Don’t Worry, This Will Only Hurt a Bit: The Role of Expectation and Attention in Pain Intensity

To cause pain, it is not enough to deliver a dose of noxious stimulation. Pain requires the interaction of sensory processing, emotion, and cognition. In this paper, I focus on the role of cognition in the felt intensity of pain. I provide evidence for the cognitive modulation of pain. In particular, I show that attention and expectation can influence the experience of pain intensity. I also consider the mechanisms that underlie the cognitive effects on pain. I show that all the proposed mechanisms of pain modulation affirm the view that cognition impacts the sensory and discriminative aspects of pain. I conclude that pain perception is a cognitively penetrated phenomenon.