Your Brain Interprets Prolonged Loneliness as Physical Pain – Why?

Scientists are finding that loneliness has real medical consequences, and the brain sees it as pain.


One of humankind’s great advantages has been that we band together to accomplish more than we can on our own. You might expect that our bodies would have evolved in such a way as to promote social interaction, and you’d be right. Studies are revealing that those outside the pack — the lonely — are 25% more likely to die prematurely, according to writer Veronique de Turenne. The chronically lonely wind up with more heart disease, more metastatic cancer, and with higher risks of stroke and neurodegenerative diseases like Alzheimer’s.

Lately scientists have been learning about the biological ramifications of loneliness. Steve Cole is a professor of medicine, psychiatry and biobehavioral sciences at the David Geffen School of Medicine at UCLA, and director of the UCLA Social Genomics Core Laboratory. He’s been working on this at the molecular level since the early 2000s, aided by data from the Human Genome Project. His interest had been triggered by a report on the survival rates of gay men with HIV. It appeared that closeted men died much more quickly than those who had come out. The main discernible difference between the groups was that closeted subjects were more worried about ostracization and rejection.

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John Caccioppo of the Center for Cognitive and Social Neuroscience at the University of Chicago, is an expert on the physical effects of social disconnection on cellular mechanisms with a book called Loneliness: Human Nature and the Need for Social Connection. He and Cole teamed up for a study of how gene expression varied between people who were lonely and those who weren’t. According to Cole, “We found the key antiviral response driven by so-called Type 1 interferon molecules was deeply suppressed in the lonely people relative to the non-lonely people.”

In addition — and ominously — Cole and Caccioppo also found “… that there was another block of genes that was not suppressed — in fact, it was greatly activated — and this block of genes was involved in inflammation.” Inflammation can be the engine underlying atherosclerosis, Alzheimer’s, and cancer.

Are people isolated socially being further undermined by their own biology? There are two plausible evolutionary explanations. Cole says, “The best theory is that this pattern of altered immunology is a kind of defensive reaction mounted by your body if it thinks you are going to be wounded in the near-future,” with no one there to protect or help you. Another theory is that if you feel bad, you may be more inclined to seek out others for help. With this notion, the emotional pain of loneliness acts much like a physical pain that tells you something is wrong that needs to be addressed.

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In any event, both ideas may have made more sense historically than they do now, and the number of people describing themselves as lonely is growing quickly — Cole refers to it as an “epidemic.”

Part of it is the aging baby boomers who’ve seen their children grow up and move out, and whose friends are dying more frequently due to age. Another factor may be the way “our culture is changing in ways that invite us — in fact, almost require us — to be more lonely and disenfranchised,” according to Cole. Among those is our migration to online relationships that just aren’t individually as powerful due to the lack of personal contact. We text, we don’t call, and our families tend to be far-flung, no longer residing in physical communities together.

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Caccioppo tells de Turenne: “The level of toxicity from loneliness is stunning,” offering as an example a surprising ratio: “The mortality rate for air pollution is 5 percent. For loneliness, it’s 25 percent.”

Naomi Eisenberger is associate professor of social psychology at UCLA and director of the Social and Affective Neuroscience Laboratory. She developed an experiment aimed at understanding better why loneliness hurts so much emotionally, and how much like physical pain it really is. Her study involved a simple online game called Cyberball in which connected players played virtual “catch.” In each test, brain scans monitored the reaction of one player who was eventually excluded from play. Eisenberger watched the brain’s reaction. Increased activity occurred in the subject’s dorsal anterior cingulate cortex and the anterior insula, the same two areas that also spring into action in response to physical pain, showing that social isolation doesn’t just feel like it hurts, it actually does on a neurological level.

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Over the course of repeated tests, Eisenberger’s team found that different subjects responded in different ways emotionally, and that the difference was reflected in brain activity. Players who reported being upset when ignored showed more activity in these brain areas, and those who shrugged it off showed less. 

Eisenberger says, “We think this is why people talk about rejection as literally hurting — because the brain processes emotional and physical pain in similar ways. Because being connected is so important to us as a species, researchers think the attachment system may have piggybacked onto the physical pain system over the course of our evolutionary history, borrowing the pain signal to highlight when we are socially disconnected.”

There was another, very surprising, finding in Eisenberger’s study that reinforced the notion of a connection between loneliness and physical pain: test subjects administered acetaminophen — aspirin — showed less activity in the dorsal anterior cingulate cortex and the anterior insula when they were left out of Cyberball. Aspirin appears to have reduced their emotional pain as it might a headache.

The upshot is that we need to start treating prolonged loneliness as seriously as we do physical illness. Of course, “The challenge is that the solutions are more nuanced and intricate than simply putting a bunch of lonely people together and telling them to connect,” as Cole notes. But it’s worth the effort, whether that means joining a reading group, a spiritual organization, a league, playing cards, or just finding people with similar interests. Having no one to share your experiences with — having no one to care about or who cares about you — can be profoundly disorienting and soul-crushing, and it’s turning out that it’s as bad for the body as it is for the heart.

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Freud is renowned, but his ideas are ill-substantiated

The Oedipal complex, repressed memories, penis envy? Sigmund Freud's ideas are far-reaching, but few have withstood the onslaught of empirical evidence.

Mind & Brain
  • Sigmund Freud stands alongside Charles Darwin and Albert Einstein as one of history's best-known scientists.
  • Despite his claim of creating a new science, Freud's psychoanalysis is unfalsifiable and based on scant empirical evidence.
  • Studies continue to show that Freud's ideas are unfounded, and Freud has come under scrutiny for fabricating his most famous case studies.

Few thinkers are as celebrated as Sigmund Freud, a figure as well-known as Charles Darwin and Albert Einstein. Neurologist and the founder of psychoanalysis, Freud's ideas didn't simply shift the paradigms in academia and psychotherapy. They indelibly disseminated into our cultural consciousness. Ideas like transference, repression, the unconscious iceberg, and the superego are ubiquitous in today's popular discourse.

Despite this renown, Freud's ideas have proven to be ill-substantiated. Worse, it is now believed that Freud himself may have fabricated many of his results, opportunistically disregarding evidence with the conscious aim of promoting preferred beliefs.

"[Freud] really didn't test his ideas," Harold Takooshian, professor of psychology at Fordham University, told ATI. "He was just very persuasive. He said things no one said before, and said them in such a way that people actually moved from their homes to Vienna and study with him."

Unlike Darwin and Einstein, Freud's brand of psychology presents the impression of a scientific endeavor but ultimately lack two of vital scientific components: falsification and empirical evidence.

Psychoanalysis

Freud's therapeutic approach may be unfounded, but at least it was more humane than other therapies of the day. In 1903, this patient is being treated in "auto-conduction cage" as a part of his electrotherapy. (Photo: Wikimedia Commons)

The discipline of psychotherapy is arguably Freud's greatest contribution to psychology. In the post-World War II era, psychoanalysis spread through Western academia, influencing not only psychotherapy but even fields such as literary criticism in profound ways.

The aim of psychoanalysis is to treat mental disorders housed in the patient's psyche. Proponents believe that such conflicts arise between conscious thoughts and unconscious drives and manifest as dreams, blunders, anxiety, depression, or neurosis. To help, therapists attempt to unearth unconscious desires that have been blocked by the mind's defense mechanisms. By raising repressed emotions and memories to the conscious fore, the therapist can liberate and help the patient heal.

That's the idea at least, but the psychoanalytic technique stands on shaky empirical ground. Data leans heavily on a therapist's arbitrary interpretations, offering no safe guards against presuppositions and implicit biases. And the free association method offers not buttress to the idea of unconscious motivation.

Don't get us wrong. Patients have improved and even claimed to be cured thanks to psychoanalytic therapy. However, the lack of methodological rigor means the division between effective treatment and placebo effect is ill-defined.

Repressed memories

Sigmund Freud, circa 1921. (Photo: Wikimedia Commons)

Nor has Freud's concept of repressed memories held up. Many papers and articles have been written to dispel the confusion surrounding repressed (aka dissociated) memories. Their arguments center on two facts of the mind neurologists have become better acquainted with since Freud's day.

First, our memories are malleable, not perfect recordings of events stored on a biological hard drive. People forget things. Childhood memories fade or are revised to suit a preferred narrative. We recall blurry gists rather than clean, sharp images. Physical changes to the brain can result in loss of memory. These realities of our mental slipperiness can easily be misinterpreted under Freud's model as repression of trauma.

Second, people who face trauma and abuse often remember it. The release of stress hormones imprints the experience, strengthening neural connections and rendering it difficult to forget. It's one of the reasons victims continue to suffer long after. As the American Psychological Association points out, there is "little or no empirical support" for dissociated memory theory, and potential occurrences are a rarity, not the norm.

More worryingly, there is evidence that people are vulnerable to constructing false memories (aka pseudomemories). A 1996 study found it could use suggestion to make one-fifth of participants believe in a fictitious childhood memory in which they were lost in a mall. And a 2007 study found that a therapy-based recollection of childhood abuse "was less likely to be corroborated by other evidence than when the memories came without help."

This has led many to wonder if the expectations of psychoanalytic therapy may inadvertently become a self-fulfilling prophecy with some patients.

"The use of various dubious techniques by therapists and counselors aimed at recovering allegedly repressed memories of [trauma] can often produce detailed and horrific false memories," writes Chris French, a professor of psychology at Goldsmiths, University of London. "In fact, there is a consensus among scientists studying memory that traumatic events are more likely to be remembered than forgotten, often leading to post-traumatic stress disorder."

The Oedipal complex

The Blind Oedipus Commending His Children to the Gods by Benigne Gagneraux. (Photo: Wikimedia Commons)

During the phallic stage, children develop fierce erotic feelings for their opposite-sex parent. This desire, in turn, leads them to hate their same-sex parent. Boys wish to replace their father and possess their mother; girls become jealous of their mothers and desire their fathers. Since they can do neither, they repress those feelings for fear of reprisal. If unresolved, the complex can result in neurosis later in life.

That's the Oedipal complex in a nutshell. You'd think such a counterintuitive theory would require strong evidence to back it up, but that isn't the case.

Studies claiming to prove the Oedipal complex look to positive sexual imprinting — that is, the phenomenon in which people choose partners with physical characteristics matching their same-sex parent. For example, a man's wife and mother have the same eye color, or woman's husband and father sport a similar nose.

But such studies don't often show strong correlation. One study reporting "a correction of 92.8 percent between the relative jaw width of a man's mother and that of [his] mates" had to be retracted for factual errors and incorrect analysis. Studies showing causation seem absent from the literature, and as we'll see, the veracity of Freud's own case studies supporting the complex is openly questioned today.

Better supported, yet still hypothetical, is the Westermarck effect. Also called reverse sexual imprinting, the effect predicts that people develop a sexual aversion to those they grow up in close proximity with, as a mean to avoid inbreeding. The effect isn't just shown in parents and siblings; even step-siblings will grow sexual averse to each other if they grow up from early childhood.

An analysis published in Behavioral Ecology and Sociobiology evaluated the literature on human mate choice. The analysis found little evidence for positive imprinting, citing study design flaws and an unwillingness of researchers to seek alternative explanations. In contrast, it found better support for negative sexual imprinting, though it did note the need for further research.

The Freudian slip

Mark notices Deborah enter the office whistling an upbeat tune. He turns to his coworker to say, "Deborah's pretty cheery this morning," but accidentally blunders, "Deborah's pretty cherry this morning." Simple slip up? Not according to Freud, who would label this a parapraxis. Today, it's colloquially known as a "Freudian slip."

"Almost invariably I discover a disturbing influence from something outside of the intended speech," Freud wrote in The Psychopathology of Everyday Life. "The disturbing element is a single unconscious thought, which comes to light through the special blunder."

In the Freudian view, Mark's mistaken word choice resulted from his unconscious desire for Deborah, as evident by the sexually-charged meanings of the word "cherry." But Rob Hartsuiker, a psycholinguist from Ghent University, says that such inferences miss the mark by ignoring how our brains process language.

According to Hartsuiker, our brains organize words by similarity and meaning. First, we must select the word in that network and then process the word's sounds. In this interplay, all sorts of conditions can prevent us from grasping the proper phonemes: inattention, sleepiness, recent activation, and even age. In a study co-authored by Hartsuiker, brain scans showed our minds can recognize and correct for taboo utterances internally.

"This is very typical, and it's also something Freud rather ignored," Hartsuiker told BBC. He added that evidence for true Freudian slips is scant.

Freud's case studies

Sergej Pankejeff, known as the "Wolf Man" in Freud's case study, claimed that Freud's analysis of his condition was "propaganda."

It's worth noting that there is much debate as to the extent that Freud falsified his own case studies. One famous example is the case of the "Wolf Man," real name Sergej Pankejeff. During their sessions, Pankejeff told Freud about a dream in which he was lying in bed and saw white wolves through an open window. Freud interpreted the dream as the manifestation of a repressed trauma. Specifically, he claimed that Pankejeff must have witnessed his parents in coitus.

For Freud this was case closed. He claimed Pankejeff successfully cured and his case as evidence for psychoanalysis's merit. Pankejeff disagreed. He found Freud's interpretation implausible and said that Freud's handling of his story was "propaganda." He remained in therapy on and off for over 60 years.

Many of Freud's other case studies, such "Dora" and "the Rat Man" cases, have come under similar scrutiny.

Sigmund Freud and his legacy

Freud's ideas may not live up to scientific inquiry, but their long shelf-life in film, literature, and criticism has created some fun readings of popular stories. Sometimes a face is just a face, but that face is a murderous phallic symbol. (Photo: Flickr)

Of course, there are many ideas we've left out. Homosexuality originating from arrested sexual development in anal phase? No way. Freudian psychosexual development theory? Unfalsifiable. Women's penis envy? Unfounded and insulting. Men's castration anxiety? Not in the way Freud meant it.

If Freud's legacy is so ill-informed, so unfounded, how did he and his cigars cast such a long shadow over the 20th century? Because there was nothing better to offer at the time.

When Freud came onto the scene, neurology was engaged in a giddy free-for-all. As New Yorker writer Louis Menand points out, the era's treatments included hypnosis, cocaine, hydrotherapy, female castration, and institutionalization. By contemporary standards, it was a horror show (as evident by these "treatments" featuring so prominently in our horror movies).

Psychoanalysis offered a comparably clement and humane alternative. "Freud's theories were like a flashlight in a candle factory," anthropologist Tanya Luhrmann told Menand.

But Freud and his advocates triumph his techniques as a science, and this is wrong. The empirical evidence for his ideas is limited and arbitrary, and his conclusions are unfalsifiable. The theory that explains every possible outcome explains none of them.

With that said, one might consider Freud's ideas to be a proto-science. As astrology heralded astronomy, and alchemy preceded chemistry, so to did Freud's psychoanalysis popularize psychology, paving the way for its more rapid development as a scientific discipline. But like astrology and alchemy, we should recognize Freud's ideas as the historic artifacts they are.

Photo by Alina Grubnyak on Unsplash
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