For instance, empathy for another person who is suffering increases our own pain experience, and expectation of pain relief underlies much of the placebo effect. Brain imaging studies show a physical basis for psychological pain modulation, with activity in pain pathways of the brain being altered by attentional state, positive and negative emotions, empathy, and the administration of a placebo. The same psychological factors activate systems in the brain that control pain, including those stimulated when opiates are given for pain relief. It is important for the clinician and the patient to understand the influence of one’s psychological state on pain transmission. Such an understanding will not only help people living with pain to learn how to participate in their own pain control, but also help the clinician to create a fostering environment.