Have you ever had a broken heart? Felt incredible inner pain that shook you to your core and would just not let up?

Perhaps the hurt was the result of a relationship breakup, a sense of abandonment and rejection by someone you deeply cared for. Perhaps it was rooted in a deep sense of disappointment in someone that you had trusted. Or perhaps it was the result of losing a loved one to death or divorce, and having to face their absence every day. Maybe you or someone you know was bullied at work or at school.

Regardless of what caused the pain, it most likely was comparable to being physically ill or aching all over. In fact, most people would say that the death of a loved one hurts a hundred times more than many physical injuries.

In my many years of counseling, I have often heard clients talk about symptoms of depression that sounded very similar to what happens when humans are physically ill. They complain about lack of energy, aching all over, having no appetite and difficulty sleeping. They often feel confused about the nature of their symptoms and might convince themselves that they have no real reason to feel this way. Russell Blaylock, a retired neurosurgeon and author of nutritional books, also connects these symptoms of depression to a physical cause.

I have also observed a similar reaction with grief in these clients.

In his fascinating book, Social, Matthew Lieberman makes a compelling case for the biological underpinnings of our social behavior. He, based on his own research at UCLA, proves that social pain stemming from an unfaithful spouse, a divorce or a bad break-up is not just metaphorical pain—it is real pain.

Lieberman also has a TEDx talk on the subject:

Based on some fMRI studies, Lieberman was able to show that the same brain regions that get activated when people feel physical pain also get activated when people feel social pain. The two brain regions connected the most to the experience of social pain are the dACC (Dorsal Anterior Cingulate Cortex) and the rACC (Rostral Anterior Cingulate Cortex).

The former has the most opiod receptors in the brain and has also been connected to mother-infant attachment behavior, so it makes sense that this region would be involved in social pain. The dACC serves as an “alarm system,” helping us to detect and distress about a painful social event. In fact, there are several cortical brain regions involved in the sensory and distressing aspects of pain. That is one of the reasons why it is hard to imagine that there are separate components to our experience of pain—and why “suck-it-up” or “just think positively” approaches are usually not effective in alleviating it. In fact, the more social pain people feel, the more these brain regions get activated. But like other physical pain, medicine can help—interestingly, research subjects have been able to alleviate such social pain with Tylenol.

Social Separation Causes Pain in Infants

Lieberman explains that social pain has the important function of motivating people to thrive for connection, to live, work and play together. This social motivation for connection is present in all of us from infancy.

This particular argument in the book has caught my attention since it connects to the concept of Attachment parenting. In fact, infants are most likely to feel real physical pain when they are left alone, even for relatively short periods of time. When you study the Ferber method, popularly termed as the “Cry-it-Out” method, you will find some ideas that will sound appealing to sleep-deprived parents, but are actually based on outdated scientific information.

For example, proponents of the “Cry-it-out” method describe the approach as “baby-training” for “sleep problems” and a method to help a baby “self-soothe.” But if being left alone and separated can cause emotional distress and real pain, how could infants be expected to soothe themselves in the presence of pain? And what does it do to mothers? When a mother hears an infant cry, her brain will release a hormone called oxytocin that will compel her to approach her baby and alleviate the pain the baby is feeling. Lieberman calls this powerful hormone the agent that “turns us from zeros to heroes” when it comes to caring for our own children. Sadly, generations of mothers (and their doctors!) have been taught to suppress this urge and expect the baby to produce something biologically impossible for an infant: self-soothing.

Mind-reading: a Social Superpower

Our amazing social ability to pick up on expectations and emotional cues has given us a superpower-like ability to cooperate and collaborate with others. This is more than just analytical thinking; humans have a separate brain system just for this type of social thinking.

Social thinking is a kind of mindreading. For example, when you see your co-worker grab his car keys and step out of the office, your brain uses its ability to understand what your coworker is doing and why. Thanks to social thinking, we are not only capable of understand what others are doing (e.g. he is picking up his car keys) but also interpret it and give a meaning to it (“he is late for a lunch date and doesn’t even have the time to tell me where he is going. That is pretty rude”).

This type of “mind-reading” has been demonstrated to manifest in relationships. You probably have heard the phrase “I feel your pain.” Can that really happen? Well, according to research, the answer is yes!

I remember going to my great-grandmother’s funeral when I was a young child. One of the aspects of the funeral that really stood out to me was a group of old ladies whom my family paid to cry at the funeral. Sounds pretty odd for us “keep-it-together” Americans, right? Not so much in other cultures. These ladies and their loud crying expressed more openly the pain my family was feeling at the loss of my great-grandmother.

Neuroimaging for Social Pain Research

Although neuroimaging and fMRI studies for social pain research are limited in accuracy and scope of detail, they have already resulted in some exciting new discoveries. I recommend the book Social, by Matthew Lieberman. It is a great read for anyone, especially those interested in the science of their emotions.

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