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What causes people to experience pain after a romantic breakup?


As we experience love, we often experience “the termination of relationships, too.” If you have ever experienced a breakup, you understand that separating from someone you used to love is hard and painful, especially if the separation is unwanted. Berit Brogaard, a professor at the University of Miami who studies the philosophy of emotions, wrote a book about feelings in relationships, “On Romantic Love-Simple Truths about a Complex Emotion.” In the book, she describes what it is like to experience a breakup: “It feels like your guts being sluggishly cut out of you with a butter knife and squeezed through a meat grinder and feel your sandpapery cheeks dissolving in tears” (Brogaard, 2015). In this quote, Brogaard’s descriptions of emotional pain invoke physical language such as “cut out of you with a knife.” Physical pain is not so different from emotional pain after all. In fact, through functional magnetic resonance imaging (fMRI) studies, researchers have found that the pregenual anterior cingulate cortex (pACC) lights up in response to both emotional and physical triggers; this is the brain region in charge of handling negative emotions due to physical pain and that caused by social events and other emotional pain (Zhang, 2019).

According to Geoff MacDonald of the University of Queensland, the pain people experience during a breakup is strongly associated with evolution. Many animals, including humans, need to form romantic relationships with others in order to reproduce and pass down their genes. Humans are one of the rare species that have a biparental care system whereby raising offspring is a joint effort between a male and female who work closely together (Pilakouta, 2018). Monogamy exists when an individual has only one partner for her whole lifetime. Prior to human civilization, the heteronormative monogamous system of parenthood allowed two individuals to alternate between familial duties. For instance, if one individual was watching over the kids, the other individual could go out to gather food. During this earlier epoch, if a human did not have a partner, then she would have a hard time passing down her genes, as even if she had a child, she would struggle to raise it. Historically then, when there was a significant amount of single people, the human population would slowly decrease. Today, similar forces are still present. In extreme circumstances, these factors might lead to the extinction of the human race.

In order to prevent extinction, our body has developed mechanisms whereby pain signals are stimulated when an event threatens individual survival. Instinctually, we will all avoid pain and pursue pleasure. For instance, when we accidentally cut and wound ourselves, we immediately feel pain. The unpleasant experience of pain will motivate us to avoid the same damage from happening again. Importantly, pain is not only stimulated physically but also physiologically. According to social pain theory, emotional pain will be activated in the absence of attachment. The experience of all kinds of pain, emotional included, acts similar to a fire alarm, which warns us when evolutionarily unfavorable events occur so we can maximize our fitness and survival. Overall, being alone is a disadvantage to human reproduction. This is why our body will trigger pain signals when we lose our loved ones, so we are motivated to form bonds (MacDonald, 2005).

Dopamine is a neurotransmitter that triggers feelings like pleasure and plays an important role in the brain’s reward systems, which are located in the midbrain--the substantia nigra (SN) and the ventral tegmental area (VTA), to be precise. The purpose of the reward system is to motivate us to behave in ways that benefit our survival. It can reinforce a certain behavior, such as eating, by increasing dopamine levels, making us feel good when we perform the desired action. Therefore, in the future, we want to perform the actions again. Dopamine changes according to our surroundings, making us more adaptable and favoring evolution (Baik, 2020).

The reward system can also be manipulated by drugs. Zou, who is a Psychology professor at Southwest University, confirms that addictive drugs like cocaine can trigger high levels of dopamine, which make people feel extremely happy (Zou, 2016). These drugs not only give users good feelings when they use them (the pull), but also cause negative emotions like depression, anxiety, and insomnia when a long-term user stops using the drugs (the push), often as withdrawal symptoms. The push and pull effects cause consumers to have an extremely hard time quitting the drugs, even when they know that the drugs are negatively impacting their health.

People often say “Love is like drugs.” This is true because, as is true of addictive drugs, positive reinforcement and negative punishment motivates people to be in love. A study done by Zhiling Zou, a psychology professor at Southwest University in China, found that several brain regions, including the ventral tegmental area (VTA), activate in romantic love just as in drug addiction (Zou, 2016). As mentioned above, the VTA region is part of the brain’s reward system. When that region lights up, dopamine transmitters are released. Therefore, individuals feel delighted when they fall in love. However, also as with drugs, there are withdrawal synonyms when individuals experience a breakup. When researchers separated sexually partnered prairie voles for several days, they observed an increase in the animals’ stress-coping behavior. This suggests that long-term separation will lead to “grieving, anxiety, stress, and depressive-like behaviors” (Zou, 2016). Overall, when we fall in love, the brain releases dopamine, so we feel joy. This positive reinforcement leads us to be attached and addicted to our loved ones. A breakup will decrease the level of dopamine that we originally have, causing us to want to restore the pleasure in order to be cheerful again. This is why people are just as addicted to love as to drugs.

Grief is unavoidable after experiencing separation from significant others. The social pain theory implies that whenever we encounter interpersonal rejection or loss, we feel discomfort. However, there are still ways where we can help to lower our levels of distress, primarily through social support. Social relationships include bonding between friends and family, not just lovers. They can help adjust our perception of pain in a parallel manner. Another study by Abdulaziz Aflakseir, a Ph.D. student at the Department of Clinical Psychology at the University of Shiraz, reveals that social support is beneficial for people who experience traumatic events. The research asked 85 disabled veterans who fought in the Iran-Iraq war to take two surveys: The Hospital Anxiety and Depression Scale (HADS) and Medical Outcomes Study (MOS) Social Support Survey. A high rating on HADS means that an individual has a higher level of distress. On the other hand, a higher score on MOS means that individuals have received high levels of support from others. The results show that as a veteran’s rating on MOS increases, her rating on HADS decreases (Aflakseir, 2010). Interestingly, Aflaskseir found that the average PTSD score for participants was relatively low given that the veterans in question were severely injured and lost their peers during the war. Aflaskseir suggested that this might be due to social support, since the average social support score was high (Aflakseir, 2010).

We often experience stressful events throughout our lifetime, but it does not mean that we have to face them alone. We can always reach out to our friends and family for comfort. Social support cannot fully eliminate sadness, but it can lower the level of anxiety and decrease the chance of mental illness following traumatic events. In return, we can support our friends and family when they are going through stressful events.


References

Aflakseir, Abdulaziz. (2010). The Role of Social Support and Coping Strategies on Mental Health of a Group of Iranian Disabled War Veterans. Iranian journal of psychiatry. 5. 102-7.


Baik, J. (2020, December 1). Stress and the dopaminergic reward system. Nature. https://www.nature.com/articles/s12276-020-00532-4?error=cookies_not_supported&code=e13dcf8c-1092-41bc-92b3-e189a69774a2


Benjamin Warach, Lawrence Josephs. (2021) The aftershocks of infidelity: a review of infidelity-based attachment trauma. Sexual and Relationship Therapy 36:1, pages 68-90.


Brogaard, B. (2015). On romantic love: Simple truths about a complex emotion. Oxford: Oxford University Press.


Flaskerud, J. H. (2011). Heartbreak and physical pain are linked in the brain. Issues in Mental Health Nursing, 32(12), 789–791. https://doi-org.proxy.wexler.hunter.cuny.edu/10.3109/01612840.2011.583714


Macdonald, G., & Leary, M. R. (2005). Why does social exclusion hurt? The relationship between social and physical pain. Psychological bulletin, 131(2), 202–223. https://doi.org/10.1037/0033-2909.131.2.202


Pilakouta, N., Hanlon, E., & Smiseth, P. T. (2018). Biparental care is more than the sum of its parts: experimental evidence for synergistic effects on offspring fitness. Proceedings. Biological sciences, 285(1884), 20180875. https://doi.org/10.1098/rspb.2018.0875


van der Watt, A. S. J., Spies, G., Roos, A., Lesch, E., & Seedat, S. (2021). Functional neuroimaging of adult-to-adult romantic attachment separation, rejection, and loss: A systematic review. Journal of Clinical Psychology in Medical Settings. https://doi-org.proxy.wexler.hunter.cuny.edu/10.1007/s10880-020-09757-x


Zhang, M., Zhang, Y., & Kong, Y. (2019). Interaction between social pain and physical pain. Brain Science Advances, 5(4), 265–273. https://doi.org/10.26599/BSA.2019.9050023


Zou, Z., Song, H., Zhang, Y., & Zhang, X. (2016). Romantic Love vs. Drug Addiction May Inspire a New Treatment for Addiction. Frontiers in psychology, 7, 1436. https://doi.org/10.3389/fpsyg.2016.01436



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