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CHAPTER 7
Understanding and Managing Pain
Lecture Outline
I. Pain and the Nervous System
All sensory stimulation, including pain, starts with activation of sensory neurons and
proceeds with the relay of neural impulses toward the brain.
A. Somatosensory System
The somatosensory system conveys sensory information from the body through
the spinal cord to the brain.
1. Afferent Neurons
Afferent (sensory) neurons convey sensory information from sense organs to
the spinal cord and then to the brain. Efferent (motor) neurons result in the
movement of muscles. Interneurons connect afferent and efferent neurons.
Primary afferents are those neurons that have receptors in the sense organs and
that originate the neuron’s message. The vast number of neurons and their
interconnections makes neural transmission complex.
2. Involvement in Pain
Nociceptors are neurons capable of sensing pain stimuli. Three different types
of neurons are involved with transmitting pain impulses. The large A-beta fibers
and smaller A-delta fibers are covered with myelin, which speeds neural
transmission. The smaller and more common C fibers require high levels of
stimulation to fire. These different fibers with their different thresholds and
transmission speeds may relate to different types of pain sensation.
B. The Spinal Cord
Primary afferents from the skin enter the spinal cord where they synapse with
neurons in the dorsal horns of the spinal cord. The dorsal horns contain several
laminae (layers). Laminae 1 and laminae 2 form the substantia gelatinosa, a
structure that receives sensory input from the A and C fibers.
Complex interactions of sensory input occur in the laminae of the dorsal horns, and
these interactions may affect the perception of sensory input before it gets to the
brain.
C. The Brain
The thalamus receives sensory input from the different neural tracts in the spinal
cord. The skin is mapped in the somatosensory cortex in the parietal lobe of the
cerebral cortex, and the proportion of cortex devoted to an area of skin is proportional
to that skin’s sensitivity to stimulation (see Figure 7.2). Sensory information from
internal organs are not mapped as precisely as the skin, leading people to have the
ability to identify stimulation from the skin but less distinct sensory perceptions of
their internal organs. This is also the reasoning behind referred pain, when pain is
experienced in a part of the body other than the site where the pain stimulus
originates.
D. Neurotransmitters and Pain
The neurotransmitters that form the basis for neural transmission also play a role
in pain perception. The discovery of the endogenous opiates—enkephalin,
endorphin, and dynorphin—led to the discovery of neural receptors specialized for
141
Chapter 7
these neurotransmitters and the conclusion that opiate drugs produce analgesia
because of the brain’s own chemistry. The neurotransmitters glutamate and substance
P and the chemicals bradykinin and prostaglandins may exacerbate pain stimulation.
Proinflammatory cytokines produced by the immune system are also involved in pain,
possibly creating chronic pain by sensitizing neurons in the spinal cord.
E. Modulation of Pain
When the periaqueductal gray, a structure in the midbrain, is stimulated, pain
relief occurs. The neurons in the periaqueductal gray synapse with neurons in the
nucleus raphé magnus, a structure in the medulla (see Figure 7.3). These neurons
descend to the spinal cord and may constitute a descending control system for pain
perception.
II. The Meaning of Pain

The traditional view of pain focused on the physical sensations, but about 100 years
ago, C. A. Strong proposed that pain consists of not only the sensation but also person’s
reaction to that sensation.
A. Definition of Pain
Perhaps the most acceptable definition of pain is the one proposed by the
International Association Subcommittee for the Study of Pain that defined pain as an
unpleasant sensory experience accompanied by an emotional experience and actual or
potential tissue damage.
At least three stages of pain have been identified. Acute pain is ordinarily
adaptive, lasts a relatively short period of time, and includes pain from cuts, burns,
and other physical trauma. Chronic pain endures beyond the time of normal healing,
is relatively constant, is often reinforced by other people, and may become self-
perpetuating. Prechronic pain is experienced between acute and chronic pain and is
critical because during this time, the pain may either go away or evolve into chronic
pain. Another type of pain is chronic recurrent pain, or when there are alternating
episodes of intense pain and no pain.
B. The Experience of Pain
Pain is both personal and subjective, but situational and cultural factors play a role
in its experience. Beecher’s observations on wounded soldiers during World War II
highlight the variability of pain—seriously wounded soldiers reported little pain.
Individual variations exist in the experience of pain, but as Beecher suggested,
situational factors are important. Cultural expectations and stereotypes as well as
cultural sanctions against the expression of pain influence pain behaviors. Sanctions
against expressing pain may be a large part of the gender difference in pain, but some
evidence indicates that women may also be more sensitive to pain. Thus, a variety of
individual, cultural, and gender-related factors influence the experience of pain.
C. Theories of Pain
How people experience pain is the subject of a number of theories. Of the several
models of pain, two capture the divergent ways of conceptualizing pain: the
specificity theory and the gate control theory.
1. Specificity Theory
The specificity theory can be traced to Descartes, who hypothesized that the
body works by mechanistic principles. Applied to pain, this theory holds that pain
is the result of transmission of specific signals. Research has failed to find pain
142
receptors or fibers specifically devoted to pain transmission. This theory also fails
to integrate the variability of the pain experience.
2. The Gate Control Theory
Melzack and Wall formulated the gate control theory of pain as a way to
explain the variability of pain perception (see Figure 7.4). They hypothesized that
a gating mechanism exists in the spinal cord and that sensory input is modulated
in the substantia gelatinosa of the dorsal horns of the spinal cord. This modulation
can change pain perception, as can brain-level alterations from a hypothesized
central control trigger. This theory includes explanations of both physiological
and psychological modulations of the pain experience. Melzack has proposed an
extension to the gate control theory, called neuromatrix theory, which places a
stronger emphasis on the brain’s role in pain perception.
III. The Measurement of Pain

Tools for measuring pain are important in order to evaluate the various pain
therapies. A number of techniques have been used to measure laboratory and clinical
pain, and these fall into three main categories: self-reports, behavioral assessments, and
physiological measures.
A. Self-Reports
Self-reports of pain include simple rating scales, standardized pain inventories,
and standardized personality inventories.
1. Rating Scales
With self-report rating scales, patients rate the intensity of their pain on a
scale; for example, the scale may range from 1 to 100. A similar technique is the
Visual Analog in which patients check severity of pain on a continuum from no
pain to worst pain imaginable. The faces scale is a similar approach consisting of
drawings of facial expressions of pain, which is suitable for children and older
adults.
2. Pain Questionnaires
Melzack developed the McGill Pain Questionnaire (MPQ), an inventory that
categorized pain into three dimensions: sensory, affective, and evaluative. The
sensory dimension includes pain described in terms of its temporal, spatial,
pressure, and thermal properties; the affective dimension defines pain in terms of
fear, tension, and autonomic properties of the pain experience; and the evaluative
dimension includes the perceived severity of the entire pain experience. The MPQ
has adequate validity, but its vocabulary is somewhat difficult.
The Multidimensional Pain Inventory (MPI) is another questionnaire that
measures several aspects of pain: characteristics of the pain, patients’ perception
of the responses of others to their pain, and ratings of daily activities of the
patient. This inventory has allowed for the development of 13 different scales that
capture different dimensions of the lives of pain patients.
3. Standardized Psychological Tests
Standardized tests, such as the MMPI-2, have also been used to assess pain.
This instrument is useful in differentiating among types of pain patients and has
some ability to predict which patients will respond to medical treatments for pain.
Other commonly administered tests include the Beck Depression Inventory and
the Symptom Checklist-90.
B. Behavioral Assessment
Chapter 7
People in pain often behave in ways that communicate to others that they are in
pain, which can be used as an informal or standardized assessment of pain. Health
care workers tend to underestimate patients’ pain, but spouses and others close to pain
patients can provide a better assessment. This approach is especially useful for
individual who cannot provide self-reports, such as small children and some older
individuals who cannot communicate verbally.
C. Physiological Measures
Although pain produces an emotional response, research has failed to identify
specific organic states that are strongly correlated with pain. Muscle tension and
autonomic responses such as heart rate and skin temperature show some relationship
to the experience of pain, but neither type of measurement shows sufficient reliability
and validity to be a good measurement technique.
IV. Pain Syndromes

Acute pain has the advantage of signaling injury, but chronic pain has no
advantages. Such pain can be classified according to location or syndrome, symptoms
that occur together and characterize a condition. Headache and low back pain are the two
most frequently treated types of chronic pain, but health psychologists also deal with
other pain syndromes.
A. Headache Pain
Headache pain is the most common of all pains, with more than 99% of
Americans suffering from some form of headache over their lifetime. The most
common varieties are migraine, tension, and cluster headaches, although the
symptoms overlap and clear classification is often impossible. Migraine (or vascular)
headaches bring about loss of appetite, nausea, vomiting, and increased sensitivity to
light. Tension headaches are muscular in origin and are characterized by
contractions of the muscles of the neck, shoulders, scalp, and face. Cluster
headaches produce intense pain localized in one side of the head and occur
frequently over a period of days, then disappear for weeks or months.
B. Low Back Pain
The most frequent causes of low back pain are injury or stress resulting in
musculoskeletal, ligament, or neurological problems in the lower back. In addition,
stress and psychological factors may play roles in back pain. Most of the people who
experience back pain do not progress to chronic pain, but those who do tend to have
persistent pain. Only about 20% of back pain patients have an identified, physical
cause for their pain.
C. Arthritis Pain
A variety of arthritic pains exist, and many involve inflammation of the joints.
Rheumatoid arthritis, perhaps the most frequent cause of arthritic pain, is an
autoimmune disorder characterized by a dull ache within or around a joint.
Osteoarthritis is a progressive inflammation of the joints mostly affecting older
people and characterized by a dull ache in the joint area. Fibromyalgia is a chronic
pain condition characterized by tender points throughout the body, fatigue, headache,
cognitive difficulties, anxiety, and sleep disturbances. This condition leads to a
diminished quality of life that is similar to the barriers faced by those with arthritis.
D. Cancer Pain
144
Cancer pain is caused by either a malignancy or by treatment of a malignancy.

Pain is present in a majority of terminal cancer cases, and both chemotherapy and
radiation therapy produce pain. Often pain goes untreated for cancer patients.
E. Phantom Limb Pain
Phantom limb pain is the experience of chronic pain in an amputated part of the
body. People who have had arms, legs, or breasts removed nearly always continue to
feel some sensation (frequently pain) despite the removal of that body part and the
nerves that underlie sensation.
V. Managing Pain
Managing chronic pain is a challenge because this type of pain has no identifiable
cause. Thus, several approaches to treatment exist, including medical and behavioral
techniques.
A. Medical Approaches to Managing Pain
Treatment of acute pain is easier than for chronic pain, but both present
challenges.
1. Drugs
Analgesic drugs are the most common treatment for acute pain. These drugs
fall into two groups: opiates and nonnarcotic analgesics. Opiate drugs have
powerful analgesic effects but also produce tolerance and dependence. However,
the fear of drug-related problems, such as addiction, leads to under-medication
more often than to drug abuse. The recent increase in the use of prescription
analgesic drugs was due mostly for the demand for oxycodone and hydrocodone,
both of which are opiates with a potential for abuse. Low back pain patients may
receive more drug treatment than the ideal level for their condition.
Aspirin and the other nonsteroidal anti-inflammatory drugs (NSAIDs) such as
ibuprofen and naproxen sodium, as well as acetaminophen drugs, are all useful in
managing minor pain, especially pain due to injury. Antidepressant drugs and
antiseizure drugs also affect pain perception and may be useful in pain
management for some people.
2. Surgery
Surgery may be directed either to repairing damage that causes pain or to altering
the nervous system to change pain perception. Surgery is an attempt to control low
back pain more often than other pain syndromes, and specific nerves or the spinal
cord may be targets. Surgery may also be used to implant devices to stimulate the
spinal cord to decrease pain. Surgery is not always effective, either in repairing
damage or in producing pain relief, especially for people with low back pain. A
related technique is transcutaneous electrical nerve stimulation (TENS), which
uses electrical impulses to stimulate skin stimulation to block pain messages. Spinal
cord stimulation is more effective than TENS.
B. Behavioral Interventions for Managing Pain
Some people classify behavioral techniques as alternative treatment or mind-body
medicine, but psychologists focus on the behavioral aspects of these treatments and
consider them part of psychology.
1. Relaxation Training
Chapter 7
Progressive muscle relaxation involves learning to relax the entire body, one
muscle group at a time, and to breathe deeply and exhale slowly. This technique
had been used to manage a variety of pain problems, including headaches,
rheumatoid arthritis, and low back pain. A National Institutes of Health
Technology panel’s evaluation for pain treatments gave relaxation training its
highest rating.
2. Behavioral Therapy
Behavior modification techniques are based on the principles of operant
conditioning and are used by health psychologists to help people cope with stress
and pain. The goal of behavior modification is to shape behavior, not to alleviate
feelings of stress or sensations of pain. People in pain may continue their pain
behaviors because they receive positive reinforcers such as attention, sympathy,
financial compensation, relief from work, and other rewards. Positive reinforcers
may create pain traps that turn acute pain into chronic pain. The rationale behind
behavior modification is to train people in the pain patient’s environment to
discontinue reinforcement for pain behaviors, thus avoid the pain trap. Progress is
measured in terms of observable behavior, such as amount of medication,
absences from work, physical activity, and so forth. Behavior modification does
not address the cognitions that underlie behavior.
Cognitive therapy rests on the assumption that a change in the interpretation
of an event can change people's emotional and physiological reaction to that
event. Because pain is at least partially due to psychological factors, cognitive
therapy attempts to get patients to think differently about their pain experiences
and to increase their confidence that they can cope with them.
Cognitive behavioral therapy aims to develop beliefs, thoughts, and skills to
make positive changes in behavior. Dennis Turk and Donald Meichenbaum have
developed a cognitive behavioral program for pain management called pain
inoculation, which parallels stress inoculation (described in Chapter 5). These
techniques involve the cognitive stage of reconceptualization and the behavioral
stages of acquisition and rehearsal of skills and follow-through.
Research indicates that behavior modification, cognitive therapy, and
cognitive behavioral therapy are effective for a wide variety of pain conditions
(see Table 7.2).
Exploring Health on the Web

Several websites provide information about many aspects of pain, including types of
pain, theories, syndromes, and treatment options.
http://www.americanpainsociety.org
This website is the one maintained by the American Pain Society, which is a
professional society for those researching the topic of pain.
http://www.americanheadachesociety.org
The website for the American Headache Society is oriented toward professionals
but also includes information accessible to students.
http://www.theacpa.org
146
This website is maintained by the American Chronic Pain Association, an

organization devoted to raising awareness and offering support to those with chronic pain
problems.
Suggested Activities
Personal Health Profile — Charting Pain
As an activity for their Personal Health Profile, your students should begin a pain
diary, which will supplement the stress diary they began with Chapter 6. This diary should
extend for at least a week, during which time everyone will experience some type of pain.
Many of those pains will be acute, but nearly everyone suffers from headaches, at least
occasionally, and some students will have other chronic pains, such as low back pain or pain
from various injuries. As part of their pain diary, your students should rate the intensity of
their pain on perhaps a 10-point scale, record time of day when the pain is most intense, and
note environmental or psychosocial events that seem to relate to the pain's onset. They
should also describe their attempts to cope with the pain. Did they try to relax, take aspirin
or other analgesic drugs, rest in bed, or use some other means to seek pain relief? With such
a detailed diary, your students can make some predictions concerning when, where, or why
a pain will return.
Creating Chronic Pain

Many factors contribute to the development of chronic pain, and social learning
theory holds that reinforcement for pain behaviors is a major contributor. To develop a
better understanding of how people reinforce pain, arrange a role-playing activity for your
students. Choose someone to be the person in pain and work with this person so that he or
she can display a realistic variety of pain behaviors. Choose others to play the roles of
family members and friends and decide who will reinforce and who will fail to reinforce the
person’s pain. (Make sure that someone ignores the person’s pain behaviors without being
mean or unkind to this person.)
This activity should be presented as a skit in which the person in pain manifests pain
behaviors, and others react to the pain behaviors in various ways. After observing the
interactions, ask your class how they felt about those people who rewarded the pain
behaviors. Did they feel that these people were being kind and helpful? What does learning
theory say about the consequences of such “help?” How did they feel about those who failed
to reward the person’s pain? Is it acceptable to fail to be solicitous to those in pain? What
problems does this dilemma pose for people who want to be helpful but also know that
reinforcement can increase the frequency of undesirable behavior?
Understanding the Impact of Chronic Pain

The common experience of acute pain does not lead to an understanding of chronic
pain. People who do not experience chronic pain have little understanding of what life is
like with everyday pain. To better comprehend life with chronic pain, arrange for your
students to interview someone who has a chronic pain syndrome. Instruct them to ask
questions about the person’s sensations; what barriers pain has imposed on his or her life,
what treatments the person has sought, and which treatments were more effective.
Exploring a Neurological View of Pain
Chapter 7
Physicians often have views that differ from those of psychologists, and you can
allow your students to become acquainted with these differences by inviting a neurologist to
be a guest lecturer on the topic of pain. A neurologist who specializes in pain treatment
would be ideal, but any neurologist should be very familiar with the puzzles of pain and its
treatment.
Describing Pain
The textbook chapter highlights a number of different pain measures. Here are
links to some of the pain measures mentioned:
McGill Pain Questionnaire:
http://www.chcr.brown.edu/pcoc/shortmcgillquest.pdf
A sample Visual Analog Pain Scale:
http://www.partnersagainstpain.com/printouts/A7012AS1.pdf
West Haven Yale Multidimensional Pain Inventory
http://www.tac.vic.gov.au/media/upload/west_haven_yale_multidimensional_pain
_inventory.pdf
Living with No Pain

Living without pain might seem like a blessing, but it is not always. Students will
be fascinated to read about Ashlyn Blocker, the “girl who could feel no pain”, in this NY
Times article (http://www.nytimes.com/2012/11/18/magazine/ashlyn-blocker-feels-no-
pain.html). The camp mentioned in the article has the following website that has
additional links about Congenital Insensitivity to Pain:
http://www.painlessbuthopeful.org/Information_and_Media.html
Relaxation Training
One behavioral technique for managing pain is relaxation training. Below are two
sample scripts you could read aloud to students to have them gain a better understanding
of this technique works.
http:/www.amsa.org/healingthehealer/musclerelaxation.cfm
http://prtl.uhcl.edu/portal/page/portal/COS/Self_Help_and_Handouts/Files_and_
Documents/Progressive%20Muscle%20Relaxation.pdf
Video Recommendations
From Films for the Humanities & Sciences:
Pain: The Language of the Body and the Mind (2000) is a 3-part series of short videos. This
series includes "The Physiology of Pain," featuring the neurology underlying pain
perception and how the nervous system can modulate these signals, "The Psychology of
Pain," which shows how emotion and behavioral factors can increase or decrease pain, and
"The Management of Pain," which examines medical and behavioral treatments.
148
The Anatomy of Pain (2003) presents various types of pain, outlines how pain is
conveyed through the nervous system, distinguishes between acute and chronic pain, and
addresses treatment through medication and acupuncture.
Chronic Pain (2005) explores causes and treatments for pain by presenting pain experts
and patients who have used a variety of approaches to manage pain.
World of Pain: Coping and Caring (2001) combines dramatization and information to show
a hypothetical family and real case studies of pain. Both pain perception and pain
management are featured.
Headache: The Painful Truth (2001) explores tension, migraine, and cluster headaches and
those who suffer from them. In addition, this video includes prominent experts who present
research and findings about this pain syndrome.
Migraines (2007) focuses on this common and debilitating type of headache, including
diagnosis and treatment.
Low Back Pain (2005) explores this pain syndrome that as many as 80 percent of people
experience at some point in their lives. This program focuses on the physical injuries that
can result in back pain and the medical treatments.
From Fanlight Productions:
A Disease Called Pain (2003) explores chronic pain through the experience of chronic
pain patients. This program clearly distinguishes between acute and chronic pain and
presents some of the approaches to managing chronic pain.
Other Films:
127 Hours –A major motion movie about Aron Ralston (played by James Franco) who
needed to cut off his arm to save his life. Available for DVD rental.
Videos from the Web:
http://youtu.be/b3fX96OugmA –This video examines the relationship between pain and

depression, how both should be treated, and why this is difficult (1:07; “Depression and
Chronic Pain is Extremely Common”).
http://youtu.be/SPOcqXkygoQ – This video explains possible reason why pain patients

often feel as though they should “tough it out” and why this is problematic (1:53;“Pain
Patients Shouldn’t Tough It Out”).
http://youtu.be/_IUmVcwGbWE – This video explains how pain patients track their pain
(1:46).
http://www.youtube.com/watch?v=6qocxopS5fc&feature=share&list=PL9DF1AB9AE98
3C82B – This video showcases the treatment for a chronic pain patient (4:09).
Chapter 7
http://youtu.be/YL_6OMPywnQ - This video explains how mirror therapy is used to help

decrease phantom limb pain (2:32).
150
Multiple Choice Questions
1. The ______ system allows us to interpret certain sensory information as pain.

a. somatosensory
b. endocrine
c. skeletal
d. muscular
ANS: a REF: Pain and the Nervous System
2. Primary afferents convey sensory impulses to the

a. spinal cord.
b. peripheral nervous system.
c. brain.
d. motor neurons.
3. Myelinated afferent neurons are called

a. A fibers.
b. beta afferents.
c. C fibers.
d. delta afferents.
4. More than half of all sensory afferents are

a. A-beta fibers.
b. A-delta fibers.
c. C fibers.
d. myelinated.
ANS: c REF: Pain and the Nervous System
5. Sherman stubbed his toe on the sidewalk. His sensation of pain traveled first to
the
a. muscles in the foot.
b. brain.
c. spinal cord.
d. cranial nerves.
6. This system conveys sensory information from the body to the brain.
a. endocrine system
b. digestive system
c. somatosensory system
d. immune system
7. _________ neurons carry nerve impulses away from the brain and toward the
muscles.
143
Chapter 7
a. Efferent
b. Afferent
c. Beta afferents
d. Delta afferents
8. Nociception refers to the process of perceiving ________.

a. stress
b. pain
c. anger
d. oxygen
ANS: b REF: Pain and the Nervous System
9. Stimulation of the A-delta fibers, since they are myelinated, leads to a _______,
whereas the unmyelinated C fibers often result in _____________.
a. “slow pain” response; “fast pain” response
b. “no pain” response; “slow pain” response
c. “fast pain” response; “slow pain” response
d. “no pain” response; “fast pain” response
10. Afferent fibers group together after leaving the skin, forming a _____.
a. nerve
b. cell
c. cell body
d. ganglion cell
11. When pain is experienced in some other location than the site where the pain was
inflicted, this is called
a. phantom limb pain.
b. referred pain.
c. prechronic pain.
d. chronic recurrent pain.
12. Recent research gave participants __________ to reduce people’s feelings of

social pain.
a. a shock
b. a hug
c. Tylenol
d. Morphine
13. Participants who are socially excluded show more activity in the anterior
cingulate cortex, similar to people who are experiencing _____________.
a. physical pain
b. depression
144
c. anxiety
d. all of the above
14. _____ are chemicals that carry information between nerves.

a. Afferent neurons
b. Efferent neurons
c. Neurotransmitters
d. Interneurons
15. _______ are neurochemicals that help modulate, or lessen, the experience of pain.
a. Endorphins
b. Interneurons
c. Glutamates
d. Proinflammatory cytokines
16. These proteins produced by the immune system increase pain sensitivity, along
with increasing fatigue and sickness:
a. proinflammatory cytokines
b. endorphins
c. opiates
d. both a and b
17. The dorsal horns are located in the

a. brain stem.
b. kidneys.
c. midbrain.
d. spinal cord.
ANS: d REF: Pain and the Nervous System
18. The substantia gelatinosa is

a. in the dorsal horns of the spinal cord.
b. in the midbrain region, adjacent to the thalamus.
c. composed of a gelatin-like material that surrounds the lower portion of the
brain.
d. a hypothetical structure that has not yet been confirmed.
19. Which structure is most capable of modulating sensory input?

a. primary afferents
b. secondary afferents
c. substantia gelatinosa
d. spinothalamic tract
145
Chapter 7
20. Sensory input information passes through what brain structure?

a. the parietal lobe of the cerebral cortex
b. the pons
c. the cerebellum
d. the thalamus
ANS: d REF: Pain and the Nervous System
21. What brain structure contains a representation of the skin’s surface?

a. somatosensory cortex
b. parietosensory area
c. sensorimotor cortex
d. occipital cortex
22. Neurotransmitters like _____ decrease pain, but those like ________ increase the
experience of pain.
a. serotonin . . . dynorphin
b. endorphin . . . glutamate
c. substance P . . . serotonin
d. endorphin . . . enkephalin
23. Which of the body's own neurochemicals does NOT have opiate-like effects?
a. serotonin
b. dynorphin
c. endorphin
d. enkephalin
24. Pain is usually defined as

a. a sensory experience only.
b. an emotional experience only.
c. neither a sensory nor an emotional experience.
d. both a sensory and an emotional experience.
ANS: d REF: The Meaning of Pain
25. Victoria has just cut her hand with a sharp knife. The pain she feels can best be
described as
a. acute.
b. prechronic.
c. chronic intractable.
d. chronic.
ANS: a REF: The Meaning of Pain
146
26. Which of these is NOT a distinction between chronic and acute pain?
a. Acute pain is usually adaptive; chronic pain is not.
b. Acute pain is physical; chronic pain is psychological.
c. Chronic pain is frequently perpetuated by environmental reinforcers; acute
pain needs no such reinforcement.
d. Chronic pain has no biological benefit; acute warns the person to avoid
further injury.
ANS: b REF: The Meaning of Pain
27. Henry Beecher reported that soldiers wounded at the Anzio beachhead during
World War II experienced ______ pain.
a. chronic intractable
b. stress-related
c. severe, excruciating
d. very little
28. Kyle is experiencing headaches and his partner has taken over the household
chores. Research by Pence et al. (2008) would suggest that Kyle’s headaches are
likely to
a. increase in intensity.
b. decrease in intensity.
c. completely disappear.
d. disappear until his partner makes him do the chores again.
29. This personality trait has been associated with a “pain-resistant” personality.
a. Conscientiousness
b. Extraversion
c. Neuroticism
d. There is no “pain-resistant” personality.
30. Physicians are likely to underestimate the pain of

a. Asian Americans.
b. African Americans.
c. European Americans.
d. no ethnic group; doctors treat all patients equally.
31. According to the gate control theory, emotions such as ______ could increase
pain by affecting the gate to open, whereas emotions such as _____ could
decrease pain by affecting the gate to close.
a. happiness; depression
b. joy; anxiety
c. anxiety; happiness
d. depression; anxiety
ANS: c REF: The Meaning of Pain
147
Chapter 7
32. Matthew is running a marathon and trips over a pile of acorns, but finishes the
race. Afterwards, he finds out his ankle is sprained. What theory best accounts for
the fact that Matthew did not immediately stop running after tripping?
a. specificity theory of pain
b. gate control theory of pain
c. delay of gratification theory of pain
d. none of the above
33. People in pain frequently receive attention and sympathy, which may provide
____________ for these pain behaviors.
a. reinforcement
b. negative scheduling
c. punishment
d. generalization
34. In some cultures, people undergo initiation rituals that call for them to have their
body pierced, cut, tattooed, burned, or beaten. These individuals
a. feel no pain.
b. show little or no pain from an accidental injury.
c. feel pain, but their culture trains them to exhibit no pain during these
initiation rituals.
d. offer proof that pain is totally psychological.
35. What is the relationship between the experience of pain and some types of
psychopathology?
a. People with personality disorders have heightened pain perception.
b. People with pain-prone personalities tend to have borderline personality
disorder.
c. People with pain-resistant personalities tend to have bipolar disorder.
d. It is not clear whether psychopathology makes one vulnerable to pain or
whether being in pain produces psychopathology.
36. During the birth process, women in some cultures exhibit many more signs of
pain than women in other cultures. This observation shows that
a. the experience of pain varies from culture to culture.
b. cultural practices can influence the expression of pain.
c. natural childbirth produces less pain than opiate drugs.
d. women who express little pain during childbirth are undergoing self-
hypnosis.
37. With regard to gender,
148
a. women sense pain more quickly than men.

b. women are more likely to hide their pain.
c. men are more likely to be aware of their pain.
d. men are less likely to report pain.
38. Specificity theory hypothesizes that

a. a person's interpretation of pain is more important that tissue damage in
determining the intensity of pain.
b. acute pains intensify over time.
c. the experience of pain is approximately equal to the amount of tissue
damage or injury.
d. chronic pain can become acute pain over time.
39. Which of these findings cast doubt on the specificity theory of pain?
a. Researchers have failed to find specific skin receptors devoted to relaying
pain.
b. Phantom limb pain occurs in 70% of amputees.
c. Injury can occur without pain, such as that experienced by the soldiers at
Anzio beach.
d. all of these
40. The theory of pain proposed by Melzack and Wall has been called the _____
theory.
a. gate control
b. sensory decision
c. cognitive-emotional
d. tension-reduction
41. According to the gate control theory of pain, the structure that is the likely
location of the gate is
a. the substantia gelatinosa.
b. the ventral horns of the spinal cord.
c. the transverse section of the medulla.
d. supraspinal nerve endings.
42. According to the gate control theory of pain, the spinal cord
a. mechanically relays sensory input information.
b. modulates the input of sensory information.
c. does not have the physiological capacity to affect pain perception.
149
Chapter 7
d. is less important in pain perception than the cerebellum.

43. The gate control theory of pain assumes

a. the physiological reality of pain.
b. the nature of motor output factors in pain perception.
c. that chronic pain is heavily influenced by both spinal cord and brain
activity.
d. that sensory input is not the only factor in pain perception.
44. Melzack proposed the _______ theory, which is an extension of the gate control
theory.
a. sensory decision
b. specificity
c. neuromatrix
d. cerebellar
45. Valid and reliable measures of pain are important to health psychologists
primarily because
a. such measurements permit accurate evaluation of various pain therapy
programs.
b. self-reports are more useful than physiological measures.
c. pain is a product of both physiological and emotional factors.
d. behavioral assessments are more reliable and valid.
ANS: a REF: The Measurement of Pain
46. Which of these methods have been used to measure pain?

a. self-reports
b. behavioral assessment
c. physiological measures
d. all of these
ANS: d REF: The Measurement of Pain
47. The Visual Analog Scale is considered to be

a. a self-report.
b. an evoked potential measure of pain.
c. a behavioral assessment of pain.
d. a pain questionnaire.
48. The most widely used pain questionnaire was developed by Ronald Melzack and
is known as the
a. Melzack and Wall Pain Questionnaire.
b. Visual Analog Scale.
c. Minnesota Multiphasic Personality Inventory.
d. McGill Pain Questionnaire.
150
ANS: d REF: The Measurement of Pain
49. A personality inventory sometimes used to assess pain is the

a. California Personality Inventory.
b. Minnesota Multiphasic Personality Inventory.
c. Edwards Personality Schedule.
d. Guilford-Zimmerman Temperament Survey.
ANS: b REF: The Measurement of Pain
50. Heart rate predicts perceptions of pain, but only for ________.
a. children
b. the elderly
c. men
d. women
ANS: c REF: The Measurement of Pain
51. Which of these techniques measures muscle tension as an index of pain?

a. electromyography
b. thermography
c. blood flow in the temporal artery
d. heart rate
52. _____ pain is the most common of all syndromes of pain with a lifetime incidence
rate of more than 99%.
a. Headache
b. Low back
c. Burn
d. Knee
ANS: a REF: Pain Syndromes
53. Rosa suffers from recurrent attacks of pain that are accompanied by exaggerated
sensitivity to light, loss of appetite, and nausea. From these characteristics you
would diagnose Rosa as having
a. migraine headaches.
b. tension headaches.
c. cancer pain.
d. phantom limb pain.
54. With regard to migraine headaches,

a. men are somewhat more likely than women to have migraines.
b. women are much more likely than men to have migraines.
c. women are slightly more likely than men to have migraines.
d. women and men are about equally susceptible to migraines.
ANS: b REF: Pain Syndromes
151
Chapter 7
55. Carlos is a 45-year-old civil engineer who has never had a migraine headache. His
chances of a first migraine are
a. very high.
b. about 50/50.
c. very low.
d. nonexistent.
ANS: c REF: Pain Syndromes
56. What type of pain has a gradual onset, sensations of tightness around the neck and
shoulders, and a steady ache on both sides of the head?
a. low back pain
b. migraine headache
c. cluster headache
d. tension headache
ANS: d REF: Pain Syndromes
57. Wendy suffers from headaches that occur nearly every day for about a month, but
then go away for about a year or more. From this description, it appears that
Wendy suffers from
a. cluster headaches.
b. migraine headaches.
c. tension headache.
d. none of the above.
58. The two most common types of pain are

a. cancer and headache.
b. arthritis and low back.
c. headache and low back.
d. cancer and low back.
ANS: c REF: Pain Syndromes
59. Which of these conditions may contribute to low back pain?
a. pregnancy
b. improper lifting of heavy objects
c. aging
d. all of these
ANS: d REF: Pain Syndromes
60. Low back pain has many causes. About what percent of back pain patients have
an identified, physical cause for their pain?
a. 20%
b. 50%
c. 75%
d. about 40% of men and about 60% of women
61. Unlike rheumatoid arthritis, osteoarthritis

a. frequently occurs in younger as well as older people.
152
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whom a general characterization would do no manner of justice. He
was an overseer, but he was something more. With the malign and
tyrannical qualities of an overseer he combined something of the
lawful master. He had the artfulness and mean ambition of his class,
without its disgusting swagger and noisy bravado. There was an
easy air of independence about him; a calm self-possession; at the
same time a sternness of glance which well might daunt less timid
hearts than those of poor slaves, accustomed from childhood to
cower before a driver’s lash. He was one of those overseers who
could torture the slightest word or look into impudence, and he had
the nerve not only to resent, but to punish promptly and severely.
There could be no answering back. Guilty or not guilty, to be
accused was to be sure of a flogging. His very presence was fearful,
and I shunned him as I would have shunned a rattlesnake. His
piercing black eyes and sharp, shrill voice ever awakened
sensations of dread. Other overseers, how brutal soever they might
be, would sometimes seek to gain favor with the slaves, by indulging
in a little pleasantry; but Gore never said a funny thing, or
perpetrated a joke. He was always cold, distant, and
unapproachable—the overseer on Col. Edward Lloyd’s plantation—
and needed no higher pleasure than the performance of the duties of
his office. When he used the lash, it was from a sense of duty,
without fear of consequences. There was a stern will, an iron-like
reality about him, which would easily have made him chief of a band
of pirates, had his environments been favorable to such a sphere.
Among many other deeds of shocking cruelty committed by him was
the murder of a young colored man named Bill Denby. He was a
powerful fellow, full of animal spirits, and one of the most valuable of
Col. Lloyd’s slaves. In some way—I know not what—he offended this
Mr. Austin Gore, and in accordance with the usual custom the latter
undertook to flog him. He had given him but few stripes when Denby
broke away from him, plunged into the creek, and standing there
with the water up to his neck refused to come out; whereupon, for
this refusal, Gore shot him dead! It was said that Gore gave Denby
three calls to come out, telling him if he did not obey the last call he
should shoot him. When the last call was given Denby still stood his
ground, and Gore, without further parley, or without making any
further effort to induce obedience, raised his gun deliberately to his
face, took deadly aim at his standing victim, and with one click of the
gun the mangled body sank out of sight, and only his warm red blood
marked the place where he had stood.
Gore Shooting Denby.

This fiendish murder produced, as it could not help doing, a
tremendous sensation. The slaves were panic-stricken, and howled
with alarm. The atrocity roused my old master, and he spoke out in
reprobation of it. Both he and Col. Lloyd arraigned Gore for his
cruelty; but he, calm and collected, as though nothing unusual had
happened, declared that Denby had become unmanageable; that he
set a dangerous example to the other slaves, and that unless some
such prompt measure was resorted to there would be an end to all
rule and order on the plantation. That convenient covert for all
manner of villainy and outrage, that cowardly alarm-cry, that the
slaves would “take the place,” was pleaded, just as it had been in
thousands of similar cases. Gore’s defense was evidently
considered satisfactory, for he was continued in his office, without
being subjected to a judicial investigation. The murder was
committed in the presence of slaves only, and they, being slaves,
could neither institute a suit nor testify against the murderer. Mr.
Gore lived in St. Michaels, Talbot Co., Maryland, and I have no
reason to doubt, from what I know to have been the moral sentiment
of the place, that he was as highly esteemed and as much respected
as though his guilty soul had not been stained with innocent blood.
I speak advisedly when I say that killing a slave, or any colored
person, in Talbot Co., Maryland, was not treated as a crime, either by
the courts or the community. Mr. Thomas Lanman, ship carpenter of
St. Michaels, killed two slaves, one of whom he butchered with a
hatchet, by knocking his brains out. He used to boast of having
committed the awful and bloody deed. I have heard him do so
laughingly, declaring himself a benefactor of his country, and that
“when others would do as much as he had done, they would be rid of
the d——d niggers.”
Another notorious fact which I may state was the murder of a
young girl between fifteen and sixteen years of age, by her mistress,
Mrs. Giles Hicks, who lived but a short distance from Col. Lloyd’s.
This wicked woman, in the paroxysm of her wrath, not content at
killing her victim, literally mangled her face, and broke her breast-
bone. Wild and infuriated as she was, she took the precaution to
cause the burial of the girl; but, the facts of the case getting abroad,
the remains were disinterred, and a coroner’s jury assembled, who,
after due deliberation, decided that “the girl had come to her death
from severe beating.” The offense for which this girl was thus hurried
out of the world was this, she had been set that night, and several
preceding nights, to mind Mrs. Hicks’ baby, and having fallen into a
sound sleep the crying of the baby did not wake her, as it did its
mother. The tardiness of the girl excited Mrs. Hicks, who, after calling
her several times, seized a piece of fire-wood from the fire-place,
and pounded in her skull and breast-bone till death ensued. I will not
say that this murder most foul produced no sensation. It did produce
a sensation. A warrant was issued for the arrest of Mrs. Hicks, but
incredible to tell, for some reason or other, that warrant was never
served, and she not only escaped condign punishment, but the pain
and mortification as well of being arraigned before a court of justice.
While I am detailing the bloody deeds that took place during my
stay on Col. Lloyd’s plantation, I will briefly narrate another dark
transaction, which occurred about the time of the murder of Denby.
On the side of the river Wye, opposite from Col. Lloyd’s, there
lived a Mr. Beal Bondley, a wealthy slaveholder. In the direction of
his land, and near the shore, there was an excellent oyster fishing-
ground, and to this some of Lloyd’s slaves occasionally resorted in
their little canoes at night, with a view to make up the deficiency of
their scanty allowance of food by the oysters that they could easily
get there. Mr. Bondley took it into his head to regard this as a
trespass, and while an old man slave was engaged in catching a few
of the many millions of oysters that lined the bottom of the creek, to
satisfy his hunger, the rascally Bondley, lying in ambush, without the
slightest warning, discharged the contents of his musket into the
back of the poor old man. As good fortune would have it, the shot did
not prove fatal, and Mr. Bondley came over the next day to see Col.
Lloyd about it. What happened between them I know not, but there
was little said about it and nothing publicly done. One of the
commonest sayings to which my ears early became accustomed,
was that it was “worth but a half a cent to kill a nigger, and half a cent
to bury one.” While I heard of numerous murders committed by
slaveholders on the eastern shore of Maryland, I never knew a
solitary instance where a slaveholder was either hung or imprisoned
for having murdered a slave. The usual pretext for such crimes was
that the slave had offered resistance. Should a slave, when
assaulted, but raise his hand in self-defense, the white assaulting
party was fully justified by southern law, and southern public opinion
in shooting the slave down, and for this there was no redress.
CHAPTER IX.
CHANGE OF LOCATION.
Miss Lucretia—Her kindness—How it was manifested—“Ike”—A battle with

him—Miss Lucretia’s balsam—Bread—How it was obtained—Gleams of
sunlight amidst the general darkness—Suffering from cold—How we took
our meal mush—Preparations for going to Baltimore—Delight at the
change—Cousin Tom’s opinion of Baltimore—Arrival there—Kind
reception—Mr. and Mrs. Hugh Auld—Their son Tommy—My relations to
them—My duties—A turning-point in my life.
I HAVE nothing cruel or shocking to relate of my own personal

experience while I remained on Col. Lloyd’s plantation, at the home
of my old master. An occasional cuff from Aunt Katy, and a regular
whipping from old master, such as any heedless and mischievous
boy might get from his father, is all that I have to say of this sort. I
was not old enough to work in the field, and there being little else
than field-work to perform, I had much leisure. The most I had to do
was to drive up the cows in the evening, to keep the front-yard clean,
and to perform small errands for my young mistress, Lucretia Auld. I
had reasons for thinking this lady was very kindly disposed toward
me, and although I was not often the object of her attention, I
constantly regarded her as my friend, and was always glad when it
was my privilege to do her a service. In a family where there was so
much that was harsh and indifferent, the slightest word or look of
kindness was of great value. Miss Lucretia—as we all continued to
call her long after her marriage—had bestowed on me such looks
and words as taught me that she pitied me, if she did not love me.
She sometimes gave me a piece of bread and butter, an article not
set down in our bill of fare, but an extra ration aside from both Aunt
Katy and old master, and given as I believed solely out of the tender
regard she had for me. Then too, I one day got into the wars with
Uncle Abel’s son “Ike,” and had got sadly worsted; the little rascal
struck me directly in the forehead with a sharp piece of cinder, fused
with iron, from the old blacksmith’s forge, which made a cross in my
forehead very plainly to be seen even now. The gash bled very
freely, and I roared and betook myself home. The cold-hearted Aunt
Katy paid no attention either to my wound or my roaring except to tell
me it “served me right; I had no business with Ike; it would do me
good; I would now keep away from ‘dem Lloyd niggers.’” Miss
Lucretia in this state of the case came forward, and called me into
the parlor (an extra privilege of itself), and without using toward me
any of the hard and reproachful epithets of Aunt Katy, quietly acted
the good Samaritan. With her own soft hand she washed the blood
from my head and face, brought her own bottle of balsam, and with
the balsam wetted a nice piece of white linen and bound up my
head. The balsam was not more healing to the wound in my head,
than her kindness was healing to the wounds in my spirit, induced by
the unfeeling words of Aunt Katy. After this Miss Lucretia was yet
more my friend. I felt her to be such; and I have no doubt that the
simple act of binding up my head did much to awaken in her heart an
interest in my welfare. It is quite true that this interest seldom
showed itself in anything more than in giving me a piece of bread
and butter, but this was a great favor on a slave plantation, and I was
the only one of the children to whom such attention was paid. When
very severely pinched with hunger, I had the habit of singing, which
the good lady very soon came to understand, and when she heard
me singing under her window, I was very apt to be paid for my
music. Thus I had two friends, both at important points,—Mas’r
Daniel at the great house, and Miss Lucretia at home. From Mas’r
Daniel I got protection from the bigger boys, and from Miss Lucretia I
got bread by singing when I was hungry, and sympathy when I was
abused by the termagant in the kitchen. For such friendship I was
deeply grateful, and bitter as are my recollections of slavery, it is a
true pleasure to recall any instances of kindness, any sunbeams of
humane treatment, which found way to my soul, through the iron
grating of my house of bondage. Such beams seem all the brighter
from the general darkness into which they penetrate, and the
impression they make there is vividly distinct.
As before intimated, I received no severe treatment from the
hands of my master, but the insufficiency of both food and clothing
was a serious trial to me, especially from the lack of clothing. In
hottest summer and coldest winter, I was kept almost in a state of
nudity. My only clothing—a little coarse sack-cloth or tow-linen sort of
shirt, scarcely reaching to my knees, was worn night and day and
changed once a week. In the day time I could protect myself by
keeping on the sunny side of the house, or in stormy weather, in the
corner of the kitchen chimney. But the great difficulty was to keep
warm during the night. The pigs in the pen had leaves, and the
horses in the stable had straw, but the children had no beds. They
lodged anywhere in the ample kitchen. I slept generally in a little
closet, without even a blanket to cover me. In very cold weather I
sometimes got down the bag in which corn was carried to the mill,
and crawled into that. Sleeping there with my head in and my feet
out, I was partly protected, though never comfortable. My feet have
been so cracked with the frost that the pen with which I am writing
might be laid in the gashes. Our corn meal mush, which was our only
regular if not all-sufficing diet, when sufficiently cooled from the
cooking, was placed in a large tray or trough. This was set down
either on the floor of the kitchen, or out of doors on the ground, and
the children were called like so many pigs, and like so many pigs
would come, some with oyster-shells, some with pieces of shingles,
but none with spoons, and literally devour the mush. He who could
eat fastest got most, and he that was strongest got the best place,
but few left the trough really satisfied. I was the most unlucky of all,
for Aunt Katy had no good feeling for me, and if I pushed the
children, or if they told her anything unfavorable of me, she always
believed the worst, and was sure to whip me.
As I grew older and more thoughtful, I became more and more
filled with a sense of my wretchedness. The unkindness of Aunt
Katy, the hunger and cold I suffered, and the terrible reports of
wrongs and outrages which came to my ear, together with what I
almost daily witnessed, led me to wish I had never been born. I used
to contrast my condition with that of the black-birds, in whose wild
and sweet songs I fancied them so happy. Their apparent joy only
deepened the shades of my sorrow. There are thoughtful days in the
lives of children—at least there were in mine—when they grapple
with all the great primary subjects of knowledge, and reach in a
moment conclusions which no subsequent experience can shake. I
was just as well aware of the unjust, unnatural, and murderous
character of slavery, when nine years old, as I am now. Without any
appeal to books, to laws, or to authorities of any kind, to regard God
as “Our Father,” condemned slavery as a crime.
I was in this unhappy state when I received from Miss Lucretia
the joyful intelligence that my old master had determined to let me go
to Baltimore to live with Mr. Hugh Auld, a brother to Mr. Thomas
Auld, Miss Lucretia’s husband. I shall never forget the ecstacy with
which I received this information, three days before the time set for
my departure. They were the three happiest days I had ever known. I
spent the largest part of them in the creek, washing off the plantation
scurf, and thus preparing for my new home. Miss Lucretia took a
lively interest in getting me ready. She told me I must get all the dead
skin off my feet and knees, for the people in Baltimore were very
cleanly, and would laugh at me if I looked dirty; and besides she was
intending to give me a pair of trowsers, but which I could not put on
unless I got all the dirt off. This was a warning which I was bound to
heed, for the thought of owning and wearing a pair of trowsers was
great indeed. So I went at it in good earnest, working for the first time
in my life in the hope of reward. I was greatly excited, and could
hardly consent to sleep lest I should be left. The ties that ordinarily
bind children to their homes, had no existence in my case, and in
thinking of a home elsewhere, I was confident of finding none that I
should relish less than the one I was leaving. If I should meet with
hardship, hunger, and nakedness, I had known them all before, and I
could endure them elsewhere, especially in Baltimore, for I had
something of the feeling about that city that is expressed in the
saying that “being hanged in England is better than dying a natural
death in Ireland.” I had the strongest desire to see Baltimore. My
cousin Tom, a boy two or three years older than I, had been there,
and, though not fluent in speech (he stuttered immoderately), he had
inspired me with that desire by his eloquent descriptions of the place.
Tom was sometimes cabin-boy on board the sloop “Sally Lloyd”
(which Capt. Thomas Auld commanded), and when he came home
from Baltimore he was always a sort of hero among us, at least till
his trip to Baltimore was forgotten. I could never tell him anything, or
point out anything that struck me as beautiful or powerful, but that he
had seen something in Baltimore far surpassing it. Even the “great
house,” with all its pictures within, and pillars without, he had the
hardihood to say, “was nothing to Baltimore.” He bought a trumpet
(worth sixpence) and brought it home; told what he had seen in the
windows of the stores; that he had heard shooting-crackers, and
seen soldiers; that he had seen a steamboat; that there were ships
in Baltimore that could carry four such sloops as the “Sally Lloyd.”
He said a great deal about the Market house; of the ringing of the
bells, and of many other things which roused my curiosity very much,
and indeed which brightened my hopes of happiness in my new
home. We sailed out of Miles River for Baltimore early on a Saturday
morning. I remember only the day of the week, for at that time I had
no knowledge of the days of the month, nor indeed of the months of
the year. On setting sail I walked aft and gave to Col. Lloyd’s
plantation what I hoped would be the last look I should give to it, or
to any place like it. After taking this last view, I quitted the quarter-
deck, made my way to the bow of the boat, and spent the remainder
of the day in looking ahead; interesting myself in what was in the
distance, rather than in what was near by, or behind. The vessels
sweeping along the bay were objects full of interest to me. The broad
bay opened like a shoreless ocean on my boyish vision, filling me
with wonder and admiration.
Late in the afternoon we reached Annapolis, stopping there not
long enough to admit of going ashore. It was the first large town I
had ever seen, and though it was inferior to many a factory village in
New England, my feelings on seeing it were excited to a pitch very
little below that reached by travelers at the first view of Rome. The
dome of the State house was especially imposing, and surpassed in
grandeur the appearance of the “great house” I had left behind. So
the great world was opening upon me, and I was eagerly acquainting
myself with its multifarious lessons.
We arrived in Baltimore on Sunday morning, and landed at
Smith’s wharf, not far from Bowly’s wharf. We had on board a large
flock of sheep, for the Baltimore market; and after assisting in driving
them to the slaughter house of Mr. Curtiss, on Loudon Slater’s hill, I
was conducted by Rich—one of the hands belonging to the sloop—
to my new home on Alliciana street, near Gardiner’s ship-yard, on
Fell’s point. Mr. and Mrs. Hugh Auld, my new master and mistress,
were both at home and met me at the door with their rosy-cheeked
little son Thomas, to take care of whom was to constitute my future
occupation. In fact it was to “little Tommy,” rather than to his parents,
that old master made a present of me, and, though there was no
legal form or arrangement entered into, I have no doubt that Mr. and
Mrs. Auld felt that in due time I should be the legal property of their
bright-eyed and beloved boy Tommy. I was struck with the
appearance especially of my new mistress. Her face was lighted with
the kindliest emotions; and the reflex influence of her countenance,
as well as the tenderness with which she seemed to regard me,
while asking me sundry little questions, greatly delighted me, and lit
up, to my fancy, the pathway of my future. Little Thomas was
affectionately told by his mother, that “there was his Freddy,” and that
“Freddy would take care of him;” and I was told to “be kind to little
Tommy,” an injunction I scarcely needed, for I had already fallen in
love with the dear boy. With these little ceremonies I was initiated
into my new home, and entered upon my peculiar duties, then
unconscious of a cloud to dim its broad horizon.
I may say here that I regard my removal from Col. Lloyd’s
plantation as one of the most interesting and fortunate events of my
life. Viewing it in the light of human likelihoods, it is quite probable
that but for the mere circumstance of being thus removed, before the
rigors of slavery had fully fastened upon me; before my young spirit
had been crushed under the iron control of the slave-driver, I might
have continued in slavery until emancipated by the war.
CHAPTER X.
LEARNING TO READ.
City annoyances—Plantation regrets—My mistress—Her history—Her

kindness—My master—His sourness—My comforts—Increased
sensitiveness—My occupation—Learning to read—Baneful effects of
slaveholding on my dear, good mistress—Mr. Hugh forbids Mrs. Sophia to
teach me further—Clouds gather on my bright prospects—Master Auld’s
exposition of the Philosophy of Slavery—City slaves—Country slaves—
Contrasts—Exceptions—Mr. Hamilton’s two slaves—Mrs. Hamilton’s cruel
treatment of them—Piteous aspect presented by them—No power to
come between the slave and slaveholder.
ESTABLISHED in my new home in Baltimore, I was not very long in

perceiving that in picturing to myself what was to be my life there, my
imagination had painted only the bright side; and that the reality had
its dark shades as well as its light ones. The open country which had
been so much to me, was all shut out. Walled in on every side by
towering brick buildings, the heat of the summer was intolerable to
me, and the hard brick pavements almost blistered my feet. If I
ventured out on to the streets, new and strange objects glared upon
me at every step, and startling sounds greeted my ears from all
directions. My country eyes and ears were confused and bewildered.
Troops of hostile boys pounced upon me at every corner. They
chased me, and called me “Eastern-Shore man,” till really I almost
wished myself back on the Eastern Shore. My new mistress happily
proved to be all she had seemed, and in her presence I easily forgot
all outside annoyances. Mrs. Sophia was naturally of an excellent
disposition—kind, gentle, and cheerful. The supercilious contempt
for the rights and feelings of others, and the petulence and bad
humor which generally characterized slaveholding ladies, were all
quite absent from her manner and bearing toward me. She had
never been a slaveholder—a thing then quite unusual at the South—
but had depended almost entirely upon her own industry for a living.
To this fact the dear lady no doubt owed the excellent preservation of
her natural goodness of heart, for slavery could change a saint into a
sinner, and an angel into a demon. I hardly knew how to behave
towards “Miss Sopha,” as I used to call Mrs. Hugh Auld. I could not
approach her even as I had formerly approached Mrs. Thomas Auld.
Why should I hang down my head, and speak with bated breath,
when there was no pride to scorn me, no coldness to repel me, and
no hatred to inspire me with fear? I therefore soon came to regard
her as something more akin to a mother than a slaveholding
mistress. So far from deeming it impudent in a slave to look her
straight in the face, she seemed ever to say, “look up, child; don’t be
afraid.” The sailors belonging to the sloop esteemed it a great
privilege to be the bearers of parcels or messages to her, for
whenever they came, they were sure of a most kind and pleasant
reception. If little Thomas was her son, and her most dearly loved
child, she made me something like his half-brother in her affections.
If dear Tommy was exalted to a place on his mother’s knee, “Feddy”
was honored by a place at the mother’s side. Nor did the slave-boy
lack the caressing strokes of her gentle hand, soothing him into the
consciousness that, though motherless, he was not friendless. Mrs.
Auld was not only kind-hearted, but remarkably pious; frequent in her
attendance of public worship, much given to reading the Bible, and
to chanting hymns of praise when alone. Mr. Hugh was altogether a
different character. He cared very little about religion; knew more of
the world and was more a part of the world, than his wife. He set out
doubtless to be, as the world goes, a respectable man, and to get on
by becoming a successful ship-builder, in that city of ship-building.
This was his ambition, and it fully occupied him. I was of course of
very little consequence to him, and when he smiled upon me, as he
sometimes did, the smile was borrowed from his lovely wife, and like
all borrowed light, was transient, and vanished with the source
whence it was derived. Though I must in truth characterize Master
Hugh as a sour man of forbidding appearance, it is due to him to
acknowledge that he was never cruel to me, according to the notion
of cruelty in Maryland. During the first year or two, he left me almost
exclusively to the management of his wife. She was my law-giver. In
hands so tender as hers, and in the absence of the cruelties of the
plantation, I became both physically and mentally much more
sensitive, and a frown from my mistress caused me far more
suffering than had Aunt Katy’s hardest cuffs. Instead of the cold,
damp floor of my old master’s kitchen, I was on carpets; for the corn
bag in winter, I had a good straw bed, well furnished with covers; for
the coarse corn meal in the morning, I had good bread and mush
occasionally; for my old tow-linen shirt, I had good clean clothes. I
was really well off. My employment was to run of errands, and to
take care of Tommy; to prevent his getting in the way of carriages,
and to keep him out of harm’s way generally. So for a time
everything went well. I say for a time, because the fatal poison of
irresponsible power, and the natural influence of slave customs,
were not very long in making their impression on the gentle and
loving disposition of my excellent mistress. She regarded me at first
as a child, like any other. This was the natural and spontaneous
thought; afterwards, when she came to consider me as property, our
relations to each other were changed, but a nature so noble as hers
could not instantly become perverted, and it took several years
before the sweetness of her temper was wholly lost.
Mrs. Auld Learning Him to Read.
The frequent hearing of my mistress reading the Bible aloud, for
she often read aloud when her husband was absent, awakened my
curiosity in respect to this mystery of reading, and roused in me the
desire to learn. Up to this time I had known nothing whatever of this
wonderful art, and my ignorance and inexperience of what it could do
for me, as well as my confidence in my mistress, emboldened me to
ask her to teach me to read. With an unconsciousness and
inexperience equal to my own, she readily consented, and in an
incredibly short time, by her kind assistance, I had mastered the
alphabet and could spell words of three or four letters. My mistress
seemed almost as proud of my progress as if I had been her own
child, and supposing that her husband would be as well pleased, she
made no secret of what she was doing for me. Indeed, she exultingly
told him of the aptness of her pupil, and of her intention to persevere
in teaching me, as she felt her duty to do, at least to read the Bible.
And here arose the first dark cloud over my Baltimore prospects, the
precursor of chilling blasts and drenching storms. Master Hugh was
astounded beyond measure, and probably for the first time
proceeded to unfold to his wife the true philosophy of the slave
system, and the peculiar rules necessary in the nature of the case to
be observed in the management of human chattels. Of course he
forbade her to give me any further instruction, telling her in the first
place that to do so was unlawful, as it was also unsafe; “for,” said he,
“if you give a nigger an inch he will take an ell. Learning will spoil the
best nigger in the world. If he learns to read the Bible it will forever
unfit him to be a slave. He should know nothing but the will of his
master, and learn to obey it. As to himself, learning will do him no
good, but a great deal of harm, making him disconsolate and
unhappy. If you teach him how to read, he’ll want to know how to
write, and this accomplished, he’ll be running away with himself.”
Such was the tenor of Master Hugh’s oracular exposition; and it must
be confessed that he very clearly comprehended the nature and the
requirements of the relation of master and slave. His discourse was
the first decidedly anti-slavery lecture to which it had been my lot to
listen. Mrs. Auld evidently felt the force of what he said, and like an
obedient wife, began to shape her course in the direction indicated
by him. The effect of his words on me was neither slight nor
transitory. His iron sentences, cold and harsh, sunk like heavy
weights deep into my heart, and stirred up within me a rebellion not
soon to be allayed. This was a new and special revelation, dispelling
a painful mystery against which my youthful understanding had
struggled, and struggled in vain, to wit, the white man’s power to
perpetuate the enslavement of the black man. “Very well,” thought I.
“Knowledge unfits a child to be a slave.” I instinctively assented to
the proposition, and from that moment I understood the direct
pathway from slavery to freedom. It was just what I needed, and it
came to me at a time and from a source whence I least expected it.
Of course I was greatly saddened at the thought of losing the
assistance of my kind mistress, but the information so instantly
derived to some extent compensated me for the loss I had sustained
in this direction. Wise as Mr. Auld was, he underrated my
comprehension, and had little idea of the use to which I was capable
of putting the impressive lesson he was giving to his wife. He wanted
me to be a slave; I had already voted against that on the home
plantation of Col. Lloyd. That which he most loved I most hated; and
the very determination which he expressed to keep me in ignorance
only rendered me the more resolute to seek intelligence. In learning
to read, therefore, I am not sure that I do not owe quite as much to
the opposition of my master as to the kindly assistance of my
amiable mistress. I acknowledge the benefit rendered me by the
one, and by the other, believing that but for my mistress I might have
grown up in ignorance.
CHAPTER XI.
GROWING IN KNOWLEDGE.
My mistress—Her slaveholding duties—Their effects on her originally noble

nature—The conflict in her mind—She opposes my learning to read—Too
late—She had given me the “inch,” I was resolved to take the “ell”—How I
pursued my study to read—My tutors—What progress I made—Slavery—
What I heard said about it—Thirteen years old—Columbian orator—
Dialogue—Speeches—Sheridan—Pitt—Lords Chatham and Fox—
Knowledge increasing—Liberty—Singing—Sadness—Unhappiness of
Mrs. Sophia—My hatred of slavery—One Upas tree overshadows us all.
I LIVED in the family of Mr. Auld, at Baltimore, seven years, during

which time, as the almanac makers say of the weather, my condition
was variable. The most interesting feature of my history here, was
my learning to read and write under somewhat marked
disadvantages. In attaining this knowledge I was compelled to resort
to indirections by no means congenial to my nature, and which were
really humiliating to my sense of candor and uprightness. My
mistress, checked in her benevolent designs toward me, not only
ceased instructing me herself, but set her face as a flint against my
learning to read by any means. It is due to her to say, however, that
she did not adopt this course in all its stringency at first. She either
thought it unnecessary, or she lacked the depravity needed to make
herself forget at once my human nature. She was, as I have said,
naturally a kind and tender-hearted woman, and in the humanity of
her heart and the simplicity of her mind, she set out, when I first went
to live with her, to treat me as she supposed one human being ought
to treat another.
Nature never intended that men and women should be either
slaves or slaveholders, and nothing but rigid training long persisted
in, can perfect the character of the one or the other. Mrs. Auld was
singularly deficient in the qualities of a slaveholder. It was no easy
matter for her to think or to feel that the curly-headed boy, who stood
by her side, and even leaned on her lap, who was loved by little
Tommy, and who loved little Tommy in turn, sustained to her only the
relation of a chattel. I was more than that; she felt me to be more
than that. I could talk and sing; I could laugh and weep; I could
reason and remember; I could love and hate. I was human, and she,
dear lady, knew and felt me to be so. How could she then treat me
as a brute without a mighty struggle with all the noblest powers of
her soul. That struggle came, and the will and power of the husband
was victorious. Her noble soul was overcome, and he who wrought
the wrong was injured in the fall no less than the rest of the
household. When I went into that household, it was the abode of
happiness and contentment. The wife and mistress there was a
model of affection and tenderness. Her fervent piety and watchful
uprightness made it impossible to see her without thinking and
feeling “that woman is a Christian.” There was no sorrow nor
suffering for which she had not a tear, and there was no innocent joy
for which she had not a smile. She had bread for the hungry, clothes
for the naked, and comfort for every mourner who came within her
reach. But slavery soon proved its ability to divest her of these
excellent qualities, and her home of its early happiness. Conscience
cannot stand much violence. Once thoroughly injured, who is he who
can repair the damage? If it be broken toward the slave on Sunday, it
will be toward the master on Monday. It cannot long endure such
shocks. It must stand unharmed, or it does not stand at all. As my
condition in the family waxed bad, that of the family waxed no better.
The first step in the wrong direction was the violence done to nature
and to conscience, in arresting the benevolence that would have
enlightened my young mind. In ceasing to instruct me, my mistress
had to seek to justify herself to herself, and once consenting to take
sides in such a debate, she was compelled to hold her position. One
needs little knowledge of moral philosophy to see where she
inevitably landed. She finally became even more violent in her
opposition to my learning to read than was Mr. Auld himself. Nothing
now appeared to make her more angry than seeing me, seated in
some nook or corner, quietly reading a book or newspaper. She
would rush at me with the utmost fury, and snatch the book or paper
from my hand, with something of the wrath and consternation which
a traitor might be supposed to feel on being discovered in a plot by
some dangerous spy. The conviction once thoroughly established in
her mind, that education and slavery were incompatible with each
other, I was most narrowly watched in all my movements. If I
remained in a separate room from the family for any considerable
length of time, I was sure to be suspected of having a book, and was
at once called to give an account of myself. But this was too late: the
first and never-to-be-retraced step had been taken. Teaching me the
alphabet had been the “inch” given, I was now waiting only for the
opportunity to “take the ell.”
Filled with the determination to learn to read at any cost, I hit
upon many expedients to accomplish that much desired end. The
plan which I mainly adopted, and the one which was the most
successful, was that of using my young white playmates, with whom
I met on the streets, as teachers. I used to carry almost constantly a
copy of Webster’s spelling-book in my pocket, and when sent on
errands, or when play-time was allowed me, I would step aside with
my young friends and take a lesson in spelling. I am greatly indebted
to these boys—Gustavus Dorgan, Joseph Bailey, Charles Farity, and
William Cosdry.
Although slavery was a delicate subject, and very cautiously
talked about among grown up people in Maryland, I frequently talked
about it, and that very freely, with the white boys. I would sometimes
say to them, while seated on a curbstone or a cellar door, “I wish I
could be free, as you will be when you get to be men.” “You will be
free, you know, as soon as you are twenty-one, and can go where
you like, but I am a slave for life. Have I not as good a right to be free
as you have?” Words like these, I observed, always troubled them;
and I had no small satisfaction in drawing out from them, as I
occasionally did, that fresh and bitter condemnation of slavery which
ever springs from nature unseared and unperverted. Of all
conscience, let me have those to deal with, which have not been
seared and bewildered with the cares and perplexities of life. I do not

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II. The Meaning of Pain

III. The Measurement of Pain

IV. Pain Syndromes

Cancer pain is caused by either a malignancy or by treatment of a malignancy.

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This website is maintained by the American Chronic Pain Association, an

Creating Chronic Pain

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From Films for the Humanities & Sciences:

From Fanlight Productions:

Videos from the Web:

http://youtu.be/b3fX96OugmA –This video examines the relationship between pain and

http://youtu.be/SPOcqXkygoQ – This video explains possible reason why pain patients

http://youtu.be/YL_6OMPywnQ - This video explains how mirror therapy is used to help

1. The ______ system allows us to interpret certain sensory information as pain.

2. Primary afferents convey sensory impulses to the

3. Myelinated afferent neurons are called

4. More than half of all sensory afferents are

8. Nociception refers to the process of perceiving ________.

12. Recent research gave participants __________ to reduce people’s feelings of

14. _____ are chemicals that carry information between nerves.

17. The dorsal horns are located in the

18. The substantia gelatinosa is

19. Which structure is most capable of modulating sensory input?

ANS: c REF: Pain and the Nervous System

20. Sensory input information passes through what brain structure?

21. What brain structure contains a representation of the skin’s surface?

24. Pain is usually defined as

30. Physicians are likely to underestimate the pain of

37. With regard to gender,

a. women sense pain more quickly than men.

38. Specificity theory hypothesizes that

d. is less important in pain perception than the cerebellum.

43. The gate control theory of pain assumes

46. Which of these methods have been used to measure pain?

47. The Visual Analog Scale is considered to be

ANS: d REF: The Measurement of Pain

49. A personality inventory sometimes used to assess pain is the

51. Which of these techniques measures muscle tension as an index of pain?

54. With regard to migraine headaches,

58. The two most common types of pain are

61. Unlike rheumatoid arthritis, osteoarthritis

Gore Shooting Denby.

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I HAVE nothing cruel or shocking to relate of my own personal

City annoyances—Plantation regrets—My mistress—Her history—Her

ESTABLISHED in my new home in Baltimore, I was not very long in

My mistress—Her slaveholding duties—Their effects on her originally noble