Pain and Spontaneous Thought

Pain is among the most salient of experiences while also, curiously, being among the most malleable. A large body of research has revealed that a multitude of explicit strategies can be used to effectively alter the attention-demanding quality of acute and chronic pains and their associated neural correlates. However, thoughts that are spontaneous, rather than actively generated, are common in daily life, and so attention to pain can often temporally fluctuate because of ongoing self-generated experiences. Classic pain theories have largely neglected to account for unconstrained fluctuations in cognition, but new studies have demonstrated the behavioral-relevance, putative neural basis, and individual variability of interactions between pain and spontaneous thoughts. In this chapter, I review behavioral studies of ongoing fluctuations in attention to pain, studies of the neural basis of spontaneous mind-wandering away from pain, and the clinical implications of this research.