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Problems with the GCT

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Problems with the GCT
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PAIN
289
a perception, rather than a direct mirror image, pain is described as involving an
active interpretation of the painful stimuli.
I The individual as active not passive. According to the GCT, pain is determined by
central and peripheral fibres. Pain is seen as an active process as opposed to a passive
one. The individual no longer just responds passively to painful stimuli, but actively
interprets and appraises this painful stimuli.
I The role of individual variability. Individual variability is no longer a problem in under-
standing pain but central to the GCT. Variation in pain perception is understood in
terms of the degree of opening or closing of the gate.
I The role for multiple causes. The GCT suggests that many factors are involved in pain
perception, not just a singular physical cause.
I Is pain ever organic? The GCT describes most pain as a combination of physical and
psychological. It could, therefore, be argued that within this model, pain is never
totally either organic or psychogenic.
I Pain and dualism. The GCT attempts to depart from traditional dualistic models of the
body and suggests an interaction between the mind and body.
What opens the gate?
The more the gate is opened the greater the perception of pain. Melzack and Wall (1965,
1982) suggest that several factors can open the gate:
I physical factors, such as injury or activation of the large fibres;
I emotional factors, such as anxiety, worry, tension and depression;
I behavioural factors, such as focusing on the pain or boredom.
What closes the gate?
Closing the gate reduces pain perception. The gate control theory also suggests that
certain factors close the gate.
I physical factors, such as medication, stimulation of the small fibres;
I emotional factors, such as happiness, optimism or relaxation;
I behavioural factors, such as concentration, distraction or involvement in other
activities.
Problems with the GCT
The gate control theory represented an important advancement on previous simple
stimulus response theories of pain. It introduced a role for psychology and described a
multidimensional process rather than a simple linear one. However, there are several
problems with the theory.
First, although there is plenty of evidence illustrating the mechanisms to increase
and decrease pain perception, no one has yet actually located the gate itself. Second,
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