Does It Hurt? Tickling as a Pain Response

08 June 2021

Being the me that I am, I mysteriously injured my neck and shoulder a few months back. It may have been the Warrior X-Fit challenge that I had no business trying, the arm bar/choke holds and the partner side kick stretches I tried in MMA, or the way I lifted my coffee cup. You never know. Everything was locked. I couldn’t turn my head or lift my arm. I was the biggest baby about it and no one had any openings to fit me in for two weeks. 

When I finally found an opening with a local masseuse, I was a mess of knots that needed intense focus. I felt so sorry for this poor woman’s hands. She recommended dry needling and chiropractors; OTC medications and doctor’s appointments. We discussed the plan for follow up appointments and though the pain was not gone, I was again functional.

A week later, my neck gave a resounding crack and I scared my husband.

One thing this lovely lady and I discussed when I saw her again has been spinning around in my brain.  She told me not to apologize for my tickle response when she hit my ever troublesome IT band.

“Tickling is a pain response. Your body is telling you that it is too much.”

Did you know that gorillas are ticklish (Nye, 2013)? What about rats? On average, human infants are not ticklish until they are 46 months old Even then, the connection between an external action and and physiological response is not immediately clear to these chubby little bundles. We teach tickling. And sometimes, though we laugh, tickling hurts.

Scientific inquiries have shown that, in healthy subjects, tickling activates the hypothalamus of the brain which then sends information to the periaqueductal gray (PAG) matter. If you are interested in this sort of thing, Wattendorf et al. (2012) have a really interesting study using fMRIs.  Located in the forebrain, the hypothalamus strives to maintain homeostasis and, among other functions, is part of the important limbic system in the anterior cingulate gyrus that controls behavioral responses and emotion by releasing hormones like dopamine, oxytocin, and vasopressin through the pituitary gland. It is the source of our fight-flight-freeze response. The PAG controls vocalizations like laughter and has been linked to role in the inhibition of pain. 

Pain.

Where are we ticklish? Our armpits, our waist, our knees, and our feet are all vulnerable parts of the body. High pressure on these areas results in a type of tickling called gargalesis (Nye, 2013). Tickling that is light and almost itches is called knisimesis. When tickled, even with the best of intentions, we engage automatically in defensive maneuvers. Have you ever been kicked by a flailing ten year old with his black belt? OWW. He started it though, I swear. You don’t tickle the neck boy child. Ever. 

You can blame your cerebellum for the fact that you can’t tickle yourself. No tricking that most basic part. But maybe you can trick other parts. If some of the research is to be believed, tickling is activating the same parts of our brain that that tells us to fear, to submit, admit defeat, and to process pain. It is the social element of being tickled by a trusted source that allows us to interpret the act as pleasant. The same action of tickling has an entirely different interpretation when the person putting hands on you does not have your trust.

Children have the right to politely turn down a hug or ask not to picked up if they are not comfortable. We have the right to refuse any unwelcome touch. Should we include aggressive tickling in the conversations we have with children? I can’t claim to have that answer. If your body is physically withdrawing from the certain people, situations, and acts though I urge you to trust your instincts and listen to what your body is telling you. 

I know that, in my home, we have the right to yell, “Stop, please!” And hands are immediately removed with no questions asked. But I also know that my kids are back to tickle fighting 20 seconds later in most cases. I know that one loves the feeling of knisimesis and the other hates it. I know we have to talk rather than guess at what the other is feeling. Our moods and energy levels affect our ability to positively receive tickling.

I do wonder about the relationship between feeling pain and but showing pleasure. After all, smiling during grueling exercise only improves performance by releasing serotonin and dopamine if it is periodic and genuine. Despite ten years of cheerleading mantras, forced and continuous smiling does nothing for movement economy or overall mood. You have to mean it.

If we are hurting inside but paste on a smile is that not masking a pain response? How can you get help if you don’t express a need for it? If you are struggling today with feelings of inadequacy or loneliness but tell me that you are “fine,” are you trying to trick me or yourself?

If you are hurting, I hope you voice your need.

Nye, J. (2013, May 27). Researchers discover why we laugh when tickled – and the answer is not funny. Mail Online. https://www.dailymail.co.uk/news/article-2331500/Researchers-discover-laugh-tickled–answer-funny.html

Wattendorf, E., Westermann, B., Fiedler, K., Kaza, E., Lotze, M., & Celio, M. R. (2012). Exploration of the Neural Correlates of Ticklish Laughter by Functional Magnetic Resonance Imaging. Cerebral Cortex, 23(6), 1280–1289. https://doi.org/10.1093/cercor/bhs094