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I tried to search in textbooks and papers but barely found any concrete answer to which exact mechanism is behind non-intuitive transition from pain to pleasure. Does it have something to do with:

  1. just the effect of dopamine (once the pain is administered, endorphins inhibit GABA and increase dopamine release)?
  2. initially decreased levels of beta-endorphins in the brain, so that pain increases DA release as in (1) and even this small release is enough to feel the pleasure? And, as in people who are prone to self-harm, is it some kind of a "desperate attempt to artificially set the body to survival mode in order to mobilize the last reserves of the endogenous opioid system"?
  3. lower sensitivity (to pain?) in such people?
  4. some other explanations?

If someone have the answer or ran into papers addressing this question, I would be grateful!

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The first paper I found was this one:

Kamping, S., Andoh, J., Bomba, I. C., Diers, M., Diesch, E., & Flor, H. (2016). Contextual modulation of pain in masochists: involvement of the parietal operculum and insula. Pain, 157(2), 445.

They note:

Masochists reported substantially reduced pain intensity and unpleasantness in the masochistic context compared with controls but had unaltered pain perception in the other conditions

The context-dependence of this effect suggests to me to favor a "top-down" modulation explanation, rather than a "bottom-up" neurochemical one involving endorphins and dopamine.

The authors continue:

The masochists compared with the controls displayed attenuated functional connectivity of the parietal operculum with the left and right insulae, the central operculum, and the supramarginal gyrus. Masochists additionally showed negative correlations between the duration of interest in masochistic activities and activation of areas involved in motor activity and affective processing. We propose that the parietal operculum serves as an important relay station that attenuates the affective-motivational aspects of pain in masochists.

So indeed, their results suggest that the higher-order perception of pain is different in masochists during masochistic activities. It's difficult to make causal conclusions from these data, however in general this isn't something that's going to be easy to study causally. I'm not aware of any model of masochism in model organisms, so approaches are going to be fairly limited to observational studies of humans.

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  • $\begingroup$ I ran into this paper, too, but thought there should exist a bottom-up explanation as well. Thanks for answering and I also agree that that's a hard thing to measure. $\endgroup$ Jun 30 at 17:34

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