Anticipating Pain Is Worse Than Feeling It

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The study: Giles Story attached electrodes that would deliver electric shocks to the hands of 35 subjects, inflicting minor pain that ranged from a slight buzz to something that felt like a strong insect bite. The subjects got to choose between receiving milder shocks after an interval as long as 15 minutes or stronger shocks more immediately. Most subjects opted to receive the more-intense stimuli right away rather than experience the dread of waiting for less intense ones.
The challenge: Is the expectation of pain worse than the actual pain itself? Should we meet the unpleasant head-on, and just get it over with? Dr. Story, defend your research.
Story: A full 70% of the time our subjects opted to receive more-painful shocks right away rather than wait for less painful shocks in the near future. We infer from this that dread—the anticipation of negative outcomes—is a powerful force. But how powerful? We were trying to measure dread. And we think these findings show that dread is so painful that people will pay a significant price, in the form of more physical pain, to avoid it.
HBR: First things first. You’re jolting people with electricity? What kind of twisted lab do you run?
[Laughs.] I assure you this is very controlled and quite benign—we don’t jolt people. We used mildly painful electric shocks, on the back of the hand. And everyone who participates obviously agrees to it. It’s actually a common technique in research that looks at how to treat chronic pain.
And was the amount of pain subjects chose much higher than what they would have gotten by deferring it?
Yes. People chose up to a third to half again as much pain. On a typical 0-to-10 scale, the people with the most dread were choosing a shock that would be rated a 6 right away rather than waiting for a 4 later.
So dread feels more painful than a level 6 shock? That seems alarming.
Not quite. The idea is that dread plus the eventual shock equals more than a 6. The strange part is that opting for higher amounts of pain right away goes against the widely accepted theory of temporal discounting—which says we place lower value on future outcomes. In positive situations, this plays out as a desire to have $10 today rather than wait for $12 a week from now. According to that theory, if I’m discounting the value of a level 4 shock that happens later, there’s no way I’d choose a level 6 shock now. But most people do choose the bigger shock. Why? We believe it’s because they factor dread into their temporal discounting calculus. They’re not weighing a 4 shock versus a 6 shock. They’re weighing a 4 shock, plus five or so minutes of anticipating it, against a 6 shock that’s over in a few seconds.
But what if we said you could come back in a week to receive the shock? There must be some point at which we don’t dread future pain more than present pain.
We tested for this in a follow-up study in which, instead of administering shocks, we asked people whether they would choose to schedule a hypothetical painful dentist appointment sooner or later. We saw the same pattern. Now, in the first study we’d made the pain inevitable. In the real world you’d have all kinds of mechanisms for avoiding the painful situation—you could skip the appointment or schedule it and just cancel later. We believe people often procrastinate in the hope that maybe painful events will just go away altogether. But if an event is inevitable, the pattern of wanting to get it over with seems to hold.
If dread is so bad, won’t anyone who postpones the appointment by five months build up an unmanageable amount of it?
Well, we certainly find that dread builds up the longer the wait—but not in a linear way, as you might imagine. A short wait increases dread a lot, but prolonging the wait further has less of an impact. It looks to us as if people’s dread is much worse on the day before the appointment than when it’s a week away. It rises exponentially as an event nears.
Exponential dread sounds deeply miserable.
Yes. As you get closer, the dread grows faster. By the way, we suspect the reverse is also true. The opposite of dread in psychology is called “savoring”—the anticipation of a positive outcome. And it appears that we may enjoy that more than the actual positive outcome itself.
That’s the Christmas afternoon effect.
I’ve been dreading asking this next question.
The sooner you ask, the sooner the pain will be gone.
I remember studies from the 1960s in which researchers yoked dogs together in pairs and shocked them and discovered “learned helplessness.” The dogs just gave up resisting the shocks and whimpered, even if they weren’t shocked but their yoked partners were. Will enough dread lead to that kind of helplessness?
It very well may. We don’t have data yet, but there may be connections between the accumulation of dread and depression. Depressed people see everything as having a negative outcome. So you can imagine they’re constantly filled with dread. That’s very hard to deal with.
Have you measured the physiological markers related to dread?
No, but others have. Gregory Berns and his colleagues measured brain activity and found that people with higher anticipatory responses were more likely to choose to get pain out of the way.
Your study dealt with physical pain. Does this phenomenon carry over to the dread of emotional pain—say, the anticipation of a bad performance review?
There’s no data yet, but I’m sure the dynamics are similar. The dread experienced would probably be akin to the dread in the dentist study, where the pain was months away and subjects weren’t sure what it would feel like. People may try procrastination and avoidance here too, but our results suggest that as the review becomes inevitable, they’ll choose to get it over with—perhaps even move the date of the review up—rather than wait and endure that exponential dread curve. Looking at that would be a wonderful study!
Can anything be done to mitigate dread?
Yes, we’ve shown that in our study. When we described a shock level as a decrease from a higher level, people dreaded that shock less. We can also rig situations to reduce dread somewhat. Take a flu shot. You’re called in and sit in a chair watching the nurse prepare the needle, thinking all the while of the upcoming pain. Another way to go would be to have the needles prepped before you walk in—and have the nurse stick you right away. A worker might make self-affirmations to offset the dread of a performance review, or the boss might say, “It’s not going to be that bad.”
Unless, of course, it is. Then you might as well get it over with.
It’ll hurt less that way.

Defy Medical TRT clinic doctor
True! When I think a bout getting in my ice bath the anticpitory pain is much worse and keeps me out.

I learn to be in the moment and feel the pain as it arises as a sensation rather than the thought of pain.
Very interesting I lack motivation I am home learning a software called solidworks I have to keep pausing the videos to write down the notes I have found myself skipping a lot of days ect I had in my head its a only a chapter video coarse and each chapter is like 12 videos so in my head I was thinking maybe do one more to keep the flow now the videos are longer but part of me is thinking well yesterday you learnt how to add text to a 2d sketch and also with a arch effect once I get out of chapter 2 maybe chapter 3 will be about designing your own 3d part and when I complete the course be able to 2d sketch 3d design a part and print it with the 3d printer I have
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