http://news.bbc.co.uk/2/hi/health/7512107.stm
By Vivienne Parry
Radio 4's "The Pain Of Emotion"
Love really does hurt, just as poets and song lyric writers claim.
New brain scanning technologies are revealing that the part of the brain
that processes physical pain also deals with emotional pain.
And in the same way that in some people injury can cause long-lasting
chronic pain, science now reveals why some will never get over such
heartbreak.
Emotional pain can take many forms; a relation****p break-up or social
exclusion, for example.
But it does not get any more extreme than losing a loved one, as
Scottish broadcaster Mark Stephen did.
In July 1995 he was driving a tractor while hay-making and accidentally
hit his young daughter. She died shortly afterwards.
Mark's grief was overwhelming, he says.
"When people talk about a broken heart, that for me was where it was
seated, just below your sternum.
"It feels like your heart is leaking and you can't run away from it
because you are the source of that pain."
Thinking he would go mad with grief, he sought help from David Alexander.
Professor Alexander is director of the Aberdeen Centre for Trauma
Research. He led the psychiatric team that first responded to the Piper
Alpha oil-rig disaster.
Since then, he has been involved in helping survivors of many disasters
including the Asian tsunami, the war in Iraq and, most recently, the
earthquake in Pakistan.
He also managed to get Mark Stephen through his darkest days.
Professor Alexander is not surprised about the link between physical and
emotional pain:
"If you listen to people who are damaged emotionally, they will often
translate their pain into physical similes: 'My head is bursting, my
guts are aching' and so on. The parallel is very strong."
But medical research has tended to concentrate on physical pain.
Neuroscientist Mary Frances O'Connor at the University of California,
Los Angeles (UCLA) is one of the scientists who have propelled emotional
pain up the research agenda.
"We're at a very new time when we can use technologies to look at the
brain and the heart," she says.
Naomi Eisenberger at UCLA has shown which parts of the brain are active
when we feel emotional pain.
She devised an intriguing computer game in which participants were
deliberately made to feel left out.
Simultaneous brain scanning revealed that the pain of being socially
rejected was processed in much the same way in the brain as physical
pain and in the same area, the anterior cingulate cortex.
Why should physical and emotional pain be linked in this way?
Social relation****ps are crucial to our survival as a species. In
dangerous situations, a lone human is in peril whereas a group may
survive.
"The social attachment system is piggy-backed onto the physical pain
system to make sure we stay connected to close others," says Naomi
Eisenberger.
"Being wrenched from another or rejected by a group is painful, so we
avoid it."
Physical pain warns us not to do something, walk on a broken ankle for
instance. And emotional pain too can be a warning - "don't go near that
sort of man again", "avoid women like her".
But sometimes physical pain can become chronic, long outlasting its
original purpose, and emotional pain is the same.
Mary Frances O'Connor calls it "complex grief" and it occurs in about
10% of people after bereavement.
"They experience a lot of bitterness and anger, that their future is
senseless. They don't adapt with time as others do."
There is a very strong suspicion that people who are not adapting to
bereavement are also those who experience the greatest levels of
physical pain.
But can we die from a broken heart?
Martin Cowie is professor of cardiology at the Brompton Hospital. He is
very sure of the answer: "Yes, we can.
"There is an increased risk of dying in the six months after bereavement
and it's particularly marked amongst men."
The bereaved are much more likely to be involved in accidents, which is
perhaps understandable, but also to die from heart attacks and stroke.
The hormones involved in the stress of bereavement make these events
more likely.
This knowledge makes it essential to identify and treat those whose
emotional pain is likely to become chronic, causing debilitating
depression or even death.
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