Relieving the Sting of Social Pain

Written by Chelsea Ellithorpe

​Most people have felt the physical ache that is associated with heartbreak or rejection and the sting of another’s harsh words. Rejection can feel just as real as a slap in the face or a punch in the gut. For physical pain, pain relievers, such as Tylenol, can work wonders, and researchers are interested in examining whether or not pain medicine would be beneficial when attempting to relieve social pain as well. 

​Researchers have found that certain brain regions are associated with both physical and social pain and that there may be a gene that is linked to both physical pain and how sensitive a person is to rejection (e.g., Kross, Berman, Mischel, Smith, & Wager, 2011). Kross and colleagues (2011) found that the same neurons fired for both physical and social pain by either invoking social pain by showing participants a picture of a recent ex partner and asking them to think about the rejection or invoking physical pain by eliciting an uncomfortably hot sensation on the participant's forearm, similar to the feeling of spilling hot coffee on one's self. Similar brain regions were activated when participants thought of the recent rejection that were activated during the physical pain task. Could painkillers be used to alleviate both types of pain?

Use of Painkillers to Alleviate Social Pain

​Regarding medication, emotional pain is normally treated by anti-anxiety drugs, such as benzodiazepines; whereas, physical pain can be treated with anti-inflammatory drugs, such as ibuprofen, and over-the-counter painkillers, such as Tylenol. Randles, Heine, and Santos (2013) found that medications, such as Tylenol, that are used for physical pain were effective in alleviating emotional pain that resulted from anxiety. 

​The researchers had participants receive Tylenol or a placebo and write about either dental pain or thoughts about death and what would occur after death. They then read a story about a prostitute being arrested and were asked to set a bail price. Finally, they viewed a surrealist video and video that portrayed rioting. Those who had received Tylenol, rather than a placebo, were less affected by the anxiety-inducing tasks and were less harsh in judging the rioters, and those who had received Tylenol and wrote about death or those who wrote about dental pain were more lenient in assigning a bail amount (Randles, Heine, & Santos, 2013). 

​DeWall and colleagues (2010) also found that those who took acetaminophen, rather than a placebo, reported less social disappointment and fewer hurt feelings, along with higher levels of resilience to social disappointments, over the span of three weeks. Using fMRIs, they also found that participants who took acetaminophen, rather than a placebo, over the span of three weeks had reduced neural responses to social rejection in regions that were associated with physical and emotional pain after playing a computer game that was used to create an environment of social exclusion (DeWall, MacDonald, Webster, Masten, Baumeister, Powell, Combs, Schurtz, Stillman, Tice, & Eisenberger, 2010). Those who had only taken a placebo had more active brain regions that were associated with physical pain when they were rejected in the computer game.

But Are Social and Physical Pain Really the Same?

​Many studies have found that emotional and physical pain are quite similar, especially in regard to the overlapping brain regions, which is why evidence has been found for acetaminophen's ability to alleviate emotional pain, as well as physical pain (e.g., Kross et al., 2011; Randles, Heine, & Santos, 2013). However, the story may be more complicated due to people being able to relive social pain long after the rejection has passed, whereas physical pain is much more difficult to relive after the initial painful incident has passed. 

​Meyer, Williams, & Eisenberger (2015) found that reliving emotional, rather than physical, pain led to higher self-reported pain and more activity in brain regions that were associated with feelings of pain, and the amount of self-reported pain was positively correlated with this brain activity. Reliving physical pain led to increased activity in a separate sensory brain system that did not correlate with the self-ported pain that was relived. These different findings show that different pathways are associated with the two types of pain when the pain is relived. Reliving social pain led to activity in brain regions that were associated with mental state processing, which was correlated with response in the affective pain system; whereas, reliving physical pain led to activity in brain regions that were associated with body state processing, which was correlated with response in the sensory pain system. Therefore, although the mechanisms that lead to feelings of social and physical pain may be similar and overlap, different mechanisms are activated when mentally generating thoughts of the pain and reliving the pain. The existence of these different pathways may aid explanations of why reliving the different types of pain led to enhanced social pain but reduced physical pain. Additionally, Woo and colleagues (2014) found that there are exceptions to the overlap between neural networks for physical pain and social pain when using a finer grained analysis. Pain relievers may help lessen social pain that is felt immediately after a social rejection, but it is unclear how they would help alleviate the pain of relived social rejection.

References

DeWall, C. N., MacDonald, G., Webster, G. D., Masten, C. L., Baumeister, R. F., Powell, C., Combs, D., Schurtz, D. R., Stillman, T. F., Tice, D. M., & Eisenberger, N. I. (2010). Acetaminophen reduces social pain behavioral and neural evidence. Psychological Science, 21(7), 931-937.

Kross, E., Berman, M. G., Mischel, W., Smith, E. E., & Wager, T. D. (2011). Social rejection shares somatosensory representations with physical pain. Proceedings of the National Academy of Sciences, 108(15), 6270-6275.

Meyer, M. L., Williams, K. D., & Eisenberger, N. I. (2015). Why Social Pain Can Live on: Different neural mechanisms are associated with reliving social and physical pain. PLoS ONE, 10(6), e0128294. http://doi.org/10.1371/journal.pone.0128294
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Randles, D., Heine, S. J., & Santos, N. (2013). The common pain of surrealism and death acetaminophen reduces compensatory affirmation following meaning threats. Psychological Science, 24(6), 966-973.

Woo, C. W., Koban, L., Kross, E., Lindquist, M. A., Banich, M. T., Ruzic, L., Andrews-Hanna, J. R., & Wager, T. D. (2014). Separate neural representations for physical pain and social rejection. Nature Communications, 5, 5380-5405.