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25.

THE PHYSICAL AND THE EMOTIONAL: ONE AND THE SAME IN THE HUMAN BRAIN

A human being who faces perpetual fear and chronic stress is well on the way to brain damage. Given the overlapping symptoms of mind and body, physical decline is not far behind a mind that is in the throes of distress.

ALL OF THE hesitations about granting recovery for emotional injury—the fraudulent claims, the doubts surrounding their subjective, unprovable nature, the risk of allowing hypersensitivities to trap us all in a police state where every errant, innocuous word could lead to a jail sentence—are mollified given what we now know about the real effects of harmful speech. Intentionally assaultive words cause stress, and prolonged stress leads to physical harm—quite apart from the more obvious and direct psychological damage. Recent neuroscientific discoveries provide medical confirmation that speech can be a form of violence.

Psychologist and scholar Lisa Feldman Barrett has been at the forefront of research discoveries related to the study of emotion. In her recent book, How Emotions Are Made, published in 2017, she addressed specifically the false dichotomy under the law between physical injury and emotional harm. The danger that emanates from words is an open secret with serious consequences. And the failure to have acknowledged this obvious truth has had all the staying power of an urban myth that everyone mystifyingly believes. Barrett states that “emotional harm can do more serious damage, last longer, and cause more future harm than breaking a bone. This means the legal system might be misguided when it comes to understanding and gauging the degree of lasting injury that can come from emotional harm. Chronic stress manifested in psychological illness doesn’t stop merely with the brain. It eventually has the potential to lead to physical illness and injury. Rather than dismissing the consequences of emotional harm, it is time for the legal system to recognize that emotional damage can shorten a life.”²³⁷

The human brain, apparently, does not compartmentalize injury in the same way as courts do. When the brain is activated from the neural sensations of pain, it apparently cares little for how it got there—whether the body received a jolt or whether the pain struck below the surface of the skin. The mind is blind to external bruising, whereas the legal system believes that it has no role in resolving disputes unless a tangible, material, visible mark is created from a human interaction gone wrong. In the workings of the human brain, chronic pain, stress, anxiety, and depression are all constructed in the same manner as how emotions are made. External physical pain and interior emotional hurt are not opposite human reactions. They are twin expressions of damage.²³⁸ In fact, there is even a placebo test that can prove their symbiotic relationship, which is called a nocebo. In a routine injection, before the needle even touches the arm, the brain can actually simulate the feeling of physical pain. The physical pain was felt without there being an external incident to justify the sensation. It was all in the head. The mind did all the work.²³⁹

The irony of this phenomenon should not be lost on the legal system. Given all the efforts to separate physical from emotional injury, the bruising of the body, and the swelling and inflammation it causes, has its own analog in the brain, which is not without deleterious effects on the emotions, as well. The legal system has continually bought into an anatomical falsehood: The human brain is inactive when the body endures and registers physical injury. Wholly untrue. Physical injury is chronicled in the brain just as severely.

Whenever there is injury or illness, cells secrete cytokines, which are proteins that produce inflammation. Blood surges to the affected region, raising the temperature around its source, and causes swelling. In response to chronic stress or fear, social rejection and loneliness, even the worry that comes from persistent poverty, the body releases too much cortisol. The body can actually become flooded with cortisol and cytokines, to its considerable detriment. The consequences of having too much cortisol in the bloodstream is an increase in inflammation, due to the presence of so many proinflammatory cytokines. Neurobiologist Amy Arnsten at Yale University conducted studies demonstrating the significance of increased chronic stress and its flooding of the body with cortisol. Cortisol is a stress hormone, which, among other things, manages the flight or fight impulse of a human being. Taxing the mind with this existential decision—whether to flee or fight in response to a physical threat or verbal humiliation—releases a hormone that, in excess, is dangerous to one’s health. Cortisol can damage the cells in the hippocampus, overwhelming the brain with enzyme kinase C, which breaks down the dendritic spines of neurons in the prefrontal cortex of the brain.²⁴⁰

Professor David Alexander, director of the Aberdeen Center for Trauma Research, has conducted extensive work with survivors of disasters—the Asian tsunami, an earthquake in Pakistan, the war in Iraq, the Piper Alpha oil-rig disaster, and others. Of his many discoveries is the link between physical and emotional pain. Whether it derives from a physical or emotional setback, pain is activated in the anterior cingulate cortex of the brain. The triggering of pain makes little distinction between its original source—interior emotion or external body are equally prickly; the mind plays no favorites for pain purposes. The grief-stricken from bereavement are vulnerable to heart attacks and strokes. Humans can actually die of a broken heart. The hormones involved in managing the stress of bereavement leave a lasting imprint—on the mind and body. Alexander noted that if one listens to people who are damaged emotionally, they will refer to their pain by using physical descriptions: “‘My head is bursting, my guts are aching’ and so on. The parallel is very strong.”²⁴¹

According to Feldman Barrett, inflammation is problematic everywhere, but especially in the brain. A chronic condition of inflammation irreparably damages an immune system and causes illnesses such as diabetes, obesity, heart disease, depression, premature aging, mental illness, and dementia.²⁴² And one particularly toxic culprit of inflammation is assaultive speech. Wounding words, too freely spoken, bring about sickness, alter the brain, destroy neurons, and shorten lives. Speech that torments a human being, and instills a sense of perpetual fear, is a form of violence no less destructive of brain cells than an actual head injury. One might as well ride a motorcycle without a helmet on black ice at top speed rather than expose that same head to unremitting torment.²⁴³

The legal system has always had it wrong. Treating words as if they are ultimately harmless, mere slights that should be ignored, annoyances that can be dispatched with a shrug, has no basis in medicine or science. Courts simply choose to avoid taking emotional injuries seriously, largely for reasons of laziness—not wishing to introduce yet another category of legal relief—and on account of some stiff-upper-lip Anglo-ethos that owes its allegiance to a bygone Victorian era. There is also an exaggerated, misguided notion that America is the land of free speech, where the rights of speakers always prevail. But there is no legal or moral principle that justifies a government ignoring overt acts of violence against fellow citizens and its contribution to social instability—especially when the violence causes such severe injury. Assaults that are manifested in bodily harm, and assaultive speech that takes aim at the emotions, are at least equally hazardous to the individual. And both are disruptive of social peace. Arkes noted that there is “something in the nature of the words themselves that constitutes an assault. No government that would call itself a decent government would fail to intervene in these cases and disperse the crowd.”²⁴⁴

Seen in this way, chronic stress, which is widely dismissed as a weak-willed problem only experienced by perpetual head cases, ultimately damages one’s physical health by, among other things, remodeling the brain and rewiring its circuitry. Feldman Barrett wryly concluded, “So much for the classical division between mental and physical illness.”²⁴⁵

And this is even more true when it takes the form of racial prejudice, in which many different occurrences of bigotry accumulate, leading to both psychological harm and physical decline. In the 1954 landmark civil rights case, Brown v. Board of Education, which effectively put an end to racial segregation in public schools, the Supreme Court implicitly recognized, wholly apart from the constitutional issue, that “segregation caused psychological harm, which was important enough to rise to a constitutional issue.” Psychological harm is harm worthy of a legal remedy. Over longer periods of time, even lesser incidents take their toll. Wearing a person down with indignities leads to cumulative damage and makes them vulnerable to poor health.²⁴⁶

Should anyone now doubt that free speech, while a perfectly fine liberty and the essence of self-government, is not without serious transaction costs? Not only does free speech not guarantee valuable ideas, when wholly unregulated, unmoderated, reckless, and maliciously exercised, it may actually be bad for one’s health. Not unlike the consequences of heedless smoking or immoderate overeating, the irresponsible, self-centered gluttonous practice of harmful speech can shorten a life. The difference here, however, is that the speaker is not bringing harm to him or herself. Violent speakers are not engaged in the verbal equivalent of secondhand smoke. The damage done to others is neither incidental nor ancillary; it is primary. And the foulness of their own speech has no consequences to them. Smokers, alcoholics, or reckless drivers at least know that an assumption of risk accompanies their habits. Speakers are not operating under the same warning labels. No such death wish befalls assaultive speakers. Indeed, it is the targets of their injurious speech who are consigned to suffer the consequences of their indulgent misuse of this liberty. The cost of violent speech is born entirely by innocent bystanders, minding their own business until someone decides to unleash his or her venomous First Amendment freedom at another’s expense.

Another difference, of course, is that we can no longer plead innocence as to the harm that speech can cause. We now know how destructive words can be. We can glimpse the final bill, and the sticker shock should be unsettling. It is time to finally address the collateral damage of speech. Our collective neglect will end up producing its own anxieties. And we know that it is dangerous. For instance, children who have been victims of verbal abuse and emotional bullying have shown low-grade inflammation that stays with them as they grow older and predisposes them to psychiatric and physical disease. Feldman Barrett noted the absurdity that “[i]t’s perfectly legal for a high school bully to insult, torment, and humiliate your children even though this will shorten their telomeres [which protect the ends of chromosomes] and potentially their lifespans. . . . Most kids are unaware that the mental anguish they inflict can translate into physical illness, atrophied brain tissue, reduced IQ, and shortened telomeres.”²⁴⁷