By Lupita Valencia
Why have poets written about the pain of heartbreak for centuries? Heartbreak, as well as other kinds of social rejection, is largely a universal feeling: we have all been left out on the playground, received job rejections, or gone through a breakup with a significant other. Put simply, social rejection hurts. We even use it in our language (i.e. “you hurt my feelings” or “my heart is broken”). The language that we use to talk about social pain is visceral and reflects the reality that humans experience social pain similar to that of physical pain.
But why does social rejection feel painful? Pain protects us, like when you reflexively move your hand after accidentally touching a hot stove. Similarly, social pain may also serve an evolutionary function. Back when survival was dependent upon group inclusion for resource accessibility, ostracism was a death sentence. Without our tribe, we were clear targets for predation and starvation. Since we are innately social creatures who depend on other humans, social exclusion motivates us to seek out and restore our relationships (MacDonald and Leary, 2005; Eisenberger et al., 2012). We can begin to see how physical and social pain might have co-evolved as instinctual protective mechanisms.
Since we are innately social creatures who depend on other humans, social exclusion motivates us to seek out and restore our relationships
One brain region responsible for processing physical pain is the anterior cingulate cortex (ACC). Since both kinds of pain feel and function similarly, is the ACC also associated with social rejection-induced pain? Scientists aimed to answer this question using a functional MRI study involving a virtual game of cyberball to measure brain responses to feelings of exclusion (Eisenberger et al., 2003). In the game, a participant and two other virtual players take turns tossing a ball to one another. However, the two virtual players eventually begin passing the ball exclusively to each other, essentially changing the game into “monkey in the middle” to make the participant feel excluded. This simple setup is a powerful way to induce feelings of social rejection in the controlled setting of a lab.
The cyberball design has been replicated in other fMRI studies and taken different forms, like the original study which included cartoon figures (Eisenberger et al., 2003), exclusion by one’s own gender versus a different gender (Bolling et al., 2012) and using an adolescent population (Masten et al., 2009). A meta analysis combined multiple studies to find common patterns across them (Rotge et al., 2015). Broadly, all results consistently showed that the ACC was more active when people were excluded in comparison to when they were included in the cyberball game. In addition, there was a positive correlation between the degree of exclusion-related distress reported and the strength of the ACC activity. Essentially, the more a participant felt excluded, the more the ACC was activated. The meta-analysis also revealed that specific sub-divisions of the ACC were more active in some studies and not others. These distinctions may be dependent on slight variations in the design of the cyberball task and even developmental differences. In sum, the meta-analysis study strengthened support for the idea that when social rejection is experienced, areas that respond to physical pain are also activated.
To further support correlational evidence between ACC activity and social exclusion, other studies have included different types of social rejection as well as physical pain tasks. There exist varying kinds of physical pain, and social pain is similar in this regard. Getting dumped is arguably a greater form of social rejection than getting left out in a cyberball game. In one particular fMRI comparison study, researchers wanted to see whether social rejection of high intensity recruits both components of pain, its physical characteristics and our interpretation of it (Kross et al., 2011). The participants in this study were individuals who had recently experienced an unwanted breakup, to see if their brain would respond differently to this more intense form of social rejection. While their brain was being imaged in the fMRI scanner, participants were shown photos of their ex-partner and asked to reflect on the breakup. Then, they saw images of a friend of the same sex as their previous partner and were asked to recall a positive experience shared with them. The second part of this experiment consisted of a set of physical pain trials. Participants experienced and rated hot (painful) and warm (nonpainful) sensations while in the fMRI scanner. Researchers then identified areas across these different experimental conditions. Regions like the ACC that respond to physical pain were also strongly activated when recalling intense social rejection (i.e., seeing an image of their ex-partner). The results revealed that social and physical pain share a common representation in the brain. This evidence further points to a shared neural network between social and physical pain, thus suggesting that this overlap is why we perceive social rejection as painful.
Regions like the ACC that respond to physical pain were also strongly activated when recalling intense social rejection… The results revealed that social and physical pain share a common representation in the brain
If physical and social pain are so similar, is it possible to treat a broken heart? Researchers are investigating whether the negative effects of social rejection can be treated similarly to that of physical pain. Surprisingly, opioids, known for alleviating physical pain, reduced sensitivity to social pain (Bach et all., 2019). Conversely, social support, known for its benefits to mental health (Harandi et al., 2017), was shown to reduce physical pain (Roberts et al., 2015), even when chronic (Sturgeon and Zautra, 2016). However, given the addictive nature of opioids, social support remains the most universally viable option to treat pain, in its physical and social manifestations. Certainly, the overlap between physical and social pain is promising, but more studies are required to further tease out the degree of similarity.
Exploring why we experience social pain from social situations and how it’s connected to physical pain can help us better grasp the deep impact of heartbreak and feeling left out. Just like physical pain, social pain serves a purpose, reminding us of the importance of social connections for our survival. Empathizing with others who are experiencing rejection becomes more meaningful when we acknowledge the reality and depth of their pain. Whether you seek comfort in your social network during times such as these, or you find company in the stanzas of poetry, recognizing the universality of this pain draws us closer to one another.
Written by Lupita Valencia
Illustrated by Federica Raguseo
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