An interesting thing happened this morning while I read the news online. In the left column of the page was the story of MP Steven Fletcher, whose advocacy of assisted suicide was accompanied by this sobering quote: "When you're in real pain, you would do anything to stop it. You just want it to end -- death is better than the pain."
The story immediately to the right of this story was about a 15 year-old Saskatchewan teen (Todd Loik) who committed suicide after being the victim of cyber bullying.
I would venture to guess that the reaction of most people to reading these stories would be to draw the obvious parallel -- both cases involve the use of death to escape pain. However, I would also guess that most people would view this parallel as having a key difference -- they would draw a distinction between the types of pain. One is emotional pain and the other is physical pain. They are different, right?
This is where I believe the public needs to be educated about the potential effects of bullying and about pain. Specifically, the pain caused by bullying could be more similar to physical pain than most people realize.
All pain gets processed in the brain. If you burn your hand, the pain you feel is not in your hand. Receptors and neurons have been activated and they carry a signal through the spinal cord to different regions in the brain. It is in the brain that pain exists.
Two areas of the brain known to process physical pain are the Anterior Cingulate Cortex (ACC) and the Pariaqueductal Gray (PAG) (1). Interestingly, scientists have learned that these areas of the brain also process social pain. Social pain occurs when we are hurt through our relationships, or lack thereof, with other people. Rejection and social isolation are two examples of events that can cause social pain.
With the assistance of MRI scans, researchers have seen the ACC in people's brains "light up" when they are rejected. Research evidence from various fields, such as neuroscience and psychology, has been accumulating over the years supporting the claim that social pain and physical pain are closely related. Our bodies and brains seem to be designed to treat social threats in a similar manner to physical threats. In fact, when you look at how we describe rejection and social exclusion, the language is almost always pain-based:
"Her words stung."
"I was crushed after the break-up."
"When they said those things on Facebook, it really hurt."
A Need to Rethink Bullying
It is with this research in mind that we all must start to rethink how we conceptualize bullying. At present, most people seem to think of physical assault and cyber bullying as being different experiences. However, whether you are punched in the face or humiliated online, if the end result is pain caused by the activation of the same brain regions, then the experiences are not that different. Furthermore, the pain caused by both can lead to problems with anxiety, depression and suicide.
Children, adolescents, parents and adults in general should rethink how words affect people. We are no longer justified in saying that these are simply feelings and emotions that are being affected. It is actual pain.
This kind of education about bullying might have a few notable benefits.
First, for those people who consider physical assault as always being more harmful than the use of hurtful words, knowing that such a distinction is somewhat arbitrary could change their attitude and behaviour in fundamentally important ways. For example, I am willing to guess that many parents would react more swiftly and purposefully if they learned that their child was biting or hitting another person, than if they learned their child was mocking another person. Knowing that both acts lead to a pain experience that can approximate each other in strength and harm might motivate them to intervene more appropriately in both instances.
Similarly, if children and adolescents were aware that words can literally be as harmful and painful as physically hitting someone, it too might alter their behaviour.
Second, just as physical assault can leave scars, so too can social pain. Social scars can actually be worse because no one can see them. Feedback can lead to empathy. If you punch someone, seeing their bruise gives feedback that your actions have caused real damage. This feedback can produce guilt, shame, self-criticism and hopefully empathy for the person you attacked. With cyber bullying, you don't always get this useful feedback.
Well, here's a message for those who use hurtful words against others -- you might not see it, but it is there, and I (a psychologist) eventually get to see it many years later. Learning to avoid physical pain is a simple concept that everyone can grasp. If you touch a hot stove, you learn to never touch the stove again. People need to know that social pain leads to learning as well -- a form of learning that is not always obvious.
The scars from painful social experiences in childhood and adolescence can last a long time -- even a lifetime. These scars exist emotionally, cognitively and behaviourally. It is not unusual for psychologists to see social anxiety, substance abuse, extreme fear of rejection, clinging in relationships, avoidance of intimacy (to name several) - all in adults who learned a long time ago that these behaviours can be used as protection from social pain. Indeed, it tends to be people's efforts to numb (e.g. drugs and alcohol) and avoid (e.g. self isolation) social pain that cause many of their problems.
Finally, knowing how the brain is affected by bullying can assist in treating the problem. Whereas MRI scans show the brain's pain regions becoming activated in response to rejection, similar research has also found that these pain regions can be deactivated with social support (2). Therapy can be very helpful for those currently being bullied and those still living with the scars of past abuse.
As stories like those of Todd Loik and Rehtaeh Parsons raise our collective awareness of how severe the consequence of bullying can be, it is imperative that we improve upon our understanding of exactly how the psychological and neurological processes governing the response to these events affect the individual. It is with the knowledge of just how painful social exclusion can be that we can start to understand how something like assisted suicide for a terminal illness and suicide from bullying can be related.
1. MacDonald and Leary (2005). Why does social exclusion hurt? The relationship between social and physical pain. Psychological Bulletin, 131, 202-223.
2. Keiichi, O. et al. (2009). Decreased ventral anterior cingulated cortex activity is associated with reduced social pain during emotional support. Social Neuroscience, 4, 443-454.