Beyond metaphor: contrasting mechanisms of social and physical pain

doi:10.1016/j.tics.2013.06.002

Trends in Cognitive Sciences

Volume 17, Issue 8, August 2013, Pages 371-378

https://doi.org/10.1016/j.tics.2013.06.002 Get rights and content

Highlights

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At a regional level, brain responses to social distress and physical pain overlap.
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This overlapping activity, however, is not pain-specific.
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This overlap cannot be used to claim that social distress is physically painful.
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New analysis methods may discriminate physical pain from other salient experiences.

Physical pain can be clearly distinguished from other states of distress. In recent years, however, the notion that social distress is experienced as physically painful has permeated the scientific literature and popular media. This conclusion is based on the overlap of brain regions that respond to nociceptive input and sociocultural distress. Here we challenge the assumption that underlies this conclusion – that physical pain can be easily inferred from a particular pattern of activated brain regions – by showing that patterns of activation commonly presumed to constitute the ‘pain matrix’ are largely unspecific to pain. We then examine recent analytical advances that may improve the specificity of imaging for parsing pain from a broad range of perceptually unique human experiences.

Section snippets

Beyond metaphor: does social exclusion really ‘hurt’?

Poets, novelists, and philosophers have, for centuries, attempted to make seemingly intangible emotional states more tangible by comparing them to sensory states. A common example of this literary device is the comparison of emotional distress to physical pain. Although both states may involve suffering, it is undeniable that physical pain is perceptually distinct from the emotional experiences to which it is commonly compared. Thus, a ‘broken heart’ from a failed relationship does not ‘feel’

The arguments for social ‘pain’: commonalities in neurochemistry and brain activation

Two arguments have been put forth to support the hypothesis that social distress is physically painful: common neurochemistry and common patterns of brain activation. Given that functional neuroimaging studies have propelled this hypothesis into the spotlight, the focus of this review is on common patterns of brain activations.

The myth of the ‘pain matrix’: a construct based on reverse inference

In a seminal study that introduced the use of laser-evoked brain potentials to study nociception in humans, Carmon et al. concluded that ‘it is possible that only the arousing and alerting effect of pain is responsible for the electroencephalographic phenomenon observed’ [16]. A few years later, Chapman et al. stated that these responses ‘cannot be considered neurophysiological representations of pain sensations’ [17]. In the past 20 years, studies conducted with different types of in vivo

Social and physical pain: mechanistic similarities and differences

Despite the reviewed evidence prompting a more cautious interpretation of the apparent similarities between brain responses to social and physical pain, we maintain that examining the neural overlap between these experiences is an important endeavor. First, such overlap provides a critical window into how evolutionary pressure might foster efficiency by developing a common system for detecting and responding to potentially threatening environmental events, regardless of their origin.

Perhaps

Concluding remarks

In sum, the experimental evidence that has been used to support the view that social and physical pain are experientially similar because they share a common neurophysiological substrate is questionable. Indeed, the overlap between the brain regions responding to social pain and those responding to physical pain can be entirely explained by the fact that the two experiences are salient and hence trigger multimodal cognitive processes involved in detecting, orienting attention towards, and/or

Acknowledgments

We wish to thank Dr Jonathan Downar and Dr Meng Liang for their insights. This work was supported by a Wellcome Trust project grant and a Royal Society University Research Fellowship to G.D.I.; a Marie Curie European Reintegration 715 Grant to A.M.; an IASP International Trainee Fellowship to M.M.; and a Canadian Institutes of Health Research grant to K.D.D.

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Trends in Cognitive Sciences

OpinionBeyond metaphor: contrasting mechanisms of social and physical pain

Highlights

Section snippets

Beyond metaphor: does social exclusion really ‘hurt’?

The arguments for social ‘pain’: commonalities in neurochemistry and brain activation

The myth of the ‘pain matrix’: a construct based on reverse inference

Social and physical pain: mechanistic similarities and differences

Concluding remarks

Acknowledgments

Neurosci. Biobehav. Rev.

Pharmacol. Biochem. Behav.

Pain

Neuroimage

Neurophysiol. Clin.

Eur. J. Pain

Pain

Neuron

Pain

Pain

Trends Cogn. Sci.

Neuroimage

Neuroimage

Curr. Biol.

Brain Res.

Neurophysiol. Clin.

Neuroimage

Does rejection hurt? An FMRI study of social exclusion

Science

Why does social exclusion hurt? The relationship between social and physical pain

Psychol. Bull.

Acetaminophen reduces social pain: behavioral and neural evidence

Psychol. Sci.

Affective Neuroscience: The Foundations of Human and Animal Emotions

Variation in the mu-opioid receptor gene (OPRM1) is associated with dispositional and neural sensitivity to social rejection

Proc. Natl. Acad. Sci. U.S.A.

What do we (not) know about how paracetamol (acetaminophen) works?

J. Clin. Pharm. Ther.

Neuroscience. Pains and pleasures of social life

Science

Do neural responses to rejection depend on attachment style? An fMRI study

Soc. Cogn. Affect. Neurosci.

Social rejection shares somatosensory representations with physical pain

Proc. Natl. Acad. Sci. U.S.A.

Central mechanisms of pain revealed through functional and structural MRI

J. Neuroimmune Pharmacol.

Pain intensity processing within the human brain: a bilateral, distributed mechanism

J. Neurophysiol.

Evoked cerebral responses to noxious thermal stimuli in humans

Exp. Brain Res.

Rate of stimulus repetition changes evoked potential amplitude: dental and auditory modalities compared

Exp. Brain Res.

Localization of pain-related brain activation: a meta-analysis of neuroimaging data

Hum. Brain Mapp.

Dissociating pain from its anticipation in the human brain

Science

Neuroimaging of pain: what does it tell us?

Curr. Opin. Support. Palliat. Care

Opinion
Beyond metaphor: contrasting mechanisms of social and physical pain