Feeling Hurt: Revisiting the Relationship Between Social and Physical Pain

Abstract

Pain overlap theory has generated decades of controversy and still receives considerable research attention. A major advance has been the revelation that social and physical pain activate similar neural regions, providing suggestive evidence of a “piggybacked” alarm system that coevolved to detect social exclusion. Recent developments, however, have brought neural evidence for pain overlap into question. We analyze these developments from a social psychological perspective and identify the need for a reformulated approach. To meet this need, we provide a framework that a priori predicts generalized overlap and specific divergence across a range of biopsychosocial domains. The framework points to a functional pattern for similarities and differences, which can be utilized to generate testable hypotheses so that the field can move forward. To demonstrate the utility and promise of the framework, we identify key hypotheses relating to attention, motivation, and responses to pain, and review research relevant to these hypotheses.

Bidirectional longitudinal associations between loneliness and pain, and the role of inflammation

“…However, the direct overlap between neural processes implicated in physical and social pain is uncertain, and the association may reflect more fundamental motivational pathways. 15 While the associations between loneliness and later pain parallel previous research, 19 the longitudinal results for pain being related to later loneliness were more robust than those of other population studies. For example, analyses of the Health and Retirement study reported by Emerson et al 12 did not find that baseline pain predicted future loneliness, though the combination of pain both at baseline and follow-up was related to loneliness.…”

“…However, the direct overlap between neural processes implicated in physical and social pain is uncertain, and the association may reflect more fundamental motivational pathways. 15 …”

“… 3 , 32 , 39 Loneliness and pain are positively associated, 34 and it has been argued that there are common brain mechanisms underlying physical and social pain. 10 , 11 , 15 However, the temporal relationship between loneliness and pain is uncertain. Pain may limit activity and social engagement, thereby contributing to loneliness, whereas the stress of loneliness may exacerbate pain.…”

Social exclusion increases the executive function of attention networks

“…However, correctness rate did not significantly differ between the inclusion and exclusion groups. In recent years, studies have shown that social exclusion causes pain 27 , 28 . The neural regions that process the emotional components of pain include the ACC and the anterior insula; these regions exhibit greater activation in response to the experience of social exclusion 29 , 30 .…”

Does It Matter What I Say? Using Language to Examine Reactions to Ostracism as It Occurs

“…Being ignored and excluded is an intensely painful experience ( DeWall et al, 2010 ; Eisenberger, 2012 ; Ferris et al, 2019 ) and strongly motivates its targets to achieve re-affiliation ( Williams, 2007 ). Ostracized individuals, thus, tend to try to connect with individual interaction partners ( Maner et al, 2007 ), are motivated to work with others, join social clubs ( Baumeister and Leary, 1995 ), or even join extreme groups ( Hales and Williams, 2018 ).…”