Social Pain and Physical Pain: Shared Paths To Resilience

Abstract

Although clinical models have traditionally defined pain by its consequences for the behavior and internal states of the sufferer, recent evidence has highlighted the importance of examining pain in the context of the broader social environment. Neuroscience research has highlighted commonalities of neural pathways connecting the experience of physical and social pain, suggesting a substantial overlap between these phenomena. Further, interpersonal ties, support and aspects of the social environment can impair or promote effective adaptation to chronic pain through changes in pain perception, coping and emotional states. The current paper reviews the role of social factors in extant psychological interventions for chronic pain, and discusses how greater attention to these factors may inform future research and clinical care.

Neurocognitive Mechanism of Human Resilience: A Conceptual Framework and Empirical Review

“…You can think of resilience as a recovery process in order to maintain optimal predictions (i.e., reducing prediction errors) between a perceived adverse event (e.g., prediction, anticipation, expectation) and sensory input (i.e., the severity of the adverse event, causing a sensation of physical pain). Recent evidence has demonstrated the commonalities of neural mechanisms connecting the experience of physical, emotionally aroused, and social-related pain, suggesting a substantial overlap between these phenomena [36][37][38][39][40]. Although pain perception is certainly related to physiological processes, how individuals react to a new episode of pain is shaped and influenced by previous experience, which is shaped by both cognitive [41] and emotional [40] influences on the perception of pain through sensory signals, constituting a complex emotional experience that varies significantly from one individual to the next.…”

Towards a science and practice of resilience in the face of pain

“…Other examples of potentially interesting resilience resources and mechanisms that gained varying research attention include secure attachments, benefit finding, trait resilience, hope and social intelligence (Ciechanowski et al, 2003;Gatchel et al, 2007;Smith et al, 2009;Tremblay and Sullivan, 2010;Ramírez-Maestre et al, 2012;Sturgeon and Zautra, 2016). Pain self-efficacy has received quite some research attention as a resilience mechanism explaining less impairment, affective distress and pain severity (Jackson et al, 2014;Tomlinson et al, 2017).…”

Affective disturbance in rheumatoid arthritis: psychological and disease-related pathways

“…Interventions that attend to the bidirectional interplay between these social factors and physical pain, 135 and that enhance awareness of the roots of patients’ perceptions of disregard on the part of their medical providers and mindsets that promote stereotyping, distrust and social isolation 136 are especially worthwhile, and fill a gap in the current behavioural approaches. Similarly, interventions combining pharmacotherapy and psychotherapy have shown promising preliminary results in treating depression in patients with arthritis 137 , but remain a relatively poorly studied area overall.…”