US troops are pulling out of Iraq, and many of these brave women and men return home with serious physical injuries and mental challenges. One of the most devastating is the loss of one or more extremities.
The most common feature of phantom limbs is their absolute reality to the amputee. The eerie occurrence of sensations, such as pressure, cramping, warmth, cold, itchiness, tickling, sweat, burning, a feeling of wetness and/or intractable pain, can give rise to more substance in the invisible appendage than an actual limb. Vivid feelings and a precise sense of location in space can make the phantom seem so lifelike that an individual may try to step off a bed or try to raise a cup. Stimulation elsewhere in the body can sometimes be felt in a phantom limb.
Seventy percent of amputees experience phantom pain. With hundreds of thousands of military men and women returning home, many missing an arm or leg, the need for understanding the cause and associated suffering of phantoms has never been so urgent.
Ronald Melzack, co-author along with the late Patrick D. Wall, of the gate control theory of pain, has postulated some interesting explanations. The extensive research he and his colleagues lead rattles some of the most accepted concepts of neuroscience, psychology and the relationship between the brain and the body. Here are some of the concepts their research puts forth:
1. The brain is a neuromatrix that not only responds to sensory stimulus, but also generates a characteristic pattern of impulses indicating that the body is intact and unequivocally one’s own.
2. This neural network is prewired, primarily determined by genes, later sculpted by experience. (This is evident in the many people who are born without a limb and yet experience a vivid lifelike phantom.)
3. The brain not only detects and analyzes input; it generates a perceptual experience even when no external stimulus occurs. The brain generates the experience of the body. Sensory input merely modulates that experience; it does not directly cause it. We do not need a body to feel a body!
4. The key to solving the mystery of phantom-limb and other chronic pain situations lies in the brain. It’s all in our heads!
Stay tuned for my next post when I’ll share my own experience working with amputees and discuss the research around reflexology and phantom-limb pain.