Physical and Psychological Pain: The Case of Hurt Feelings

FROM THE LECTURE SERIES: Understanding the Mysteries of Human Behavior

By Mark Leary, Ph.D., Duke University

Pain has two components: physical and psychological. Each component comes from a particular region in the brain. This gives a physical base to pain in the body, which can be affected and controlled with medication. Does this mean we can decrease grief with painkillers?

Image of a shy girl
Many languages express emotional discomfort with a connotation of physical pain. (Image: fizkes/Shutterstock)

Consider all the phrases that people use after an emotional event such as being rejected: it ‘hurt’, it ‘broke their heart’, or it ‘crushed them’. These expressions include metaphors of physical pain, especially ‘hurt feelings’ itself. This is not exclusive to the English language; in fact, many other languages express this emotional discomfort with a connotation of physical pain.

This is a transcript from the video series Understanding the Mysteries of Human Behavior. Watch it now, on The Great Courses Plus.

Events That Cause Psychological Pain

Various events in life can hurt our feelings, rejection being one of the many. Since the mid-1990s, emotion researchers have focused on psychological pain. We now know what hurts one’s feelings.

One particular study asked more than 160 people to describe a situation where their feelings were hurt and what happened afterward. Most of the participants shared the same experiences of not being chosen as a member of a desired group or team, being dumped by a romantic partner, and being fired from their job. The researchers, then, grouped these situations into six main categories:

  1. Explicit rejection
  2. Implicit rejection
  3. Criticism
  4. Betrayal
  5. Being mocked
  6. Being taken for granted

Explicit rejection involves experiences where the person is directly told that they are accepted: I don’t want to live with you anymore. You’re not invited to my party. You’re fired. I don’t want to be your friend. Get out of my class. I never want to see you again. Implicit rejection, on the other hand, refers to situations where a person feels that others reject or ignore them; for example, when a person does not return their call, or when a group of friends does not look happy when they arrive.

Image of a broken heart
Implicit rejection refers to situations where a person feels that others reject or ignore them. (Image: pathdoc/Shutterstock)

Despite these findings, one crucial question remains unanswered: why do we use metaphors of physical pain to describe this emotional experience?

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Physical and Psychological Pain

Pain has two components: a sensory component (physical) and an emotional or affective component (psychological). The former informs your body where the pain is coming from, while the latter causes psychological distress after an experience of pain. Throughout human history, as our biological systems evolved, so did our pain systems.

Initially, the pain was a physical alarm for survival. Throughout the process of evolution, human bodies began using their existing system of pain for social survival as well. Researchers in the 1970s found that neurotransmitters in the brain involved in processing physical pain, play a role in reactions to social separation as well. Thus, the same neurotransmitters involved in pain are activated when a baby cries because it is taken away from the mother.

The two components of pain – sensory and emotional – show that two separate areas of the brain are involved in perceiving pain. That is why people with chronic pain can undergo surgeries to reduce pain. In fact, the pain is still physically the same, but they do not find it as bothering as before the operation since the psychological distress is gone. Likewise, if the sensory part is damaged, one cannot locate the pain, yet they feel the psychological distress it causes. But what do pain and its components have to do with hurt feelings?

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The Pain of Hurt Feelings

When a person’s feelings are hurt, the area of the brain responsible for the affective component of pain is activated. That is, they experience the psychological distress of pain.

One of the most common experiences that hurts one’s feelings is rejection. Neuroimaging studies, where researchers scan people’s brains, focused on how a person reacts to the unpleasant experience of being rejected. Results showed that the same area involved in the affective component of physical pain is also activated when someone is rejected.

Image of a crying boy left alone in the car parking
One of the most common experiences that hurts one’s feelings is rejection. (Image: MaLija/Shutterstock)

Neuroscientists used an fMRI scanner – a functional magnetic resonance imaging scanner – to examine brain activity after rejection. The participant had to lie in an fMRI scanner and play a straightforward computer game with the controller in their hand. In the game, the participant threw a ball to two other players who were in another room. After a short while, the other players stopped passing the ball to the participant and just threw it to each other. Here the magic happened: the dorsal anterior cingulate cortex and the anterior insula were activated. These are the regions that are affected by the psychological component of physical pain.

The same two regions are also activated when people look at photos conveying social rejection, when they watch videos of disapproving faces, and when they think of or see pictures of deceased loved ones. This shows why grief is also a ‘painful’ experience.

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Curing Pain and Its Effects

Painkillers are the most common way to fight physical pain, but they have side effects. Is it worth the side effects to cure pain? Is it right to do so at all?

Studies show that people who are more sensitive to physical pain get their feelings hurt more easily. In one study, researchers applied hot probes to each participant’s arm and asked them to rate how unpleasant it felt. People who had rated the heat more unpleasant were also distressed more in the ball-tossing rejection.

Interestingly, people report less pain when a loved one is present. This is why many want a loved one by their side when they undergo painful medical procedures. It makes them feel valued and accepted, and this reduces the activity in the pain regions of the brain.

Both components of pain originate in the brain, and the brain can be affected by medicines. A three-week study aimed to find out if medication for physical pain lowers hurt feelings. There were two groups of participants: one taking acetaminophen – a common painkiller – and the other taking a placebo pill every day of the experiment. According to the results, those who took a daily dose of acetaminophen showed a decrease in hurt feelings throughout the three weeks, but the other group showed no change.

Clearly, we can rely on measures that reduce physical pain to manage psychological discomfort. This is because our brain interprets pain both in terms of where it originates and how it feels. So, the next time someone hurts your feelings or breaks your heart, try taking a painkiller to reduce the pain. But be careful not to overdo it.

Common Questions about Physical and Psychological Pain

Q: How do you treat psychological pain?

Psychological pain is derived from the emotional component of pain. The brain has two separate areas processing psychological and physical pain, and they can both be affected by painkillers. So, emotional pain can also be treated through medication, to some extent.

Q: Is pain an emotion or a sensation?

Pain is composed of two components: physical and psychological. This means that pain has both an emotional and a physical side, so it cannot be regarded as just an emotion.

Q: What is the difference between emotional and physical pain?

Physical and psychological pain are two components of the same concept. Two separate regions in the brain respond to the physical and emotional components when a pain trigger is applied to the body.

Q: How does emotion affect pain?

Physical and psychological pain create the experience of pain that we know. Each component – emotional and physical – is processed by a specific area in the brain. If the emotional component of pain is controlled, the whole pain experience is easier to tolerate. A typical example is when a patient under a painful medical procedure holds the hand of a loved one.

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