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Authors: Temple Grandin

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BOOK: Animals in Translation
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When I started looking into the literature on frontal lobes and pain I found out that psychiatrists have known about this connection for years. The idea that active frontal lobes mean active pain was so well established that in the 1940s and 1950s a few psychiatrists began treating cases of severe and intractable chronic pain by surgically disconnecting the patient's frontal lobes from the rest of his brain. The operation they did was called a
leucotomy,
and basically it was a less-invasive lobotomy. Where a lobotomy removed the frontal lobes completely, a leucotomy left the frontal lobes in place but cut the connections between the frontal lobes and the rest of the brain.

Both operations had a lot of horrible side effects, but the positive effect on a pain patient's suffering was almost miraculous. A couple of days after the operation patients who'd been completely disabled by pain would be up and about, doing the things they used to do. The “recoveries” were so dramatic that Antonio Egas Moniz, who invented the operation, won the Nobel Prize for his work in 1949.
3

I put “recovery” in quotation marks because leucotomy patients
didn't exactly recover. They
acted
like they'd recovered, but whenever people asked how they felt, they'd always say the pain was still there. What was different after surgery wasn't the pain; it was their
feelings
about the pain. They didn't care about it anymore. Antonio Damasio has a description of one of these patients in his book
Descartes' Error.
4
The first time Dr. Damasio saw him, the patient was in such bad shape he was “crouched in profound suffering, almost immobile, afraid of triggering further pain.” Two days after the operation the man was sitting in a chair, playing cards with another patient. He looked completely relaxed.

When Dr. Damasio asked the patient how he was doing his answer was, “Oh, the pains are the same, but I feel fine now, thank you.” You can read story after story exactly like that one in the literature on leucotomy and pain. After their operations, leucotomy patients stopped
caring
about their pain. Dr. Damasio says they kept their pain but lost their suffering.

It's impossible to imagine what it would feel like to have severe pain but not be bothered by it, because for the rest of us severe pain means severe suffering, period. They aren't two different things. I'm sure that's because our frontal lobes integrate sensory pain pathways so totally with frontal, emotional pathways of suffering that we can't perceive any separation at all. It's a little like stereoscopic vision: if your vision is working right you
can't
separate what your right eye is seeing from what your left eye is seeing without closing one eye.

Even though we can't feel what the leucotomy patients were feeling, it
seems
like they were still feeling something like what we would call pain, because they still asked for painkillers. On the other hand, after the operation they stopped asking for really strong painkillers like morphine. All they needed was aspirin. It's possible they were feeling something similar to what the rest of us feel when we have pain mild enough to ignore. Mild pain is still pain, but it doesn't ruin your life, whereas severe pain hijacks your attention system. That's almost the definition of severe pain, that it commands all of a person's attention.

Another piece of evidence the leucotomy pain patients were still feeling “real” pain, at least to some degree, is that if you suddenly poked one of these patients with a pin they would shriek in pain.
They would actually shriek
louder
than a normal person with normal pain perception. Most researchers chalk this up not to greater pain but to lower
impulse control.
The frontal lobes censor and control outbursts of any kind, including screams of pain. Since these patients had lost their mental brakes, they screamed at a mild poke.

I think injured animals are probably somewhere in between a leucotomy patient and a normal human being. They do feel pain, sometimes intense pain, because their frontal lobes haven't been surgically separated from the rest of their brains. But they probably aren't as upset about pain as a human being would be in the same situation, because their frontal lobes aren't as big or all-powerful as a human's. That's why they don't slow down after surgery the way we do. They don't feel bad enough to slow down. I think it's possible that animals may have as much pain as people do, but less suffering.

A
UTISM AND
P
AIN

A lot of autistic people are the same way, which is another reason I tend to think animal pain is less severe than human pain
on average.
As I've mentioned more than once, whenever I come across a difference between animals and normal people that involves the frontal lobes, I've usually found the same difference in autistic people. We have a lot in common with animals. So I'm expecting to find the same thing with pain perception.

Just like animals, quite a few autistic people—not all, but many—
act
like they feel less pain than nonautistic people. This happens so often that
insensitivity to pain
is listed on most symptom checklists for autism. It's especially shocking with little kids who are self-injurious. Some of them can slap their heads hard with their hands and not seem to feel any pain at all (other autistic children slap their heads and then cry). There've even been reports of autistic children burning their hands on hot stoves and not reacting, although fortunately that's extremely rare. Autistic children don't have such low pain sensitivity that they're in danger of injuring themselves without knowing it.

Another interesting thing: a lot of parents tell me their autistic children don't have normal sensitivity to cold, either. They can spend
hours in the deep end of a freezing cold swimming pool while all the other kids just splash around for a few minutes and then go warm up on the deck. I don't know whether animals have lower cold sensitivity on the whole. Animals in northern climates do better in winter cold than people do, but they have nice fur coats to keep them warm and people don't. A wolf's coat is so thick snow doesn't melt on its body.

So I have no way of knowing how cold perception compares between animals and people with autism. Also, I want to make sure I'm not implying to parents or teachers or anybody else that autistic people are impervious to everything that comes their way. The autistic sensory system is abnormal for a person, while an animal's sensory system is normal for an animal, so I don't know where the similarities begin and end. I do know that while some things are less painful for autistic people than for typical people, other things, especially certain types of sounds, are more painful. I remember one autistic woman saying she found the sound of the ocean excruciating. (There might even be stimuli that are more dangerous for people with autism, though we don't know that. A few years ago I talked to a woman involved in autism research who said she was concerned that some autistic people might be more susceptible to heat stroke. I'd never heard that before, and she based her comment on just a couple of families, so I don't want parents to start worrying about it. I bring it up because I don't want to minimize the discomfort an autistic person could be feeling.)

I don't remember how I reacted to pain as a child, but as an adult I've been told that I'm a lot less sensitive to pain than nonautistic people. When
I
was “spayed” (I had a full hysterectomy, medically the exact same procedure as spaying a dog, that left an eight-inch scar across my stomach) I acted more like my friend's Lab than a post-surgical human being. The nurses said I didn't use anywhere near the amount of IV painkiller other patients did. Then when I went home, I took one prescription pain pill and that was it. I didn't need any more.

In the hospital I ran a little experiment on myself. When I was sure the nurses weren't around, I got out of bed and got down on all fours like a dog. The staff would have had a fit if they'd seen me. I found out that as long as I held still my pain was a lot less than it
was standing up or sitting down. Crawling felt terrible, but not as bad as walking did. Still, even on all fours I didn't feel like jumping up on a sofa, so obviously I'm not as impervious to pain as a Labrador retriever. Then again, no
dog
is as impervious to pain as a Labrador retriever, either. Labs are notorious for their high pain threshold, which is one of the reasons they make such good pets for children. A little kid can jump all over them and maul them half to death and they feel nothing. (Not that I'd recommend any child being allowed to do that. It's bad manners, and with other breeds it could be dangerous.) Try stepping on any normal dog's paw and you get an ear-splitting yelp so loud that for a moment you think you've killed your pet. Step on a Lab's paw and he doesn't even blink. Labs are built for racing through bramble and brush to retrieve game, or jumping into freezing cold water to retrieve fish. Nothing fazes them.

Back to my experiment, it's possible there's something about being a four-legged creature instead of a two-legged creature that makes the pain of physical injuries less intense. But even if that turns out to be true, I expect it's going to be only part of the explanation for why animals act as if they have less pain than we do for the same injury. Eventually we'll find out that the real explanation for the difference in behavior is a difference inside the brain.

F
EAR
I
S
W
ORSE
T
HAN
P
AIN

A lot of effort has been put into creating humane slaughter systems so the animal doesn't suffer. That part was easy, relatively speaking. If all you had to do to eliminate suffering was to make sure the animal died instantly, today almost all of our slaughterhouses would have to be considered humane.

But eliminating pain isn't enough. We have to think about animals' emotional lives, not just their physical lives. We're responsible for slaughterhouse animals; they wouldn't even exist if it weren't for us. So we have to do more than just take away physical pain.

The single worst thing you can do to an animal emotionally is to make it feel afraid. Fear is so bad for animals I think it's worse than pain. I always get surprised looks when I say this. If you gave most
people a choice between intense pain and intense fear, they'd probably pick fear.

I think that's because humans have a lot more power to control fear than animals do. My guess is that animals and normal humans are opposites when it comes to fear and pain, and for roughly the same reason: different levels of frontal lobe functioning. This idea first popped out at me when I read two studies back-to-back on the frontal lobes in pain and in fear.
5
What struck me was that while an active prefrontal cortex was associated with increased pain, it was also associated with reduced fear (though not with reduced anxiety). Pain and fear, at least in these studies, were opposites.
6

The story isn't that simple, of course, but it's close enough that, until we learn more, I believe animals have lower pain and higher fear than people do. My other reason for believing this at least provisionally is that it's the same with autistic people. As a general rule, we have lower pain, higher fear, and lower frontal lobe control of the rest of our brain than nonautistic people. Those three things go together. (I'm not saying that autistic people have no pain at all and don't need painkillers. I don't want to give that impression.)

You almost have to work with animals to see what a terrible emotion fear is for them. From the outside, fear seems much more punishing than pain. Even an animal who's completely alone and giving full expression to severe pain acts less incapacitated than an animal who's scared half out of his wits. Animals in terrible pain can still function; they can function so well they can act as if nothing in the world is wrong. An animal in a state of panic can't function at all.

I also think intense fear is an easier state for animals to get into than it is for normal human beings—a lot easier. Animals feel intense fear when they're threatened in any way, regardless of whether they're predators or prey.

While all animals can be overwhelmed by terror, prey animals like cows, deer, horses, and rabbits spend a lot more time being scared than predators do. You've heard the expression “like a deer caught in the headlights”—that pretty much sums up the prey animal's psyche. They are very nervous animals, because the only way a prey animal can survive in the wild is to run. Since a prey animal has to start
running
before
the lion does, that means it has to be hyper-alert all the time, keeping a watch out for danger.

You have to be gentle when you're working with prey animals. I've seen so many animals ruined by owners who traumatized them through rough or ignorant handling. The whole idea of
breaking
a horse is a perfect example. If you break a horse, he's
broken.
He's traumatized for life and usually no use to anyone after that, including himself a lot of times. Just like the horses at my school.

That's another thing autistic people have in common with animals: we have long memories, especially for fear. Clara Barton had a famous saying: “I distinctly remember forgetting that.” No autistic person would have come up with that. We
can't
forget bad stuff on purpose, and neither can animals.

I'm sure that's why I relate to prey animals like cattle as strongly as I do: because my emotional makeup is similar. Fear is a horrible problem for people with autism—fear
and
anxiety. Fear is usually defined as a response to external threats, while anxiety is a response to
internal threats.
If you step on a snake you feel fear; if you
think
about stepping on a snake you feel anxiety.

BOOK: Animals in Translation
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