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Each week on Two Guys on Your Head, Dr. Art Markman and Dr. Bob Duke, explore different aspects of human behavior and the brain.

Why Emotional Pain Feels Different from Physical Pain

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Pain can range from barely noticeable to excruciating. Yet pain, in all its forms, is important. It is how the body communicates there is a problem.

Physical pain in the ankle may ask us to stop walking so fast or demand a pair of crutches immediately. Likewise, emotional pain may indicate that we need to talk about a problem with our partner or severe the relationship entirely.

In this episode of Two Guys on Your Head, Dr. Art Markman and Dr. Bob Duke, add to the series on pain and the brain, with a discussion on emotional pain and memory.

Both physical and emotional pain are evolutionary signals designed to tell us when we need to stop, re-evaluate a situation, and potentially change our current course of action — whether that's to stop walking on a hurt foot or leave an unhealthy relationship. In this second segment of the three-part series on pain, Dr. Bob Duke and Dr. Arthur Markman discuss the relationship between the emotional and physical components of pain.

The line between physical and emotional pain is often much blurrier than most people realize or would like to admit. Both play key roles in our perception of pain. Emotional pain can actually cause physical pain and vice versa. And, perhaps most importantly, developing a better understanding of the relationship between these two types of pain may be crucial in successful pain management and healing strategies.

Any type of pain has two parts: a physiological component and an affective component. The physiological component is the responses sent from pain receptors in the body to the brain. But these signals don't function as unidirectional messengers. The brain evaluates these signals in the context of the rest of its information about the environment. For example, the same physical injury of a injured elbow may be interpreted very differently in a game of touch football than a fall down the stairs. This response is related to the affective component, or how someone feels in response to the pain-invoking stimulus.

Both the physiological and affective components work together to create an overall interpretation of the situation — how the pain is perceived and whether further attention to a potentially harmful or threatening situation is needed.

Like physical pain, emotional pain can (and likely always does) have both of these components. With emotional pain, its link to physiological responses can be harder to identify. One problem may be cultural. In Western society, we often say, “I shouldn’t feel that” over emotional situations that we don’t want to, or feel we can’t face. But that’s the physiological equivalent of saying, “I shouldn’t see red lights when I’m running late": It’s going to end poorly.

Sometimes, spotting the link is relatively easy, such as when anxiety causes difficulty breathing or heartbreak causes trouble eating. Other times, such as with mysterious chronic illnesses that leave doctors scratching their heads, it can be far more challenging because most people are completely unaware of the connection (often including the doctors).

With all types of pain, addressing it from both the physiological and affective ends may be the best solution until the actual root of the problem is uncovered. If you’ve broken your arm, a cast is likely the best first step. If it’s an emotional wound, four different prescriptions for antibiotics and painkillers won’t fix the problem. But physical pain impacts our emotions, and, as Western science is finally beginning to realize on a meaningful level, our emotions impact our bodies. So getting a hug after the cast may not be a bad second option.

Rebecca McInroy is an award-winning show creator, host, and executive producer for KUT, KUTX, and KUT.ORG.
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