Stuff You Should Know - Must We Suffer Emotional Pain?

Episode Date: January 31, 2023

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.See omnystudio.com/listener for privacy information.

Transcript
Discussion (0)
Starting point is 00:00:00 What would you do if a secret cabal of the most powerful folks in the United States told you, hey, let's start a coup? Back in the 1930s, a Marine named Smedley Butler was all that stood between the U.S. and fascism. I'm Ben Bullitt. I'm Alex French. And I'm Smedley Butler. Join us for this sordid tale of ambition, treason, and what happens when evil tycoons have too much time on their hands. Listen to Let's Start a Coup on the iHeart radio app, Apple podcast, or wherever you find your favorite shows. I am Dr. Romany, and I am back with season two of my podcast, Navigating Narcissism. This season, we dive deeper into highlighting red flags and spotting a narcissist before they spot you. Each week, you'll hear stories from survivors who
Starting point is 00:00:44 have navigated through toxic relationships, gaslighting, love bombing, and their process of healing. Listen to Navigating Narcissism on the iHeart radio app, Apple podcast, or wherever you get your podcasts. Welcome to Stuff You Should Know, a production of iHeart 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 Know. Not emotionally painful, right this second. That's not true. Not at all true. I'm just really good at masking, mind. Oh. How about you? I'm feeling pretty good today. I'm glad, man. In this moment. But this is an interesting topic, because as we'll see when we cover our history section
Starting point is 00:01:39 here at the beginning, and thanks to Olivia for helping out with this one, right? Wouldn't it, Olivia? Yeah, she wrote this right around Christmas too. I felt kind of bad. Yeah. It's like, do one of puppies next. Right. We will soon learn, and it's probably no surprise that things like emotional pain and mental distress have quite often, and still quite often, take a backseat in the West, and then the medical world, and it's sort of, not 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, so there's no new concept to it that you're just going to be like, oh, that's emotional pain.
Starting point is 00:02:26 Anytime you felt like heartache, sadness, embarrassment, something where you felt like your body was responding to a sudden emotion, that's emotional pain, right? Yeah. 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 real pain, your leg is missing right now, and I need to sew it up. You're like, no, but I'm emotionally
Starting point is 00:03:06 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 Descartes. That's right. I studied Descartes in college a bit, and this was a big deal. But in the 17th century, Rene Descartes proposed the idea of dualism with a mind and body. And you think like, okay, great, that kind of makes sense in a way, and especially in the 17th century. But that was a big deal that really, it was sort of a sea change and a fundamental split that happened, in which European medical science 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 mental illnesses were really a distinct, separate thing from physical
Starting point is 00:03:55 maladies. Yeah, and still today in Western medicine, we do not combine those two, which is, there's other cultures like traditional Chinese medicine, Indian Ayurvedic medicine, that they see mental and physical pain as pretty much at the very least deeply connected, not two completely separate things, one of which may or may not exist, like we believe in Western medicine. And to be able to trace it back to this point where the early medical doctors were like, I call body, and the church was like, oh, 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,
Starting point is 00:04:44 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, he was short and he was skinned. They were both skins. Oh, wow. Yeah, it was a sexy day. People like Sigmund Freud, it's not like no one ever talked about emotional pain in the West, or it was studied or anything like that. It was just that separation. Freud, he did write about psychological pain as did a lot of people that followed Freud, or not necessarily Acolytes of Floyd, but people that followed after him, and kind of wrote about more in the terms of like
Starting point is 00:05:29 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 what we're talking about today, which is this mind, body connection where, and as we'll see where study after study kind of, and again, it's the 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 that. 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. There's a term called psychic that a guy named Edwin Schneidman coined. I like that term.
Starting point is 00:06:22 Psychic? Yeah. It's so 90s. It sort of is now that I think about it. That is a 90s term, psychic, all one word, right? Sure. And Edwin Schneidman, he did coin it in 93, and he basically said it's just another term for psychological anguish, and that he was a suicidologist, and he believed that psychic was essentially behind every single suicide that was ever attempted or completed, and he kind of chalked it up to a few different things. And you'll kind of see in the 90s and then kind of expanding today, it's kind of expanded and 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 feel like you
Starting point is 00:07:19 yourself are at fault somehow. Yeah. And there's, again, as we'll see, it's a very hard thing to study. It's pain period is super subjective, as we all know, physical pain is subjective, emotional pain, maybe, no, it's probably about equally subjective, none of the think about it. Yeah. 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 as psychic, like somebody may be really good at getting over stuff like that a lot better than someone else. The level of the event may not necessarily always correlate to a level of emotional pain in any given individual. Some people maybe can process somebody's passing or death really, really well because they just get drunk all the time.
Starting point is 00:08:11 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 a chronic emotional pain that people feel that's tied to certain disorders of obviously depression can be a big factor, but all these things aren't mutually exclusive either. No, 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 10 years maybe, have come up
Starting point is 00:08:56 with a consensus definition from what I can tell. Let's hear it. 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. The basic emotion of psychic pain, psychological pain, emotional pain, is self-disappointment. You're in an aversive state where you have a high self-awareness of inadequacy and that that is what you can 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 things that might be brought on by what you might think of as
Starting point is 00:09:49 stress, but if you experience sort of chronic mental anguish and emotional pain, a lot of times it is just an overall body woundedness that you might feel that you can't specifically, and that's sort of one of the issues, is you don't walk into a doctor in America and say, my whole body feels off because I'm in emotional distress. They're going to say, well, you've called the wrong doctor. Right here, take these sugar pills and go home, but also give me $5,000. Right, and I'm sorry about the weight. So they're not really sorry about the weight. They may say that, Chuck, but they don't mean it. What's social pain? Social pain is either the same thing as emotional pain or it's kind of a subset of it, but they say it's strictly from
Starting point is 00:10:45 social interactions like rejection, being dumped, damage to your social connections. FOMO. FOMO, that would be one. Yeah, it's like a joke that people say, but that is very real with some people. Right, and so like when you feel FOMO, you feel bad. It's not just in your head. It's so hard to get across. 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 would your body feel at all weird? Why wouldn't it just be strictly in your emotions or 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 too,
Starting point is 00:11:34 your body actually feels bad, wrong, off, pained, 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 physical pain system. And because social bonds were so important to survival that it became a thing where you felt pain when those social bonds were threatened or broken. Right. Like Tuk Tuk very sore from long hunt today, but Tuk Tuk feel especially painful today because Tuk Tuk not invited to main fire. Tuk Tuk doesn't use prepositions. Should he? I don't know. It depends. If he's like unfrozen caveman lawyer, yes.
Starting point is 00:12:39 Right. Yeah. So the thing is, is what Tuk Tuk would have learned from there, Chuck, from that experience is 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 it 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.
Starting point is 00:13:34 What would you do if a secret cabal of the most powerful folks in the United States told you, hey, let's start a coup. Back in the 1930s, a Marine named Smedley Butler was all that stood between the US and fascism. I'm Ben Bullitt and I'm Alex French. In our newest show, we take a darkly comedic and occasionally ridiculous deep dive into a story that has been buried for nearly a century. We've tracked down exclusive historical records. We've interviewed the world's foremost experts. We're also bringing you cinematic historical recreations of moments left out of your history books. I'm Smedley Butler and I got a lot to say. For one, my personal history is raw, inspiring and mind blowing. And for another, do we get the mattresses after we do the ads or do
Starting point is 00:14:18 we just have to do the ads? From I Heart Podcast and School of Humans, this is Let's Start a Coup. Listen to Let's Start a Coup on the I Heart Radio app, Apple Podcast, or wherever you find your favorite shows. I'm Dr. Romany and I am back with season two of my podcast, Navigating Narcissism. Narcissists are everywhere and their toxic behavior and words can cause serious harm to your mental health. In our first season, we heard from Eileen Charlotte, who was love bombed by the Tinder swindler. The worst part is that he can only be guilty for stealing the money from me, but he cannot be guilty for the mental part he did. And that's even way worse than the money he took. But I am here to help. As a licensed psychologist and
Starting point is 00:15:10 survivor of narcissistic abuse myself, I know how to identify the narcissist in your life. Each week, you will hear stories from survivors who have navigated through toxic relationships, gaslighting, love bombing, and the process of their healing from these relationships. Listen to Navigating Narcissism on the I Heart Radio app, Apple Podcast, or wherever you get your podcasts. MySpace was the first major social media company. They made the internet, which up until then had been kind of like a nerdy space, feel like a nightclub, and also slightly dangerous. And it was the first major social media company to collapse. Rupert Murdoch lost lots and lots of money on MySpace because it turned out it was actually not a good business.
Starting point is 00:16:00 My name is Joanne McNeil. On my new podcast, Main Accounts, The Story of MySpace, I'm revisiting the early days of social media through the people who lived it, the users. Because what happened in the MySpace era would have sweeping implications for all the platforms to follow. Listen to Main Accounts, The Story of MySpace on the I Heart Radio app, Apple Podcast, or wherever you find your favorite shows. This is a tough one to joke about, you know? Yeah, no, it is. But I think more than anything to me, it's a tough one to talk about. And I don't understand why. Maybe it's because it's not fully understood yet, so I'm having trouble
Starting point is 00:17:03 understanding or explaining it, you know? Yeah, and when I say joke about, of course, I mean joke alongside, none of this is joke worthy. But we're a part comedy show, so we try to work in these angles when we can, right? Yes, the funniest is when we explain that we're making jokes about it and why, but why we really shouldn't or that they don't really count. I think new people come along. Did you see somebody who was very upset about your awesome, awesome Midwest joke? Which one?
Starting point is 00:17:35 From Mara. And Memphis Gerald 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 it was a great joke. I said, I was trying to think of the game, the card game, Euker. Oh, no, it was in Tarot cards. And I said, what was that game? I said that Midwesterners often played and you went, get me out of here. And then this person, I said, it was just a joke, of course, and that you're from the Midwest. So you can say that in this person, I think felt a little bad even, which I then felt bad about.
Starting point is 00:18:19 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 FMRI, we actually know that the same parts of your brain that are responsible for experiencing different types of physical pain, they light up, they become active in the presence of emotional pain. And they did this by basically inflicting emotional pain on poor participant studies and then seeing what their
Starting point is 00:19:02 brains did. Yeah. And here's the thing with a lot of these studies, what's important, I think, to know is that it wasn't necessarily in an exact time of crisis. 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 see, it's like studying your brain during resting rates or your heart during resting rates. And it feels like it's more, and I'm not saying they're all in emotional pain still, but they didn't juice these studies by getting just these 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
Starting point is 00:19:51 emotional pain on you. In the experiment, they would be playing a game with other subjects, and they would exclude the actual study participant from the game. Yeah. Or they would tell them that one of the other participants admitted to not liking them, and they would show them 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. With a K. Yeah. Chris Cross style. He'll make you jump, jump for his study results. I wonder if he wears his clothes backwards when he presents his findings. Those kids made like a million dollars from wearing their clothes backwards at the mall once. Oh really? Just to go out there and do that? That's how they,
Starting point is 00:20:38 I mean, no, that's how they, that's how they were discovered at the mall. Oh. Discovered them. Wow. Yeah. What a world. It is a world. But anyway, back to Ethan Chris 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 were 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. Yeah. Or 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, mm-hmm. Very interesting. I see. And watched their brains do different things. Yeah. And they said, how did you get that picture? Don't ask about that.
Starting point is 00:21:28 They give them a zap when they ask too many questions. Yeah. And I think there were about 40 people in this study. And again, he eventually used, he used the fMRI eventually, right? Yes. And what he found out was that the negative emotional state 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. Right. So I think there's something about heat and 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
Starting point is 00:22:18 fMRI 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 the brain regions associated with our effective experience about the aversive quality of pain, which is, like, if you hurt yourself physically, right, you are, you're suffering. That suffering is your desire for that pain to stop. You want it to go away. It's like hurting you existentially. It goes beyond just the actual physical experience, the sensory experience of it. That's the, 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
Starting point is 00:23:12 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's 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
Starting point is 00:23:57 and it's this almost like this fear response in me. So it's hard to believe that, you know, something like fight or flight is just so universally accepted, but something like this, which to me is the same thing going on, can still be poo pooed. Yeah, poo poo for now, but not much longer, I predict. Yeah, 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. Yeah. 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 the vagus nerve that connects the brain through the
Starting point is 00:24:42 chest and your abdomen and into your, I believe your junk area because it's activated during orgasms from our orgasm episode years back. I think the middle term is your bits. But they, oh, okay. They found that the anterior singular cortex activates the vagus nerve, which can become overstimulated in the presence of a huge jolt of emotion, which can transfer to the vagus 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 crazy. You really are feeling that way. Yeah. And like I remember feeling this stuff from the time I even knew what feelings were. Nobody likes to be picked last as far as the social pain. No one likes to
Starting point is 00:25:39 be embarrassed in front of people, but that stuff doesn't stop. The social thing, like when we're talking about it, it might sound like obviously something you will experience in adolescence and growing up, but that stuff doesn't go away. No, it really doesn't. At least it didn't for me. 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 just seems like part of, and 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. And it's totally true. I think people who don't have to deal with that are really just dealing
Starting point is 00:26:25 with it less than other people. I don't think anybody's ever managed to eradicate emotional pain from their lives, you know? Yeah. 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 bearing that stuff or what have you. Yeah, like Flanders types. Right. Exactly. There's one other thing about 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. If you put your hand on like a hot oven, you can pull your hand away. But if you experience like an emotional injury and you feel emotional pain, you can't
Starting point is 00:27:08 like hold your hand. You can't run it under water. There's nothing you can do right then to stop it except for essentially self soothe 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. And that's an acute thing. I totally agree. But what I think is 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. Right. And whenever 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
Starting point is 00:27:57 in reference to the podcast kind of helping calm them down in some way, which is really nice to hear. But I always tell people the same ways, 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? Right. Self soothe. Yeah. But it's more than self soothe to me because it's like, 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 it's soothing, but it's also doing something to your body. And interestingly, we'll talk about things you can do. You just nailed a bunch of them,
Starting point is 00:28:42 but apparently walking outside in nature is a really great way to, I guess, alleviate emotional pain. And like if you have a forest, great, walk around the forest. If you have a meadow, walk around a meadow. If you have a public park, walk around the park. Just getting outside can help a tremendous amount. Yeah, I agree. I think that's a really nice thing that you say to people though, Chuck, my pat response is, hey man, keep on trucking. Right. Is, hey, just like that mudflap says. Yeah. No one ever writes back. Although if they do, they're like even madder than they were before. They're more upset than before. Yeah, it's weird. People are strange. Do you want to talk about drugs? Yeah, this is really interesting to me, this first bit on acetaminophen, because
Starting point is 00:29:32 and I had no idea about any of this, but they have found out through studies that acetaminophen, like Tylenol or other types of generic painkillers, it actually can dull you emotionally. I'm wondering about to what degree because they say it can dull that like the social pain that you might feel if you're foam odor left out of something. Yeah. 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 acetaminophen. And that was really surprising. The converse is true too. Because you're less empathetic, you experience fewer positive emotions too. So the weird thing is, it's not like it affects your brain or your processing of events. You're fully aware of like,
Starting point is 00:30:23 this is a really great thing my friend's telling me. And I understand that my friend is proud, reasonably proud for this, but I don't feel at all happy for them because of the acetaminophen. 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. I don't really ever take that stuff that much, but I feel like even, you know, just the 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 your hand is suddenly making trails of itself, even though that's the first time you've taken this, you noticed that that happened because it was a pronounced effect. Same thing with, you know,
Starting point is 00:31:06 emotions being blunted with acetaminophen probably. Good point. Opioids, obviously, is something we can't not talk about such and, you know, we should probably tackle bits and pieces of the opioid epidemic in full episodes. But opioids are interesting in that sometimes you might be taking them for a real physical malady and you happen upon 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. Sure. Basically anything that can give you some sort of positive feeling
Starting point is 00:31:55 can be, you know, used to stave off emotional pain. Yeah. 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. Sure. Especially if they haven't found a better way yet to deal with it. Yeah. So, you know, I mentioned before that all kinds of pain is very subjective and especially emotional pain. And obviously, because of that, it's a really hard thing to quantify. 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 are scores of data behind it and they talked with a bunch of people who live with mental pain
Starting point is 00:32:43 and they kind of signed off on it. It's weird that they haven't really done that, but 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 use the Orbach and Michelin Sir mental pain scale pretty frequently. But the problem is there was a review of 10 major scales that are used around the world that was published in 2022 in the British Medical Journal. And they said, none of these seem to be valid. Like they're all, they might as well be like tea leaves and lizard guts. Like that's 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
Starting point is 00:33:29 out how to do it better. So essentially the upside 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. So I hope that's not the case. It's called getting wonky. It's no surprise. We mentioned a little bit earlier about other conditions related to mental pain. I guess comorbidities, 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 like an heartbreak to
Starting point is 00:34:19 drug withdrawal and it makes a lot of sense because when you are in love 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 is taken away from you, that's sort of like drug withdrawal because you've got all sorts of 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 sixth to ninth grade. Sixth to ninth, man. Boy, through college. Okay, sure, fair enough. Welcome to sixth grade through the rest of your life. How about that? Kind of. The thing is, is because you're experiencing this and because you're experiencing stress, like when you undergo
Starting point is 00:35:11 rejection or a sense of betrayal or a sense of loss, your body actually does relief cortisol, 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 called Can You Dive a Broken Heart and the answer is yes, you can. There's something called Takosubo cardiomyopathy, which is a sudden emotional or physical stressor basically weakens the heart and you basically have a heart attack from 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?
Starting point is 00:35:57 Let's do it. What would you do if a secret cabal of the most powerful folks in the United States told you, hey, let's start a coup? Back in the 1930s, a marine named Smedley Butler was all that stood between the US and fascism. I'm Ben Bullitt and I'm Alex French. In our newest show, we take a darkly comedic and occasionally ridiculous deep dive into a story that has been buried for nearly a century. We've tracked down exclusive historical records. We've interviewed the world's foremost experts. We're also bringing you cinematic historical recreations of moments left out of your history books. I'm Smedley Butler and I got a lot to say. For one, my personal history is raw, inspiring and mind blowing. And for another, do we get the mattresses after we do
Starting point is 00:36:52 the ads or do we just have to do the ads? From iHeart Podcast and School of Humans, this is Let's Start a Coup. Listen to Let's Start a Coup on the iHeart radio app, Apple Podcast, or wherever you find your favorite shows. I'm Dr. Romany and I am back with season two of my podcast Navigating Narcissism. Narcissists are everywhere and their toxic behavior and words can cause serious harm to your mental health. In our first season, we heard from Eileen Charlotte, who was love bombed by the Tinder swindler. The worst part is that he can only be guilty for stealing the money from me, but he cannot be guilty for the mental part he did. And that's even way worse than the money he took. But I am here to help. As a licensed psychologist and
Starting point is 00:37:45 survivor of narcissistic abuse myself, I know how to identify the narcissist in your life. Each week, you will hear stories from survivors who have navigated through toxic relationships, gaslighting, love bombing, and the process of their healing from these relationships. Listen to Navigating Narcissism on the iHeart radio app, Apple Podcast, or wherever you get your podcasts. MySpace was the first major social media company. They made the internet, which up until then had been kind of like a nerdy space, feel like a nightclub and also slightly dangerous. And it was the first major social media company to collapse. Rupert Murdoch lost lots and lots of money on MySpace because it turned out it was actually not a good business.
Starting point is 00:38:35 My name is Joanne McNeill. On my new podcast, Main Accounts, The Story of MySpace, I'm revisiting the early days of social media through the people who lived it, the users. Because what happened in the MySpace era would have sweeping implications for all the platforms to follow. Listen to Main Accounts, The Story of MySpace on the iHeart radio app, Apple Podcast, or wherever you find your favorite shows. So I think one of the first things people think about when they think of emotional pain is depression. 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 depression, if you have really high levels of emotional pain, it's not
Starting point is 00:39:49 necessarily correlated with the largest burden of depression. So if you put 10 people together and you've got one guy who's the most depressed of all, he's not necessarily the person with the greatest levels of emotional pain, which suggests that depression and emotional pain are not one in the same. Depression is its own thing. It has other symptoms. It just correlates very strongly with emotional pain, which seems to be one of the leading symptoms of depression, but not 100% what depression is. They're not interchangeable. Yeah. And a lot of these that we're talking about here, they're weaving in and out of each other all the time in some cases. But I think the distinction is still important to make though, rather than just lumping it in as all one kind
Starting point is 00:40:36 of thing. And eating disorders too. A lot of people are like, you got an eating disorder, you really like the food. 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 these people can use to cope, that they can use to feel better about themselves or forget or distract themselves for a little while. But really what they're doing is dealing with 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 2021 that I'm surprised it wasn't higher, honestly, that found that 44% of disordered eating patients experience significant mental pain compared to 6% of
Starting point is 00:41:20 the control. So that's quite a jump. Yeah. I mean, that's huge. That's pretty much all you need to say. What else, Chuck? Well, this is sort of the big one. I mean, they're all big, but borderline personality disorder, BPD, this may be 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 might suffer. Because a lot of times, for many reasons, but a lot of times you suffer from BPD because of childhood abuse or childhood neglect. Sometimes there's some genetics thrown in there, but this is stuff that's very, very deeply rooted in somebody. Yeah. And so it's chronic mental pain, especially those related to narcissistic wounds, where you feel a sense of rejection and it just completely undermines your
Starting point is 00:42:16 sense of self-worth and pride. But the way that it manifests itself in people with borderline personality disorder is that they might have inappropriate anger. They might dissociate from themselves or reality. They might feel emptiness. They are emotionally unstable in most cases. And what I saw it ascribe to is that essentially, because of that childhood neglect or abuse or trauma of some sort, they become so afraid of being abandoned that they actually alienate people with their behavior, which that sounds to be like an old medieval curse, essentially. Like the more you try to keep people around you the further away they're going to get and you're really going to want them to be around you. That sounds about as awful in a fiction as
Starting point is 00:43:05 you can have, really. Yeah. And you shouldn't be surprised that if you suffer from borderline personality disorder, you're way more likely to abuse or misuse substances, maybe suffer from that eating disorder we were talking about, have obviously anxiety, depression, 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 DSM is concerned. And it can be its own symptom. It can be a symptom of other things, like people with BPD often engage in non-suicidal self-injury. But essentially what it is is self-cutting, punching a wall like a bunch of times. What they frequently thought was that
Starting point is 00:44:01 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'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 and euphoria by cutting themselves or by punching the wall or whatever self-injurious behavior they're engaged in. And that that's really what's behind it. But that what differentiates them from people who don't engage in that
Starting point is 00:44:46 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. 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. In fact,
Starting point is 00:45:36 that phrase rejection sensitive dysphoria isn't even part of the medical community. Like they haven't even I guess what would you call that? Well, the medical community a lot of it accepts that it exists but it's not in the DSM. So it's technically not an actual diagnosis. Is that what it is? Yeah, that's my understanding. All right. And this could obviously go along with some other neurodivergences, other mood disorders. Like we said, a lot of these are sort of crisscross each other but they might experience mental pain or discomfort and feel this rejection that we keep talking about and the thing that really stood out to me or interpret like something ambiguous as rejection. Right. So when they're rejected, when you feel rejected and you have RSD, you have a
Starting point is 00:46:27 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 misspoke about, telling you that you're doing something wrong. Anything 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. Suicide, we've talked about here and there throughout the episode. Obviously, that's a big risk if you're suffering from depression
Starting point is 00:47:19 and BPD but emotional pain. And again, this is something that we want to draw a 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 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 sense is there's suicidal ideation and that that can be a coping mechanism for people who are at risk of suicide and that they're basically saying like, 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's suicidal ideation. And some people just use that to get by and get through emotional pain to
Starting point is 00:48:15 just remind themselves that it's not that bad yet. Right. Well, I had not heard of that. But I mean, I get the basis of it. It's very, very saddening but I get the strange logic behind it, you know. Yeah, for sure. All right. So we would love to end on a bit more of a positive note, which is there are treatments for these things. Like we mentioned, it is an evolutionary signal when you're feeling emotional pain to do something about it. It is your body saying, hey, this is 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 treatments and there are quite a few treatments that are out there for you, right? Yeah, there's cognitive behavioral
Starting point is 00:49:05 therapy which basically says you, 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 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 toward treating emotional pain. One's called dialectical behavioral therapy. It's been around since the 70s. A psychologist named Marshall Linehan came up with it. Yeah, this one's interesting
Starting point is 00:49:53 and they say that this is one of the best treatments if you suffer from borderline personality disorder to undergo and if you, everyone experiences emotional pain but if you experience these things really, really, really intensely then this DBT might be for you. It's called dialectical because 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 piece to DBT as well as ACT acceptance and commitment therapy, right? Yeah, dialectical means like things that are concepts that are in logical opposition to one another. This one makes a lot of sense. I thought it was pretty cool. They also, one of the big
Starting point is 00:50:44 things about DBT is there's group therapy and you practice your skills in it. So you're like, watch this emotional regulation everybody. I'm not quite sure what the groups are like, but I saw that it was more akin to a classroom setting than a group therapy setting. Yeah. There's also acceptance and commitment therapy. It has a lot of the same ideas behind it basically that you need to accept that you feel emotional pain and kind of move on without or move on with it. Make the best of your life using mindfulness techniques typically. Both of those things, they center on the idea of you have emotional pain. There's not a lot. You're never going to free yourself from emotional pain. So let's teach you the person how to deal with emotional
Starting point is 00:51:35 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 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 Mark Rigo. He's a psychiatrist at Yale and he's on the other side and says we need to figure out how to treat emotional pain. You're not going to get any great signals or any great understanding from your emotional pain. We need to get rid of it however we can. And that's 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
Starting point is 00:52:18 way more acute or way more chronic emotional pain that's actually debilitating and rather than them 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 ACT and work it out. But 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 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. Like I can be this and also be something else. Totally.
Starting point is 00:53:02 Which is I think can be very empowering. I mean, I've learned a tremendous amount from my therapy and it's essentially geared toward that. Like you said, I'm not my behaviors. I'm not my thoughts. I'm not my feelings like I am the kind of the sum total of all of those things. And also just learning not to be such a negative Nellie. Same here, my friend. You got anything else? I got nothing else. All right. Well, if you want to know more about emotional pain, just 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.
Starting point is 00:53:45 What? First ever, our old pal, John Hodgman, friend of the show and friend of ours in real life, called me. He still listens to our show some. Oh, really? Yeah, which made me feel really good. It's shocking. Yeah, that's great. I doubt if he listens to him all. He probably surfs through and skips around and listens to
Starting point is 00:54:07 what might appeal to him. But he he listened to the episode on the word and phrase origins, which, you know, John, of course, is a talented orator and wordsmith. So it's not surprising that one jumped out at him. But he called because he wanted to talk about the P.U. Remember when something stinks? Yeah. 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 evolutionarily
Starting point is 00:54:46 speaking means it could be poisonous. You go, you know, like spit something out and he thinks P.U. may have evolved from that. I saw other places that it's kind of a nuanced version of that where like when you get smacked in the face by a disgusting smell, like the exclamation you make involuntarily is like P.U. Yeah, kind of that kind of thing. It makes sense. And just something I think you'll enjoy have been holding out on this to tell you. He said, and by the way, he said, did I retell you, Chuck, that for the first couple of years I listened to this show before I knew you guys, I thought you had a ponytail.
Starting point is 00:55:27 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 know. Just 10 or months. So thanks to Haji, good guy, good friend. Yeah, great guy.
Starting point is 00:55:43 Thanks a lot, Haji, 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. In the meantime, you can also send us an email to stuffpodcastatihartradio.com. Stuff you should know is a production of iHeartRadio. For more podcasts, my heart radio, visit the iHeartRadio app. Apple podcasts are wherever you listen to your favorite shows. What would you do if a secret cabal of the most powerful folks in the United States told you, hey, let's start a coup?
Starting point is 00:56:25 Back in the 1930s, a Marine named Smedley Butler was all that stood between the U.S. and fascism. I'm Ben Bullitt. I'm Alex French. And I'm Smedley Butler. Join us for this sordid tale of ambition, treason, and what happens when evil tycoons have too much time on their hands. Listen to Let's Start a Coup on the iHeartRadio app.
Starting point is 00:56:45 Apple podcasts are wherever you find your favorite shows. MySpace was the first major social media company. They made the internet feel like a nightclub. And it was the first major social media company to collapse. My name is Joanne McNeil. On my new podcast, Main Accounts, the Story of MySpace. I'm revisiting the early days of social media through the people who lived it. Listen to Main Accounts, the Story of MySpace on the iHeartRadio app,
Starting point is 00:57:15 Apple podcasts, or wherever you find your favorite shows. I am Dr. Romany, and I am back with season two of my podcast, Navigating Narcissism. This season, we dive deeper into highlighting red flags and spotting a narcissist before they spot you. Each week, you'll hear stories from survivors who have navigated through toxic relationships, gaslighting, love bombing, and their process of healing. Listen to Navigating Narcissism on the iHeartRadio app,
Starting point is 00:57:45 Apple Podcasts, or wherever you get your podcasts.

There aren't comments yet for this episode. Click on any sentence in the transcript to leave a comment.