Music, art, and the perception of pain

ResearchBlogging.orgAs a young child, my family was poor and we had to go to a public clinic for dental work. Since we were being seen by dental students, often the process was painful and took much longer than it should have. It was a tremendous relief when my uncle opened a swanky dental practice with a lake view, and soothing '70s rock wafted out over the audio system. I'm pretty sure my uncle was a better dentist than the students who had been seeing me before, but it also seemed like just the environment in his office contributed to me feeling better when he had to do an awful procedure like filling a cavity.

I felt like the total environment in the office contributed to my sense of well being -- his pretty young assistants, his elegant timber-framed reception area, the splashing waters of Lake Union against the pier. But recent research suggests the primary factor may have simply been the music. While the results haven't been consistent, there is some evidence that playing music for patients who've undergone painful medical procedures may help mitigate their sensation of pain.

The problem in the research comes in identifying the kind of music to play. Some researchers have focused on finding the ideal type of music for all patients -- "anxiolytic" music that is supposed to reduce anxiety and relax patients. But different people have different music preferences. Music that Jim finds relaxing seems obnoxious and grating to me. Music that I find relaxing seems obnoxious and grating to Greta. Greta and Nora like Broadway musicals, which I enjoy too, but in much smaller doses.

People nowadays are used to creating their own personal audio environment on their iPods. Wouldn't it make sense to let them choose their own music as a way of distracting them from medical pain?

A team led by Laura Mitchell recruited 80 people to bring their favorite song to the laboratory, where they would be paid to dip their hands in frigid water for as long as they could tolerate it. The musical selections they chose ranged from works by Johnny Cash, to The Verve, to Rancid. The volunteers first dipped their hand in warm water to bring it to a consistent 32°C. Then they held it in a circulating cold water bath at 5°C -- close to freezing! This was repeated three times -- once while listing to their favorite song, once while staring at a blank wall, and once while looking at a work of art they selected from 15 chosen by the experimenters. They were told to hold their hand in the water as long as they could stand it, or five minutes, whichever came first. Did listening to the music affect their ability to tolerate pain? Here are the results:


As you can see, people held their hands in the water significantly longer while listening to the music (look at the blue line and the scale on the left) and they also perceived significantly less pain (the green columns correspond to the scale on the right, which extends of 1 to 100). Viewing the artwork had no effect on these results -- the difference between pain ratings for art-viewing and no-distraction conditions was not significant. But the artwork did have one interesting effect. The participants were also asked to rate how well they were able to distract themselves from the pain. Now the effect of viewing art was significant:


While listening to music was best, participants who viewed the artwork rated their ability to distract themselves from the pain as significantly higher compared to when there was no distraction (again, on a scale of 0-100).

Perhaps it was the combination of factors: the music, the scenery, the comfort in being cared for by a family member, which combined to make me feel better at my uncle's office compared to the public clinic. But in any case, it seems clear that allowing patients to choose their own music while experiencing pain does indeed go a long way toward mitigating that pain.

The researchers point out that there are some limitations to their study. If you undergo a surgery procedure or are experiencing chronic pain, there's no way to escape it. If you're a real patient, you can never just remove your hand from the frigid water to remove the pain, and in these circumstances music may have a different effect.

But it certainly makes intuitive sense that putting patients in a pleasant environment where they have some degree of control would be a good start to helping reduce their experience of pain.

Laura A. Mitchell, Raymond A. R. MacDonald, Christina Knussen (2008). An investigation of the effects of music and art on pain perception. Psychology of Aesthetics, Creativity, and the Arts, 2 (3), 162-170 DOI: 10.1037/1931-3896.2.3.162


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thanks for not asking us to do a poll "stick your hand in frigid water and listen to your favorite song. How do you feel?" I don't think I'd have participated in that one.

I'm not sure it's specifically music that makes the difference. I think it's the distraction from the pain. It would be interesting to check if a short video, as an example cartoons would have a similar or even better impact.

I haven't read the article, but it strikes me that there might have been a signigicant amount of Hawthorne-effect in this study. The fact that when it came to music, patients were allowed to choose it themselves freely, while the pieces of art were already pre-selected thereby presenting a much more limited choice might have influenced the effect of the different distractions.

I wonder what the results would be if the researchers reversed the testing process, i.e., if they had the participants listen to the music on the first go-round and stare at a blank wall on the last try. It seems to me that a tolerance for pain would develop over time, no matter what the order of testing, and that might be a partial explanation for the results.

I wonder how much emotion plays into this. If you define "reacting to the pain" in terms of an emotional response then it makes sense that music, a very powerful mechanism for evoking emotion, would supplant the emotional reaction you are having to the pain. I wonder how many people close their eyes to listen during this experiment, allowing even greater immersion in the emotion of their favorite song.

This is a pretty good study, as far as it goes.

As a composer, I think it's safe to say that some characteristics make music inherently more distracting, volume changes, percussion, and segues between low and high information densities, to name a few. Barring sensory overload, these effects may be reduced by the memory engagement of familiar music.

So you might want to "rate the music" in some way as well.
"Stops the pain but I can't dance to it while I'm under anesthetic, I give it an 8.5!"

When I'm at the dentist I like Sarah McLachlan tunes.

Dave32 makes a good point, but it doesn't seem like the tests went sequentially from no distraction to art to music - that's just how its displayed on the chart right?

I think these studies merely confirm something we've known for a long time: individuals can choose to focus their cognitive attention/concentration on something else while experiencing relatively short, small periods of certain kinds of pain/stress... We do this on a daily basis... Ever gotten a tattoo? While you're getting tattooed you need to draw your attention away from the pain - you might clench something hard, or just think about your *safe place*... or if you are an athlete, you know about *playing through the pain* and focusing your attention away from the pain... so i think what this study fails to do is demonstrate the superiority of either art or music as cognitive distractions from pain. indeed, i can easily imagine how being exposed to shitty art or horrible music while sticking your hand in hot water would make the pain feel worse!!!

I've dealt with migraines, sometimes lasting for three to four days, since very young and have always used music to help me control the pain. The music isn't so much the 'safe place' as a barrier against other distractions that can keep me from being able to go to my 'safe place'. The wrong music will only make matters worse by being just another distraction, an irritation that instead of being a barrier becomes the focus and thereby making the headaches worse. But my music works very well for me. I found the article interesting as a kind of confirmation of my own trial and error.

I wonder how much emotion plays into this. If you define "reacting to the pain" in terms of an emotional response then it makes sense that music, a very powerful mechanism for evoking emotion, would supplant the emotional reaction you are having to the pain. I wonder how many people close their eyes to listen during this experiment, allowing even greater immersion in the emotion of their favorite song.