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The Role of Pain on Leadership Functions on Long Duration Space Journeys

High Altitude Venus Operational Concept (HAVOC), Source:
Composite: Earth-Rise and Venus Settlement Concept (source: Wikimedia, NASA)

As humans journey further across our solar system, our relationship with - and in - deep space will be shaped by the nature of leadership nurtured on earth. I am interested in the formative and distractive nature of pain signals on leadership behaviour, and the influence of that on emerging leadership in this new world of deep space. In this article I focus on headache pain.

Demands and Conditions for Human Presence in Deep Space

Ongoing investments for long-range human spaceflights indicate that we will see multiple human Lunar and Mars missions over the next two decades, including perhaps pioneering settlements. Many factors will impact how humans will relate, cooperate, self-govern and survive on progressively longer deep-space journeys. Functioning as crews in confined, hyper-vigilant, risky environments may amplify strain, some of which could express as pain. Adjusting to Earth independent operations could trigger forging and defending independent relationships with other international or sovereign settlers, and securing new assets.

As spacefarer recruitment transitions toward non-military demographics, the behavioral dynamics of community leadership will evolve. Maintaining human presence in deep space will require crews and settlers to be multi-vocational and to demonstrate operational competence covering cognitive, emotional, social, teamwork, and behavioral skills. In leadership contexts, the stakes will rise as responsibilities extend to team self-care and cohesion.

This growing complexity of demands accompanies stress, a major leadership shaper. Debilitating headaches are one expression of stress, which relates to performance and behavior impairments among leaders. In space, in particular, cognitive and behavioral impairments are more directly correlated with stress perception and stress response beyond just the exposure to the challenges of spaceflight. Human endurance and capabilities will be stretched in the midst of this complex interplay.

The Journal of Headache and Pain
source: The Journal of Headache and Pain

The State Of Pain On Earth - Brief Sensemaking

I took the prevalence of headaches, leadership vulnerabilities and its relevance for Earth and deep space as good reasons to explore its causal and impact pathways on Earth, and in space. Borrowing the crude lens of stress-strain curves used for materials elasticity, I explored the stress influences across STEEPLE for the year 2040.
source: Wikimedia

Delineating elastic, plastic and breakage zones simply meant identifying to what extent a person could ‘stretch’ functionally and behaviorally before reaching the debilitating destructive zone.

Stress Strain Curve Curves STEEPLE General Population, Earth, Space, Analogue
source: Ashish Manwar

In general while social and environmental factors seemed to push people to the plastic zone much more quickly, technology factors seemed less strenuous.

Having similar scans for leaders in high-stake Earth and space roles might offer useful comparisons.

With a small representative panel, I reflected on the impact and influence of the emerging nature of headaches, back across STEEPLE and key domains analogous to space travel. Dealing with pain, such as headaches - simply implied being absent in the role, being unable to function and contribute. That meant personal and corporate productivity loss. Plus over time, increased psychosocial risks and strained bonds within teams and families. In leadership contexts, you can argue that presenteeism can degrade decision or performance quality that might adversely impact others.

What Does This Mean for Space Travel?

On Earth, headache epidemiology is a relatively young discipline. Its public health impact and societal costs are also not well known. In space and isolation analogue environments as well, both - leadership studies and the state of headaches - are in very early stages.

We know from recent studies that:

How does this compare for astronauts? Including space adaptation occurrences, headache frequency ranks behind backpain and insomnia. What about leaders’ abilities to take risks under constant cognitive and behavioral loads, and when dealing with function-limiting pain? Is it also possible that long haul space journeys could also reveal better practices and solutions to pain and stress responses?

There’s certainly room to invest greater anticipatory energy to:

  1. Learn from these interactions of life in space, physiological triggers, responses and solutions, and decision impact envelopes.

  2. Examine and experiment with leadership behavior and performance, stress and pain signals, in deep space (like) conditions

  3. Invite stakeholders, who might form remote human settlements, to shape dialogues, learning and prototypes.

These efforts could be vital for deepening and sustaining human presence in space, to connect new discoveries, opportunities and crises, and perhaps to use those as avenues to circle back and inform our behaviors on Earth.

Examining Headache Trends, Significance, Anticipation
source: Ashish Manwar


-Strangman G. Human Cognition and Long Duration Spaceflight. Produced for NASA’s Behavioral Health and Performance 2010.

-Vuralli, D., Ayata, C. & Bolay, H. Cognitive dysfunction and migraine. J Headache Pain 19, 109 (2018).

-Vein, A. et al (200). Space Headache: A New Secondary Headache. Cephalalgia. 29. 683-6.

-Monzani L, Zurriaga R, Espí López GV (2018) Anxiety and the severity of Tension-Type Headache mediate the relation between headache presenteeism and workers’ productivity.

-Lea R, Artemis Accords, accessed January 20, 2023

-Human Research Roadmap, NASA, accessed November 25, 2023

-Global Burden of Disease 2019, The Institute for Health Metrics and Evaluation, accessed December 3, 2023 ,

Image References

4. STEEPLE Signal Influence and Gaps, Ashish Manwar

5. Headache Influences on Analogous Domains, Ashish Manwar

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John Smart
John Smart
May 02, 2023

Hi Ashish, Thanks for this thoughtful and complex piece. I wonder if you've thought of applying this thinking to the current and coming emotional challenges of human interaction in digital worlds (the Metaverse). Today's consumer VR/AR hardware and bandwidth doesn't yet allow multiple people going on complex journeys together in real-time, but it will soon. Apple's next headset will be a big leap over the Oculus. I think many of the same challenges you outline for outer space are already occurring in our current social gaming worlds. Amazing times!

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