Dear Doctor: I recently heard a radio report that said Tylenol could ease the pain of hurt feelings. That seems hard to believe. If it’s true, how does it work?

Dear Reader: When you consider the language we use to express how it feels when someone is unkind, it’s filled with pain. Their words sting, you ache, you’re wounded, your heart is broken, you’re torn up inside. Now, new research is shining an unexpected light on how accurate that imagery turns out to be.

Here at UCLA, Naomi Eisenberger, Ph.D., the director of the Social and Affective Neuroscience Laboratory, has been at the leading edge of research into the physical and emotional effects of loneliness and social isolation. Part of that is looking at how emotional distress affects the body. In an experiment conducted by Eisenberger and some colleagues, the group was surprised to find that the same neural circuitry that gets activated by physical pain also lights up in brain scans of individuals undergoing emotional pain.

This particular study centered on an online game of catch. Several players seated at computers in different locations “tossed” a ball to each other. One of those players was the test subject, whose brain activity was being scanned.
At first the ball is thrown equally between all of the players in the game. But at a certain point, the other players begin to exclude the test subject. As the test subjects begin to realize that they are being ostracized, their brain activity changes. It mirrors what you would see when someone is experiencing physical pain.

A further twist to the findings involved how each test subject responded to being excluded. Those who became visibly angry or upset showed a marked increase in activity in two regions of the brain associated with physical pain. The players who shrugged off the change in the game — Who cares? this isn’t important — showed significantly less activity in the physical pain centers.

Then the researchers reverse-engineered the experiment. They gave over-the-counter pain medications to some of the subjects for a period of three weeks, and again measured their brain activity during the online game. This time, the subjects who received the medication and not a placebo had significantly less activity in the physical pain centers of their brains.

It turned out that the same pain meds that eased physical aches also provided relief for emotional pain. This strongly suggests that the brain processes both types of pain in the same way. As a result, the meds work on both types of pain.
As for why this would be, researchers suspect it’s because living in interconnected groups was crucial to the survival of our earliest ancestors. Physical pain alerts us to injury. Emotional pain warns us that we may be drifting too far from our fellow humans. Both put us at grave risk. So, over time, the two types of warning signs — physical pain and emotional pain — began to share the same neural pathways.

The bottom line? We need to take emotional pain just as seriously as we do physical pain.

Eve Glazier, M.D., MBA, is an internist and assistant professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and primary care physician at UCLA Health.