Neurophilosophy

Feeling the pain of others

HOW do you react when you see somebody else in pain? Most of us can empathize with someone who has been injured or is sick – we can quite easily put ourselves “in their shoes” and understand, to some extent, what they are feeling. We can share their emotional experience, because observing their pain activates regions of the brain which are involved in processing the emotional aspects of pain.

But can seeing somebody else in pain actually cause pain in the observer? People with mirror-touch synaesthesia are known to experience touch sensations when they see others being touched, and this may also extend to pain in such individuals. There are also several anecdotal cases of patients who experience pain in the absence of noxious stimuli. And a new study by British psychologists now provides evidence that a significant minority of healthy people can also experience pain when seeing others’ injuries. 

Jody Osborn and Stuart Derbyshire of the University of Birmingham recruited 108 participants, and showed them static images (below) and film clips depicting painful events. The participants were asked to report anything they felt while viewing the images, and to rate the level of disgust, unpleasantness, sadness and fear elicited by each, using a questionnaire. They were also asked to report the level of empathy they felt for the person in each photograph.

Thirty one of the 108 participants, or about one third of the group, reported feeling pain in response to one or more of the images or clips. The sensations they felt were most often described as “tingling”, followed by “aching”. Other descriptions included “sharp”, “shooting”, “throbbing”, “stabbing” and “tender”. The pain was described as lasting for “a few seconds”, “fleeting”, or “for a split second as soon as the picture appeared.” The black and white photograph of the athlete with a broken leg generated the most pain responses, and the highest pain intensity. In every case, the pain they felt was in the same location as that of the observed injury. For example, when they saw the image of the finger injury, they marked a cross on the finger of a diagram in the questionnaire.

pain_images.jpg

Ten of these “pain responders” were then selected for a functional neuroimaging study, along with another ten non-responders, who acted as controls. The twenty participants then had their brains scanned whilst viewing the same images and film clips. These experiments confirmed the behavioural data – in the responder group, observing the images and film clips was correlated with strong activation of the so-called pain matrix, a diffuse network of brain areas which includes the anterior cingulate cortex, insula and prefrontal and somatosensory cortices. In the non-responders, those components of the matrix involved in emotional responses to pain (the cingulate and prefrontal cortices) were activated, but those which process sensory signals (the insula and somatosensory cortex) were not.

These experiments provide convincing evidence that a significant minority of otherwise healthy people experience not just the emotional component of pain, but also the sensory one, when they observe others in pain. When asked about the pain they experience when observing somebody else in pain, all thirty one responders spoke about it as if it was normal, and assumed that their experiences were representative of the population as a whole. Interestingly, no significant relationship was found between the reported levels of pain intensity and empathy, or feelings of disgust or unpleasantness. So although many will readily share the emotional perspective of someone seen to be in pain, and empathasize with them, this is in most cases unrelated to any sensory experience.

It is unclear why observing pain elicited pain in some participants but not others. The pain responders were found to have a stronger emotional response to the images and film clips of injuries, and this was associated with stronger activation of the pain matrix components involved in processing the emotional content of the stimuli. They also reported higher levels of empathy with the people depicted in the photos and films. It is therefore possible that this increased emotional response may drive a secondary reaction in the somatosensory areas. Conversely, the pain experienced by the responders may be dependent on a stronger somatic response, which drives a secondary emotional response.

Osborn and Derbyshire are now investigating whether responders can see things from others’ perspective more readily than non-responders, and if they are more suggestible. Regardless of the underlying neural mechanisms or of individual differences, the knowledge that seeing others in pain can generate painful sensations in some observers may provide insights into the mechanisms of functional pain. It could also help researchers to gain a better understanding of conditions such as chronic pain and fibromyalgia, in which there is often no identifiable physical cause for the symptoms.

Related:


Osborn, J., & Derbyshire, S. (2009). Pain sensation evoked by observing injury in others. Pain. DOI: 10.1016/j.pain.2009.11.007.

Comments

  1. #1 E Wolke
    December 17, 2009

    I wonder if there have been any studies done to correlate this pain empathy with syndromes like fibromyalgia or other “non-obviously-caused” pain syndromes (i.e., chronic back pain and the like)? It would be interesting to see if it correlated with these syndromes one way or the other, though I suspect that suggestibility might be higher for both groups.

  2. #2 Billy Muyo!
    December 17, 2009

    Reminds me of Octavia Butler’s Parable of the Sower

  3. #3 Jan-Maarten
    December 18, 2009

    Fascinating. I wonder (slightly of topic maybe); some people are notoriously bad at keeping left from right, do those people have a higher chance of experiencing mirrored mirror-touch synaesthesia? If so, it would provide a great way to find out more about cognitive, top-down effects on synaesthetic experience!

  4. #4 RMoore
    December 18, 2009

    I agree. This does remind me of Octavia Butler’s Parable of the Sower. She was so brilliant and ahead of her time.

  5. #5 JZ
    December 18, 2009

    This is so interesting! My husband could never understand why I couldn’t watch videos of people falling or getting hurt. All I could say was “It hurts to watch!”… he didn’t believe me that it actually hurt me, physically. Thank you!

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  7. #7 Mihku Paul-Anderson
    December 19, 2009

    Neuroscience is like the new frontier. I, too, am deeply sensitive to things I see. I actually don’t even like to be touched alot, because I pick up things from people, both sensory and other information I don’t care to know. I have trouble filtering it out. I have no idea why I am like this, but I presume something triggered it when I was young.
    I don’t think of it as mysterious, just unexplained at this time. I also have a very strong kinesthetic sense, highly sensitive, but I have no idea if the two are related. My belief is that we will eventually understand how extraordinary our capabilities are, as well as how to more consciously make use of them, through the exploration and study of neuroscience.
    Thanks for the great site!

  8. #8 Jonas Kubilius
    December 21, 2009

    I’m not convinced. Maybe I should read the study for details, but let me say this: Often, studies that look at correlations following the logic “insula lit up –> the subject is feeling pain“ fail to show that insula always responds only to pain. Cause if not, then “insula lights up” could just as well imply that “the subject is feeling cold” (for example).
    The only remedy for that, as far as I know, is to do an adaptation study. For example, subjects would first watch painful pictures, then experience pain themselves. The responders should show decreased activity in the insula when experiencing physical pain (because they adapted/got used to the pain by watching painful images).

  9. #9 Kathy Orlinsky
    December 22, 2009

    @E Wolke
    I found a study about a found a whole new sensory system in the skin:
    http://www.eurekalert.org/pub_releases/2009-12/itd-rfh120709.php

    The researchers think this sensory system might be involved in fibromyalgia or other pain syndromes. Maybe it’s also triggered in people sensitive to other people’s pain.

  10. #10 William Lu
    December 22, 2009

    Did the researchers control for subjects who did and did not have previous serious injuries (e.g. fractured arm). I would imagine pictures and videos of injuries would elicit more empathy from people who had gone through similar painful experiences, perhaps activating already sensitized pain networks in the brain.

  11. #11 Jennifer
    December 23, 2009

    How is this different from what Ramachandran describes in Phantoms of the Brain where he talks about experiments where, with a little bit of work, people can “feel” on their arm, the touching of the table (that their arm is under)?

    I assume it is different, but I’m wondering how.

  12. #12 Crazy Mermaid
    December 28, 2009

    Not to scare him/her, but Mikhu’s comments are interesting because when I was in the late stages of my nervous breakdown/psychotic episode, I had the ability to pick up other people’s emotions. Anxiety from other people would make me so anxious that I had to leave the room full of anxious people in my group therapy sessions at the mental hospital.

  13. #13 Michele Bowling
    December 31, 2009

    I can barely watch a movie or telvision show where someone falls or gets hit. I feel pa[n in my legs whenever I see someone get hurt. Photographs do not bother me, but video is painful to watch. It seems to get worse with age. I thought I was the only one with this problem. My kids think I am crazy.

  14. #14 sac kesim modelleri
    January 1, 2010

    thank you for this post..
    i read and it was very difficult for us
    to be or not to bee..you know..
    thnxx againn

  15. #15 Adair
    January 21, 2010

    Fascinating! I don’t experience physical pain, but I cringe and wince or close my eyes and sometimes have to leave the room when there are pictures of injuries being shown. I’ll have tears in my eyes and start begging for someone to stop if they’re describing a painful injury. So I don’t think feeling the physical pain is necessary for a strong emotional reaction, but it’d be interesting to see more details on the pain-feelers.

  16. #16 Heather
    March 10, 2010

    I am linking to another post here because I think there is a good deal of synchronicity between your posts.

    There is very new research (in mice) with promising results for feeling another’s pain. I have left a comment there about empathy- which interests me because I am researching emotional processing. Empathetic arousal modes include mimicry, conditioning(which linked post research supports with neuroimaging data) and direct association. I’m excited about the direction of this research.

  17. #17 felicci
    March 16, 2010

    i’m glad i found this research of yours… i first heard it on the news here in the Philippines; and i said, hey! that’s me. so, i looked, of course… well, i’m more interested to know how to manage or at least lessen the pain i feel every time i see someone in pain. it’s nice to know i’m not the only one because it batters my self-confidence. i already fainted twice… i’m trying so hard not to have a third one. but there’s no escaping it because it’s kinda part of my job. you see, i’m a nurse… and yeah, this is a major problem. i don’t know how long it would take for me to get used to all of it. i am hoping that your research will somehow help me find answers to this problem.

  18. #18 Karinne
    May 20, 2010

    I have heard of this problem, I exhibit these behaviors responding to pain in others as well, but 100% more on the emotional side. Seeing a woman cry over the loss of a child, HER agony and despair become MINE. A lost child in the store, HER fear and hysteria become MINE. A beloved pet dies, I am hysterical holding my own pet. I can’t watch the news, read the paper, see any dramas that have any kind of tragedy. I will be saddened almost depressed and may cry for days. My empathy is on a different level that I DO NOT LIKE and is very difficult to explain to others. Does anyone have any information on this topic?

  19. #19 Monika
    May 28, 2010

    I expierience the exact physical pain that somebody else is having. If my husbands knee hurts so does mine, my friends daughter hurt her tricep and mine hurts also, when my husbands drummer shoulder hurts mine hurts also and usually it happens without me even knowing the other person is hurting until later and then i put two and two together. It only happens with people that are very close to me. My daughter also feels others pain sometimes but not as much..she is only 15. Does anybody know why this happens?

  20. #20 Blythe
    October 23, 2010

    Like Adair, I cringe and flinch and turn away on seeing someone physically hurt. There is initially a quick “sharp” sensation. The feeling is far worse if a child is hurt. This is becoming more pronounced as I become older.
    Oddly, when I trained as a nurse many, many years ago, this sensation was completely absent when working in the operating room. If the patient was unconscious, I could witness cutting and bleeding with complete aplomb.

  21. #21 Dee
    October 26, 2010

    Omg, both Mikhu’s and Crazy mermaids posts have struck a chord with me. I too seem able to able to ‘tune’ into other peoples emotions after some time spent with them and it can sometimes effect me in the oddest way. E.g. I could be in a calm mood, but after spending time with someone who has hidden anger/grief or anxiety, I seem to absorb it and ‘feel’ it and then that mood takes over me. I hate it and wish I knew of some way I could shut it out or prevent it from affecting me.

  22. #22 Monica
    December 5, 2010

    I get a shooting pain in the back of my legs when I see someone get injured or has had an injury. Just moments ago, I observed a bandage on my father’s finger. I asked him what happened to his finger, and he said he cut it the night before on the lid of a can. I cringed and experienced the shooting pain in the back of my legs.

    I have experienced this painful empathetic response since I was a young girl. My mother would often speak of the pain in her legs associated with others’ pain and now my daughter does as well. Perhaps it is an inherited trait.

  23. #23 Atul Gandotra
    January 10, 2011

    Feeling pain of others, both physical and emotional is one side of the coin while being copassionate to others suffering from pain is another side of the coin.
    A Very few are sensitive and have faith in the other side of the coin.
    People are so self centric and shortsighted that they can not see or they do not want to see anything outside them.
    The offshoot of such an insensitive behaviour is isolation, desperation, distress and depression.
    It is a must to start a crusade in training people on compassion.

  24. #24 Kendall Tingey
    April 25, 2011

    Interesting, I feel the same thing as Monica, a shooting pain in the back of my legs. It tingles. What you said about it being a child makes sense too, because it happens to me. I had wondered about it for a while, and decided to google it. I like that google is an acceptable verb now. Anyway, I think mine has become more pronounced with age too. I’d like to learn more about it. I am a very empathetical person, and can…empathize with those who say they walk away from an angry person feeling angry and a joyful person feeling joyful.

  25. #25 Tim
    April 26, 2011

    Fascinating study. I think this CAN be a really valuable skill, because it might help you to better understand other people – but you should be able to “switch it on” or off so that you’re not overwhelmed by it constantly.

  26. #26 Sherly
    May 3, 2011

    Hmm, this is quite interesting, like Monica and Kendall Tingey, I feel waves of pain in my legs when I see people, usually the elderly, who look like they could be in pain. It even hurts to remember seeing them – for example, my grandmother hurt her arm a few months ago, and thinking about it this morning triggered the pain again (and also made me google this). When she actually had the injury, it was terrible – even though she didn’t look all that concerned about it, I couldn’t stop feeling the pain when i looked at her or thought about her.. I’ve noticing this ever since I was a very small child (I actually think I might have experienced it more frequently then). Sometimes I see people and I feel like crying for them…. I always thought I was just being emo, but maybe I was empathizing (through a valid neurological condition) with their feelings of loss, sadness or loneliness.
    Anyway, keen to hear more about this leg pain thing! I don’t know anyone else who feels it!

  27. #27 James Flames
    May 6, 2011

    I ALSO get shooting pains in the back of my legs, that correspond to the perceived amounts of pain that I am witnessing. When I watch ‘home video’ shows with people falling off bikes etc, it’s a strange experience, as my legs react to each incident with a sort of ‘rating’. It doesn’t seem to dim from the beginning of the show to the end. The pain is not unpleasant but very real, if I am standing up and see someone get hurt, it can cause me to buckle. It’s instantly gone. I don’t think it happens when someone tells me about pain, only when i see it.

    I thought that EVERYONE experienced this until yesterday! Apparently not!

  28. #28 ron
    May 25, 2011

    I experience a very unpleasant sensation in the soles of my feet which has got worse as I get older. I now avoid watching videos of falls or accidents or even thinking about the them. I thought everybody had this sensation to some extent in the soles of the feet.

  29. #29 supratall
    May 26, 2011

    OK, I’ll come clean: this reminds me of an embarrassingly recent conversation with my materials science-trained boyfriend.

  30. #30 Appendix Operation
    June 20, 2011

    I cannot take the sight of such injuries. It gives me the sensation of pain.

  31. #31 Lea
    June 29, 2011

    When seeing someone injured, I have sensation in my legs (on the inside of my knees radiating down toward my calves). This occurs mostly when actually seeing the injury, not pictures or video. I’m writing because I don’t know anyone else who experiences this. It’s nice to know that others do….

  32. #32 Sandra
    June 30, 2011

    I have an painful empathy response in my hips that shoots down my legs when I witness an injury, see the wound of a loved one, or hear about how it happened. This is very similar to what Michele (12), Monica (20), Kendall (22), Sherly (24), James (25), Ron (26), and Lea (27) have shared above.

    As background, ever since I was 5 years old, I was aware of a strong connection between the passage of time and a spatial reference point (dates in a year are represented in an “annual calendar” which is represented in a full circuit around the horizon). This is known as a form of synesthesia, which is a confusion or overlap of sensory inputs and experiences. For me it’s time and space. For others it’s vision and hearing, or shapes and tastes, etc.

    I have always thought that somehow my synesthetic experience is tied to the quality of experiencing the pain of others … like it’s a heightened sensory perception.

    My family gives me a hard time when it comes to movies and television. I find it extremely painful to witness cruelty or malevolence. For me the visual aspect is the most difficult. If I leave the room, I can often wait it out, still listening, and return when it’s “safe”.

    I’m curious about how medical professionals understand these phenomena and how they’re being educated about such things in medical school. When is one person’s “disorder” another person’s “order”?

    PS: I had no idea that so MANY people experience this pain down their legs! I feel less alone.

  33. #33 chasity
    July 3, 2011

    So good to see Im not the only one that gets these feelings of pain or sharp shooting sensation but mine doesnt primarily stay in my legs its happens to the backs of my arms as well when ever I see someone in pain it doesnt have to be some one close to me it can be anyon being phycally harmed… in person or on TV…anyone else know anything about this..please email me

  34. #34 Lynn
    July 18, 2011

    Thank goodness I am not crazy. So good to read that others suffer this strange wave of tingles in my legs when I see others hurt or injured. When watching medical shows on tv, I get these feelings and have to turn away or close my eyes. When I think about others falling down or getting cuts, I cringe and tingle. Thanks for the infomation.

  35. #35 Sarah
    July 31, 2011

    Oh! I thought everyone felt that ‘electric / heavy tingling’ sensation when they saw someone get hurt! Well, at least I have some insight into how my husband can bear to watch Jack Ass, though I certainly can’t empathise with him! I’ve been know to walk out of the cinema because the film was just too violent to bear! Like Ron, these feelings have become more intense as I’ve got older, especially after I had my children. The sensations I get can be in any of my limbs or in my tummy. What I’m curious to know though, does anyone get these similar feeling in a pleasurable, sexual context – or am I just super weird?

  36. #36 Sarah
    August 1, 2011

    Response to Jonas Kubilius

    Jonas – I am not convinced an adaptation study would be helpful in understanding this phenomena. I notice that many people here describe a generalized sensation, not a replica of the pain they have witnessed, or even any sort of pain. Shooting, tingling, sharp are used to describe the sensation. One person describes it as unpleasant. Personally I find it nether unpleasant or pleasant in itself. If I see a child fall over and graze their knee I feel this physical sensation and I wince and hurt *emotionally* – it is a distressing feeling. However, in other contexts (for example, reading a book and something unexpected happens in the story) I can experience to same electric / tingling sensation and perceive it as exciting / pleasurable. I can think of a parallel in ‘tickling’ – it can be funny and make you laugh – or it can be intensely annoying. The sensation is a physical feeling; it is the context that gives it an emotional interpretation.

  37. #37 Gina
    August 15, 2011

    For as long as I can remember, I have experienced “empathy” pains in my legs. I always thought it was normal until I was 12 or 13 years old when I was told at the lunchtable that no one else experienced it and thought I was weird. My grandmother and brother experience it too! I also have intense and sudden outbursts of sadness when I see others that are sad. I will cry hysterically, even if it’s just a commercial. I’d love to know what causes these things to happen…