Is emotional pain “real” pain? “Of course it’s real!” you might be thinking. Historically, researchers have been skeptical that it’s “real” pain. Oh, sure, they’d agree that suffering is real, but not that it’s actual pain. Yet emotional pain is certainly “real” enough that people will end their lives when they believe death is the only way to put an end to that kind of pain resulting from depression or grief. It is only in the past two decades or so that we are starting to get evidence to support the argument that emotional pain is real.
This matters. If your pain is not believed to be “real” then what is it? Your experience and your reality have been invalidated (which only adds to the pain of your experience). If you stub your toe, no one doubts you when you say it hurts. But when it comes to emotions, we can’t point to any physical damage, so how can we know that it truly does hurt? And what, exactly, is hurting since we’re talking about emotions and not physical damage?
What is interesting to me is that we don’t generally doubt that physical pain is “real,” yet we know that people are experiencing pain that they “shouldn’t” be experiencing. It’s pain that can’t be explained. The best example of this is “phantom limb” pain, pain some people experience after having an arm or leg amputated. Long after all the physical healing is complete, people may experience “pain” in a part of the body they no longer even have! Conversely, a soldier might experience a severe injury yet report far less pain than would be expected. And consider the migraine: it is a painful experience many have had, yet we can’t identify any physical damage to explain it. Back pain, one of the most common types of chronic pain in the U.S., is also unpredictable based on physical damage. Many people who report chronic back pain have no discernible damage to their spines. Studies have looked at the scans and images of people who report having no back pain and found damage in up to 80% of the participants! Physical damage, we know, is not the sole basis of physical pain. Researchers are starting to explain why pain can be so unpredictable and mysterious, and that appears to be due to the many different structures of the brain which play a role in experiencing pain.
I think about people who are grieving a devastating loss. That might be the death of a loved one or it might be the loss of a once-in-a-lifetime opportunity or of physical abilities as someone ages or after an injury. When someone’s life is permanently altered in such a profound way, we as a people tend to expect people to “get over it” sooner rather than later. “Is she still talking about John? He died almost a year ago!” This emotional pain can linger and we judge people for still hurting. Can you imagine someone saying, “Do you believe Andrew? He’s still complaining about pain and it’s been almost a year since his lower leg was amputated! He needs to get over it!” I think most of us would be appalled if we heard someone talking about physical pain in that way, yet we don’t honor the reality and intensity of emotional pain.
It has been accepted now for more than 50 years that emotions can affect our experience of physical pain. Negative emotions often exacerbate the perception of physical pain. Pain that might otherwise have been a 6 out of 10, may turn into an 8 out of 10 when a person becomes angry, sad, or lonely, for example. In fact, this is one of the foundational pieces of the therapy I use for helping people with chronic pain improve their qualify of life and decrease their pain.
This has been on my mind this past week as I think about everyone who is living a changed life in the era of COVID-19. Many of us are sheltering at home. We may be feeling isolated, lonely, scared, frustrated, angry or sad– or maybe all of those cycling around and around in an exhausting emotional cyclone. Those who are still leaving their houses to go to work to help the rest of us by providing crucial services (health care, food preparation and delivery, groceries, delivering mail and packages, etc), have their own stresses. They may not feel as isolated, but they may lack protective gear and worry, legitimately, that their lives are at risk every time they go to work. All of these feelings (anxiety, fear, loneliness, isolation, sadness, frustration, anger, etc) can act like oxygen to a fire, fueling any physical pain we may already have. Now, as the deaths mount from COVID-19 and as millions have lost their paychecks overnight (but not their rent or mortgage bills), emotional pain begins to grow. People struggle to deal with either alone but at this time in our history, many people are having to deal with both at the same time. And that is exhausting and scary all by itself. Research has shown that when people experience “social distress,” sadness, and grief, the emotional pain centers of the brain activate and it appears that psychological pain uses the same “neural tracks” as physical pain. This is important because hardly anyone’s life is untouched or will remain untouched by social distress, sadness, and grief, particularly at this time.
“Be kind to everyone you meet, for they are fighting a hard battle.” This quote, in multiple forms, is more true now than ever. And I want to remind you to include yourself in your consideration and kindness. You, too, are dealing with far more than you normally do. It’s a tough time. It’s a painful time. And the difficulties magnify the pain. Our culture does not typically honor emotional pain (just think about the lingering stigma of receiving mental health services). Even if others minimize your pain, you don’t have to. Take a few minutes and acknowledge the painful emotions you are experiencing. Don’t cling to them, but don’t push them away. Let them be and experience them as they are for a few minutes and you will likely find that, like clouds in the sky, they blow on by. This isn’t to say they won’t make a reappearance. After all, the clouds you were watching have blown out of sight, but there are likely others moving toward you. Those feelings will ebb and flow and allowing this to happen will result in the least amount of suffering for you overall.
Having a mental health professional to talk to can be a help and a relief. Many of us try to protect our loved ones by keeping our worries and troubles to ourselves. We don’t want to burden them. But this leaves us feeling isolated and alone. If nothing else, by talking to a mental health professional, you can freely express all the pent up emotions without having to worry about protecting the listener. This is what we are here for! I humbly invite you to contact me if you are ready to talk to someone. I’m a double-board certified therapist and I’m also a certified grief counselor, a Certified Clinical Trauma Professional, and I work with chronic pain. I will listen when you want to be heard, problem-solve with you when that’s your need, and share tools and knowledge with you (such as for dealing with anxiety) when helpful. I offer a free 30-minute consultation and if we determine during that time I’m not the right fit for you, I’ll gladly give you referrals to some other people who might be. Call/text me at (816) 226-4678 and let’s find out. And because I am aware that 10 million people have already filed for unemployment, with more expected, I am offering some hardship scholarships. Don’t assume you can’t afford to take care of your mental well-being at this time.
Biro, David. (2010). Is there such a thing as psychological pain? And why it matters. Cult Med Psychiatry, 34, 658-667. DOI 10.1007/s11013-010-9190-y