What Is Pain, and What Is Emotional Pain?

Pain has two meanings, both presented in standard and medical dictionaries. One meaning refers to standard nociceptive, or physical pain. The other refers broadly to all types of unpleasant feeling states - emotional as well as physical. Unpleasant emotional states are associated with feelings that hurt - they cause suffering. This is emotional pain. Types of emotional pain for which substantial evidence exists in animals include fear (and phobias), anxiety, separation anxiety (or separation distress), isolation distress (loneliness), boredom, frustration, anger, helplessness, grief, and depression.

The Functional Value of Unpleasantness

The aversiveness of physical pain serves to command attention, interrupt ongoing behavior, and motivate actions aimed at mitigating the aversive experience. It has been theorized that the function of emotional pain is analogous to that of physical pain, focusing attention on threats and motivating behavior to minimize the threat. For example, it is widely accepted that physical pain promoted survival by protecting the individual from bodily harm - precisely the function of fear. Indeed, pain and fear frequently operate in unison, as in avoidance learning.

Evidence That Emotional Pain Is Not Just a Metaphor

Much of our language refers to unpleasant emotional states as “painful” and using pain-related terms like broken heart, heartache, crushed, burned, and reopened old wounds. But is this just a metaphor? In recent years evidence has been mounting to indicate that it is not, and that the view of unpleasant emotional states as a form of pain appears to have a valid scientific rationale.

1.  A common neuroanatomical basis
Research in humans and nonhuman animals has provided convincing evidence that social pain and physical pain rely on shared brain processes, both anatomically and physiologically.

2.  Sensitivity to physical pain corresponds to an enhanced sensitivity to the emotional pain
Findings from several human studies provide evidence that when an individual shows an enhanced sensitivity to one type of pain they also show an enhanced sensitivity to the other.

3.  Eliciting physical pain produces the experience of social pain
One study found that social and physical pain cause common psychological consequences. Both social and physical pain produce feelings of being ignored and excluded; previously, only social pain was found to lead to these effects.

4.  Methods for alleviating one type of pain alleviate the other
In animals and humans, physical and socio-emotional pain are alleviated similarly by 2 different methods: social support and drugs. Regarding drug therapy, it was recently demonstrated in humans that acetaminophen - a drug well-known for its analgesic effects for physical pain - can alleviate some forms of emotional pain. (Note: Acetaminophen should not be used in animals in any capacity other than as specified in current veterinary drug manuals.)

Evidence That Social Pain Can Be More Distressing Than Physical Pain

Can emotional and physical pain be compared? Empirically, studies have historically argued that emotional factors weigh more strongly in animals ‘behavioral choices than does physical pain. In one study, an electrified grid was placed between puppies and persons to whom they had formed a social attachment. The puppies crossed the grid, receiving shocks the entire way, to reestablish contact with the person. In another study, infant rats were removed from their mothers and placed on the opposite side of an electrified grid. The mother rats could hear their pups’ distress vocalizations, but to reach them required walking across the active grid. The mother rats crossed the grid, picked up the pups, and carried them back across the grid to their nest, receiving constant electric shocks in both directions. Anecdotal stories provide further evidence for the greater distress potential for emotional pain. In a well-publicized news story out of Brooklyn, New York, a mother cat was nursing a litter of 4-week-old kittens in an abandoned building that caught fire. The mother cat re-entered the blazing building five times to retrieve each of her five kittens one at a time. In the process, the mother cat received severe burns to her face and head, so damaging that her eyes were swollen shut, her facial hair and ear tips were burned off, and her face was badly disfigured from the burned skin. In light of data from numerous experiments in mammals showing that the infant’s call of distress is highly arousing and motivating for the mother, this incident appears to be a dramatic example of an animal choosing to endure severe physical pain in order to relieve emotional pain. In an experiment pitting an emotional pain (social separation) against a physical discomfort (hunger) in pair-housed tufted capuchin monkeys (Cebus apella), researchers directly compared the commodity of social companionship to the commodity of food, a known physiological necessity, in a series of preference tests following commodity deprivations. The majority of subjects chose their social companion over food even after lengthy periods (22 hours) of food deprivation, suggesting that social deprivation was more aversive than food deprivation to most of the monkeys.

Additional insights into the comparison of emotional and physical pain may be found in studies of human torture survivors. Studies of such victims have found, first, that that experiences of psychological and physical torture both have the same detrimental effects on the survivor’s mental health. Second, findings have made it clear that the main objective of torture is not to inflict physical wounds or injuries; on the contrary, the objective is to leave psychological wounds. Indeed, even the real purpose of physical torture, which does bear physical scars, is to have a major impact on the long-term psyche of an individual.

Treatment of Emotional Pain

Once emotional pain is experienced, treatment principles also parallel approaches to managing physical pain. The objective is to eliminate the unpleasant feeling. Like treatment of physical pain, the first step in management should be recognizing and removing the source. Removing an animal from the fearful environment, lessening disturbing noises and stimuli, and providing hiding places can lessen the intensity of fear and anxiety. Offering mental stimulation (e.g., walks, chase games, interactive toys, chew toys, food-packed toys, videos, interactive play, novel objects to explore) and social companionship (e.g., increased human attention, accompanying owner to work, dogwalkers, doggie day care), eliminate the causes for boredom and loneliness, respectively.

A pain management technique much more useful for alleviating emotional pain than physical pain is counterconditioning. A goal of counterconditioning - a type of classical conditioning - is to change the animal’s emotional response to a particular stimulus. Counterconditioning attempts to replace negative or unpleasant emotional responses to a stimulus with more pleasant responses. Specific examples of situations which have been suggested to benefit from counterconditioning include helping an animal overcome its anxiety associated with a new baby or pet in a household by associating the baby or new animal with pleasant feelings, changing an animal’s perception of a stimulus such as a cat carrier or children from that of fear to that of desire; and eliminating an animal’s fear aggression by getting it to associate the object of fear with pleasant rather than unpleasant feelings.

Desensitization - which involves exposing an animal to an emotion - evoking stimulus - is a prominent technique in the relief of the emotional pain of separation anxiety and fears and phobias and is often used in conjunction with counterconditioning. It is advisable to consult with a certified animal behaviorist for proper implementation of desensitization techniques.

Emotional pain, like physical pain, can be alleviated centrally by nonpharmacologic and pharmacologic techniques. Nonpharmacologic methods involve gentle and soothing human contact, such as stroking, petting, and talking to the animal, which can attenuate feelings of anxiety and fear, loneliness, separation anxiety, and boredom. The distress of social isolation and separation when animals are housed apart from familiar and bonded companions (such as dogs hospitalized or kenneled) can be ameliorated by keeping familiar objects (e.g., toys, blankets, owner’s clothing) with the animal, having the owner visit, and housing housemate pets together. Some behaviorists have suggested that other measures may help lessen the feelings of separation anxiety at home, such as pet sitters, outdoor pens, radios, stimulating and distracting toys (e.g., rubber toys stuffed with foodstuffs such as peanut butter and cream cheese, and toys that dispense kibble-type food treats when played with), and, for some animals, the addition of another pet. Aromatherapy - lavender essence, chamomile, and the pheromones Adaptil® in dogs and Feliway® in cats - has also shown antianxiety effects. Other occasionally successful anti-anxiety methods in dogs include classical music and anxiety-wraps. Pharmacologic methods are frequently used to eliminate or lessen the intensity of unpleasant feelings of emotional pain. Anxiolytic and antidepressant medications are the mainstay of treatment for this purpose. Pharmacotherapy can be viewed as having two objectives: (1) relieve emotional discomfort (continuous long-term, or short-term to facilitate response to behavior therapy) and (2) change undesired behavior.

References

References are available from the author on request.