Feature Archive

Got Pain? Think Sex.

Fantasies Fight Fear

By Lynda Liu
WebMD Feature

Reviewed By Gary Vogin

Sept. 13, 2001 -- You're at the dentist's office, white-knuckling the reclining chair. As a bright light assails your eyes, you focus on the approach of that awful wailing drill and on the shrill sound of metal meeting tooth enamel. You shrink back in anticipation. Your face tightens with dread. Then something reminds you of last weekend's romantic getaway. Perhaps it's the floral painting on the wall, recalling the rose-patterned bedspread in the room where you stayed. Perhaps it's that love song playing on the radio -- the song you danced to. Your grip loosens, your grimace slackens, and your mind wanders. And when the dentist announces, "You're done," you suddenly realize it didn't hurt as much as you thought it would.

Does using fantasy to outwit pain and fear sound far-fetched? It's not, claims a study presented at the annual meeting of the American Pain Society in October 1999. A research team from Johns Hopkins and other universities found that people who fantasized about a highly pleasurable sexual scenario experienced the least pain.

For years, people have used imagery, such as visualizing the beach or other favorite places, to reduce their perception of pain during dental or medical procedures. The new sexual fantasy research suggests yet another option for nondrug pain relief.

Feel Your Pain

In the 1999 study, researchers asked 40 college students to submerge their hands in a tank of ice water and then rate their pain on a scale of 0 to 10. Researchers measured how long it took for the students to first feel pain and how long they could stand to keep their hands in the icy tank.

The subjects were then divided into four groups, and each person was asked to immerse one hand again. During this dunking, the control group was told not to use any imagery or self-distractions that would interfere with their ability to detect pain. The second group visualized a neutral scene, such as people walking. The third group thought about a sexual fantasy that each had rated as minimal in terms of pleasure or enjoyment. The fourth group focused on sexual fantasies that gave them maximal pleasure and enjoyment.

Those who had visualized highly pleasurable sexual fantasies reported significantly less pain than they experienced during their first dunking and also less pain than all of the other groups. They also were better able to tolerate the pain and kept their hands in the ice water longer. Researchers found that the highly pleasurable fantasies improved mood, reduced worry and tension, and increased the subjects' belief that they could deal with the pain.

Think Positive

Sexual fantasies work because they follow a basic pain-control theory, says Peter Staats, MD, one of the study's authors and director of the division of pain medicine in the Johns Hopkins University School of Medicine's department of anesthesiology. This theory says that something eliciting a positive emotional response during a painful experience makes it seem to hurt less. To work, the visualization has to be strongly positive, which explains why the minimally pleasurable fantasies and the neutral visualizations did not have the same effect.

The study confirms what pain management experts have known for a long time, says Martin Grabois, MD, chairman of the department of physical medicine and rehabilitation at Baylor College of Medicine in Houston. And it is not the sexual fantasy per se that's important. "It's thinking of something that is pleasurable."

According to Sandor Gardos, PhD, a clinical psychologist and sex therapist, "It is fairly well documented that sexual arousal is accompanied by a decrease in sensitivity to pain. That is why individuals often notice a bruise or hickey the next day and don't even remember how it happened."

It's All in Your Imagination

If you want to try the sexual fantasy technique, visualize with as much detail as possible and engage all of your senses, says Hamid Hekmat, PhD, another study co-author and professor of psychology at the University of Wisconsin at Stevens Point. Once you are feeling good, focus your attention on the mood and let the fantasy go. Try this technique prior to a potentially painful situation so you'll be adept at it when you need it.

Lynda Liu is a New York journalist whose writing has also appeared in Mademoiselle, Prevention, Fitness, and other publications.

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