Pain, Suffering, and the Flexible Self

This dissertation is comprised of three articles that use neuropsychological research and technologies to consider the issues of organized flexibility, the self, and pain versus suffering. The first study outlines a theoretical model based on the contention that the human mind emerges in part through the interaction of three, large-scale, neural sub-systems. We describe how rigid patterns of interaction between these neural subsystems putatively lead to rigid modes of self-related processing, and thus contribute to "suffering". The second and third articles describe two studies designed to test the potential of LORETA neurotherapy to ameliorate psychological suffering, in this case by teaching a cohort of chronic pain patients to increase their neural flexibility. There is currently a lack of clarity around the kind of electrophysiological activity that is specifically associated with the suffering aspect of chronic pain. Therefore, the second article describes a study in which a cohort of chronic pain patients entered a state of chronic pain related suffering. LORETA EEG analysis was then used to investigate the electrophysiological activity that was specifically associated with this suffering. This study failed to find statically significant results, however it did produce qualitative support for the hypothesized pattern of neural changes. Finally, the third study directly tested the possible efficacy of LORETA neurotherapy as a chronic pain management intervention. LORETA neurotherapy was used to teach a cohort of eight participants with mixed chronic pain conditions to volitionally down regulate activity in the mPFC, a region that is crucial to for autobiographical self-related processing. Participants in an active control condition were trained in Autogenics and CBT, a well-established approach to chronic pain management. The neurotherapy group members developed the ability to volitionally regulate their neural activity in the intended manner, improved their phasic pain regulation abilities, and demonstrated statistically significant clinical improvements in mood and functional status. However, the observed phasic pain regulation improvements were not statistically significant, and were not associated with the observed neural changes in the expected manner. These results are interpreted and their implications discussed.