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How Emotional Suffering Is Like Physical Pain.



At the height of my own mental turmoil, which lasted many years, my emotional suffering and distress were so intense that the only way I could carry on was to remind myself constantly that I could escape it through suicide. The major part of each day I spent obsessively going over and over in my mind how I could accomplish it successfully.

I wanted a method with a one hundred percent guarantee of working; however, whenever I came up with a method I thought I’d be brave enough to undertake, I always also came up with an idea of how it, just conceivably, might fail.

However remote the chance of this failure was, it would prevent me from going ahead as I was terrified that I would end up not only suicidally depressed, but additionally crippled, quadriplegic, and/or brain-damaged. (A previous suicide attempt I’d made, which I thought fool-proof, left me in a coma for five days and easily could have caused me to incur brain damage)

Furthermore, (and I am embarrassed to admit this) although I am not a religious person, in my paranoid state I was afraid that if I succeeded in killing myself I might be cast into hell and tortured for all eternity (actually, this is a common fear many deeply, clinically depressed people have: to sleep, perchance to dream, as Hamlet metaphorically and euphemistically expressed it). I would then go over and over in my mind all the different kinds of torture I might have to endure.

On one’s own, unable to sleep at 3 am (cue thunder clap, lightning strike, and eerily howling wind), this is a truly terrifying state of mind to be in.

When I would try to describe to doctors, therapists, and psychiatrists how I felt (impossible – this is one of the worst aspects of mental illness, the sheer incommunicability of the depth and intensity of one’s suffering) I would explain, as best I could, that I felt a constant pain in my head which tortured me, and that this pain was neither wholly physical nor wholly mental; rather, it was some indefinable combination of the two.

Why is such emotional suffering so painful, even agonizing? In fact, a look at the neurology underlying emotional pain helps us to understand at least part of the answer.

The Underlying Neurology Of Emotional And Psychological Suffering:

Recent studies (e.g.DeWall et al.) have highlighted how the brain may respond to emotional pain (such as rejection) in a similar manner to how it responds to physical pain.

Indeed, brain scans have revealed that irrespective of whether it’s the case that a person is experiencing emotional pain or physical pain, the same brain regions become highly activated. These two brain regions are:



Because the brain seems to interpret physical and emotional pain in similar ways, it is perhaps not surprising that some evidence has been found suggesting some pain killer medication (originally intended to treat only physical pain) may help to ameliorate emotional pain/mental distress, such as aspirin and Tylenol. However, this idea remains (currently) controversial due to the paucity of reliable data.

More research needs to be conducted – at the time of writing the jury remains out.


A study conducted by Hsu et al. involved 18 adults being asked to look at the personal profiles of hundreds of other adults and then to indicate which of these they might be potentially romantically interested in.

Later, the participants, whilst undergoing a PET scan of their brains, were told that all the individuals they had expressed a romantic interest in had rejected them.

The PET scans showed that, in response to being informed of the rejections, the brains of these individuals started to produce chemical opioids in the same way that it does in response to physical pain. Opioids are the brain’s natural pain killers.

Indeed, these results were obtained despite the fact that, for ethical reasons, the participants had been informed that the whole experiment was a simulation and that the rejections were not real.

It was also found that those participants who, through personality testing, had been found to score highly on the trait of resilience tended to be more able to produce opioids in response to social rejection compared to those who scored less highly on this trait. In relation to this finding, Hsu suggested that it was possible that those suffering from anxiety and depression may be less effective at producing opioids in their brains in response to adverse social experiences leading them to be more intensely negatively affected by them.


C. Nathan DeWall et al., The Push of Social Pain: Does Rejection’s Sting Motivate Subsequent Social Reconnection? Cogn Affect Behav Neurosci. Author manuscript; available in PMC 2017 Jun 1.Published in final edited form as: Cogn Affect Behav Neurosci. 2016 Jun; 16(3): 541–550. doi: 10.3758/s13415-016-0412-9 PMCID: PMC4870146 NIHMSID: NIHMS763525 PMID: 26912270

David T Hsu, Ph.D et al.,Response of the μ-opioid system to social rejection and acceptance. Mol Psychiatry. 2013 Nov; 18(11): 1211–1217. Published online 2013 Aug 20. doi: 10.1038/mp.2013.96 PMCID: PMC3814222 NIHMSID: NIHMS504557 PMID: 23958960


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David Hosier BSc Hons; MSc; PGDE(FAHE).

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