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Pleasure and pain
Pleasure-Seeking Behaviour
Pleasure and Drugs
Avoiding Pain

HelpLink : To what extent do we share the pain of others? Insight from the neural bases of pain empathyLink : Everybody Post About Mirror Neurons!!!Link : Nature and Compassion
Link : Nature's lessons for a more kind societyLink : The Neuroscience of AdmirationLink : We can literally feel the pain of strangers, study findsLink : Terms of Empathy
Link : L'homme sans douleur (extrait vidéo)Link : Empathie : la fin des neurones miroirs ?Link : Impaired Cognitive Empathy in Bipolar Disorder and in Patients with Ventromedial Prefrontal LesionsLink : The Neurobiology of Empathy through Pain Research
Link : Nature’s lessons for a more kind society Link : Compassion Meditation Changes The Brain Link : No evidence for mirror neurons in humans?!
Researcher : Jean DecetyResearcher : Alvin I. Goldman
Experiment : Understanding Others' Regret: A fMRI StudyExperiment : MRI of moral emotions while causing harmExperiment : Empathy examined through the neural mechanisms involved in imagining how I feel versus how you feel painExperiment : The neural bases of empathic accuracy

Empathy, and especially empathy for other people’s pain, is a universal human trait. Being able to understand that a situation that one of our peers is going through may also be painful for us, without our having to experience it ourselves, may have provided a significant adaptive advantage.

But what happens to people whose jobs require them to witness other people’s pain every day, or even to inflict pain in order to cure their illnesses? Do doctors, for example, feel the distress of all the patients whom they see every day? Luckily not, because doctors who were constantly affected emotionally by their patients’ suffering could never make all the informed decisions that a doctor’s work requires.

Professional caregivers thus manage to keep their initial impulse of empathy at a distance. How? A brain-imaging study by Yawei Chang and Jean Decety compared acupuncturists with a control group of people who were not in the health professions. This study showed major differences between these two groups in the ways that their brains were activated when they observed people having needles inserted into their skin.

In the control group, watching needles being inserted activated several parts of the brain that are responsible for processing pain, including the anterior insula, the anterior cingulate cortex, the somatosensory cortex, and the periaqueductal grey matter.

Among the acupuncturists, these areas were not activated at all. Instead, the researchers observed extensive activation of the brain areas associated with higher functions, such as the regulation of emotions—structures such as the medial prefrontal cortex, the medial frontal gyrus, the parahippocampal gyrus, and the inferior parietal lobe.

Moreover, when asked to rate, on a scale of 1 to 10, the unpleasantness of the needle insertions that they watched someone else receive, the acupuncturists assigned scores of only 3 or 4, while the subjects in the control group assigned much higher scores, around 6.5 on average. (Note that the members of the two groups had shown similar results in psychological tests for general empathy and for sensitivity to pain, thus eliminating differences along these lines that might have explained the results of the overall experiment.)

Thus, the most plausible explanation for the mechanisms underlying health professionals’ ability to control their empathy seems to be that they use areas of their brain associated with cognitive control functions to literally silence the circuits associated with pain. These cognitive areas might include, for example, those involved in the memory processes on which their professional experience depends (structures such as the parahippocampal gyrus) or those involved in making the distinction between self and others (structures such as the temporoparietal junction).

Link : Doctors repress their responses to their patients’ painLink : Doctors control their own brains’ pain responses to better treat patientsLink : Empathy during Medical EducationLink : About Suffering
Link : We Empathize, Therefore We Are: Toward a Moral NeuropoliticsLink : The quest for compassionLink : Empathy Marketing 101

The human predisposition toward empathy may foster mutual understanding, but this sensitivity to other people’s distress can also sometimes be a burden. For example, some people feel burdened by all the suffering of large numbers of human beings throughout the world, to which they are exposed every day through the mass media. The Romantic poets of the 19th century provided detailed accounts of this state of melancholy, sadness, or pessimism to explain their inability or refusal to adjust to the realities of what they considered a destructive world.

The German writer Jean Paul coined the term Weltschmerz
(literally, “world-pain”) to describe what French writers of the early 19th century called le mal du siècle(the illness of the age). Other authors have equated this resignation before the cruelty of the world, which can lead to depression, with the state of anomie described by French sociologist Émile Durkheim.

Many hypotheses have been offered about the evolutionary origins of empathy in human beings. One such hypothesis is that this ability to place ourselves “in someone else’s skin” enabled our ancestors to make better predictions about other people’s intentions and needs, thereby also encouraging the behaviours of co-operation and mutual assistance among the highly interdependent individuals of our species. This ability to feel other individual’s affective states would also have played a crucial role in communication.

More specifically, understanding other people’s pain often lets us avoid dangerous situations without having to experience them ourselves. Sharing other people’s distress also leads us to inhibit behaviours of aggression and self-gratification. This inhibition has been observed in many species of mammals, for example, laboratory rats who stop pressing on a lever that dispenses food to them, when they see that when they press this lever, it also gives an electric shock to a fellow rat.

Human empathy for other people’s suffering may also have evolved from brain circuits that inform us about pain in our own bodies. Numerous brain-imaging studies have shown that when we experience empathy for someone else’s pain, structures are activated in our own brains that also become activated when we experience pain ourselves (for example, the anterior cingulate cortex and the insula).

 But this raises a very fundamental question: how do we distinguish other people’s pain from our own? It certainly wouldn’t have been adaptive if we were overwhelmed with pain whenever we saw someone else experiencing it, and indeed, that is not what happens (see, however the sidebar on Weltschmerz and mal du siècle). Although we may feel other people’s pain, most of the time we manage to maintain a certain detachment from it. In any case, we know that it is not our own body that is in pain, even if we are experiencing its negative affective component ourselves.

So what are the mechanisms that let us make this distinction? To answer this question, let’s begin by reviewing what we know about some other, related phenomena. For example, we know that the difference between the brain areas activated when we make a certain movement and those activated when we simply imagine ourselves making it can be subtle. Except for the actual motor-control circuits, mentally visualizing a movement activates practically the same neural circuits as when we actually carry this movement out.

We also know that even when no pain stimulus is present, anticipating a painful experience can activate the parts of the cortex that are associated with pain. Moreover, the intensity of this anticipatory neural activity is proportional to the intensity of the anticipated pain.

Another finding that scientists have confirmed repeatedly is that when one person experiences empathy while observing another person expressing an emotion, the activation of the first person’s brain is less intense than when that person is actually experiencing this emotion himself or herself.

Thus intensity of activation seems to play a role in preventing us from confusing ourselves with other people when we are sharing affect with them. But there are other mechanisms that may also help us to make this distinction. To identify them, we will now look at three other components of empathy: affective response, emotional regulation, and cognitive influences.

The affective response that is triggered automatically when we observe other people’s emotions can be seen as the resonance of neural networks that we share with them. But this resonance is only partial: a number of studies have shown that the brain areas activated when we observe an emotion and those activated when we experience it ourselves do not overlap perfectly.

For example, some areas, such as the right temporoparietal junction, the precuneus, and the posterior cingulate cortex, are more activated when we adopt someone else’s perspective, rather than our own, in assessing emotion or pain. (This is the same role that these structures are already known to play in other mental tasks.)

In contrast, in other studies, when the subjects imagined themselves in pain, their pain matrix was more widely activated (awakening structures such as the secondary somatosensory cortex and the posterior part of the anterior cingulate cortex) than when they observed someone else in pain. This difference in activation was seen even at the level of individual cortical structures. Within the insula, for example, the sub-groups of neurons that fired under the former condition were different from those that fired under the latter.

These findings thus suggest a possible mechanism behind the difference between the sensation aroused by our own pain and that aroused by pain that we observe in other people. Researchers have also noted a continuum of activation between these two situations, with an increasingly posterior activation in structures such as the insula and the anterior cingulate cortex the more that the painful situation being considered relates to ourselves.

Painting by Paul Walsh

Thus, though it is useful for us to be able to share other people’s suffering to a certain extent, our brains also have mechanisms that they can apply to let us maintain a certain degree of autonomy and a certain amount of control over this empathic response. (This response is also subject to a number of external factors, discussed in the box below.) For example, doctors and nurses, who are in contact with other people’s suffering every day, must maintain some control over their empathic response to maintain the distance they need to make good decisions for their patients (see sidebar).

One of the most effective psychological strategies for achieving this regulation of your emotional response to other people’s pain is to adopt a detached position with respect to them. Forming a mental image of yourself as an observer who is not very affected by what he or she sees can reduce the anxiogenic experience associated with observing pain. Brain-imaging experiments have identified specific areas in the medial and anterolateral prefrontal cortex that appear to inhibit this automatic component of the empathic response.

There are other, cognitive mechanisms that you can use to control this automatic aspect of empathy and thus maintain a boundary between yourself and others (these mechanisms probably remain idle when you get caught up in phenomena such as emotional contagion, for example). These mechanisms involve, for example, your theory of mind, in other words, your ability to make a conscious effort to imagine things from someone else’s point of view, to try to see the world through their system of beliefs and way of thinking.

In this regard, there is a large amount of data indicating that the medial prefrontal cortex is involved in such tasks that require you to make inferences about other people’s mental states to achieve a more nuanced understanding of them. For instance, imagining yourself going through the precise kind of pain felt by someone who has just lost a family member is a more complex cognitive process than simply recognizing the emotion of sadness expressed on his or her face. Brain-imaging data also show that although these processes generally occur together, they recruit different neural networks. These networks are interconnected, however (for instance, the connections between the medial prefrontal cortex and both the insular cortex and the anterior cingulate cortex are well known).

Thus, the affective and cognitive mechanisms of empathy are somewhat like two sides of the same coin, the former acting more “from the bottom up” and the latter “from the top down”, depending on what information you have access to about a given situation.

This mental effort of imagining what someone else is feeling thus goes well beyond an automatic mimicry based on mirror neurons. For example, French neurologist Nicolas Danziger has shown that people who (as the result of genetic mutations) were born without the ability to feel pain could nevertheless tell how much pain someone else was in, by judging from the expression on his or her face. Because these people necessarily accomplished this task without recalling painful sensations that they themselves had experienced in the past, they must have had to perform a cognitive task to imagine the other person’s pain.

When these subjects looked at images evocative of pain, such as a picture of a hammer striking someone’s finger, their ventromedial prefrontal cortexes became activated. This suggests that they were applying an elaborate reasoning process to understand what other people must feel in such situations.

Thus, in normal human subjects, empathy—not just superficially recognizing someone else’s subjective experience but actually understanding it—most likely requires this significant cognitive contribution by the prefrontal cortex as well. In other words, the mirror neurons are only part of the story.


Though we humans are predisposed to have empathy for other people, this response can vary greatly, depending on the circumstances. Several factors can alter the degree of empathy that we feel for someone else.

The intensity of the emotion shown by the person whom we are observing is one such factor: in general, the more intense this emotion, the greater the empathy that we will feel. Seeing a needle penetrating deeply into someone’s skin, we will respond with more empathy than if the needle only scratches the surface. Similarly, seeing someone in acute pain activates our pain matrix more than when we see someone who is suffering from chronic pain.

The context of the situation can also influence our perception of someone else’s pain. For example, in experiments where the subjects are told that the person whom they are watching is in pain because he or she is receiving a treatment that will be beneficial, their empathic responses are more limited.

Another factor that can modulate empathy is attention. When subjects are simply asked to look at pictures of hands in painful situations, the parts of their brain associated with pain are activated more than when the subjects are distracted because they have been asked to count the number of injured hands in the pictures.

Certain characteristics of the person experiencing the empathy can also modulate the intensity of the emotions that they share from someone else. Hospital caregiving staff who are exposed to other people’s pain every day manage to control their empathic responses more effectively than the general public (see sidebar).

Another factor that can be decisive for the amount of empathy experienced is the relationship between the subject and the person observed. We all know that seeing a loved one suffer arouses more empathy than seeing an enemy in pain. An experiment by German social neuroscientist Tania Singer has also shown that, in male subjects but not in female subjects, the empathic response to an observed person’s pain is more limited if the subject has just formed an opinion of that person as being unfair for having cheated at a game.

In the second part of this study, published in 2006, functional magnetic resonance imaging (fMRI) revealed less activity in the pain circuits of the brains of these men who were less empathic toward cheaters. Moreover, fMRI images also revealed concomitantly greater neural activity in these men’s pleasure circuits, betraying their enjoyment at seeing the cheaters punished. From an evolutionary standpoint, this reaction seems consistent with the value placed on co-operation, which has fostered cohesiveness in human groups since time immemorial.

Other studies have shown that observers’ relationships with the person whom they are observing can also modify their perception of their own pain when they receive nociceptive stimuli. Subjects who receive burning stimuli at the same time as they observe someone whom they like receiving such stimuli will experience them as more painful than when they observe someone whom they do not like receiving the same stimuli. And the more they like the person whom they are observing, the more unpleasant they will find the stimuli that they are receiving themselves. This same increased perception of pain also occurs when the subjects observe people whom they like receiving non-nociceptive stimuli. The authors of the study in question therefore conclude that the origins of this phenomenon seem to lie in the empathy that the subjects inherently feel toward the people whom they are observing, and not in the specific situation in which these people are experiencing pain.

Another somewhat counterintuitive study, on the influence of family situation on perception of pain, showed that this perception was positively correlated with the degree of concern that women showed for their husbands who suffered from chronic back pain. When a pain stimulus was applied to the backs of a group of such men, those husbands whose wives tended to show a great deal of caring or concern about their pain experienced more pain than those husbands whose wives tended to distract them from their pain by calling their attention to something else. Thus chronic pain, contrary to acute pain, seems to be eased more by distractions than by displays of concern.

Experiment : Empathy for another's distress affects pain perceptionExperiment : Empathy hurts: Compassion for another increases both sensory and affective components of pain perceptionLink : Social factors may deepen chronic painLink : I feel how you feel but not always: the empathic brain and its modulationLink : Terms of Empathy

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