Tuesday, October 24, 2006

Physical/Social Pain Overlap Theory

In their paper Why It Hurts to Be Left Out: The Neurocognitive Overlap Between Physical and Social Pain (or see this later version if you prefer), Eisenberger and Lieberman present the pain overlap theory which proposes that social pain, the pain that we experience upon social injury (when social relationships are threatened, damaged or lost), and physical pain, the pain that we experience upon physical injury, share parts of the same underlying neural circuitry and computational processes. They review evidence from the animal lesion and human neuroimaging literatures suggesting that the anterior cingulate cortex plays a key role in the physical-social pain overlap. And they present evidence for the four corollary hypotheses derived from pain overlap theory:

  • hypothesis #1: physical and social pain share a common phenomenological and neural basis
  • hypothesis #2: physical and social pain rely on the same computational mechanisms
  • hypothesis #3: inducing or regulating one type of pain similarly influences the other
  • hypothesis #4: trait differences relating to (a heightened sensitivity to) one type of pain relate to the other type as well

In conclusion, they say, accumulating evidence is revealing that physical and social pain are similar in experience, function, and underlying neural structure. Continuing to explore the commonalities between physical and social pain may provide us with new ways of treating physical pain and new techniques for managing social pain. Having a better understanding of the physical-social pain overlap may help to grant social pain the same status that physical pain has achieved in the medical and clinical communities, as evidenced by the amount of time and attention dedicated to its treatment and prevention.

The authors insist that social connection is a need as basic as air, water, or food and that like these more traditional needs, the absence of social connections causes pain. Indeed, they propose that the pain of social separation or social rejection may not be very different from some kinds of physical pain, and they highlight that the anticipation and experience of being socially excluded has been shown to have damaging psychological, behavioral, and physiological effects. Damages must be especially large, I would say, when the pain is chronic. I am thinking of those socially wounded mass killers in schools, or other ‘terrorists’, and I reiterate that question raised in a previous post: how shall we manage chronic social pain in our societies?

We may relate also social pain to Wilkinson’s social suffering (see that post). What is the difference or similarity between pain and suffering? Eisenberger and Lieberman speak of “the evolution of a social pain system that piggybacked onto the physical pain system”. By analogy, a converse suggestion could be made : suffering is a basic mind-brain phenomenon to which sensory pain got “hardwired”, and from which it can be sometimes disconnected. What is pain without unpleasantness? What is unpleasantness if not suffering? Hopefully, the day is approaching when a new terminology will allow things to be referred to unequivocally in the field of pain-and-suffering research.

I want to thank Tony Cole who drew my attention to the pain overlap theory, first in the Wikipedia article on suffering, and then in his Pain Blog, which I was allowed to find when the ever commendable Gary Rollman mentioned it on October 6 in his Psychology of Pain Blog.

Tuesday, October 17, 2006

Book of the Year Prize for 'Suffering: A Sociological Introduction'

Congratulations to Iain Wilkinson for these good news concerning his book Suffering: A Sociological Introduction, a book which I mentioned earlier in that post.

Iain is developing a programme of research that can be referred to as a 'sociology of suffering'. In the whole field of knowledge there is presently NO specialty whatsoever that deals specifically with suffering : it is high time that there be a beginning somewhere. Our societies utterly need, admittedly, better knowledge and management concerning this phenomenon which torments or threatens all their members. Therefore, Iain's work deserves utter support, doesn't it? This prize from the British sociology community is a great opportunity : those of us who care should ask how we can contribute to advance Iain's work further, if we can.

I have a suggestion : let's include a mention about it in Wikipedia's article on suffering. I say "let's do it" rather than "I'll do it" because the whole idea of what I propose has more to do with our knowledge and action about suffering, which is our common business, than with our truth and commitment about it, which is our own private concern. We care since millenia in various partial ways, let's start organizing what we can do as a whole.