Must We Suffer Emotional Pain?

Published Jan 31, 2023, 4:06 PM

It’s part of the human condition, to feel the pain of sorrow, loss, embarrassment. But isn’t it kind of weird that an overwhelming emotion can cause you physical discomfort or even pain? Turns out that depends on how you think about the mind and the body.

Welcome to Stuff you should know, a production of I Heart Radio. Hey, and welcome to the podcast. I'm Josh, and there's Chuck and Jerry's here, and we're all feeling rather chipper today. And this is stuff you should not know. Not emotionally painful is not at all true. I'm just really good at masking mine. Oh how about you. I'm feeling pretty good today. I'm glad man in this moment. But this is a This is an interesting topic because, as we'll see when we cover our history section here at the beginning. And thanks to Olivia for helping out with this one, right, wouldnt Olivia? Yeah? This was she wrote this right around Christmas. Kind of bad. Yeah, it's like one of puppies next right, Uh. We will soon learn and there's probably no surprise that things like emotional pain in and mental distress have quite often and still quite often take a back seat in the West and then the medical world. And it's just sort of that's sort of it's incredibly sad that that's the case. Yeah, And just to do it just a brief sketch, emotional pain is exactly what you've always thought it was. There's nothing, you know, there's no new concept to it that you was gonna be like, oh, that's emotional pain. Anytime you felt like heartache, sadness, embarrassment, something where you felt like your body was responding to a sudden emotion, that's that's emotional pain, right, um. And it's just a part of life. People have said it's a part of life for a very long time. If you're a Buddhist, it is definitely a part of life. Same with Christians. It's just kind of how people have approached it. But you said something that I didn't realize that here in the West. I mean, I guess I realized this part here in the West. If you go to a doctor and you say I'm having emotional pain, they're like, actually, no, you're not. It's it's real pain and your leg is missing right now and I need to sew it up. And you're like no, but I'm emotionally affected by this. They'd be like, shut up, that doesn't matter. And there's a reason for that. And you can trace it all the way back to Decartes, that's right. I studied decart in college a bit um and the and this was a big deal. But in the seventeenth century, Renee Decart proposed the idea of dualism with the mind and body, and you think, like, okay, you know, great, that kind of makes sense in a way, especially in the seventeenth century. But that was a big deal that really it was sort of a sea change in in a fundamental split that happened, which in which European medical science, uh was was trying to separate from the Church as far as their oversight goes. But what the real effect was was what I was talking about was, you know, mental illnesses were really good distinct separate thing from physical maladies. Yeah, and still today in the in in Western medicine, we do not combine those two, which is, you know, there's other cultures like traditional Chinese medicine, um, Indian I are Vedic medicine that they see mental and physical pain as pretty much, at the very least deeply connected, not too completely separate things, one of which may or may not exist like we believe in Western medicine. And to to be able to trace it back to like this point where um, the early medical doctors were like I call body and the Church is like I call mind, and they just kind of went their separate ways. I just find that fascinating, and it's landed us in this problem where we are in the United States and other Western countries where we don't we really give short shrift to emotional pain. But we're learning more and more that it is just as real and just as sometimes unbearable as physical pain, sometimes worse because there's not a lot of recognized treatments for it. Yet when they called mind and body, who was shirts and who was skinned? Uh they were both skins. Oh yeah, it was a sixty day Uh. People like Sigmund Freud. You know, it's not like no one ever talked about emotional pain in the West, or it was studied or anything like that. It's just that separation. Freud he did write about psychological pain, as did a lot of people that followed Freud or you know, not sorry acolytes of Floyd, but people that followed after him. Um, and you know kind of wrote about, you know, more in the terms of like mourning, like mourning someone's death or maybe a big romantic loss or something. And this emptiness or loneliness or sadness you might feel. But that's still not where we're what we're talking about today, which is this mind body connection where and as we'll see where study after study kind of um. And again it's a very hard thing to kind of prove outright, but strong correlations between physical conditions and emotional distress. Yeah, And I think Freud was still talking about it. He was saying, like, yes, you actually feel pain when you suffer a loss, like a death or a breakup or something like that. But it's become a little more a lot more sophisticated since Freud's time. Um, there's a term called psychic that a guy named Edwin Schneidman coin and m is psychic. It's so nineties. That is a nineties term, psychic all one word, right, And Edwin Schneidman, Um, he did coin in ninety three and um he he basically said it's a it's a it's just another term for psychological anguish um and that he and he was a suicideologist, UM. And he believed that psychic was essentially behind every single um suicide that was ever attempted or completed. UM. And he kind of chalked it up to a few different things. And you'll kind of see in the nineties and then kind of expanding today, it's kind of expanded in contracted until we finally arrived at a decent definition. But all of it has to do with you are suddenly experiencing a terrible discrepancy between the way you think things should be and the way they suddenly are. And you are, you are, you're you feel like you yourself are at fault somehow. Yeah, and there's you know again. And as we'll see, it's a very hard thing to study. Uh, it's pain period as super subjective. As we all know, physical pain is subjective. Emotional pain maybe, well it's probably about equally subjective now that I think about it. But there's not, as Olivia points out, there's not a one to one relationship between like an event and what he refers to his psychic Like, somebody may be really good at getting over stuff like that a lot better than someone else. Um, the level of the event may not necessarily always correlate to a level of emotional pain and any given individual. Um, some people maybe can process somebody's passing or death really really well because uh, they just get drunk all the time. That's a joke, but we will talk about that. That's a big component of all this stuff, definitely, But the point is like what Freud was talking about is something like an event happens or a loss happens. We realize over the years that it's not always just that, and there can be chronic, a chronic emotional pain that people feel that's UH tied to certain disorders of obviously depression UH can be a big factor. But all these things aren't mutually exclusive either now and the other thing that emerges is what we've all always known. All of us experience emotional pain to some degree or another, like you said, at different times, and some people chronically unfortunately, And they finally, I guess in the last ten years maybe have come up with a consensus definition for what I can tell. They say that emotional pain, which by the way, is interchangeable with psychological pain, psychical pain, psychic it's all the same thing. But emotional pain is a lasting, unsustainable and unpleasant feeling resulting from negative appraisal of an inability or deficiency of the self. So that the basic emotion of psychic pain, psychological pain, emotional pain is self disappointment because you're in an adversive state where you have a high self awareness of inadequacy, and that that is what you can kind of trace all of it back to yeah, and we'll talk about physical symptoms. There can be very specific things at times, like upset stomach or you know, things that might be brought on by what you might think of his stress. But if you experience sort of h chronic mental anguish and emotional pain, a lot of times it is just a an oh, we're all um body uh wounded nous that you might feel that you can't specifically, And that's sort of one of the issues is it's you don't walk into a doctor in America and say, my, I just my whole body feels off because I'm an emotional distress. They're gonna say, you've called the wrong doctor right here, take these sugar pills at home, but also give me five thousand dollars and I'm sorry about the weight. So they're not really sorry about the way. They may say that chuck, but they don't mean it. What's a social pain? Social pain is either the same thing as emotional pain, or it's kind of a subset of it. But it's they seem to strictly um. They say it's strictly from social interactions like rejection, being dumped, um, damage to your social connections. I saw m fomo that would be one. Yeah, it's like a joke that people say, but that that is very real with some people now, right, And so like when you when you feel fomo, right, you you feel bad? You don't it's not just in your head. It's so hard to get across, and it's almost totally unnecessary to get across because all of us have experienced emotional pain at some time or another. But if you've ever stopped and thought about it, why why would your body feel at all weird? Why wouldn't it just be strictly in your emotions are strictly in your head or strictly in your mind, like I've got this problem and I can't stop thinking about it instead or in addition to that, because that definitely happens to your body actually feels bad, wrong, off, pain, tense because of this emotional pain. And they actually believe this, to me, is the fact of the podcast. They believe that emotional pain came along as a result of our increasing socialization from the time we were primates up until now, and it piggybacked on our existing uh physical pain system. And because social bonds were so important to um survival that it was. It became a thing where you felt pain when those social bonds were threatened or broken. Right Like, uh, took took very sore from long hunt today, but took took feel especially painful today because Took Took not invited the main fire. It took. Took doesn't use prepositions, should he? I don't know. It depends if he's like unfrozen caveman lawyer. Yes. So. So the thing is is what took Tuk would have learned from their chuck from that experiences, I need to, like, I need to pay attention to this. There's something I'm doing wrong, There's something somebody else is doing wrong, and I need to remedy. I need to do something different in the future. And then in that way my social connections will be stronger. And when a saber tooth tired comes along, I'll have my crew to take care of it rather than its just making a meal out of me. Yeah, this is a great setup, I think so too. Should we take a break, Yes, let's all right. We'll be right back to talk more and hopefully make a few other little jokes about emotional pain. This is a tough one to joke. About. Yeah, no it is, but I think more than anything, to me, it's a tough one to talk about, and I don't I don't understand why. Maybe it's because it's not fully understood. Yeah, yeah, so I'm having trouble understanding or explaining it, you know. Yeah. And when I say joke about, of course I mean joke alongside. Uh. None of this is is joke worthy. But we're a part part comedy show, so we try to work in these angles when we can, right. Yes, the funniest is when we explained that making jokes about it and why why we really should know that they don't really count. I think new people come along. Uh, did you see somebody was very upset about your awesome, awesome Midwest joke for which one from Edmond Fitzgerald podcast. Somebody wrote in and I didn't even remember because we recorded a lot to get ahead for Christmas, but I didn't even remember the joke. Somebody was very offended, and I said, well, what happened? I said, I feel like it was probably a joke that I could explain, but just let me know what happened and then rot back and it was a great joke, I said. I was trying to think of the game, the card game yuker. Oh no, it's in tarot tarot cards. And I said, what was that game? I said that Midwesterners often played, and you get me out of here. And then this person, as I said, it was just a joke, of course, and that you're from the Midwest, you can say that in this person, I think felt a little bad, even which I then felt bad about. Uh, And that's no good for anyone. Now the rest of us feel bad because you shared it, and we all feel bad for you and the other person. All right, Can we talk about how mental pain affects the body? Yes, because here's the point. It's not just that mental pain exists. It actually is real pain. And thanks to our friend the Wonder Machine, the f m R, I, we actually know that the same parts of your brain that are responsible for experiencing different types of physical pain, uh, they light up, they become active in the presence of emotional pain. And they did this by basically inflicting emotional pain poor participant studies and then seeing what their brains did. Yeah, and here's the thing with a lot of these studies, what's important I think to know is that uh, it wasn't necessarily in an an exact in an exact time of crisis, like you know, we wanted to gather up people who had been dumped the day before, because of course you're going to be in that sort of state of mind at the time. Like most of these studies, you'll you'll see it's like studying your brain during resting rates or your heart during resting rates, and it's you know, it feels like it's more. And I'm not saying, you know, they're all in emotional pain still, but they didn't like juice these studies by getting just these like recently devastated people, I guess is what I'm trying to say right at first. And some of the techniques they use is just take an average person off the street and say we want to inflict emotional pain on you. They would um, in the experiment, they would be playing a game with other subjects, and um they would exclude the actual study participant from the game, or they would tell them that one of the other participants um admitted to not liking them and and they would show him rejection theme pictures stuff like that, and it was coming up with some pretty tepid results. But then there was a guy named Ethan Cross from University of Michigan. Yeah, he'll make you jump jump for his study results. I wonder if he wears his clothes backwards. When those kids made like a million dollars from wearing their clothes backwards at the mall once, just to go out there and do that. That's how they I mean, no, that's how they. That's how they were discovered at the mall discovered them. Yeah, it is a world. But anyway, back to Ethan Criss Cross. He used the Wonder Machine, but he did recruit people who were in an intense negative emotional state who had just been recently dumped and we're not taking it very well. And he put them in the Wonder machine and he said, hey, here's a picture about your ex that just dumped you. For a picture of them. Now think about some memory of them dumping you and how bad it feels. And then he sat there with a clipboard and a pencil and went very interesting, I see, and watched their brains do different things and they said, how did you get that picture? Don't ask about that. They give him a zap when they asked too many questions. Uh yeah, And I think there were about forty people in this study. Uh, and again he eventually used he used the fm R I eventually, right, Yes, And what he he found out was that the negative emotional state uh lit up the sensory and effective brain areas just like putting like hot heat on their arms. So this physical heat and this sort of made a little sense to me as far as like if you get like, if I get really really intensely upset about something, I feel like my head is on fire. Uh, So that I think there's something about heat, and then maybe that's why I used it. But they would like I don't think they would burn them, burn them, but they would put what was called a painful heat on their forearm. And found that the FMR I lit up just the same as with the emotional pain. Yeah. And so that supported something that he had also found in a review of existing literature that, um, they're the brain regions associated with our effective experience about the aversive quality of pain, which is, um, we like, if you hurt yourself physically, right, Um, you are you're suffering. That suffering is your desire for that pain to stop. You wanted to go away. It's like hurting you um existentially, it goes beyond just the actual physical experience, the sensory experience of it. That's them, that's the effective experience of physical pain. And that region of the brain definitely lights up the same for emotional pain and physical pain, because we're suffering from both equally. But what Cross said or showed was that, no, your actual sensory experience, like what your body feels when you're physically in pain, is the same when you're in emotionally in pain. So he said, ipso facto, my research shows emotional pain and physical pain, as far as the body is concerned, is the same thing. It's really just your doctor in the United States that is having trouble admitting this whole thing. All the evidence is showing your body is fully aware that they're the same. Yeah, And it's I don't know, it's so frustrating because, like I said, when I think everybody, when they get really emotionally upset, the first thing that happens is your body is going to start physically reacting. Like I said, my head gets flush and hot, and like the heart races, and it's this almost like this fear response in me. Uh So it's hard to believe that you know, something like fight or flight, it's just so universally accepted. But something like this, which to me is the same thing going on, it can still be pooh pooed. Yeah, poop poo for now, but not much longer, I predict and for me, chuck, since we're throwing out our own stories. If I suffer some sort of emotional injury or whatever, right usually like embarrassment or something like that, it washes over me. Is the best way I can put it, basically, from the back of my head down the front and then through my chest and abdomen. And I actually saw research that suggested UM the vagus nerve that connects the brain through the chests and your abdomen and into your I believe your JOHNK area because it's activated during orgasms. From our orgasm episode, you'rs back. I think the medical term is your bits, but they okay, so they they they found that the anterior singular cortex activates the vegas nerve, which UM can over become overstimulated in the presence of a huge jolt of emotion, which can transfer to the vegas nerve, which can make you feel in your chest and abdomen like there's some sort of discomfort or sensation. Again, an emotion created a physical response. You're not You're not crazy, you really are feeling that way. Yeah, And like I remember feeling this stuff from the time I even knew what feelings were. You know, nobody likes to be picked last. As far as the social pain, Uh no, one likes to be embarrassed in front of people. But that stuff doesn't stop, you know, um, the social thing. Like when we were talking about it, it might sound like, um, obviously something you will experience an adolescence and growing up, but that stuff doesn't go away. Uh No, it really doesn't. Me No, no, same here. I thought about making that joke, but then I pulled it back from the edge. I mean, maybe some people have really squared themselves away such, but to me, it's just seems like part of in you know, a bunch of the history that we kind of truncated at the beginning. Talked about it being part of the human condition, and I just think that's so obviously true, It's totally true. I think people who don't have to deal with that are really just dealing with it less than other people. I don't think anybody's ever managed to eradicate emotional pain from their lives, you know, But in the people that seem like they've got it all together could be suffering the worst. You never know, they might just be really good at at burying that stuff or what have you, like Flanders types exactly. There's one other thing about the the comparison, though, of physical pain and emotional pain, that really is a difference, and that is that when you're experiencing physical pain, there's usually something you can do to kind of stem it off immediately. Do you put your hand like a hot of it, You can pull your hand away. But if you experience like an emotional injury, uh, and you feel emotional pain, you can't like hold your hand, you can't run it underwater, you can't. There's nothing you can do right then to stop it except for essentially self soothed as best you can until it subsides. Whereas with physical pain there's often stuff you can do to kind of treat it immediately. Yeah, what I think, and that's an acute thing, I totally agree. But what I think it's interesting is that like evolutionarily speaking, emotional pain is a signal, just like a physical pain is a signal to like tend to yourself in some way and whenever. And we get a lot of emails from people that are suffering great deals of emotional pain, like listeners, you would not believe some of the emails we get of people that are in such distress. And I always try to say the same thing, which is like and usually it's in reference to the podcast, kind of help can calm them down in some way, which is really nice to hear. But always tell people the same way as which is like, hey, listen, get some help and treat yourself right, like drink a lot of water, go for a walk, Like these are literal physical things that you can do that will it's not a cure, but it will certainly help alleviate acute symptoms. You know, self soothe. Yeah, but it's it's more than self suit to me, because it's like it's it's like, no, you need to treat it like there's a physical problem, Like that's why you should drink a lot of water and go outside, and uh, it's soothing, but it's also doing something to your body. And interestingly, we'll talk about things you can do and you just nailed a bunch of them. But apparently walking outside in nature, um is a really great way to, um, I guess, alleviate emotional pain. And like, if you have a forest, great, walk around the forest. If you have a meadow, walk around the meadow. If you have a public park, walk around the park. Just getting outside can help a tremendous amount. Yeah, I agreed. I think that's a really nice thing that you say to people that chuck My pat responses, hey, man, keep on trucking? Is hey just like that mud flap says Yeah, no one ever writes back, although or if they do, they're like even matter than they were before, They're more upset than before. It's weird. People are strange. Uh. Do you want to talk about drugs? Yeah, this is really interesting to me. Uh, this first bit on a seat a menafin because they and I had no idea about any of this, but they have found out through studies that a seeda menafin like thailand are or other types of you know, generic pain killers, it actually can dull you emotionally. UM. I'm wondering about to what degree, because they say it can dull that like the social pain that you might feel if your pomoed or left out of something, Uh, it can emotionally blunt your reactions that other Like if somebody tells you about something bad, you can be I guess less empathetic if you're taking a seat a menafin, And that was really surprising. The converse is true too, You're because you're less empathetic, you experience fewer positive emotions too. So the weird thing is is it's not like it affects your brain or your processing of events you're fully aware of, Like, this is a really great thing my friends telling me, and I understand that my friend is uh is proud, reasonably proud for this, but I don't feel at all happy for them because of the sea a menafin. That's a really weird effect. I wonder how much and how pronounced, Like I don't know, Yeah, I need to I want to follow up on that guy. I don't really ever take that stuff that much. But but I feel like, even you know, just a few times you have taken it, if it was a pronounced effect, you probably would have noticed it. Probably, you know what I'm saying, Like if you're if your hand is suddenly making trails of itself, even though that's the first time I mean you've taken this, you noticed that that happened. I would because it was a pronounced effect. Same thing with you know, emotions being blunted with a Sina benefit probably good point. Opioids obviously is something we can't not talk about, uh such an you know, we we should probably tackle bits and pieces of the opioid epidemic in full episodes. But uh, opioids are interesting in that sometimes you might be taking them for a real physical malady and you happen upon the um the emotional relief that all of a sudden feels good to you when you take an opioid, whereas other people that is exactly what they're seeking when they're like med seeking or buying pills on the black market or whatever. Yeah, which is a huge problem. And it's you know, obviously not just opioids, but alcohol and food, um, basically, anything that can give you some sort of positive feeling can be you know, used to stave off emotional pain. That that is not the way to do it, though, but you know a lot of people do do it that way, and it's tough to blame them, especially if they haven't found a better way yet to deal with them. So you know, I mentioned before that pain, all kinds of pain is very subjective, and especially emotional pain, and obviously because of that, it's a really hard thing to to quantify. Uh. We've talked about the physical pain scale that was developed, but there have been various attempts over the years at mental pain scales, and they've never really all agreed like, hey, this is the really really good one because there's scores of data behind it, and they talked with a bunch of people who live with mental pain and at all they kind of signed off on it. It's weird that they haven't really done that, but they've The long story short is they've never been able to land on a really great one, although I think one they do kind of use, right, the Orbach one. Yeah, they used the Orbach and michaelins Or mental pain scale pretty frequently. But the problem is there was a review of ten major scales that are used around the world, um that was published in two in the British Medical Journal, and they said none of these seem to be valid, Like they're all they might as well all be like tea leaves and lizard guts, like that's that's as as good as they are. At really nailing down emotional pain or quantifying it. So they said, don't we shouldn't give up or anything like that. We just need to figure out how to do it better. So essentially the upshot is there's no way at the moment to accurately measure emotional pain, and then I guess figure out how to treat it depending on the measurement from there. Why else would you want to measure it? Yeah, I guess so, Because I was about to say why, I feel like sometimes a discipline can get so hung up on something like this that it thwarts progress. Uh. So I hope that's not the case. It's called getting wonky. Uh. It's no surprise. We mentioned a little bit earlier about other conditions related to mental pain. I guess code morbidities for lack of a better word. But heartbreak you mentioned is obviously one of the big ones. What I found interesting in this is that some people have UM like in heartbreak two drug withdrawal. And it makes a lot of sense because when you are in love UM and especially if you've ever been sort of that new love, if you've ever been newly in love, but that really flamed out fast, and it's taken away from you. UM, that's sort of like drug withdrawal, because you've got all sorts of uh dopamine and oxytocin and things firing when you have that fresh new love happening, and if that's taken away, then it's like taking away a feel good drug. Yeah, welcome to six to ninth grade, six ninth man boy through through college. Okay, sure, fair enough. Welcome to sixth grade through the rest of your life. About that, the thing is is, because you're experiencing this, and because you're experiencing stress, like when you when you undergo rejection or a sense of betrayal or a sense of loss, your body actually does reliefs cortissolve, So you actually are experiencing stress, and you actually can have physical symptoms from that, like digestive problems, tough to sleep, your immune system is down, you might get sick. And then we did an episode a long time ago UM called can you die of a broken Heart? And then yes you can. There's something called taco subo cardiomyopathy, which is a sudden emotional or physical stressor basically weakens the heart and you basically have a heart attack from it, possibly from being dumped. If it's bad enough. I knew that sounded super familiar. I say, before we go any further, Chuck, we take our last break. How about that, let's do it so. I think, UM, one of the first things people think about when they think of emotional pain is depression, Like there's you know, there are people out there who have depression, and you can make an argument that with depression you're suffering chronic emotional pain. What they found, though, is that people with emotional pain, if you if people with depression, if you have really high levels of emotional pain, it's not necessarily correlated with the UM the largest burden of depression. So if you put ten people together, you've got one guy who's the most suppressed of all, he's not necessarily the person with the greatest levels of emotional pain, which suggests that depression, UM and emotional pain are not one and the same. Depressions its own thing has other symptoms. It's just correlates very strongly with emotional pain, which seems to be one of the leading symptoms of depression, but not with depression. Is they're not interchangeable. Yeah, and and a lot of these that we're talking about here, like they're weaving in and out of each other all the time in some cases. And but I think the distinction is still important to make though you know it, rather than just lumping it in as all one kind of thing. Um. And eating disorders to a lot of people are like, you've got any disorder, you really like the food, huh. And most people who treat eating disorders are aware that it has very little to do with food. Food just happens to be something that, um, these people can use to cope, that they can use to uh feel better about themselves or forget or distract themselves for a little while. But really what they're doing, it's dealing with um, emotional pain that they don't have a better way to deal with, so they turn to food. That's what eating disorders are. Yeah, there was a study in that I'm surprised it wasn't higher, honestly, that found that of disordered eating patients experienced significant mental pain compared to six percent of the control So that's quite a jump. Yeah, I mean that's huge. It's pretty much all you need to sing, uh, well, we've got well this is sort of the big one. Um. I mean they're all big, but borderline personality disorder bp D. UM. This maybe sort of at the top of the ladder as far as what might cause the most consistent and the worst kind of mental pain that someone UH might suffer because a lot of times, for many reasons, but a lot of times, UH, you suffer from bp D because of childhood abuse or childhood neglect. Uh. Sometimes it's genets. There's some gener edics thrown in there, but you know, this is stuff that's very very deeply rooted in somebody. Yeah, And so the it's chronic mental pain UM, especially those related to narcissistic wounds, where you feel a sense of rejection in It just completely undermines your sense of self worth and pride. But the way that it manifests itself and people with borderline personality disorder is that they might have inappropriate anger, They might UM dissociate from themselves or reality. They might feel emptiness. UM there are emotionally unstable in most cases. And what I saw it UM ascribed to is that essentially because of that childhood neglect or abuse or trauma of some sort there, they become so afraid of being abandoned that they actually alienate people with their behavior. That's that, which that sounds to be like a old medieval curse essentially, like the more you try to keep people around, the further way they're going to get and you're really gonna want them to be around you. That sounds about as awful and affliction as you can have. Really. Yeah, and you know, you shouldn't be surprised that if you suffer from borderline personality disorder, uh, you're way more likely to abuse or missuse substances. Uh, maybe suffer from that eating disorder we were talking about, have obviously anxiety depression, uh, and even be at risk or suicide. Yeah, that's I think we should do a BPD episode someday. Yeah, there's a lot there, for sure. There's also something called non suicidal self injury and it is a fairly new diagnosis as far as the d s M is concerned. UM, and it can be its own symptom, it can be a symptom of other things. Like people with BPD, UM often engage in non suicidal self injury. But essentially what it is is self cutting, UM, punching a wall like a bunch of times. UM. What you're what they've frequently thought was that they they're these people are overcome with emotions and the only way to release that tension from that emotion is to cut themselves or punch that wall. And more recent research has found that actually they think that what they're what they've stumbled upon is this kind of innate mechanism humans have where when you experience a painful stimulus, when it subsides, you don't just go back to how you felt right before the painful stimulus, You actually have a bit of a sense of euphoria, and that they're actually doing they're actually going for that sense of relief in euphoria by cutting themselves or by punching the wall or whatever self injurious behavior. They're engaged and that that's really what's behind it. But that what differentiates them from people who um don't engage in that behavior that they feel like they deserve it, they deserve punishment, or they're defective, there's something wrong with them. So that's why they respond in that manner where they hurt themselves to kind of cope, rather than say turning to food or something. Yeah, it's just devastating, And that's that sense of self that it seems like we just keep going back to when it comes to this emotional pain. It's something is wrong with me, and maybe I deserve this. It's just I've never had these kind of feelings, and I just my heart breaks to think about someone walking around feeling this way. You know. UM, rejection sensitive dysphoria is something that I had never heard of, because it seems like it's really sort of on the leading edge of what's being studied. Now that's that. In fact, that phrase rejection sensitive dysphoria isn't even part of the medical community. Um, Like they haven't even UM. I guess what would you call that? Well, the medical community a lot of it, except that it's it exists, but it's not in the d s M. So it's technically not an actual diagnosis. Is that what it is? Yeah, that's my understanding, all right, And this is UM and this, you know, obviously go along with some other neurodivergences, other mood disorders. Like we said, a lot of these are sort of criss cross each other, but they might experience mental pain or discomfort and feel, you know, this rejection that we keep talking about. And the other thing that really stood out to me or interpret like something ambiguous as rejection, right, so when they're when they're rejected. When you feel rejected and you have rs D, you have a full body sense of being overwhelmed by the emotions that you feel. Nobody likes to be rejected. Now take that feeling of being rejected and amplify it a million times so that it completely saturates every fiber in your being, and then make it so that just about anything anyone says to you is a form of rejection. Correcting you for something that you you you misspoke about, UM, telling you that you're doing something wrong, anything like like breaking plans with you because you have to take your ailing mother to the hospital. Like, all of that is considered rejection, and all of it is met or responded to by this overwhelming flood of negative emotion. UH suicide We've talked about UM kind of here and there throughout the episode. UM. Obviously that's a big risk if you're suffering from depression and uh bp D. But emotional pain, and again this is something that we want to draw distinction. Emotional pain is a real major factor and it's not everyone, but many Many people who have died by suicide or attempted suicide had reported previously that they it was a psychological pain that they were trying to escape from or end. Right. One thing that I hadn't thought about but makes total senses. There's some suicidal ideation um and that that that can be a coping mechanism for people who are UM risk at risk of suicide UM, and that they're they're basically saying, like, I can, I can keep making it. It's not quite bad enough yet. And I always have that out of taking my own life if things get too bad, and that suicidal ideation, and some people just use that to get by um and get through emotional pain, to just remind themselves that, you know, it's not that bad yet. Right. Well, I had not heard of that, but I mean I get I get the basis of it. It's very very saddening, but I get the strange logic behind it, you know, yeah for sure. Um. All right, So we would love to end on a bit more of a positive note, which is there are treatments for these things. Uh. Like we mentioned it, it is an evolutionary signal when you're feeling emotional pain too uh to do something about it. It is your body saying, hey, this is uh not just this is no way to live. But like, this is dangerous for you, and you need to take care of yourself and self soothe and do all those things, but also seek treatment. And there are quite a few treatments that are that are out there for you. Right. Yeah, there's cognitive behavioral therapy, which basically says, you, Um, we don't know why you're feeling the way you're feeling. Who knows, We might never uncover it. The point of what we're trying to do is to teach you how to live a better life with being saddled with these negative emotions, learn to deal with them better, learn to think of them as less powerful than they are. And CBT has been around for a while and it is probably the most successful, UM psycho psychological therapy there is, and it's kind of given birth to some subsets of it, and a couple of them are really specifically geared towards treating emotional pain. Once called dialectical behavioral therapy, it's been around since the seventies. A psychologist named Marcia Linahan UM came up with it. Yeah, this one's interesting, UM, And they say that this is one of the best treatments if you suffer from borderline personality disorder to undergo and uh, if you everyone experiences emotional pain, but if you experience these things really, really really intensely, then this, uh DBT might be for you. It's called dialectical because, um, it's about sort of accepting your behaviors, accepting your situation that you're in, but trying to change them. So the acceptance part is a big is a big piece to DBT as well as a c T Acceptance and commitment therapy. Right. Yeah, Dialectical means like things that are concepts that are in logical opposition to one another. And then this one makes a lot of sense. I thought it was pretty cool. Um. They Also one of the big things about DBT is there's group therapy and you practice your skills in it, so you're like, watch this emotional regulation everybody, you know. I'm not quite sure what the groups are like, but I saw that it was more akin to a classrooms setting than a group therapy setting. There's also acceptance and commitment therapy. It has a lot of the same ideas behind it. Basically that you need to um accept that you feel emotional pain and and kind of move on without and move on with it make make make the best of your life using mindfulness techniques typically, and both of those things they center on the idea of, um, you have emotional pain, there's not a lot you like, you're never going to free yourself from emotional pain. So let's teach you, the person, how to deal with emotional pain better. And that makes a lot of sense, and it actually is effective for a lot of people. But there's also another school of thought that says, like they're those things are wrong because they're coming from a premise that you have emotional pain, you just have to accept it and deal with it. There's a guy named um Mark Rigo. He's a psychiatrist at Yale, and he's on the other side and says, we need to figure how to treat emotional pain. You're not gonna get any great signals or any great understanding from your emotional pain. We need to get rid of it however we can, um. And that's a kind of controversial because people are like, well, you're pathologizing maybe emotional pain that everybody has, and he's saying, not necessarily, some people have way more acute or way more chronic emotional pain that's actually debilitating and rather than them, you know, going to group and practicing their skills. Let's figure out some medications to help them get back on their feet, and then they can go to like CBT or DBT or a c T H and work it out. But they're they're so far beyond that. We need to bring them back to the place where that therapy can actually help. Yeah, I mean, I guess if that helps you, that's great. I think I identify a little more with the um the previous ones we were talking about, the acceptance because it kind of ties into the whole I am not my behaviors line of thought, Um, like I can be this and also be something else totally, which is I think could be very empowering. I mean, I've learned a tremendous amount for my therapy and it's essentially geared towards that of like you said, I'm not my behaviors, I'm not my thoughts, are not my feelings, like I am the kind of the sum total of all of those things. And also just um, you know, learning not to be such a negative nelly. Same here, my friend, you got anything else? I got nothing else? All right? Well, if you want to know more about emotional pain, sit back and wait because it'll come sooner or later. And since I said that, it's time for listener mail. Oh no, no, it's time for listener phone call. What first ever um our old or old pal? John Hodgman, friend of the show and friend of ours in real life, ye called me as he still listens to our show some really yeah, which made me feel really good. I doubt if he listens to him all. He probably sturfs through and skips around and listens to what might appeal to him. But he, uh, he listened to the episode on the word and phrase origins, which you know, John of course is in talented orator and wordsmiths, so it's not surprising that when jumped out at him. But he called because he wanted to talk about the peu remember when something stinks, And he said, I think that might have come about And it made sense to me when because that's sort of the sound you make when you spit something out that might be bad for you. So like evolutionarily, if you put something in your mouth, it's like super bitter, which evolutionary and speaking means it could be poisonous. You go to you know, like like spit something out and he thinks, p you may have evolved from that. I saw other places that it's kind of a nuanced version of the where like when you get smacked in the face by a disgusting smell, Like the exclamation you make involuntarily is like pure kind of that kind of thing. It makes sense and just something I think you'll enjoy. I've been holding out on this to tell you, he said. And by the way, he said, did I ever tell you, Chuck that for the first couple of years I listened to the show before I knew you guys, I thought you had a ponytail. Oh, that just tickled me. I would pay good money to see you with a ponytail. Yeah, I thought that was good stuff. This Halloween's coming up, Chuck, you never so thanks to Hodgi. Good good guy, good friend. Yeah, great guy. Thanks a lot, Hodgi for the first ever listener phone call. And if you want to be like Hodgman, see if you can find Chuck's phone number and give him a call. Uh. In the meantime, you can also send us an email to Stuff Podcast at i heeart radio dot com. Stuff you Should Know is a production of I Heart Radio. For more podcasts, my heart Radio, visit the I heart Radio app, Apple podcasts, or wherever you listen to your favorite shows. H

Stuff You Should Know

If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD,  
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