twentyfourstudents-fiAcetaminophen Reduces Social Pain? The Physiology Of Bullying

by David Palank, Principal at San Miguel School in Washington D.C.

Study Abstract Summary

Pain, whether caused by physical injury or social rejection, is an inevitable part of life. These two types of pain-physical and social-may rely on some of the same behavioral and neural mechanisms that register pain-related affect. To the extent that these pain processes overlap, acetaminophen, a physical pain suppressant that acts through central (rather than peripheral) neural mechanisms, may also reduce behavioral and neural responses to social rejection. In two experiments, participants took acetaminophen or placebo daily for 3 weeks. Doses of acetaminophen reduced reports of social pain on a daily basis (Experiment 1). We used functional magnetic resonance imaging to measure participants’ brain activity (Experiment 2), and found that acetaminophen reduced neural responses to social rejection in brain regions previously associated with distress caused by social pain and the affective component of physical pain (dorsal anterior cingulate cortex, anterior insula). Thus, acetaminophen reduces behavioral and neural responses associated with the pain of social rejection, demonstrating substantial overlap between social and physical pain.

The Physiology Of Bullying

A student’s social status faces no bigger threat in schools than bullying.

In research, schools with a higher bullying rate, subsequently had lower scores on algebra, geography, earth science, biology, and world history. At first glance, bullying and academic achievement should not be related because one is academic and one is behavioral. This is not a coincidence. While bullying has taken the mainstream media by storm in recent years, the neuroscience behind what truly happens to students is usually absent from these reports.

Bullying is most detrimental to students when others stand by and do nothing while the harassment occurs. The brain perceives the bystanders as participating in the action because their lack of action is processed as a tacit endorsement of the bullying.  On a psychological level, we think that bullies speak for everyone. We are wired to believe that if this person has socially rejected us, then the masses have rejected us.

Bullying is dangerous because social pain actually activates the same neural circuitry as physical pain. This means that the system in the brain that sends pain signals is hijacked when one is in social pain or is exposed to a social threat.

When you stub your toe, the pain is pretty much all you can think about for a few seconds. Pain may be considered a purely physiologically effect by some, but that would not explain the fact that we can use meditation and hypnosis to deter some of the effects of pain.

A 2011 study found that “After 4 days of mindfulness meditation training, meditating in the presence of noxious stimulation significantly reduced pain unpleasantness by 57% and pain intensity ratings by 40% when compared to rest.” Therefore, pain must also be a psychological process. Banging your funny bone, elbow, toe, or other body part will decrease your ability to concentrate on anything else but that pain.

Pain and emotion are experienced at the same time in the brain. If we are in pain it invokes an emotional response (remember that our brains are wired to seek pleasure and avoid pain).  The same concept applies to social pain  Unfortunately, social pain can last a lot longer. Students, who were bullied on regular basis in middle school, had a much higher rate of suicide years later. Those who were bullied at age 8, were six times more likely to commit suicide by age 25.

The part of the brain that processes social pain is the Dorsal Anterior Cingulate Cortex (dACC). “Studies have suggested that the dorsal anterior cingulate cortex (dACC) is a key brain region involved in the detection of social exclusion.” Removal of this part of the brain in rats resulted in the survival of only about 20% of their pups. This is due to the fact that they did not feel enough attachment to their pups to help them survive.

When part of the dACC was removed in patients with chronic pain, anxiety, and depression those in chronic pain still had pain. However, they claimed that the pain “didn’t bother them anymore.” Using this logic, scientists wanted to see if painkillers would dampen social pain as well.

cheriejoyfulSocial Rejection–And Tylenol?

Cyberball is a game designed by scientists to make the player (the research subject) feel rejected.  One subject believes he or she is playing against two other players in a virtual video game.  However, the subject is only playing against a computer. At first, all three players toss the ball to each other in turn. But at a certain point, the computer controlled players cut the poor research participant out of the game. They toss the ball just to each other.

Even though this is a silly game in a research study and has no bearing on real life, the research subjects reported (and brain scans showed) that they were really distressed, hurt and rejected. Even when then scientists told him it was not a human, but just a computer, his brain reacted the same way. This social rejection is so ingrained that even when we are told that it’s a not human, we feel the pain.

The most interesting part of the study is how their brains processed the social rejection. To the brain, social pain feels a lot like physical pain. The more rejected the participant said he or she felt, the more activity there was in the part of the brain that processes the distress of physical pain.

In a follow-up study, participants were called into the lab and, like last time, played Cyberball in the brain scanner. But this time, the researchers added a new variable. Before they came into the lab, half of them had taken Tylenol every day for three weeks while the other half had taken a placebo. What the researchers found in this study was remarkable: the placebo group felt just as rejected and pained as those in the initial study, but the people in the Tylenol group were immune to the social pain of feeling left out.

Social rejection is so central to our well-being that evolution decided that social pain is processed the same way as physical pain.

Social Pain, Rewards, and Consequences

Evolutionarily, the better we understand our social environment the better our lives became. Therefore, in students, social interest is no distraction, but it is actually the most important thing they can learn well. A person in pain has fewer cognitive and attentional resources at their disposal, and this is no different when it comes to social pain. This social pain can lead to a dramatic reduction not only in a student’s sense of well-being, but in their ability to learn, which creates a destructive cycle.

Teachers that do not allow social interaction are actively contributing to this pain. Disallowing social interaction is like telling someone that hasn’t eaten to turn off his or her desire to eat. The more that you allow for positive social interaction, the likelihood of social hunger being a distraction will inevitably decline.

It becomes a distraction to students because our bodies realize that social interaction is critical to survival.

You can visit David’s blog and look for his upcoming book, “Class Hacker.”; Acetaminophen Reduces Social Pain? The Physiology Of Bullying; image attribution flickr user twentyfourstudents and cheriejoyful

1 Lieberman, M. (2013). Educating the Social Brain. In Social: Why our brains are wired to connect (p. 277). Broadway Books.
2 Zeidan, F., Martucci, K., Kraft, R., Gordon, N., Mchaffie, J., & Coghill, R. (2011). Brain Mechanisms Supporting the Modulation of
Pain by Mindfulness Meditation. Journal of Neuroscience, 31(36), 5540-5548.
3 Lieberman, M. (2013). Social: Why our brains are wired to connect (p. 69). Broadway Books
4 Kawamoto, T., Onoda, K., Nakashima, K., Nittono, H., Yamaguchi, S., & Ura, M. (2012). Is dorsal anterior cingulate cortex
activation in response to social exclusion due to expectancy violation? An fMRI study. Frontiers in Evolutionary Neuroscience.
5 Lieberman, M. (2013).Broken Hearts and Broken Legs. In Social: Why our brains are wired to connect (p. 53). Broadway
Books
6 Eisenberger, N. (2003). Does Rejection Hurt? An FMRI Study Of Social Exclusion. Science, 290-292
7 Lieberman, M. (2013). Educating the Social Brain. In Social: Why our brains are wired to connect (p. 282-283). Broadway
Books
8 Lieberman, M. (2013). Educating the Social Brain. In Social: Why our brains are wired to connect (p. 270). Broadway Books.
9 Ibid.
10 Ibid. p.283
11 Ibid. p.283