Sticks and Stones May Break My Bones, But Words Will Never Hurt Me?

By the time we’d reached about age five, we had all come to the realization that the sing-song echo of kids on the pre-school playground, “sticks and stones may break my bones, but words will never hurt me,” was complete and utter bullshit. And once we were old enough to listen to the radio, we realized that the grown-up world had known this all along. No where else beyond the fence of that playground will anyone challenge the concept that feelings can be “hurt”, hearts can be “broken”, spirits can be “bruised”. If you ask our dear Miss Dickinson, she’ll claim it’s everywhere:

Pain has an element of blank;
It cannot recollect
When it began, or if there were
A day when it was not.
It has no future but itself,
Its infinite realms contain
Its past, enlightened to perceive
New periods of pain. (1)

But beyond the metaphor, however poetic, is there a scientific reason the linguistics of so many languages have never offered a distinct word to describe emotional suffering any differently than physical distress? Or is the sensation of pain truly so fluid?

Eisenberger et al. sought to answer this very question. He and his colleagues set up a clever neuroimaging experiment enabling them to investigate whether the metaphor of the psychological pain of social loss is in fact reflected in the neural circuitry of the human brain (2). Combining the technology of functional magnetic resonance imaging (fMRI) with a simple virtual reality video game, the experimenters were able to measure the neural sensations stimulated by feelings of social exclusion while subjects remained lying in an MRI machine. The thirteen participants observed a virtual ball-tossing game while brain blood flow was monitored. During a baseline period, subjects were led to believe that because of technical difficulties they were only observing the game. Then, during the experimental phase, they became active participants in the game. However, within a few throws of the ball, the two other “players” (actually computerized stooges) stopped throwing the ball to the subjects, triggering feelings of exclusion. The subjects’ experienced emotional distress as indicated by substantial blood-flow changes in two key brain areas. (2, 3)

One of these areas, the anterior cingulate cortex, has been implicated in generating the aversive experience of physical pain; the other, in the prefrontal cortex, linked to the regulation of pain distress. Eisenberger and his colleagues demonstrated that the greater the feeling of social distress, the more the anterior cingulate was activated. The region in the prefrontal cortex, however, was associated with diminished distress after social exclusion. These opposing responses suggest that the anterior cingulate plays a larger role in the elaboration of feelings of emotional distress, while the prefrontal cortex counteracts these painful feelings. (3, 2)

No matter how the details of their results are analyzed, the core of their findings is a striking one in and of itself. By revealing that a pattern of neural activity very similar to that found in studies of physical pain emerged during social exclusion, Eisenberger’s study has provided evidence that the experience and regulation of social and physical pain share a common neuroantomical basis (3). This take on the concept calls to question the evolutionary implications of this link between emotional and physical processing of pain within the nervous system. It has been widely understood and accepted that the purpose of physical pain is to alert the body of injury; pain warns us when something is wrong, allowing us to care for injuries and repair damages. Suggesting that social pain is analogous in its neurological function to physical pain, places social well being on par with physical well being. Social pain alerts us when we have sustained injury to our social connections, allowing restorative measures to be taken (3). This idea ties in nicely with what is already known about separation distress in other animals, as well. The correspondence between the brain regions activated during human sadness and those activated during animal separation distress suggests that human feelings may arise from the instinctual emotional action systems of ancient regions of the mammalian brain. Given the dependence of many young mammals on their caregivers, it is not hard to comprehend the strong survival value of common neural pathways, elaborating both social attachment and the affective qualities of physical pain. Additionally, it has been well-established in neurobiology that the same neurochemicals known to regulate physical pain, also control the psychological pain of social loss, alleviating separation distress in dogs, guinea pigs, chickens, rats, and primates. (2)

However, despite the provocative insight provided by these connections, there are some biological mysteries that arise from the evidence that both types of pain share a common neurological link. If the brain truly does process pain, both emotional (or social) as well as physical, in similar (if not the same) way, then shouldn’t the dysfunction of one sensation indicate a dysfunction of the other? This question can only be considered by examining some of the most uncommon phenomena of pain. Congenital insensitivity to pain with anhidrosis (CIPA) is an extraordinarily rare disease marked by patients’ inability to feel sensations of physical pain. Though the exact cause of the condition remains somewhat unknown, the nerves appear to be normal and to function properly in the majority of cases (4). Operating in our investigation under these assumptions, one might assume that in the absence of proper neural networks for the processing of physical pain, that emotional pain might be halted as well. This however does not appear to be at all the case, as none of the few sufferers of CIPA report any absence of heartache in their lives. Conversely, there are more and more people, particularly teens, who report experiencing an insensitivity to emotional pain, which can trigger self-mutilation in attempts to break through this numbness by causing themselves physical pain (5). This concept again presents a paradox of pain, as it seems inconsistent that these “cutters”, who have such difficulty processing emotional pain, could retreat so easily to the “comfort” of physical pain.

Although there are clearly facets of pain that remain a mystery, the connections between emotional and physical pain are wholly apparent, not only on a neurobiological level, but also at the rawest definitions of pain as an emotional experience and emotion as a painful experience. As the enduring poetic insight into the human condition now gains the support of neurological findings, the question remains if the opposite will prove to be the case as well. Can socially support and loving feelings ease the sting of physical pain? Do the feelings of a broken heart actually arise from the autonomic circuits of the brain’s limbic system that control cardiac neurodynamics? Perhaps we shall see. Nonetheless, the links already established do indeed add “a humanistic touch to the mind-brain sciences” (2).

WWW Sources
1. “Poetry Archives: Emily Dickinson”
http://www.emule.com/poetry/?page=poem&poem=555

2. “Feeling the Pain of Social Loss”
http://www.sciencemag.org/cgi/content/summary/302/5643/237

3. “Does Rejection Hurt? An fMRI Study of Social Exclusion”
http://www.sciencemag.org.proxy.brynmawr.edu/cgi/content/full/302/5643/290?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=rejection+hurt&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT

4. “In the Absence of Pain”
/bb/neuro/neuro06/web1/aschmid.html#2

5. “Inside the Mind of a Self-Cutter”
http://www.mindpub.com/art545.htm