Wednesday, May 8, 2013

Social and Physical Pain on Common Ground

By Guest Contributor Jacob Billings 
Neuroscience Graduate Student 
Emory University

Societal changes, when they occur, coincide with changing outlooks among the populace. Take for example the American Civil Rights movement of the 1960’s. Largely, the motivations corresponding to economic and political enfranchisement for African-Americans and women resulted from changing identities among these groups during the mobilization of all of America’s resources during World War II. Notably, African Americans observed naturally pleasant interactions with European whites during tours of duty in WWII [1]. When returning to the US, it was impossible to allow American racism to continue unchallenged. During that same period, women acquired expertise in a great variety of professions for which they had been refused the opportunity to work [2]. The expectation that women return to a subordinate place in the household was immediately risen against.

In our modern age, the outlooks held by our friends and neighbors are being changed daily by new evidence from neuroscience. Using an arsenal of tools and techniques at colleges and hospitals around the world, including functional magnetic resonance imagers (fMRI) that can peer into our brains as we think and dream [3], the science marshals each facet of lived experience in turn to hold fast to territory mapped onto the physical domains of the central nervous system. The ground acquired during the campaign is that which is lost by ignorance and outmoded tradition.

How should our societies change as a result of new facets of evidence-based understanding, particularly when that evidence grounds lived experience directly to the material and functioning of our nervous systems?

In the following blog post, we’ll examine this question as it relates to developments in a particular topic: the shared neurological bases of physical and social pain. We’ll consider this facet of neurosciences discoveries as it measures against the often tragic decisions that perpetuate inter-group strife and identify a possible initiative each of us may take to help curb those attitudes that cause suffering.

The Findings

Naomi Eisenberger, Assistant Professor of Social Psychology at UCLA, works to expand our understanding of how social relationships affect our emotional and physical well-being. In a 2012 review entitled, “The Pain of Social Disconnection: Examining the shared neural underpinnings of physical and social pain [4],” Eisenberger identifies that the brain regions activated during the experience of physical pain are the same regions activated during socially painful experiences. Physical pain is considered to be represented in the brain through two interdependent though dissociable networks. The first, containing elements of the somatosensory cortex and the posterior insula, is involved when an insult is physically sensed and localized to an area in the body. The second, comprised of the dorsal anterior cingulate cortex and the anterior insula, is involved in the generation of an insults affective components that distress us, driving us to end the noxious stimulus.
The medial view on the left shows the dorsal anterior cingulate cortex (dACC). The lateral view on the right shows the primary somatosenory cortex (S1) on the outer surface of the brain, the secondary somatosensory cortex (S2) on the edge of the cut-out of the brain and the anterior insula (AI) and posterior insula (PI) in the middle of the cut-out of the brain. Sensory components are shown in green and affective components in red [4]
The review cites social pain as activating the sensory component of the pain network during instants of extreme social rejection, for example, during an unexpected break-up. When lovers scorned speak of a throbbing heart, modern science can now insert that pain to a physical space in the brain whose activation results in the sensation of physical pain. The two experiences have the capacity to be painful in the same ways.

While the above activity patterns arise in only extreme circumstances, the affective portion of the pain network is consistently activated during social pain. The network is a component of the attention regulation system that informs our awareness that something is wrong. The system is an integral part of our cognitive machinery providing the physical space for realization—from those observing that the body is damaged to realizing that one’s mind has wandered from meditative concentration [5].

As we become aware of just what is wrong, our sensing and perceiving brains engage somatic responders to mobilize the endocrine system for flight or a fight via the pituitary and adrenal glands [6]. Heart pounding with epinephrine, eyes widened, and forehead sweating, asking a person on a date can feel in some ways as intimidating as staring down a lion. The body’s chemical immune responders are also activated during this stress response. Under habitually stressful conditions, both social and physical, this immune activation can run the body ragged, killing otherwise healthy cells and impeding normal bodily functions [7], leading to anhedonia, weakness, and depression at best, cardiovascular and autoimmune diseases at worst [8].

Through experiment after experiment, the power of socially distressing events to affect us physically and experientially is becoming apparent.


Famously, the United States, the country of my birth, assigned itself the emblem of a bird of prey, the bald eagle, when forming a unified state. Some, Ben Franklin particularly, thought the Turkey a nobler bird. But here we have it, a nation that honors a predator. To be sure, the fact of different groups weathering through a violent maelstrom of legal oppression for what are proclaimed inalienable rights—the right that the makings of one’s own hands be lawfully inviolable, the right to govern as a representative of the people—demonstrates the added difficulties that forming a nation based around between-group predation brings. Over the years, this nation has made some strides to extend basic human rights to groups who aren’t white male landowners. Recently, the electorate promoted the nation’s first president with a Nigerian parent to two terms in office. But predation of various kinds still exists—subtly in the comments of Emory University President Wagner who touted the legal definition of the African people as 3/5ths of a person [9]; and more overtly in the failed foreign policy decision to conduct a supposed War on Terror that murdered 200,000th Afghani and Iraqi civilians through cluster bombs, drone attacks, and other senseless instruments of death [10]. In the face of laborious political change, lingering racist attitudes, and flagrant abuses of power, what does it mean knowing that the social disconnection feels physically painful?

Whereas our nation still fosters the cancers of racism and sexism that bends certain outlooks to grant, by law and by custom, certain people with a privileged caste, neuroscientific findings trumpet forth a new era of social change, one with eyes opened to the common properties shared by all humanity. Eisenberger’s work contributes to the growing understanding of the vast similarities between us. Particular, her review asserts an evolutionary path by which social pain co-opted the brain space developed for physical pain to pique within us a sensitivity to social connection necessary for our social species to survive and thrive. With evidence demonstrating that positive social interactions are inherently tied to each person’s well-being, we can no longer have a basis to ignore that callousness, of whatever variety, is harmful.

Final Thoughts

The community of Tibetan refugees proclaims that compassion for each other is an ideal contemplation to adopt during those idle moments of introspection. Personally, I agree. The perspectives that allowed the ousting of Native Americans, Africans, and Tibetans from the places of their birth, that established rules of order caring little for the investiture of women with the reins of power have made this world, filled with bountiful resources and boundless creativity, a more troubling place to live. Eisenberger’s review helps us to see that actions we may have thought to be innocuous, antisocial and un-diplomatic behavior, leads to the kind of painful sensations that rouse people to end the noxious social stimuli. The cultivating of compassion, individually and perhaps institutionally, is, I think, a good way to begin sewing up the discord and strife that separate our species.

1. Highmam, J., Civil Rights and Social Wrongs: Black and white relations since World War II. 1997: Balch Institute for Ethnic Studies.
2. Weatherford, D., American Women during World War II: An Encyclopedia. 2009: Taylor and Francis.
3. Horikawa, T., et al., Neural Decoding of Visual Imagery During Sleep. Science, 2013.
4. Eisenberger, N., The Pain of Social Disconnection: Examining the Shared Neural Underpinnings of Physical and Social Pain. Nature Reviews Neuroscience, 2012.
5. Hasenkamp, W., et al., Mind wandering and attention during focused meditation: A fine-grained temporal analysis of fluctuating cognitive states. NeuroImage, 2012. 59(1): p. 750-760.
6. Raison, C.L., L. Capuron, and A.H. Miller, Cytokines sing the blues: inflammation and the pathogenesis of depression. Trends Immunol, 2006. 27(1): p. 24-31.
7. Maes, M., et al., The effectts of psychological stress on human: increased production of inflammatory cytokines and Th1-lik response in stress-induced anxiety. Cytokine, 1998. 10(4): p. 313-318.
8. Cohen, S., D. Janicki-Deverts, and G.E. Miller, Psychological stress and disease. JAMA: the journal of the American Medical Association, 2007. 298(14): p. 1685-1687.
9. Severson, K.B., Robbie Emory University President Revives Racial Concerns. New York Times;, 2013.
10. University, W.I.f.I.S.a.B. Costs of War. 2011 2013 [cited 2013 4/28/2013]; Available from:

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Billings, J. (2013). Social and Physical Pain on Common Ground. The Neuroethics Blog. Retrieved on
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James Burkett said...

It is interesting that you cite compassion as the remedy for indifference to shared social pain. Similar studies by Tania Singer, Richard Davidson and others have implicated the same brain regions in empathic pain, or the pain you feel from observing the pain of others. This suggests one possible social solution - that in order to foster compassion, disenfranchised groups must share their pain in real and accessible ways.

Jacob Billings said...

You are absolutely right, James, that empathy requires perception of a wrongness. I worry, though, that the onus for prosocial change is misplaced when I read your last statement. Should any who read this expect that the excluded continue to ask, at increasing pitch and magnitude, the people who exclude them to finally change their ways? When is it time to become, ourselves, proactive forces for prosocial change?