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     I think it is interesting to explore expectations of pain. Someone mentioned in class last week that if we are expect to be in pain it makes the pain less, less intense, and noticeable. While I think this is true, another component is also what emotional state a person is in when they feel the pain or when their actions lead to pain. If someone is in a very depressed state, as we discussed in class, pain can be more intense and the body is more susceptible to pain. My question is how do our perceptions of what pain is define how we rate the intensity of pain? Pain is a very independent and personal bodily expression, as proposed by the "beetle in the box" model. Since pain is so individual, pain scales are just irrelevant. I think these scales while they ultimately try to give a patient a sense of their pain, are primarily available to offer legal administration of opiates during severe pain. I think that these scales exist for legal purposes to ensure proper use and treatment using narcotic pain medications, but also to protect the health care provider.

            I also think Professor Grobstein brought up an interesting point, that we have a very hard time describing our pain. I think it’s hard to describe pain because there are so many emotional and social factors that influence our description of pain, including a limited pain vocabulary. While I think pain scales attempt to make a standard pain vocabulary, it is impossible that the select vocabulary would accurately gauge someone’s pain. The pain vocabulary is limited and is bias to one type of pain terminology and language. Pain is so personal that I think that a person has a hard time describing pain because they feel they are expected to use the pre-determined pain vocabulary that does not accurately describe what they are feeling. Like emotion, pain varies from person to person and the vocabulary used to describe pain varies according a person’s perception of pain.

            Another point that was not mentioned in the class discussion was hypochondriacs. Although this relates to somatoform disorders, discussed last week, I think it is very relevant to the discussion of pain, especially pain perception. Hypochondriacs believe that they are seriously ill, and experience a variety of physical symptoms, including severe pain. Perhaps these severe sensations of pain are related to distorted pain receptor pathways that cannot be identified by physicians. So it could be that these individuals are in extreme pain but there are no techniques or procedures to accurately diagnose a dysfunctional or distorted pain system. Since pain is a private and individual perception, perhaps people who are hypochondriacs are more sensitive to what some people might call small insignificant pains. It could be that a hypochondriac’s pain is the body’s form of announcing or flagging a problem within the brain.