Heartbreak To Heartache: How Physical Pain Can Reflect Emotional Pain

Have you ever felt butterflies in your stomach? That common fluttering in your abdomen before a big exam, a first date, or any other situation triggering nervous or exciting energy. This feeling is actually stimulated by stress hormones like cortisol, which target the blood vessels around your gut and make you think your stomach is in knots. Similar hormones such as dopamine and oxytocin produce different happy and ecstasy-like feelings. On the flip side of these seemingly physical experiences of euphoria, what is the science behind literal gut-wrenching sadness? When heartache is real chest pain? 

First, let’s backtrack a little and take a lesson in “Pain 101.”  If you’ve ever wondered why humans and other animals feel pain in the first place, you aren’t alone. Many scientists and evolutionary biologists have theorized why pain is a necessity; most have concluded that it serves as a warning to our brains to keep ourselves healthy. A common example used to explain this is that of touching a hot stove. If one did not feel physical pain in such a situation, one’s hand would possibly burn and render less effective. Fortunately, we have neurons to detect what we call pain and transform it into a danger signal to the brain which immediately makes us pull our hands away from a dangerous hot stove. 

So pain is important, in a way. But how does mental pain overlap with physical pain? Recently, psychologists have come to understand that emotional pain may also be an evolutionary means to survival in that it helps us avoid such situations in the future. Dr. Geoff MacDonald, a professor of psychology at the University of Toronto, explains in Live Science magazine that our ancestors depended on each other a lot for gathering food and being able to find a mate to reproduce with. He states that rejection, even for our ancient predecessors, was never a good thing – and the emotional pain that results may have developed as a way to overcome it. 

“Many psychologists think the experience of emotional pain “piggybacked” onto the already existing physical pain system in the brains of our early ancestors,”

Dr. Ethan Kross, a professor of psychology at the University of Michigan and first author of the 2011 study (Kross et al. 2011) to the magazine Live Science.

In 2011, psychologists conducted a unique study comparing the regions of the brain during physical pain and emotional pain (Kross et al. 2011). The experiment included 40 participants all of whom were on the receiving end of a painful breakup – ouch! For the betterment of science, this group of people had their brains scanned while viewing their exes who had dumped them. They also had brain scans when endured physical pain in the form of touching a hot object. Interestingly, researchers found that during both scans, the same areas of the brain were activated – ones associated with pain. This provides evidence for neural similarities in emotional and physical pain. Other studies have replicated similar results in mouse models. Scientific American reports research describing mice with increased pain sensitivity after witnessing their mates in pain.

There is one pressing question. How come we feel emotional pain in places such as the chest and abdomen? Many studies have attributed this to the activation of the vagus nerve which stems from the brain into the neck, chest, and abdomen, according to Live Science. The prominent science magazine goes on to describe a rare condition known as  “broken-heart” syndrome, a temporarily weakened state of the heart as a result of stressful experiences. 

The vagus nerve runs from the brain to the neck, chest, and stomach regions. This nerve is hypothesized to be the connection between emotional and physical pain. Image by Adobe Stock.

On the other side of the coin, there have also been studies on how positive emotions and social interactions can help in pain tolerance. A study conducted by Coan et al. (2006) used brain scans to observe 16 married women and their experiences of electric shock threats when they were holding hands with their husbands, strangers, and nobody. Interestingly, the researchers concluded that the simple act of holding hands with someone you love can greatly aid in pain tolerance. This further supports the connection between emotional states and physical pain.

Figure 2 in Coan et al. (2006) describing the positive impacts of holding hands when subject to electric shock threats.

Overall, there have been some pretty substantial evidence suggesting a connection between emotional and physical pain. While more research is needed, it is definitely something interesting to think about. Did this odd pain connection arise from our ancestors’ need to survive? Are there any medical implications? Let us know your thoughts in the comments below!


Coan, J. A., Schaefer, H. S., & Davidson, R. J. (2006). Lending a hand: Social regulation of the neural response to threat. Psychological science, 17(12), 1032-1039.

Emery, R. E., & Coan, J. C. (2010, March 1). What Causes Chest Pain When Feelings are Hurt? Scientific American. https://www.scientificamerican.com/article/what-causes-chest-pains/ 

Kross, E., Berman, M. G., Mischel, W., Smith, E. E., & Wager, T. D. (2011). Social rejection shares somatosensory representations with physical pain. Proceedings of the National Academy of Sciences, 108(15), 6270-6275.

Whitcomb, I. W. (2021, May 10). Why does “emotional pain” hurt? Live Science. https://www.livescience.com/why-emotional-pain-hurts.html 

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