral cortex.

The centers of pain sensitivity of the head are located in various parts of the central nervous system. The activity of the cerebral cortex largely depends on the special formation of the nervous system - the reticular formation of the brain stem, which can both activate and inhibit the activity of the cerebral cortex.

1.2 Factors that determine pain perception

Pain is a psychophysiological reaction of the body that occurs with severe irritation of sensitive nerve endings embedded in organs and tissues. This is the oldest defense reaction of the body in evolutionary terms. It signals trouble and causes a response from the body aimed at eliminating the cause of pain. Pain is one of the earliest symptoms of some diseases.

There are a huge number of factors that determine the perception of pain in humans or animals. Among them are racial, gender, and age characteristics, and the state of the autonomic nervous system, and fatigue, and experimental conditions, and the research setting, and the order of stimulation, and many other physiological, biochemical, psychological and other reasons that influence pain thresholds . Soviet pharmacologist A.K. Sangailo argues that social conditions largely determine the perception of pain. According to him, adolescents are more tolerant of pain and adapt to it more easily than adults. Young people react sharply to painful stimuli, but easily adapt to them. Old people have a slightly reduced sensitivity to pain.

Beecher counted 27 factors that determine the sensation of pain, but there are probably many more. That is why, when studying pain in an experiment, it is necessary to especially carefully observe the homogeneity and uniformity of the conditions in which the research takes place.

The mental state of the subject is of great importance for the perception of pain. Expectations and fears increase pain; Fatigue and insomnia increase a person's sensitivity to pain. However, everyone knows from personal experience that with deep fatigue the pain is dulled. Cold intensifies, warmth weakens pain.

T. Schatz talks about the strategic significance of pain both for the person reporting it and for the relatives, friends, and acquaintances around him. Therefore, when assessing pain, one should take into account the social situation, the subjective characteristics of the suffering person, and the reaction of people close to him.

It must be assumed that the perception and overcoming of pain largely depends on the type of higher nervous activity. When Leriche says: “We are unequal in the face of pain,” this, translated into physiological language, means that different people react differently to the same painful stimulus. The strength of irritation and its threshold may be the same, but the external manifestations and visible reaction are purely individual.

The type of higher nervous activity largely determines human behavior in response to painful stimulation. In people of the weak type, whom I. P. Pavlov classified as melancholic, a general depletion of the nervous system quickly occurs, and sometimes, if protective inhibition does not occur in time, a complete disruption of the higher parts of the nervous system.

In excitable, uncontrollable people, the external reaction to pain can take on an extremely violent, affective character. The weakness of the inhibitory process leads to the fact that the limit of efficiency of the cells of the cerebral hemispheres is crossed and an extremely painful narcotic or psychopathic state develops.

At the same time, people of a strong, balanced type seem to suppress reactions more easily and are able to emerge victorious in the fight against the most severe painful stimuli.

Some people in a normal state, others with various diseases, experience increased sensitivity to pain, so-called hyperalgesia. In order to cause pain in them, it is enough to apply a weaker irritation than in people with normal pain sensitivity. These people have a lower pain threshold, and they react to irritation and damage to the skin that is completely invisible to most people.

There are people for whom pain that is far from strong causes excruciating pain that does not subside for a long time. Sometimes increased sensitivity is limited to certain areas of the body surface, sometimes affecting the entire skin and visible mucous membranes.

People suffering from hypersensitivity begin to complain of pain with every touch. It is difficult for them to wear clothes; they cause pain. It is enough to lightly stroke the skin to cause a burning sensation, which sometimes lasts for quite a long time.

There are, although not very often, people who react poorly to pain. With many diseases of the nerve trunks, brain and spinal cord, sensitivity to pain decreases. Sometimes on the surface of the body you can find areas where irritation or damage does not cause pain.

Reduced pain sensitivity (hypoalgesia) is also observed in some nervous and mental diseases, for example, hysteria.

Such data allow us to take a new approach to resolving some controversial aspects of the problem of pain. The absence of pain sensitivity, says Melzack, is perhaps the most convincing evidence of the positive value of pain in a person's life.

Chapter 2 The influence of psychosocial factors on the course of the disease

2.1 Mental factors in chronic and acute pain

Pain tolerance varies from person to person. It depends on how much attention is paid to pain, on the personality of the patient, and can vary greatly with mental illness.

Pain is usually divided into acute and chronic. It is necessary to determine what is considered acute pain and what is chronic. Acute pain is always a symptom of some organic suffering. On the contrary, chronic pain, as a rule, is not a symptom, but a disease itself, in which the decisive factor is not morphological tissue damage, but defective perception and other dysfunction of mental processes. Chronic pain is usually defined as pain that lasts 6 months or more.

One of the main difficulties with chronic pain is that in addition to the pain itself (even if it is the only complaint), it is necessary to evaluate many other factors influencing the patient's condition. Mental factors influence pain of any origin. A football player, having been injured during a game, soon returns to the field; the same injury in everyday life can put him in bed for several days. The dependence of pain on the psychological state is well known to those who were in the war.

The following factors contribute to increased pain:

Depression. Since the affective component appears more clearly in chronic pain than in acute pain, it can be assumed that the intensity of chronic pain depends on the influences of the limbic system. With major depression and associated sadness, dysphoria, or irritability, pain increases. For chronic pain, the first thing to look for is depression; some even believe that almost all chronic pain is caused by severe depression.

Anxiety. Many patients with chronic pain are in a state of anxiety or even fear, which increases the severity of pain.

Psychogenic pain. If it is not possible to identify the physical cause of the pain, but its connection with psychological factors is discovered, we can talk about psychogenic pain. In this case, there must be a relationship in time between the occurrence of pain and the subconscious benefit that the patient receives from his condition. Thus, a pilot who lands unsuccessfully may experience an excruciating headache during briefing before the next scheduled flight. Another psychological factor often identified in psychogenic pain is the need for sympathy, which a person cannot receive in any other way.

In pain and depression, there are common formation mechanisms associated with angioedema - the inability to experience pleasure. Therefore, depression is one of the forms of mental disorders that are closely related to the occurrence of psychogenic pain. These disorders may occur simultaneously or one may precede the manifestation of the other. Patients with clinically significant depression have a decreased pain threshold, and pain is considered a common complaint in patients with primary depression. Patients with pain caused by a chronic somatic disease also often develop depression. From a psychodynamic position, chronic pain is considered as an external protective manifestation of depression, alleviating mental impulses (feelings of guilt, shame, mental suffering, unrealized aggressive tendencies, etc.) and protecting the patient from more severe mental anguish or suicide. Pain is often a consequence of a defense mechanism - repression, typical of hysterical conversion. In many cases, the combination of pain symptoms and depression is considered as masked depression, where pain syndrome or somatoform pain disorder comes to the fore.

Psychopathy may play a critical role in chronic pain; This is especially true for antisocial, dependent and borderline psychopathy. The doctor almost always focuses on the pain itself and its treatment, losing sight of possible pathological personality traits.

Currently, chronic pain is considered as an independent disease, which is based on a pathological process in the somatic sphere and primary or secondary dysfunction of the peripheral and central nervous systems. An integral feature of chronic pain is the formation of emotional and personal disorders; it can only be caused by dysfunction in the mental sphere, i.e. treat idiopathic or psychogenic pain.

The close connection between chronic pain and depression is obvious. Statistical data on the presence of mental disorders of a depressive nature in half of patients suffering from chronic pain; according to S.N. Mosolov, 60% of patients with depression have chronic pain syndromes. Some authors are even more specific, believing that in all cases of chronic pain syndrome there is depression, based on the fact that pain is always accompanied by negative emotional experiences and blocks a person’s ability to receive joy and satisfaction. The greatest controversy is not the fact of the coexistence of chronic pain with depression, but the cause-and-effect relationship between them.

On the one hand, long-term pain limits a person’s professional and personal opportunities, forces him to abandon his usual life patterns, disrupts his life plans, etc. Decreased quality of life can give rise to secondary depression. On the other hand, depression may be the root cause of pain or the main mechanism of chronic pain syndrome. Thus, atypical depression can manifest itself under various masks, including under the mask of chronic pain.

It is obvious that a chronic disease can affect the psyche, upset the individual’s goals, change his character, emotional reaction to stimuli, creating an imbalance between the processes of excitation and inhibition.

2.2 Impact of gender differences on pain perception

Differences between men and women in pain response have been supported by many epidemiological and experimental data. In most cases, it is found that women and girls report pain to a greater extent than men and boys. The same differences, but to a lesser extent, were noted in clinical studies.

To explain these differences, in most cases the biological characteristics of men and women are invoked. Recently, work has appeared that has shown the important contribution of psychological and social factors to differences in pain response in men and women. At the same time, much more attention is paid to the influence of affective factors on the sensation of pain.

There are still very few studies devoted to studying the role of social factors, although the problem (“the influence of social factors”) seems to be very relevant. In recent years, the problem of gender socialization has caused heated debate.

To date, only a few studies have been conducted that directly examine the role of gender differences in pain syndromes. Available evidence suggests that the role of psychological and social factors in the context of gender differences sometimes plays a role in the assessment of pain.

Social cognitive learning theory and cognitive development theory suggest that young boys and girls identify themselves as male or female as they learn. By observing other people and whether their actions are punished or rewarded, they learn different types of behavior. S. Bem's theory of gender integrates elements of both theories to explain the reasons why men and women choose masculine or feminine behaviors in accordance with existing cultural stereotypes. Several studies have shown that the consequences of violating gender norms differ for boys and girls (men and women). Parents, especially fathers, reward boys more for conforming to gender stereotypes and punish boys more severely if they violate gender norms. If boys who act “unmanly” are ridiculed by their peers and scolded by their parents, girls can more often get away with deviating from the gender role. This leads to the fact that boys strive more firmly to conform to their gender role, including pain tolerance, than girls.

Because the masculine gender role implies a high tolerance for pain, gender theory suggests that men who choose a masculine behavior pattern will be motivated to endure pain so as not to be seen as “unmanly.”

Psychosocial theories of pain behavior focus on the effect of contingency on the emergency and persistence of pain behavior, as well as the important role of learning in observing pain behavior and considering the consequences (reward or punishment) of pain behavior in others.

Several researchers have shown a correlation between the number of individuals with pain behavior in a family and the frequency of pain presentations by young people from these families. It was shown that this dependence was more pronounced in females. Women also show greater alertness to pain and greater willingness to report pain (complain about pain), while men do so reluctantly and with embarrassment.

A large body of evidence suggests that men and women, on average, differ in their pain reports in most cases across different pain stimulus characteristics and different research approaches.

Also, according to epidemiological studies, it is clear that women complain more of pain and are more likely to visit health care facilities for pain. However, until recently, all work on the study of sexual dimorphism was reduced mainly to identifying the physiological/anatomical causes (determinants) of the observed sex differences. The role of biological characteristics on the manifestations of sexual dimorphism has been sufficiently covered, but there are practically no studies where an attempt has been made to assess the proportion and role of psychosocial factors on the manifestations of sexual dimorphism in pain syndromes. Numerous behavioral characteristics of men and women, including communication style, dressing style, professional and non-professional interests, can be explained to a greater extent by differences in social learning and gender stereotypes of behavior than by biological characteristics.

Various data (laboratory, clinical, epidemiological) indicate that, on average, men and women assess clinical symptoms, severity (severity) and the significance of symptoms for health differently, and differ in their attitude towards their health and the system (various types) of medical care , and they see differently how a man and a woman should respond to pain. Men and women also differ in the expression of their negative emotions, which is an essential part of any pain syndrome.

It can be argued that men and women differ greatly in their pain expectations. These expectations are gender-specific, that is, in accordance with gender stereotypes (norms), both men and women believe that men are less sensitive to pain, better able to tolerate pain, and less willing to report pain. However, the extent of these differences varies greatly depending on the type of study (experimental or clinical), cultural factors (ethnic norms, etc.).

Chapter 3 The influence of the disease on the psyche and behavior of the individual

3.1 Emotional and behavioral aspects of pain perception

The perception of pain is associated with a person's early childhood experiences. Depending on this experience, the individual develops attitudes that determine his attitude towards pain. Pain and suffering are perceived as the opposite of joy and pleasure.

Parenting plays a huge role in overcoming pain. However, a person’s strength does not lie in chance, but in the willful, conscious overcoming of pain, in the ability to overcome the painful sensation, to rise above suffering, to achieve victory over the stubborn, persistent feeling of pain.

It has long been known that people who grew up in harsh conditions, accustomed to firm discipline and constant self-control, have better control of their feelings than pampered, undisciplined and selfish representatives of the human race. They do not respond to every painful stimulus by screaming, crying, fainting, or attempting to escape.

This is taught by the experience of our entire life, the experience of health and illness, work and rest, peace and war. Of course, one cannot go to extremes here and think that the only way to deal with pain is to suppress painful emotions. On the contrary, pain must be fought, it must be destroyed in all its manifestations. But this must be done courageously. A person must control excruciating pain. He must not become their prisoner

Fear, rage, pain and hunger, writes the outstanding physiologist W. Cannon, are elementary feelings that are equally characteristic of both humans and animals. They are among the most powerful factors determining the behavior of living beings. These are subjective states that cover all types of human feelings and experiences. And their role in human life is extremely important.

Much has been written about the emotional perception of pain. Pain, with rare exceptions, is regarded as a negative emotion. But the elimination of pain, the cessation of excruciating pain is a positive human experience.

Acute pain is usually accompanied by a cry, which is the result of convulsive contraction of the respiratory muscles. The scream arose from the initial sharp movement - exhalation. It became a signal of danger, a call for help, and partly turned into a weapon of defense, since it could frighten the attacker.

Some physiologists tried to explain the cry as self-defense of the body. They argued, and perhaps not without reason, that screaming - and a prolonged scream, characteristic of pain - is, among other things, a painkiller. It relieves and soothes pain, partly also because it promotes the accumulation of carbon dioxide in the blood.

If medical examination cannot find a physical or organic cause for a disease, or if the disease being examined is the result of emotional conditions such as anger, anxiety, depression, guilt, then it may be classified as psychosomatic.

Psychosomatics (from the gr. psyche - soul, soma - body) - studies the influence of psychological factors on the emergence and subsequent dynamics of the development of psychosomatic diseases. According to the main postulate of this science, the basis of psychosomatic illness is a reaction to emotional experience, which is accompanied by functional changes and pathological disorders in organs.

In modern psychosomatics, they distinguish: predisposition, factors that resolve and delay the development of the disease. The impetus for the development of psychosomatic diseases is difficult life situations, including as a consequence of difficult relationships in the family. In any case, to diagnose both a psychosomatic and a neurotic disease, it is necessary to understand the situational nature of its origin.

Often, when a psychosomatic illness occurs, conflict dynamics are defined by the concept of “stress.” But it's not just stress, i.e. stress that leads to illness. A person who is in a harmonious relationship with his environment can endure extreme somatic and mental stress and avoid illness. However, in life there are also such intrafamily problems that cause such a painful fixation and mental discord that, in certain situations, they lead to negative emotions and self-doubt, and ultimately “turn on” psychosomatic diseases.

Both in functional pain and in pain based on organic changes, personality relationships play an important role (not in the occurrence, but in the degree of pain experience). Pain often reaches its greatest severity in patients with personal unsettlement, lack of purpose and other unresolved conflicts. By focusing the attention of patients on themselves, pain in such cases is used as a means of getting out of a traumatic situation and helps patients avoid resolving real life difficulties.

During human development, pain and relief from pain influence the development of interpersonal relationships and the formulation of concepts of good and evil, reward and punishment, success and failure. As a means of eliminating guilt, pain thereby plays an active role in influencing interactions between people.

Psychosocial influences, interacting with factors of hereditary predisposition, personality characteristics, and the type of neuroendocrine reactions to life difficulties, can change the clinical course of certain diseases. The effect of psychosocial stress, provoking internal conflicts and causing an adaptive response, can manifest itself covertly, under the guise of somatic disorders, the symptoms of which are similar to the symptoms of organic diseases. In such cases, emotional disorders are often not only not noticed and even denied by patients, but also not diagnosed by doctors.

3.2 Influence of socio-constitutional factors on the concept of disease

People who have experienced trauma believe that the world is full of dangers and they need to be on guard at all times. This belief can have a powerful impact on everything people experience. Core beliefs play a central role and influence the organization of almost all experience. Some core beliefs place limits on what can be experienced.

It is known that for each age group there is its own register of disease severity - a unique distribution of diseases according to socio-psychological significance and severity.

For children, adolescents and young people, the most psychologically difficult diseases are those that change a person’s appearance and make him unattractive. This is due to the system of values, the prioritization of a young person, for whom the highest value is the satisfaction of a fundamental need - “satisfaction with one’s own appearance.” Thus, the most severe psychological reactions can be caused by diseases that are not medically life-threatening. These include any illness that negatively, from the teenager’s point of view, changes appearance (skin, allergic), crippling injuries and operations (burns). At no other age are such severe psychological reactions of a person to the appearance of boils, pimples, freckles, birthmarks, pallor, etc. on his facial skin.

Mature people will react more psychologically to chronic and disabling diseases. This is also connected with the value system and reflects the desire of a mature person to satisfy such social needs as the need for well-being, well-being, independence, self-sufficiency, etc. It is the satisfaction of such needs that can be blocked by the appearance of any chronic or disabling disease.

The second extremely important group of diseases for a mature person are the so-called “shameful” diseases, which usually include sexually transmitted and mental diseases. The psychological reaction to them is due to their assessment not as a threat to health, but is associated with worries about how the social status and authority of the sick person will change if others become aware of this.

There are groups of the population (primarily people in leadership positions) for some of whom heart disease (heart attack) is shameful, which is associated with limited opportunities for promotion.

For elderly and elderly people, the most significant diseases are those that can lead to death. Heart attack, stroke, and malignant tumors are scary for them not because they can lead to loss of ability to work or work, but because they are associated with death.

The characterologically determined subjective attitude towards the disease is formed mainly in the process of family upbringing. Moreover, there are two opposing family traditions of nurturing a subjective attitude towards illness - “stoic” and “hypochondriacal”.

As part of the first, the child is constantly rewarded for behavior aimed at independently overcoming illnesses and poor health. He is praised when he, not paying attention to the existing pain, continues to do what he was doing before it occurred.

The opposite is the “hypochondriacal” family tradition, which is aimed at creating a highly valuable attitude towards health. Parents are encouraged to be attentive to the state of their health, thorough in assessing painful manifestations, and identifying the first signs of the disease. In a family, a child gets used to paying his own attention and the attention of others (first parents, and then educators, teachers, spouses, etc.) to painful symptoms at the slightest change in well-being.

Family traditions determine a kind of ranking of diseases according to their severity. For example, the most severe may not include those that are “objectively” severe, but those that most often killed or affected family members more often. As a result, the subjectively most significant disease may be hypertension rather than cancer or mental illness.

The typology of response to diseases adopted in Russian clinical psychology was created by A. E. Lichko and N. Ya. Ivanov based on an assessment of the influence of three factors:

1) the nature of the somatic disease itself;

2) personality type, in which the most important component

determines the type of character accentuation;

3) attitudes towards this disease in the reference frame for

Similar types of responses are combined into blocks.

The first block includes types of attitude towards illness in which social adaptation is not significantly impaired (harmonious, ergopathic and anosognosic types).

Harmonious. A sober assessment of your condition without a tendency to exaggerate its severity and without reason to see everything in a gloomy light, but also without underestimating the severity of the disease. The desire to actively contribute to the success of treatment in everything. Reluctance to burden others with the burden of caring for oneself. In the case of an unfavorable prognosis in terms of disability, a switch of interests to those areas of life that will remain accessible to the patient.

With a harmonious type of mental response, realism in the perception of symptoms and understanding of the objective severity of the disease is important. At the same time, the patient tries to base his reactions on facts known to science (medicine) about the possibility of a cure for a specific disease, the origin of symptoms, etc. And such information can be provided to him.

Ergopathic. “Leaving illness for work.” Given the objective severity of the disease and suffering, patients try to continue working at all costs. They work with ferocity, with even greater zeal than before the illness, they devote all their time to work, they try to receive treatment and undergo examinations so that this does not interfere with their work.

Therefore, they try not to succumb to the disease, actively overcome themselves, overcome malaise and pain. Their position is that there is no disease that cannot be overcome on your own. Such patients are often fundamentally opposed to medications (“I have never taken analgesics in my life,” they say proudly).

Anosognosic. Actively discarding thoughts about the disease and its possible consequences. Not recognizing oneself as sick. Denial of the obvious in the manifestations of the disease, attributing them to random circumstances or other non-serious diseases. Refusal of examination and treatment. The desire to “get by with your own means.”

Anosognosia is quite common. It may reflect an internal rejection of the patient’s status, an unwillingness to reckon with the real state of affairs. On the other hand, this may be behind a person’s misconception about the significance of the signs of the disease. Active non-recognition of oneself as sick occurs, for example, in alcoholism, as it contributes to evasion of treatment.

The second block includes types of reactions that lead to mental maladjustment, predominantly with an intrapsychic orientation (hypochondriacal, anxious and apathetic).

Hypochondriacal. Focusing on subjective painful and other unpleasant sensations. The desire to constantly tell others about them. Reassessment of real and search for non-existent diseases and suffering. Exaggeration of side effects of drugs. A combination of the desire to be treated with disbelief in success. Requirements for a thorough examination combined with fear of harm and painful diagnostic procedures.

Anxious. Continuous anxiety and suspiciousness regarding the unfavorable course of the disease, possible complications, ineffectiveness and even danger of treatment. Search for new methods of treatment, thirst for additional information about the disease, possible complications, methods of therapy, continuous search for medical “authorities”.

Apathetic. Apathy in its true sense is complete indifference to one’s fate, to the outcome of the disease, to the results of treatment. Passive submission to procedures and treatment only with persistent encouragement from the outside. Loss of interest in everything that previously excited you.

The third block includes types of response with a violation of mental adaptation according to the interpsychic variant, which is most dependent on the premorbid personality characteristics of the patients (neurasthenic, obsessive-phobic and paranoid).

Neurasthenic. “Irritable weakness” type behavior. Outbursts of irritation, especially during pain, discomfort, treatment failures, and unfavorable examination data. Irritation is often poured out on the first person encountered, and often ends in repentance and tears. Intolerance to pain, impatience, inability to wait for relief. Subsequently - regret about the anxiety and incontinence caused.

Obsessive-phobic. Anxious suspiciousness, which primarily concerns fears that are not real, but unlikely: complications, treatment failures, poor outcomes, as well as possible (but also unfounded) failures in life, work, family situation in connection with the disease. Imaginary fears worry more than real ones.

Paranoid. The belief that illness is the result of something malicious. Extreme suspicion of medications and procedures. The desire to attribute possible complications of treatment or side effects of medications to the negligence or malice of doctors and staff. Complaints to all authorities, accusations and demands for punishment in this regard.

Thus, a person’s level of education and level of culture, as personal properties, also influence the assessment of the subjective severity of the disease. This is especially true for the level of medical education and culture. Moreover, both extremes turn out to be psychologically negative: both low medical culture and high one, which are equally likely to cause psychologically severe reactions. However, their mechanisms will differ. In one case, this will be due to a lack, in another - to an excess of information about diseases, their objective severity, course and outcomes.

Pain plays an extremely important role in the psychological life of an individual. During human development, pain and relief from pain influence the development of interpersonal relationships and the formulation of concepts of good and evil, reward and punishment, success and failure. As a means of eliminating guilt, pain thereby plays an active role in influencing interactions between people.

Conclusion

Pain is a complex phenomenon that includes perceptual, emotional, cognitive and behavioral components. Physiological pain plays a protective signal role, warns the body of danger and protects it from possible excessive damage. Such pain is necessary for our normal functioning and safety.

Painful sensations are sensations that characterize such effects that can lead to a violation of the integrity of the body, accompanied by a negative emotional coloring and vegetative shifts (increased heart rate, dilated pupils). In relation to pain sensitivity, sensory adaptation is practically absent.

The idea of ​​pain as a simple alarm signal sounding in the brain seems correct only at first glance. The modern point of view is much more complex. In understanding the intensity of pain, the emotional aspects of the injury are immeasurably more important than the degree of physical damage. The holistic perception of pain depends on the emotional state and thought process, coordinated with pain signals coming from the site of injury.

As it turned out, the threshold of pain sensitivity does not have significant age differences, but laboratory analysis reveals a whole set of small variations in the nature of responses to painful stimuli.

Gender differences in pain tolerance have also been noted. Men, in general, tolerate pain somewhat better than women. In general, however, it is difficult to judge, since the external expression of pain is often determined by upbringing. In addition, differences in the expression of reactions to pain exist between the elderly and the young, as well as between men and women, even with similar upbringings.

Pain is a mental state that occurs as a result of super-strong or destructive effects on the body when its existence or integrity is threatened. It is known that the emotional state of a person is the cause of many diseases. Even ancient scientists implied the inseparability of the physical and mental.

The noted features of the social development situation in which a suddenly ill person finds himself can change his entire lifestyle: his life attitudes, plans for the future, his life position in relation to various important circumstances for the patient and to himself.

The severity of pain is almost impossible to measure objectively. As it seems to a person, so it hurts. The strength of pain depends not only on the sensitivity of nociceptors, but also on how pain signals are perceived by the brain, on the physiological state, upbringing, education, personality characteristics, and “pain experience.” If a person is depressed, the pain will seem stronger. An optimist, who has not been accustomed to whining and complaining since childhood, will bear it more easily.

It can be argued that pain is the most valuable acquisition of the evolution of the animal world. The clinical significance of pain as a symptom of disruption of the normal course of physiological processes is extremely great, since a number of pathological processes of the human body make themselves felt in pain even before the appearance of external symptoms of the disease.

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