How Emotional Pain Affects Your Body

Physical and Psychological Pain: The Case of Hurt Feelings

How Emotional Pain Affects Your Body
Many languages express emotional discomfort with a connotation of physical pain.

(Image: fizkes/Shutterstock)

Consider all the phrases that people use after an emotional event such as being rejected: it ‘hurt’, it ‘broke their heart’, or it ‘crushed them’.

These expressions include metaphors of physical pain, especially ‘hurt feelings’ itself. This is not exclusive to the English language; in fact, many other languages express this emotional discomfort with a connotation of physical pain.

This is a transcript from the video series Understanding the Mysteries of Human Behavior. Watch it now, on Wondrium.

Events That Cause Psychological Pain

Various events in life can hurt our feelings, rejectionbeing one of the many. Since the mid-1990s, emotion researchers have focused onpsychological pain. We now know what hurts one’s feelings.

One particular study asked more than 160 people to describe a situation where their feelings were hurt and what happened afterward. Most of the participants shared the same experiences of not being chosen as a member of a desired group or team, being dumped by a romantic partner, and being fired from their job. The researchers, then, grouped these situations into six main categories:

  1. Explicit rejection
  2. Implicit rejection
  3. Criticism
  4. Betrayal
  5. Being mocked
  6. Being taken for granted

Explicit rejection involvesexperiences where the person is directly told that they are accepted: I don’twant to live with you anymore. You’re not invited to my party. You’re fired. Idon’t want to be your friend. Get my class.

I never want to see youagain.

Implicit rejection, on the other hand, refers to situations where aperson feels that others reject or ignore them; for example, when a person doesnot return their call, or when a group of friends does not look happy when theyarrive.

Implicit rejection refers to situations where a person feels that others reject or ignore them. (Image: pathdoc/Shutterstock)

Despite these findings, one crucialquestion remains unanswered: why do we use metaphors of physical pain todescribe this emotional experience?

Learn more about why we care so much about what others think of us.

Physical and Psychological Pain

Pain has two components: a sensorycomponent (physical) and an emotional or affective component (psychological). Theformer informs your body where the pain is coming from, while the latter causespsychological distress after an experience of pain. Throughout human history, asour biological systems evolved, so did our pain systems.

Initially, the pain was a physical alarm for survival. Throughout the process of evolution, human bodies began using their existing system of pain for social survival as well.

Researchers in the 1970s found that neurotransmitters in the brain involved in processing physical pain, play a role in reactions to social separation as well.

Thus, the same neurotransmitters involved in pain are activated when a baby cries because it is taken away from the mother.

The two components of pain –sensory and emotional – show that two separate areas of the brain are involvedin perceiving pain. That is why people with chronic pain can undergo surgeriesto reduce pain.

In fact, the pain is still physically the same, but they do notfind it as bothering as before the operation since the psychological distressis gone. wise, if the sensory part is damaged, one cannot locate the pain, yetthey feel the psychological distress it causes.

But what do pain and itscomponents have to do with hurt feelings?

Learn more about why relationships succeed or fail.

The Pain of Hurt Feelings

When a person’s feelings are hurt, the area of the brain responsible for the affective component of pain is activated. That is, they experience the psychological distress of pain.

One of the most commonexperiences that hurts one’s feelings is rejection. Neuroimaging studies, whereresearchers scan people’s brains, focused on how a person reacts to theunpleasant experience of being rejected. Results showed that the same areainvolved in the affective component of physical pain is also activated whensomeone is rejected.

One of the most common experiences that hurts one’s feelings is rejection. (Image: MaLija/Shutterstock)

Neuroscientists used an fMRIscanner – a functional magnetic resonance imaging scanner – to examine brainactivity after rejection. The participant had to lie in an fMRI scanner andplay a straightforward computer game with the controller in their hand.

In thegame, the participant threw a ball to two other players who were in anotherroom. After a short while, the other players stopped passing the ball to theparticipant and just threw it to each other. Here the magic happened: thedorsal anterior cingulate cortex and the anterior insula were activated.

These arethe regions that are affected by the psychological component of physical pain.

The same two regions are also activated when people look at photos conveying social rejection, when they watch videos of disapproving faces, and when they think of or see pictures of deceased loved ones. This shows why grief is also a ‘painful’ experience.

Learn more about why people make mountains molehills.

Curing Pain and Its Effects

Painkillers are the mostcommon way to fight physical pain, but they have side effects. Is it worth theside effects to cure pain? Is it right to do so at all?

Studies show that people whoare more sensitive to physical pain get their feelings hurt more easily. In onestudy, researchers applied hot probes to each participant’s arm and asked themto rate how unpleasant it felt. People who had rated the heat more unpleasantwere also distressed more in the ball-tossing rejection.

Interestingly, people reportless pain when a loved one is present. This is why many want a loved one bytheir side when they undergo painful medical procedures. It makes them feelvalued and accepted, and this reduces the activity in the pain regions of thebrain.

Both components of painoriginate in the brain, and the brain can be affected by medicines. Athree-week study aimed to find out if medication for physical pain lowers hurtfeelings.

There were two groups of participants: one taking acetaminophen – acommon painkiller – and the other taking a placebo pill every day of theexperiment.

According to the results, those who took a daily dose of acetaminophenshowed a decrease in hurt feelings throughout the three weeks, but the othergroup showed no change.

Clearly, we can rely onmeasures that reduce physical pain to manage psychological discomfort. This isbecause our brain interprets pain both in terms of where it originates and howit feels. So, the next time someone hurts your feelings or breaks your heart,try taking a painkiller to reduce the pain. But be careful not to overdo it.

Common Questions about Physical and Psychological Pain

Q: How do you treat psychological pain?

Psychological pain is derived from the emotional component of pain. The brain has two separate areas processing psychological and physical pain, and they can both be affected by painkillers. So, emotional pain can also be treated through medication, to some extent.

Q: Is pain an emotion or a sensation?

Pain is composed of two components: physical and psychological. This means that pain has both an emotional and a physical side, so it cannot be regarded as just an emotion.

Q: What is the difference between emotional and physical pain?

Physical and psychological pain are two components of the same concept. Two separate regions in the brain respond to the physical and emotional components when a pain trigger is applied to the body.

Q: How does emotion affect pain?

Physical and psychological pain create the experience of pain that we know. Each component – emotional and physical – is processed by a specific area in the brain. If the emotional component of pain is controlled, the whole pain experience is easier to tolerate. A typical example is when a patient under a painful medical procedure holds the hand of a loved one.

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Psychogenic Pain: 10 Types of Physical Pain Linked to Emotional Stress

How Emotional Pain Affects Your Body

#PsychogenicPain #PainCuasedByEmotionalStress #PhysicalPain #HoffstetterCounseling

Our bodies often express what our minds cannot handle feeling, or knowing. This is called psychogenic pain – when physical pain is linked to emotional stress.

Psychogenic pain isn’t a flighty new-age concept. In fact, quite a few studies have looked at the relationship between physical pain and emotional stress.

Even ancient practices Ayurveda and Chinese Medicine have been aware of how the state of our mind affects our body. For example, irritability and inappropriate anger can impinge liver function, resulting in menstrual pain, headache, redness of the face and eyes, dizziness and dry mouth (1).

What is Psychogenic Pain?

Psychogenic pain is a term for pain caused by psychological factors depression and anxiety (2).

It is closely linked to the emotions of depression and anxiety, but can also be caused by other factors stress (which is inherently, more often than not, linked to anxiety).

People with depression and anxiety may report experiencing psychogenic pain all over their bodies, even when there is no physical cause.

Unfortunately, psychogenic pain is harder to treat than pain caused as a direct result of injury, nerve damage or inflammation.

With the aforementioned types of pain, herbal remedies to reduce inflammation and gentle stretching can often be used to remediate the problem.

However, with psychogenic pain, you need to battle your mind in order to get to a different state of thinking and being – which, as you might have guessed, is a little more difficult.

How Emotions Can Cause Physical Pain

Trying to address the physical causes for chronic pain is not always sufficient.

According to Sarah Irons, MA and Registered Clinical Counsellor, the body-mind relationship can be coined as a condition medical practitioners call Mind-Body Syndrome (MBS), or Tension Myositis Syndrome (3). Dr. John Sarno is the one who founded the movement, and has written several books explaining the condition.

The basic idea here is that our minds are capable of creating many types of physical symptoms in the body. Whether that is back pain, shoulder pain, or neck pain, the mind is a powerful contributor to the aches and pains we experience.

And while many doctors claim that these symptoms are “all in our heads,” Sarah Irons points out that “These are real headaches, real physical pain, real digestive distress, and so on. But their origin may be fundamentally emotional.

A great book that touches on this subject of mind-body pain is “Waking the Tiger: Healing Trauma,” written by Peter A. Levine. As children, many of us grew up without parents or caretakers who were able to help us process whatever difficult things happened to us.

But as children, we rely on our parents to help us make sense of what’s going on (after all, they’re our main source of trust!). When we don’t get that support, we do the best we can. We find ways of coping that develops protection mechanisms against frightful scenarios or feelings.

We internalize by keeping quiet, or externalize by acting out.

With wild animals, dealing with trauma is completely different. Take a gazelle who has just been chased by a cheetah, for example. Let’s say the cheetah didn’t chase the gazelle, but the gazelle is still left with the trauma of being chased.

They instinctively deal with their trauma by quite literally shaking it off, and getting on with their lives. This doesn’t work the same way in humans.

We don’t have ways of discharging trauma and stress, and so instead, it builds up inside of us and we repress it.

Western Society Not Set up For Healthy Healing

This largely has to do with the way Western society is currently structured – without ceremony, and without understanding that we all need different ways of processing trauma and stress, or even excitement. From a young age, we learn these feelings are not welcome for expressing around other people.

Sarah Irons put is very well: “…we learn, before we even know what we are learning, how to shove our feelings back down into our bodies (4).”

And it’s this repressing of emotions, pain, sadness, and even excitement, that causes real, physical pain. Instead of processing your anger or hurt feelings, you get a headache. Instead of dealing with the fact that you’ve taken on too much responsibility, the “weight of the world” manifests as shoulder pain – feeling weighed down.

While certainly not all physical pain is caused by ailments of the mind, it’s important to get in tune with your body so you can distinguish between emotionally based issues, and physically-es.

If you’ve been making changes to your diet for years, but you’re still having problems, maybe it’s time to look a little more inward.

New Scientific Proof

Even science is finding links between the way the mind affects the body, physically. A new study published in Psychology Today explored how emotional trauma can be just as responsible for chronic pain as it is physical injury.

According to Dr. Susanne Babbel (5):

Chronic pain is defined as prolonged physical pain that lasts for longer than the natural healing process should allow.

 This pain might stem from injuries, inflammation, or neuralgias and neuropathies (disorders of the nerves), but some people suffer in the absence of any of these conditions.

Chronic pain can debilitate one’s ability to move with ease, may hinder their normal functioning, and the search for relief can lead to pain medication addictions, which compound the problem. Chronic pain is also often accompanied by feelings of hopelessness, depression, and anxiety.”

She goes on to say how physical pain “functions to warn a person that there is still emotional work to be done, and it can also be a sign of unresolved trauma in the nervous system.”

Sound familiar? This is exactly what Ancient Chinese Medicine and Ayurveda have been saying for centuries.

10 Types of Physical Pain Linked to Emotional Stress

What body parts pain you the most? Use the guide below to find out what you might need to work on, and how you can break through to release the tension. Helping heal the body simply through state of mind is a practice many of us are not aware of – but is possible.

1. Pain in the Neck

If you have a pain in your neck, you might have issues forgiving yourself and/or others.

“Your neck is where you hold guilt and self-recrimination,” according to Reiki practitioner and kinesiology expert, Lori D’Ascenzo (6).

If you feel you’re having strong judgements about yourself, now would be a great time to start making a list of all the things you love about yourself (and others). If you feel guilty about something, come clean.

2. Pain in the Shoulders

After her 26 years of bodywork experience, and a decade of teaching yoga, Darragh Simon of Trinity Wellness has a deep understanding of body-mind connection. According to Simon, tense shoulders could be a sign that you’re carrying too much weight of the world around with you.

You take on more responsibilities than you can handle, and the stress of trying to keep up is getting to be a bit too much. Try slowing down and not taking on so much.

Take some you-time every now and then, and believe that you’re worth your time, just as much as everyone else is.

3. Pain in the Elbows

If you’re experiencing elbow pain, it may represent a resistance to change in direction. Perhaps you have a goal in life that you’ve been putting off, or you’re resisting it for some reason.

Maybe you don’t trust your own path and goals, and are resistant to accepting new experiences. Try bringing down your walls a bit and open yourself up to those new experiences.

You’ve only got one life – so live it!

4. Pain in the Upper Back

According to life coach and self-help author, Ronda Degaust, “The upper back has to do with feeling the lack of emotional support. You may feel unloved or you may be holding back your love from someone else (7).

” If you’re having some upper-back problems, and you don’t sit hunched over at a computer all day, you might want to try opening yourself up to love.

If you’re single, because you feel you’re “unlovable,” now’s the time to get back in the dating scene.

5. Pain in the Lower Back

Ronda Degaust also mentions pain associated with the lower back. According to Degaust, the lower back represents worries regarding finances. Perhaps you have a fear of money, or fear not having enough.

Or maybe you fear material loss. Whatever the worry is, your lower back could be suffering because of it.

The amount of money you have has nothing to do with the pain, it’s the “fear of your own survival that amplifies the pain (8).”

6. Pain in the Hips

According to Lindsay Simmons, owner of Empower Healing, tightness in the hips could mean you fear your future, fear relationships and aren’t quite sure of how to move forward in major life decisions.

Having trouble at work, or in other inter-personal relationships? You might be holding that energy in your hips. This is a message to your body that you need to move on an important decision, and stop stalling.

7. Pain in the Knees

Your knees represent your ability to bend and flow with life. They are the power center of your legs. If your knees are healthy, they bend easily. If not, they are rigid and painful. Rightfully so, if you’re a rigid, non-bending person, your knees will also be the same. Rigid knees often go hand-in-hand with those who are stubborn and ego-ridden. Learn to ease up a bit and be humble.

8. Pain in the Ankles

Our ankles represent support. In comparison to our feet and legs, they’re incredibly tiny and fragile, and yet enable us to stand upright and walk. Our ankles reflect the support we depend on from others, and the support others depend on from us. When we feel un-supported, or that we’re not being a good enough support, our ankles might feel the blame (9).

9. Pain in your Feet

Similar to our ankles, our feet are what carry us forward day in, day out. They’re also what ground us to the earth. If your feet are experiencing more pain than normal, maybe you need to tread different terrain – try something new. Or, maybe you just need to sit back and give your feet a break. You can’t accomplish everything in one day!

10. Pain in your Hands

According to Lori D’Ascenzo, “Hands reach out to others. Are you stifling your need to reach out and connect with others?” (11).

If your ‘hands are tied’ you might be getting involved in other people’s emotional matters a little too much. You need to realize that people are only capable of saving and helping themselves.

While you can be a support (empathy is great!), giving it your all, and trying desperately to change or help a person will sometimes backfire in the end.

Article courtesy of By Carly Fraser

No copyright is claimed in this article and is posted under fair use principles in U.S. copyright laws. If you believe material has been used in an unauthorized manner, please contact us via email.


The Emotional Impact of the Pain Experience

How Emotional Pain Affects Your Body

Maris Pasquale, LCSW, has been the social worker for Hospital for Special Surgery's Ambulatory Care Center Pain Management Clinic for the past four years, working with patients who have musculoskeletal pain due to rheumatologic and orthopedic pain conditions.

The Experience of Pain

Many different factors influence the experience of pain, which is different for everyone. These include:

  • Age
  • Gender
  • Culture
  • Ethnicity
  • Spiritual beliefs
  • Socio-economic status
  • Emotional response
  • Support systems
  • Life before pain onset

Other factors can include a learned response that can be related to the response of your family.

Parents, for example, may respond to a child’s pain in a certain manner, setting a foundational pain response for an individual that may influence future pain experiences.

Also, societal and medical care systems can impact the pain experience. For example, you may not have access to the care of a physician who is an expert in managing pain.

Additionally, changes in functioning, role (societal, social, or family), daily routines, job status, and sleep disturbance may contribute to chronic pain. These factors can cause distress which may also increase pain.

Some common emotional responses to pain can include anxiety, depression, anger, feeling misunderstood, and demoralization.

According to a 2004 study, individuals who are experiencing chronic pain in primary care settings have a higher probability to experience anxiety and depressive disorders than those who are not.(1)

It is important to recognize whether these factors are prevalent in your life. If they are, it's important to seek help from your primary care doctor or social worker, or call 1-800-LIFENET, a multilingual crisis intervention hotline.

Emotions and the Chronic Pain Cycle

Pain is influenced by emotions, and the cycle of pain and emotions are interrelated. Emotions may directly impact physical change as well.

For example, when you are anxious or angry, your muscles may tighten, and that physical change may also contribute to increased pain.

Another challenge may be that patients might feel stigmatized when they demonstrate intense emotions these in the context of their treatment.

Believing that you have control over your life and can continue to function despite the pain or subsequent life changes has been shown to decrease depression.

Impact of Pain on Identity

How you identify yourself to others is an important element of your individuality, and having chronic pain and not knowing when it will ever go away, if ever, is a huge issue that can change the course of your identity.

If you are experiencing chronic pain, you might not be able to do certain tasks or fulfill certain roles that were once common, and that can feel disempowering.

Where and how people derive value in their identity is culturally informed, including gender, ethnicity, and socioeconomic status. Depending on what roles or characteristics are most valued to an individual, impairment in that area will most affect his or her identity and make the pain feel more pronounced.

For example, someone who feels culturally that physical strength and ability is extremely highly valued may feel the impact of the pain experience more significantly if it impairs this ability and he or she can no longer complete the same physical tasks.

Similarly, the invisibility of pain can be isolating, especially in cases when a person’s outwards appearance remains the same.

Impact of Pain on Family

As you experience pain symptoms, either acute or chronic, this can shift family patterns and roles. For example, a parent might not be able to fulfill certain tasks anymore and communication between family members may change not wanting to “bother” the affected member.

Other family factors may include increased stress, financial burden, effect on sexuality and other intimate relationships, and potential resentment in the relationship. For family members of people in chronic pain, a goal is to strike a balance between validating patient’s pain and experience while helping him/her stay involved in life.

Impact of Pain on the Medical System

According to another study in 2005, patients report not feeling heard by their doctors because they may not agree with the medical interpretation of pain.(2) Patients may believe that the pain is related to other ailments or medical history and disagree with the doctor’s opinion.

When patients’ pain does not respond to a certain treatments or interventions, they may feel symptom magnifiers and complainers. As a result, patients may feel demoralized or feel they are not being heard or taken seriously, all increasing patient distress.

Communicating with Your Doctor

Pain is a disease of reporting. Keeping a home journal may help to be more descriptive, accurate, and increase recall, since pain experience may be different on each day.

To speak the same language as your doctor, become more familiar with common pain scales. Familiarity with these scales and anticipating the way pain is measured medically may help communicate this very personal experience in the most objective way.

Common Pain Assessment Tools

Brief Pain Inventory

The BPI measures both the intensity of pain and the interference of pain in the patient's life. It also asks the patient about pain relief, pain quality, and patient perception of the cause of pain. BPI is scales:

“0” represents “no pain” and “10” represents “pain as bad as you can imagine”

“0” represents “does not interfere” and “10” represents “completely interferes”

Wong-Baker Faces Pain Scale

This scale, which goes from Level 0-10, asks the person in pain to choose from a series of faces that best indicate the level of pain he or she is experiencing.

Level 0 is a happy face, indicated as “No Hurt”, and the scale goes up to Level 10, which is a sad/pained face with tears, indicated as “Hurts Worst.” More information and a visual example are available at

Numeric Verbal Faces Pain Scales

This scale also uses facial pictures and a rating scale of 0-10. Level “0” is “No Pain,” while Level “10” is “Pain as Bad As It Could Be.”

Describing Pain Experience

What is pain? Other commonly used terms: Aches, soreness, discomfort.

Be descriptive: Include location, timing, and intensity. Using descriptive words will help medical team be more informed about type of pain, where it roots, etc. Examples: Burning, aching, stabbing, piercing, throbbing.

Maladaptive Pain Beliefs and Ways to Address Them

As we experience pain, we may have many different beliefs of how we should live our life with the pain we are experiencing; these beliefs may be maladaptive and might hinder our functioning level. In other words, some coping and adaptive mechanisms used by those with chronic pain may not be the most physically or psychologically beneficial.

Examples of maladaptive beliefs as related to pain are:

  1. Catastrophizing: Exaggerated, negative reaction towards actual or anticipated pain experiences. In this case, patients report higher pain, poorer physical functioning, more depression and stress, and more disability.(3,4,5)
  2. Pain is sign of damage.
  3. Pain means activity should be avoided.
  4. Pain leads to disability.
  5. Pain is uncontrollable.
  6. Pain is permanent.

According to a 2007 study, these maladaptive beliefs can cause higher pain, poorer physical functioning, depression, stress, and more disability.(3)

Maintaining a sense of control over your life and believing you can continue to function, despite the pain, can decrease risk of depression.

Gaining control can mean finding more resources to understand the impact of pain, such as patient education about how to live with pain, communicating to your doctor about your different concerns and challenges, discussing if pain is a sign of damage or whether activity can be continued tolerance, and accepting your situation.

Coping with Pain through Education and Spirituality

It is important for you to ask for any educational materials that can be helpful to understand the symptoms of pain and how to reduce pain, as well as effective methods to acknowledge your feelings and communicate them to others.

Also, many people find it effective to bring spirituality into their life as a way of coping with pain. Several studies have shown that spiritual belief can help reduce pain. If you so choose, you should be able to feel comfortable to share this component with your health care providers and let them know which methods you feel are helpful to the pain experience.

Mindful Meditation and Other Techniques

Mindful meditation, shown to help decrease stress and pain, involves focusing the mind to increase awareness of the present moment. This method to help cope with pain can be easily done anywhere, even on the bus.

An example of mindful meditation would be to sit up straight, close your eyes, and put aside all thoughts of the future and past. Staying present, the focus of awareness remains on your breathing.

This exercise could be done for just a couple of minutes, letting your thoughts come and go while being aware of your current state. It can be most helpful during stressful times such as holidays or during difficult life events.

Taking a few minutes in the day to do practice mindful meditation can be beneficial. Through performing this kind of exercise, you can create a sense of control, which is crucial in making your pain experience more manageable.

In addition to mindful meditation, yoga and tai chi are recommended.


Some helpful websites may enhance knowledge and understanding of coping with pain:

  • American Pain Foundation

Most importantly, the impact of pain is an entirely individual experience.


1. Gatchel, R. J. Comorbidity of chronic pain and mental health disorders: The biopsychosocial perspective. American Psychologist, 59 (8), 795-805.

2. Harding, G., Parsons, S., Rahman, A., & Underwood, M. (2005). «It struck me that they didn't understand pain:» The specialist pain clinic experience of patients with chronic musculoskeletal pain. Arthritis & Rheumatism, 53 (5), 691-696.

3. Karoly, P. & Ruehlman, L. (2007). Psychosocial aspects of pain-related life task interference: An exploratory analysis in a general population sample. Pain Medicine, 8 (7), 563-572.

4. Gatchel, R., Peng, Y., Peters, M., Fuchs, P. and Turk, D. (2007) The Biopsychosocial approach to chronic pain: Scientific advances and future directions. Psychological Bulletin, 133:581–624.

5. Peters, M., Vlaeyen J., and Weber, W. (2005) The joint contribution of physical pathology, pain-related fear and catastrophizing to chronic back pain disability. Pain, 113:45-50.

Updated: 4/22/2011

Summary by Lay Tep, SLE Workshop Coordinator and Social Work Intern. Updated summary by Steve Rudolf, SLE Workshop Coordinator and Social Work Intern.



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