Question: Is the Pain Physical, Mental or Emotional? Answer: Yes

Let me start with this disclaimer – this post is not meant to convince you that the “pain is all in your head.” I hope the Blog thus far has shown that mental impacts physical and vice versa, and that I am not a professional who believes pain patients are “faking it” or “drug seeking.” However, some interesting research of late suggests that the overlap of physical, mental and emotional is much more significant than we thought. Two studies recently showed that, at the brain’s chemical level, looking at photos of loved ones (in the early stages of romantic relationships) eased perceived pain levels, and that holding the hand of or thinking about a loved one reduced perceived pain experience. We’ve talked before about the benefits of distraction through pleasant experience as a means of reducing pain – sure, if you think about your kids instead of the pain then your reduced focus on the pain should lessen its impact. However, these studies are showing something more than just distraction from the pain – the pain, in direct focus, is either felt emotionally as less painful, or at the chemical level in the brain is perceived and interpreted as less painful. And take note, this is pain relief (even if minor) brought on by thoughts and touch, not pills and needles. To further make this point, functional MRI scans of the brain’s activity showed patients felt the laboratory equivalent of 8 out of 10 pain in their brain when looking at photos of ex-lovers who dumped the patient recently. This study elaborates upon the idea of an overlap, at the neural level, in physical and emotional pain. The areas of the brain that were activated/stimulated by these emotional memories were areas of the brain typically only noted for physical pain sensations. Many past studies (too many to cite but including the Journal of the American Medical Association) show similar but less definitive results – that the pain of social rejection mirrors, or feels like, physical pain. None of this news should be all that surprising, given the recent push by drug manufacturers to market medications with taglines like “depression hurts” and so on. We are finding more and more in the medical and scientific pursuit of treating pain that pain and mood are strongly interrelated. Again, this is an obvious statement and something we clinicians have treated psychologically for the longest, even at times using antidepressants as an additional treatment aid. But these studies show in greater visual, hard detail the why and how of this overlap. It is not just that being in pain is depressing, or that being depressed makes you focus on your negative lot in life. The wires are actually crossed in the brain – pain hurts, no matter what caused it. The take away point here is that, whether it is depression, personal loss, chronic low back pain or fibromyalgia, the end result may FEEL the same – and when you have more than one, well, you see where this is going… So, while the statement “the pain is all in your head” is usually meant to demean pain patients as “fakers or exaggerators,” these studies show otherwise – pain is ALWAYS in your head, whether mental, physical, or emotional. All the more reason to tend to hurt feelings, and cultivate positive relationships…heartache hurts just like headaches, and sometimes one is easier to fix than the other. Exercise: Try thinking about someone or something special to you when that breakthrough pain comes.
Kross, E., Berman, M., Mischel, W., Smith, E., & Wager, T. (March 2011). Social rejection shares somatosensory representations with physical pain. PNAS, published online before print March 28, 2011 doi: 10.1073/pnas.1102693108 Master, S., Eisenberger, N., Taylor, S., Naliboff, B., Shirinyan, D., & Lieberman, M. (November 2009). A Picture’s Worth: Partner Photographs Reduce Experimentally Induced Pain. Psychological Science, 20 (11), 1316 – 1318. Younger, J., Aron, A., Parke, S., Chatterjee, N., & Mackey, S. (2010). Viewing pictures of a romantic partner reduces experimental pain: involvement of neural reward systems. PLoS ONE 5(10): e13309. doi:10.1371/journal.pone.0013309
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