Feeling hurt: advances in the social psychology of pain

Abstract

Pain is a fundamental part of the human condition. It aids survival, indicates threats to bodily integrity, and forms a part of life-transitions and rites of passage from childbirth to death. Pain is experienced within a sociocultural context and attracts a constellation of different meanings – pain as damage, a sign of effort, or pain as cleansing or purifying, such as in religious practice. This thesis advances a novel approach to the human experience of pain as a functional part of our social world. Pain is conceptualised with a biopsychosocial approach, in which pain is seen as more than nociception. Four key frontiers in the social psychological understanding of pain are broached: revisiting how physical pain may relate to the experience of social rejection or ostracism (hurt feelings); how social groups can affect our experience of pain; and how sharing pain and enjoyment can bring us closer to others in our social world – but may also turn others away. I examine these focal areas with a conceptualisation of pain underpinned by the biopsychosocial model, where pain can be viewed as an experience that is biological, psychological, and social in nature, and which must incorporate these key components to be fulsomely understood. In detail, Chapter 1 introduces the thesis with an overview of the literature along with the aims and scope of the work. Next Chapter 2 is a theoretical chapter which reviews the literature on physical and social pain overlap theory and offers a new synthesis of the relationship between physical and social pain. In essence, the overlap concept binds social pain with the tangibility of physical pain and promises a unified understanding of pain and suffering. However, fMRI evidence now casts doubt on the posited neural basis of overlap. This thesis proposes a conceptualisation of pain overlap that reconnects with the principles of a biopsychosocial approach, and supports recognition of convergence as well as overlap. By unpacking the antecedents, cognitions, and emotions that are associated with each pain, the question of overlap versus difference can be better understood. Chapter 3 is an empirical examination of how groups can affect our experience of pain. The chapter presents the findings of an fMRI study into the impact of social group memberships on the experience and communication of pain. This research shows fMRI and behavioural evidence that salient group memberships facilitate pain communication. Furthermore, to the extent that people reported more pain in response to salient social groups stimuli, we found corresponding changes in brain activation in areas associated with pain experience (insula and dorsal anterior cingulate cortex). This suggests an adaptive response to pain, whereby modulating pain communication in line with salient group memberships may produce a relative reduction in pain-associated brain activation. Chapters 4 and 5 turn the spotlight on pleasure and enjoyment alongside pain. These chapters provide field and experimental evidence that sharing pain and enjoyment can help people feel more connected and serve important identity functions by revealing who we are (Chapter 4), but that pain and pleasure also invite adverse moral judgements (Chapter 5). Chapter 4 presents the findings of a field study at a cold-water mass swim in Tasmania, Australia. Experiencing intense pleasure and pain during the swim was associated with larger increases in self-revelation from pre- to post-swim, which in turn predicted enhanced identification with others over the course of the event. Chapter 5 reports 2 experimental studies with large online samples, in which participants made moral judgements about individuals portrayed to be enjoying pain. Targets who enjoyed pain were consistently considered less moral and more immoral than no-pain controls. These experiments suggest that in unlocking any psychosocial gains from pain and enjoyment, people may also need to be wary of observers’ moral judgements. In sum, this thesis advances theoretical and empirical understanding of pain; by examining how pain may bring benefits, and how pain may influence, and be influenced by, psychosocial factors. Within this research lies an important overarching theme: there are many perspectives on the phenomenon of pain, and social psychology has an important role to play within the broader scientific effort toward understanding pain.