When you see someone else in pain, the pain network in your own brain winces as if you were experiencing their pain yourself. This is great for everyday empathy, but not necessarily so useful if you're a doctor. When you're the one wielding the needle or planning a treatment regimen, you need to make sure your concern for your patient's pain doesn't distract you from the task at hand. According to Jean Decety, doctors get around this conflict by reducing their sensitivity to other people's pain.
Decety's team used electroencephalography (EEG) to monitor the electrical activity arising from the brains of 15 doctors and 15 controls while they looked at dozens of static pictures of people being pricked in various body parts by a needle or prodded by a cotton bud.
When a person looks at someone else in pain, their EEG response typically shows two distinct characteristics: a frontal component after 110ms, which is thought to reflect an automatic burst of empathy, and a more central, parietal component after about 350ms, which reflects a conscious evaluation of what's been seen.
As expected, the control participants showed an enhanced early and later phase EEG response to the needle pictures compared with the cotton bud pictures. The doctors, by contrast, showed no difference in brain response to the two categories of picture.
This suggests that even the very early, automatic brain response to other people's pain is suppressed in doctors, as is the later more evaluative response. Decety and his co-authors said that from a practical perspective, this is a good thing: 'Effective emotion regulation is essential for physicians exposed to the suffering of others because it dampens counterproductive feelings of alarm and fear and frees up processing capacity to be of assistance for the other.'
However, the researchers warned that the constant need to suppress their natural emotional response could prove stressful for doctors and place a strain on their relationship with their patients. 'Physicians face the challenge of devoting the right balance of cognitive and emotional resources to their patients' pain experience,' Decety's team said. 'They must try to resonate and understand the patient without becoming emotionally over-involved in a way that can preclude effective medical management.'
Decety J, Yang CY, & Cheng Y (2010). Physicians down-regulate their pain empathy response: an event-related brain potential study. NeuroImage, 50 (4), 1676-82 PMID: 20080194