Circumcision, the removal of the foreskin over the penis, was long thought to be a painless experience for an infant and was treated accordingly with little or no anesthesia. Most of the times during the surgical procedure, the babies cry very forcefully. This was for a long time thought to be normal and healthy. Other times, they lie still without making a sound from either shock or the act of passing out from the pain (1). This unresponsiveness was always thought to be from undeveloped pain receptors, or Nociceptors in the Somatosensory system (2) . These pain receptors send information to the spinal cord, then to the brain stem, thalamus, and somatosensory cortex. Modulation can occur through these pathways by way of suppression using large mechanosensitive fibers that enter the spinal cord or by endorphine release. This modulation involves changing the information about the pain to lessen the perception of its magnitude. Endorphines (or endorphine neuromodulators) and Morphine act as inhibitors to the pain pathways. The body itself can minimize pain using A(delta) fibers which can inhibit nociceptors, and together, they reduce information about the pain coming from the interneurons (3). Sometimes the nervous system causes an increase in pain rather than a decrease in pain, as when inflamed skin will become really sensitive. This is useful to decrease the use of an injured body part that could incur more harm (3). Along with the experience of physical pain comes emotional pain that can sometimes manifest itself later on in life. This manifestation can occur through location of the pain that has been stored in long-term memory or just through the unconscious flow of information through the memory. Recollection of the pain can sometimes occur through a process called hypnotism. Hypnosis is an altered state of consciousness which is dissimilar to either being awake or being asleep, during which attention is drawn from the outside world. Sigmund Freud, the founder of psychoanalysis, used the hypnotic state of the patients to uncover painful and forgotten memories. Freud believed that during development, unacceptable sexual and aggressive drives are forced out of one's consciousness. These repressed urges and feeling are sometimes expressed later as neurotic images brought forth by hypnosis (4).
"There's a sensation I've never experienced before. It's in my back, being drawn up, pulled in... I'm on something hard and cold! I feel myself arching. It's cold!.. I don't know what's going on. I hear babies crying and I'm crying too, I don't know why. Oh! They're pulling on my penis and I'm feeling some pain. It hurts there; I'm not sure why...They are holding my legs down... They are cutting my penis and it hurts. It hurts! I feel my penis being pulled. I feel sharp points there. I'm hurting and my back is tight. Someone picks me up and holds me. I can't relax. I am stiff. My penis hurts; it burns...It takes a long time to relax... I'm tired now. I cried hard. I'm all cried out...(2)"The pain and intense emotion experienced during and after rape can sometimes be recalled without the concentration of hypnosis. Rape is defined many ways but can generally be identified by the victim as any act that is performed sexually and without her consent. It generally affects more women than men and comes in many forms including date rape, incest, stranger rape, and even "gang bangs", or multiple attacker rapes. The emotional pain involved in rape is generally much more permanent than the physical input. The physical input of pain signals the I-function to process and identify what is happening to the person and the self. The I-function in this case is an active participant in the whole process. Many rape victims say that they were able to separate from themselves, or turn "off" the I-function during their time of trauma. This particular separation from the I-function has not yet been studied enough for a definitive answer to be given regarding truth of the separation. The way that many people recall their experience(s) using long-term memory is a loss of "self" and a change in "I."
"Don't be fooled by the face I wear, for I wear a thousand masks. And none of them are me, don't be fooled...Beneath dwells the real me in confusion, in aloneness, in fear... And so begins this parade of masks...I tell you everything that's really nothing, and nothing of what's everything that's crying deep within me...Who am I you may wonder. I am every man you meet, and also every woman that you meet. I am you, also."(5).
Their memories recall a change in self and separation from the physical body sometimes for many years afterwards. Scientifically, in order for the painfully emotional experiences to be stored in long-term memory, the nervous system itself must change to accommodate the memories. Memory is necessary for an experience to have an effect after the time in which it occurs. This effect could be manifested in severe neurotic images and great emotional instability. Pain is stored in Declarative or Explicit memory, which is the memory of facts and events, and the establishment of the relationship between objects and events. A type of Explicit memory is called Episodiac memory, which is recalling what one has experienced. Long term memory, which is by definition, a long lasting change in the nervous system, requires the synthesis of a protein (3). Protein synthesis requires DNA and is stimulated by increases in cAMP, activation of PKA, and phosphorylation in the nucleus of the neuron of CREB. CREB is a transcription factor(7). Long term memory is stored in the temporal lobe, in the Hippocampus of the Limbic System. The Limbic System controls emotional behavior and body changes that are associated such as an increase in heart rate (3). In the case of rape, inputs of physical violence can produce different outputs relating to emotional state and participation of the I-function. In many memories, everything in the long-term memory in the nervous system has been changed so drastically, that the I-function is not recognizable as the same that was there previously. At this point, a person may not know who "she" is or anything about the self or I-function that existed before the rape.
"Around the age of seven I was sexually abused by my older sister...And through all of this I had a story to convince myself of, a story to live in my head. Just to get through the everyday hell I was living... A different story for everyday, just something to keep me from going crazy, from killing myself... Years passed...And although I want it all to stop; the pain, the emptiness inside, the hurt, the fear... I find I can never leave the security of my stories behind. And sometimes, when I can laugh about it, I ask myself when I wake up... Who am I today?" (6)
Because there is not enough neurological experimentation going on to study the I-function related to rape victims, it is very hard to answer the question of whether the I-function can be turned off or changed in relation to the effects of pain. Even without neurological evidence from experimentation with rape victims, there is evidence in the amount of personal testimonies and stories reflecting the idea of a loss of self or change in I-function. Almost every recollection explains a feeling of being detached and not being aware of whom the self was. There are many possibilities as to why the I-function could be turned "off" or repressed in painful experiences. Is it possible that a corollary discharge forms avoiding the I-function in times of great trauma? Is that what is referred to as "shock?" This topic definitely deserves more experimentation and study in the scientific world.
Pain and Circumcision:
1) Circumcision and the Jewish Religion
2) Babies Remember Pain
From abuse to violence: Psychophysical Consequences of Maltreatment
Glossary of Pain Terms
Poem: I Used To
6) Poem:Who Am I Today
Poem:Alone and Scared
7) Creb and Memory
Genetic and Cell Biological Studies of Memory
3) Delcomyn, Fred. Foundations of Neurobiology. New York: W.H. Freeman and Co, 1998.
4) Encyclopedia, Microsoft Bookshelf 1998, for PC's.
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