• By Dartington SRU
  • Posted on Friday 19th February, 2010

Get over it! Take Tylenol

Suggest that experiences of rejection, social exclusion or emotional conflict can be as painful or as damaging as physical injury, and scientists and policy makers are unlikely to bat an eyelid or turn a hair.As psychobiologist Naomi Eisenberger readily acknowledges, the overlap in the language of pain and exclusion is common to all cultures and all eras. But demonstrate that the effects of physical and emotional abuse on the neural system are actually indistinguishable and that the resulting condition may respond to similar treatment – then the implications for practice become more real.Eisenberger is director of the Social and Affective Neuroscience Laboratory at the University of California, Los Angeles, which in recent years has succeeded in applying neuroimaging techniques to a range of emotional experiences.Its mission is to improve understanding of how the need for social connection leaves its mark on minds, brains, and bodies.The work originated in an experiment in exclusion whose participants played a “rigged” internet Cyberball game while they were wired to fMRI scanners.Individuals expelled from the game as “losers” showed increased activity in two neural regions associated with the unpleasantness of physical pain – the dorsal anterior cingulate cortex (dACC) and the anterior insula.Those who showed greater activity in the dACC reported feeling more upset by the episode. Eisenberger and her colleagues concluded, “Neural responses to an episode of social exclusion recruited some of the same neural regions that are involved in the distress of physical pain, supporting the commonsense notion that rejection really does ‘hurt.’”Since then the Los Angeles research has become more widely speculative and some of the findings more subtle. Writing in the newsletter of the International Society for Interpersonal Acceptance and Rejection at the University of Connecticut, Eisenberger describes variation in the neural sensitivities of her participants:

    "For rejection-sensitive individuals, merely looking at an individual displaying a disapproving facial expression (which signifies that one could be rejected) can lead to activation in these pain-related neural regions as well – even though there may be no direct experience of social pain.
There is also evidence that individuals more sensitive to physical pain are similarly more likely to experience "social pain". Among them, the Los Angeles laboratory has identified individuals with the rare form of the muopioid receptor gene (OPRM1), who are known from previous research to show greater physical pain sensitivity. They reported higher levels of rejection sensitivity and more pain-related neural activity (dACC, anterior insula) in response to an episode of social exclusion.In another experiment, women were asked to rate the unpleasantness of a skin burn, as they experienced, in sequence, holding their partner’s hand, a stranger’s hand or a squeezeball, and, next, viewing a picture of their partner, a stranger, or a chair. In rather less Californian vein, the laboratory has examined whether Tylenol, a common physical painkiller (generic paracetamol in the UK), could reduce experiences of social pain as much as a partner’s reassuring hand. Participants took either Tylenol or placebo for three weeks and reported on their daily levels of “hurt feelings”. Those who had taken Tylenol showed a significant reduction in daily hurt; those who had taken placebo reported no change.Most recent Tylenol experiments have taken the brain-scanning activity full circle to a rerun of the original Cyberball game.Consistent with the first study, Eisenberger reports that the participants who had been taking Tylenol showed significantly less activity in pain-related neural regions in response to being socially excluded. She concludes that because of what she has identified as the Physical-Social Pain Overlap a physical painkiller may be capable of reducing the pain of social exclusion in addition to the pain of other ailments.She closes her newsletter article by considering the genetic and evolutionary aspects of the overlap:
    Over the course of evolutionary history, avoiding social rejection and staying socially connected to others likely increased chances of survival, as being part of a group provided additional resources, protection, and safety. Thus, the experience of social pain, while distressing and hurtful in the short-term, is an evolutionary adaptation that promotes social bonding and ultimately survival.
ReferencesDeWall et al (in press) “Tylenol reduces social pain: Behavioral and neural evidence” Psychological Science.Burklund L, Eisenberger N I, and Lieberman M D (2007) “The face of rejection: Rejection sensitivity moderates dorsal anterior cingulate activity to disapproving facial expressions” Social Neuroscience 2, 238-253.

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