2-faced Pain

Which hurts more, to know that the person you love doesn’t love you back or to get cut on the finger by a knife as you slice an apple? To find out that you failed the most important exam (e.g. boards) of your life or to recover from an operation you just had? For you and your family to discover you’re suffering from a serious illness or to experience the side effects from all the medicines you’re taking to get well? To get brutally scolded by your dad with the belt or to suffer from guilt as he looks you in the eyes silently after he finds out that you did something terribly wrong? Has it ever occurred to you why, more often than not, we suffer a greater deal of pain when it’s not physically induced? What is it with “symbolic” stimuli such as statements, gestures and facial expressions that give us a reminiscent feel to physical stimuli such as electric shocks, heat and pain? Where in our brains do our sense of touch (from direct stimulation) and sense of sight and hearing enter a crossroad.

Allow me to introduce to you five “street signs” that may come in handy the next time you randomly wonder about your “pains”. Not only will you become wary of the internal processes that are happening to your body, a wise man once told me to try saying these terms out loud in a restaurant and they may actually find you smart (which, mind you, is a turn on for some individuals). Kidding aside, we first have the amygdala. Thinking of how to get something good out of your negative emotions? Remember this: negative emotion with high arousal and positive emotion lead to pain reduction, but negative emotion with low arousal leads to pain enhancement (Rhudy & Williams, 2005). For athletes who seek arousal in rigorous exercise, thank your activated amygdala for inhibiting the pain you feel from daily setbacks. For married couples, you now know what biologically aids in making your relationships long, bearable and pleasurable. Next, did you ever encounter a time in which you felt OP (out of place)? Some people, myself included, find it really hurtful to be nobody at times. What makes us feel this way? Say hello to your Anterior Cingulate Cortex (ACC). Explicit exclusion (e.g. when your friends deliberately choose not to pass the Frisbee to you, exclude you in their gimmicks, etc.) was found to increase activation not only in the ACC but right ventral prefrontal cortex (MacDonald & Leary, 2005). So, at times when you are lying alone, with your head on the phone, don’t forget to think about your activated ACC - - against all odds, it will never leave you.

It is important to note, however, that pain affect (acknowledgement of pian) was the only factor the researchers zeroed into. The implication? Although you know what allows you to perceive your pain as people exclude you, there are a myriad of other structures responsible for the intensity of your felt pain.

Other systems worth mentioning include the Periaquedictal Gray (PAG), Opioids and Oxytocin, despite the fact that they haven’t been tested on humans. More than getting hurt when socially excluded, activation of PAG serves as a survival mechanism in animals, especially those species who defend, escape and rely on interdependent relationships with their conspecifics (MacDonald & Leary, 2005). Opioids and oxytocin regulate both physical and social pain as well - - reduces pain in isolation and enjoys a more satisfactory social environment. (MacDonald & Leary, 2005)

No doubt there exists a general agreement that emotions influence pain (Rainville, Hyung, Bao & Chre’tien, 2005). As you think about the relationship between these two factors, don’t forget the amygdala, ACC, PAG, Opioids and Oxytocin that made these crossroads possible.

References:

MacDonald, G. & Leary, M. (2005). Why Does Social Exclusion Hurt? The Relationship Between Social and Physical Pain. Psychological Bulletin, 2, 202-223.

Rainville, P., Huynh Bao, Q. & Chre´tien, P. (2005). Pain-related emotions modulate experimental pain perception and autonomic responses. Pain, 118, 306-318. doi:10.1016/j.pain.2005.08.022

Rhudy, J. & Williams, A. (2005). Gender Differences in Pain: Do Emotions Play a Role? Gender Medicine, 2, 208-226.