Special topic: Inbodied interaction

XXVII.2 March - April 2020
Page: 40
Digital Citation

Discomfort design


Authors:
m.c. schraefel, Aaron Tabor, Elizabeth Murnane

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Over the past 30 years, as digital technologies have become both cheaper and near ubiquitous, from computerized environmental controls in buildings, to cellular networks for no-downtime connectivity, to the pervasive smartphone, we have likewise seen the exponential increase of so-called lifestyle diseases: obesity, cardiovascular disease, type II diabetes, chronic stress, and lack of sleep—all ailments associated with certain kinds of abundance or excess. That is, we have designed our environments such that, for many of us, for many contexts, much of the time, we do not have to feel discomfort.

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We stay dry in the rain; warm in the cold. We do not have to feel a visceral response of discomfort for longer than it takes us to reach for the thermostat, the fridge—or now, our phone—to have whatever urge we feel satisfied momentarily, from transportation to meal delivery.

back to top  Insights

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In inbodied interaction terms, we could frame this urge fulfillment as optimizing on hedonic satisfaction. That is: We optimize designs to reduce any immediate discomfort and amplify immediate pleasure and reward. Or, if not satisfying immediate pleasure, our innovations are largely targeted at reducing the momentary discomfort of energetic cost: elevators rather than stairs, cars rather than bikes, voice controls to avoid a trip to the light switch. From an inbodied interaction perspective that strives to promote positive, holistic adaptation, one may even say that the so-called lifestyle diseases are diseases of constant comfort, and are overly tilted to the hedonic—only possible in times of abundance—rather than toward the homeostatic. Indeed, physiologically—from mental to physical to social practices—we are wired to adapt through discomfort. As described in the overview article, our bodies are highly adaptive, plastic, and efficient. We likewise load to learn or fire to wire: We must constantly stimulate through practice what we wish to build and maintain.

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This adaptation process, however, is not comfortable. Whether that discomfort is being chilly, hot, hungry, or fatigued, our bodies—including our brains—thrive and even rejuvenate from these acute (as opposed to chronic) physiological stresses. They also improve not only our physiological but also our psychological resilience to challenge and threat. Stresses may include learning a new concept, or a new approach to solving a problem, or lifting a heavier than typical load. Indeed, because we are constantly adapting to stimuli and becoming more efficient at responding to them, we also must regularly adapt the adaptation. Anyone who has used one strength-training program one season may find it does not have the same response the next season. But it's not our fault; we've just adapted and become more efficient. We need to change the challenge, restart the adaptation. And that induces discomfort.

back to top  Inbodied Science Underpinning Discomfort Design

As the science of our neurology, genetics, and microbes grows, it is increasingly clear that we are designed—perhaps ironically—to be at our best when we are taxed; we progress through discomfort.


Whether it is being chilly, hot, hungry, or fatigued, our bodies—including our brains—thrive and even rejuvenate from these acute physiological stresses.


Research on human fasting is showing that we rejuvenate in incredible ways when we actually simply stop eating for approximately 12 to 13 hours [1]. Go a little further to 16 hours, and evidence suggests that lean tissue building (muscle building) is stimulated. Occasionally go as far as three days (akin to going to the dentist for an annual checkup), and research suggests that we practically completely reboot: Our bodies seem to pick up that they are entering a potential scarcity scenario, and so clean out all the crud, not unlike pruning dead branches. When the refeed happens at the end of three days, the space is there to rebuild afresh.

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This work on fasting is still in its early days, but it certainly aligns with positive adaptations in other physiological processes, such as physical effort. The Wingate test evaluates anaerobic power. In the test, a rider pedals a stationary bicycle loaded to 7.5 percent of their mass, and then pedals at full exertion for 30 seconds. This test is often perceived as physically draining and psychologically daunting. Researchers got quite excited at the effects of athletes performing six Wingates in a row, repeated three days a week. The result improved physiological function at a tenth of the training volume in a quarter of the time, compared with a more familiar 40- to 60-minute, moderate-intensity, steady-state effort [2]. This program is an extreme instance of degree of discomfort mapped to accelerated adaptation, but it is not unique. Other examples of how we are wired to respond positively to discomfort challenges are abundant:

  • Breath holding post-hyperventilation to the point of eliciting, and then managing, the panic response has been shown repeatedly to significantly improve immune response [3]. Similarly, "intermittent hypoxia training" is being used to positive effect in areas from athletic performance, to cognitive-function improvement, to increasing insulin sentitivity in type 2-diabetic men.
  • Both uncomfortable doses of heat [4] and cold [5] have distinct restorative properties.
  • Muscular hypertrophy (growth) is associated with training to muscular fatigue (uncomfortable experience) where one cannot complete that next rep [6].
  • Novel eccentric contractions from such effort (like slowly lowering oneself from a pull up) often induces "delayed onset muscle soreness" [7].
  • In terms of cognitive performance, chronic challenging physical activity (where one feels one is doing hard work) is strongly correlated with improved cognitive performance [8].
  • The concept of "deliberate practice"—of working on something that is not easy, that is in fact difficult, whether this is a challenging piece in a musical performance, or working through a math problem—is shown to be more productive in problem solving than hours of repetition of the familiar [9].

back to top  Why Discomfort?

Novel inbodied challenges create discomfort as part of supporting an adaptation. Discomfort is often framed as part of what may be called a pain continuum, and often described as more psychological than physical, as a mechanism to keep us safe. From an inbodied adaptation perspective, we can view discomfort as part of a complex warning system in the body—mediated via the nervous system—that alerts us something unfamiliar is happening that either may be a novel threat or may be reminiscent of a past experience that was a threat and may be happening again. Discomfort-as-signal brings our conscious attention to the experience as a signal in order for us to respond to that signal and make a decision. Our response can be either to stop the activity (I don't like the taste of vegetables; I shall not eat them) or to continue on (one more mile in this run; one more hour trying to learn this statistics method), unless that signal intensifies and we find we can no longer execute the task.

It is important to note that neither discomfort nor pain is always related to physical harm. Both discomfort and pain signaling are (as per the tuning and insourcing articles in this section) related to context, including those of our own experiences. For example, in a highly arousing situation like combat, soldiers focused on keeping their team alive have reported being shot and not realizing it until well after the current priority signal had been addressed. Similarly, when all else is calm, a minor paper cut may become the entire focus of our attention. In other words, whether we interpret something as painful or uncomfortable does not mean that other inbodied processes are not happening to address an injury: Inflammation will still set up around a wound; we will bruise even if we don't remember feeling ourselves bump into something hard enough to cause that under-the-skin bleeding. And yet, how we perceive and interpret pain has consistently been shown to affect our experience of pain severity and associated debilitation. Migraine sufferers who have mental models for the pain experienced report being better able to manage and reduce its intensity. Cyclists who justify the discomfort of a long training ride in the rain as part of their race preparation, to familiarize the experience, respond to that discomfort differently from people for whom this is unfamiliar and thus potentially threatening, and so an undesirable experience to be avoided.

back to top  Inbodied Interaction of Discomfort Means Strategic Adaptation and Recovery

A significant attribute of effective discomfort is that it is acute, not chronic. It lasts within part of a particular focused activity, to be followed by recovery. The challenging practice session ends; the exercises of the new math concept finish.

Another key fact for design consideration is that the adaptation elicited in response to discomfort happens after the event itself—during recovery. It is in the recovery phase that our bodies build the new strength, skills, and interpretations of an uncomfortable experience. For every deliberately uncomfortable process we ask of ourselves, we need to provide sufficient recovery from that process to benefit from it. A strenuous workout without quality sleep—in particular, deep sleep—will not enable the tissue repair and development necessary for optimal strength improvements. An intense session in learning new skills will not translate into reusable knowledge as deeply or effectively without quality REM sleep. A key design opportunity, therefore, is to help people deliberately prepare for discomfort, so that the soreness they feel after their first gym session, for example, does not cause them to abandon their new movement practice.

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In the following, we highlight opportunities for exploring deliberate discomfort design in HCI.


Our ability to stick through the discomfort has been shown to improve the speed and accuracy of progress in skills acquisition.


Sustainability and. health. An HCI opportunity for discomfort design may be to explore how we can leverage sustainability practices to align with inbodied well-being. For example, cold showering has been associated with an enhanced sense of discipline, reduced sick time at work, and increased confidence [10]. We can explore connecting this practice with reduced heating energy/cost savings in the home. There may be similar opportunities to explore the benefits of supporting preparation for inclement weather cycling for increased brown fat (fat-burning adaptation) and environmental benefits. Similarly, there may be design opportunities to help explore the health and environmental benefits, for instance, between increasing plant-based eating, reducing meat consumption, and incorporating time-restricted eating.

Before flow, deliberate practice is uncomfortable. A popular theory of engagement is psychologist Mihaly Csikszentmihalyi's concept of flow: that we achieve flow state when a task is sufficiently challenging that it engages our attention to the point that time passes without our awareness. The activity itself is the locus of attention. Deliberate practice is not likely where we find flow: Deliberate practice—working through a challenging problem—is generally uncomfortable. Our ability to stick through the discomfort has been shown to improve the speed and accuracy of progress in skills acquisition. Not only can we design to prepare for discomfort and help individuals and groups make sense of it, to manage it; we can also explore designs to help embrace discomfort within the experience itself. Such work may focus on relating effects to anticipated benefits, or relating experience to how these discomfort signals help insource and build one's tuning process (see related articles).

back to top  Foregrounding Inbodied Adaptation Rather Than (Only) Prevention

In sum, our bodies—including our brains—respond to practices of discomfort and adapt when followed by phases of recovery. Indeed, a certain degree of discomfort is simply, fundamentally part of any inbodied adaptation. These uncomfortable adaptations are essential to developing physical, social, and emotional skills.

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As shown in this article, inbodied adaptation itself is part of a cycle of modulating discomfort and recovery; of supporting crafted, acute bouts of discomfort and recovery associated with growth, strength, creativity, well-being, and social harmony. In relation to tuning, we propose inbodied interaction as a focus on design for positive adaptation, complementing the medical model's focus on prevention and the sports-science focus on performance.

The above is not to say that insight cannot be crafted without discomfort, that art must always be painful—far from it. HCI has understandably had a focus on making interactions as easy as possible to reduce frustration, if not pain and discomfort. As proposed here, discomfort design offers HCI potentially new territory: how to make deliberately exploring and using discomfort as easy and effective as possible. The inbodied interaction concepts of tuning, insourcing, and adaptation, leveraging inbodied fundamentals like the in5, offer us starting points to build deliberately into discomfort design for positive adaptation toward better quality of life for all.

back to top  References

1. Chaix, A., Zarrinpar, A., Miu, P., and Panda, S. Time-restricted feeding is a preventative and therapeutic intervention against diverse nutritional challenges. Cell metabolism 20, 6 (2014), 991–1005. https://doi.org/10.1016/j.cmet.2014.11.001

2. Burgomaster, K.A., Howarth, K.R., Phillips, S.M., Rakobowchuk, M., MacDonald, M.J., McGee, S.L., and Gibala, M.J. Similar metabolic adaptations during exercise after low volume sprint interval and traditional endurance training in humans. The Journal of Physiology 586, 1 (2008), 151–160; https://doi.org/10.1113/jphysiol.2007.142109

3. Kox, M., van Eijk, L.T., Zwaag, J., van den Wildenberg, J., Sweep, F.C.G.J. van der Hoeven, J.G., and Pickkers, P. Voluntary activation of the sympathetic nervous system and attenuation of the innate immune response in humans. Proc. of the National Academy of Sciences of the United States of America 111, 20 (2014), 7379–7384; https://doi.org/10.1073/pnas.1322174111

4. Hussain, J. and Cohen, M. Clinical effects of regular dry sauna bathing: A systematic review. Evidence-Based Complementary and Alternative Medicine:eCAM (2018); https://doi.org/10.1155/2018/1857413

5. Roszkowska, K., Witkowska-Pilaszewicz, O., Przewozny, M., and Cywinska, A. Whole body and partial body cryotherapies—lessons from human practice and possible application for horses. BMC Veterinary Research 14 (2018), https://doi.org/10.1186/s12917-018-1679-6

6. Morton, R.W., Colenso-Semple, L., and Phillips, S.M. Training for strength and hypertrophy: An evidence-based approach. Current Opinion in Physiology 10 (Aug. 2019), 90–95; https://doi.org/10.1016/j.cophys.2019.04.006

7. Heiss, R., Lutter, C., Freiwald, J., Hoppe, M.W., Grim, C., Poettgen, K., Forst, R., Bloch, W., Hüttel, M., and Hotfiel, T. Advances in delayed-onset muscle soreness (DOMS) - Part II: Treatment and prevention. Sportverletzung Sportschaden: Organ Der Gesellschaft Fur Orthopadisch-Traumatologische Sportmedizin 33, 1 (2019), 21–29; https://doi.org/10.1055/a-0810-3516

8. Rathore, A. and Lom, B. The effects of chronic and acute physical activity on working memory performance in healthy participants: A systematic review with meta-analysis of randomized controlled trials. Systematic Reviews 6, 1 (2017), article 124; https://doi.org/10.1186/s13643-017-0514-7

9. Ericsson, K.A. and Harwell, K.W. Deliberate practice and proposed limits on the effects of practice on the acquisition of expert performance: Why the original definition matters and recommendations for future research. Frontiers in Psychology 10 (2019); https://doi.org/10.3389/fpsyg.2019.02396

10. Buijze, G.A., Sierevelt, I.N., van der Heijden, B.C.J.M., Dijkgraaf, M.G., and Frings-Dresen, M.H.W. The effect of cold showering on health and work: A randomized controlled trial. PLoS ONE 11, 9 (2016); https://doi.org/10.1371/journal.pone.0161749

back to top  Authors

m.c. schraefel directs the International Wellthlab (wellthlab.soton.ac.uk). Its mission is to explore where and how interactive technology can help make normal better, for all, at scale. mc@nopain2.org

Aaron Tabor is a Ph.D. student in the HCI Lab, University of New Brunswick. His work applies inbodied interaction to explore connections between breathing practices and health, wellness, and performance. He is leading the upcoming 3rd Body as Starting Point workshop on inbodied interaction this April at CHI 2020. Aaron.Tabor@unb.ca

Elizabeth Murnane is a postdoctoral scholar in computer science at Stanford University. She conducts research in human-computer interaction, informatics, social computing, and ubiquitous computing, aiming to develop technologies that empower people in managing various aspects of their daily lives and well-being, on both personal and collective levels. emurnane@stanford.edu

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