28.

THE MIND’S RECALL OF PAIN

The human brain exhibits amnesia when called upon to reexperience the blows from sticks and stones. With humiliation and indignity, however, the brain is a steel trap of merciless memory.

IT SHOULD COME as no surprise that victims of hate crimes suffer greater emotional distress and cumulative psychological harm than victims of non-bias-motivated crimes. Indeed, five years after the traumatic encounters, they experience greater levels of depression and anxiety than other crime victims. The impact to both mind and body lingers much longer. The incidence of severe trauma from hate crimes requires a lengthier recovery period—if recovery is even possible at all.²⁷¹ Similarly, hate crime victims report that their reintegration into society is much more difficult to achieve. Deprived of self-respect after experiencing ordeals of indignity, victims of hate speech struggle with the everyday tasks of socialization. One obvious outcome is in “trying to be less visible,” which the hate crime victim achieves by moving to an entirely different environment.²⁷² In this way, hate speech serves to undermine free speech itself precisely because it silences the targeted group, compelling them to disappear socially.²⁷³

Moreover, even watching someone else experiencing pain can create greater sensitivity in one’s own pain perception. So finely calibrated is the processing of emotions in the human brain, it turns out that showing empathy to a fellow human being carries some emotional risk. In a 2009 study conducted simultaneously at the universities of Arizona and Maryland, researchers discovered that the anterior cingulate cortex, the region of the brain that regulates emotional reactions, responds to an emotional insult by unleashing a wide variety of physical responses—stress-induced sensations in the chest, muscle tightness, an increased heart rate, and stomach pains—all triggered from the same sector of the brain. Another study undertaken by two professors from the University of Virginia in 2006 supported the finding that activation in the anterior cingulate cortex coincides with the onset of chest pains. The researchers concluded that “emotional pain involves the same brain regions as physical pain, suggesting that the two are inextricably linked.”²⁷⁴

In fact, medical evidence abounds showing how emotion and physical harm share the same circuitry in the human brain. The New England Journal of Medicine published a research study in 2013 on how subjects experienced both physical and emotional pain by looking at a photo of a cherished person who died. Brain scans indicated the same neural activity when a subject was exposed to heat on his or her forearm as when shown a photo of a lost loved one. Experiencing physical pain did not yield a separate neural response that was distinguishable from emotional pain. A burned forearm and an aggrieved heart elicited identical neural reactions. One of the researchers on the study, Tor Wagner, a professor of neuroscience at the University of Colorado in Boulder, explained the reasons for this unexpected outcome, stating “[t]hat may be why social pain is so painful: every time you remember it, you feel it all over again and that is not true for physical pain. Of all the things I’ve observed in the brain, nothing is more similar to physical pain than social pain.”²⁷⁵

And the consequences of “social pain” are even more severe. The pain from social exclusion and indignity, which begins with emotional distress, ends up rendering a person physically sick. The two regions of the brain once thought to be the epicenter for the processing of physical pain show similar patterns of neural activity when the mind focuses on a photograph reminiscent of rejection or loss. A research team from the University of Kentucky set out to demonstrate this neural overlap between social and physical pain systems. Apparently, the same behavioral and neural mechanisms are at work in processing what many would believe to be disparate manifestations of pain. Psychology professor C. Nathan DeWall explained the significance of his team’s findings in 2009: “Social pain, such as chronic loneliness, damages health as much as smoking and obesity. We hope our findings can pave the way for interventions designed to reduce the pain of social rejection.”²⁷⁶ He also speculated about the reasons why the human brain evolved in this manner. “Instead of creating an entirely new system to respond to social hurt,” he said, “evolution piggybacked the system for emotional pain onto that for physical pain.” The evolution of the human brain allowed emotional injury to take a free ride on the circuitry associated with physical pain.

And not surprisingly, when it comes to hate crimes and their origins in racial bigotry, the overall bodily damage arising from such injurious speech tends to be even worse. Law professor Richard Delgado noted that, “[i]n addition to these long-term psychological harms of racial labeling, the stresses of racial abuse may have physical consequences. There is evidence that high blood pressure is associated with inhibited, constrained or restricted anger . . . American blacks have higher blood pressure levels, and higher morbidity and mortality rates from hypertension, hyper-intensive disease, and stroke than do white counterparts. Further, there exists a strong correlation between degree of darkness of skin for blacks and level of stress felt, a correlation that may be caused by the greater discrimination experienced by dark-skinned people.”²⁷⁷

Psychology professor Geoff MacDonald, from the University of Toronto, has charted the trajectory of bodily and psychological harm caused by social insult. He noted that, not unlike damage done to the body, the initial sensation of emotional hurt produces a surge of stress hormones. In the context of a physical injury, the purpose of this hormone is to brace the body for yet another attack. It provides confidence to both body and mind that the individual can actually take and survive a punch. The release of these stress hormones accounts for why a person can actually walk away on a broken leg or manage to speak despite having a shattered skull. After the surge of this energy dissipates, the pain ensues. The same release of stress hormones occurs when a person faces severe emotional, social pain. Proving the Talmudic injunction not to humiliate a fellow human being because it is tantamount to draining him of his blood, neuroscience can now account for how the ancients knew something about what happens, physiologically, to human beings who have experienced severe indignity. The brain discharges a sufficient amount of stress hormones to handle the first blow. When the damage is done and the insult has subsided, the body will begin the process of dissipating the pain, and the blood flows away from the afflicted area.²⁷⁸

The difference, however, is that, unlike physical pain, where bones will ultimately heal, and the pain of the experience will become wholly forgotten, social pain can be—and often is—relived over and over again. The sensation of the pain is instantly recalled and reexperienced. This is the consequence of how our memories cope with traumatic stress, resulting in a cruel admixture of the mind. Physical pain, by contrast, can be remembered as once being painful, but the pain itself cannot be reclaimed. The human brain exhibits amnesia when called upon to reexperience the blows from sticks and stones. With humiliation and indignity, however, the brain is a steel trap of merciless memory.

With sets of patients who had experienced physical injury and another group that suffered from emotional harm, researchers at Purdue University did a five-year study and checked back in with the participants each year after the incidents that caused them such pain. The focus of the study was to determine how they felt about what they had experienced five years earlier. The results, published in 2008, were not surprising to neuroscientists but surely would be perplexing to emotionally adverse judges. Those participants who had experienced emotional injury reported higher levels of pain than participants who experienced physical harm. They were still feeling the emotional effects of the harm. Psychology professor Kip Williams of Purdue stated that, “While both types of pain can hurt very much at the time they occur, social pain has the unique ability to come back over and over again, whereas physical pain lingers only as an awareness that it was indeed at one time painful.”²⁷⁹ A few law professors had been making similar points over the years, with much skepticism from their colleagues and the courts. It must have just seemed intuitively obvious. Arkes, for instance, once presciently wrote during the Stone Age of such speculations (in 1974), “There is in fact such a thing as a psychological injury, which may be quite grave . . . as an assault on one’s body or a broken leg.”²⁸⁰

Heresy and constitutional apostasy at the same time.

Today, there is research showing that something far less than a hate crime—say, perhaps, an emotional injury that might arise from social exclusion—can cause chronic pain disorders such as fibromyalgia. Psychology professor Ethan Kross, a lead researcher in yet another study—this one from the University of Michigan—explained just how damaging emotional trauma can be on both the human brain and body: “What’s exciting about these findings,” Kross said in 2011, “is that they outline the direct way in which emotional experiences can be linked to the body.” The study demonstrated that the same sectors in the brain that are activated when experiencing physical pain—dorsal posterior insula and the secondary somatosensory cortex—overlap with the network of brain regions involved in processing emotional pain. Kross’ team compared MRI brain scans with a database of five hundred published studies and were able to establish positive predictive values up to 88 percent. The brain is a pinball machine with bells ringing and pain pulsating regardless of whether the pain originated from a blow to the body or the heart. Sickness eventually emanates from either.²⁸¹

Apparently, heartaches and painful breakups are “more than just metaphors,” Kross concluded. Feelings of rejection, indignity, and emotional trauma are direct causes in the development of chronic pain disorders.²⁸² In conducting research on the neural responses to social rejection, Jonathan Rottenberg, Professor of Psychology at the University of South Florida where he directs the Mood and Emotion Laboratory, concluded in 2009 what now seems to be obvious among the neuroscientific community in their search for how emotion is processed in the human brain. He stated that, “in interviewing depressed people, I’ve often been struck by the tremendous blurring between physical and emotional pain. In depression, everything hurts.”²⁸³

We now also know that pain medication, in the form of aspirin or acetaminophen, works equally well for emotional pain. The same pill that provides medical relief for a headache can also work miracles for heartache. Pain relief and dissipating inflammation works the same in both cases. As reported in Psychological Science in 2011, the participants in a study undertaken at the University of Kentucky were given pain medication—like acetaminophen—as a remedy for the emotional pain they were all experiencing. And just like the dissipation of a throbbing headache, the ache caused by a wounded heart was given temporary relief.

In spite of a long-standing nursery rhyme that reassures us that we have nothing to fear from name-calling, we now know that “words alone are capable of activating our pain matrix. Even verbal stimuli lead to reactions in certain areas of the brain,” confirms Thomas Weiss, a professor at Friedrich-Schiller University Jena in Germany. In a study published in Pain in 2010, healthy people whose brains were scanned were each asked to listen to words associated with pain—such as “excruciating,” “tormenting,” “terrifying,” or “grueling.” In every instance, the processing center of the brains of each participant evidenced significant neural activity simply after hearing a word associated with pain. So powerful are words, they are not only suggestive, they actually trigger neural reactions that cause physical pain—remarkably, even if the individual has experienced no pain at all.²⁸⁴

And unlike physical pain, emotional injury leaves an imprint on the mind that digs deeper than any scar permanently etched on the skin. Neuroscientist Martin Teicher from the Harvard Medical School published a study in 2010 of brain imaging in the American Journal of Psychiatry on the lingering effects of taunting and other verbal abuse.²⁸⁵ The participants, age eighteen to twenty-five, had been exposed to verbal abuse from their peers since middle school. The brain scans revealed less developed neural connections between the left and right sides of the brain and a detrimental buildup of fibers—called corpus callosum—connecting the two sides. Verbal abuse causes more than emotional trauma. It inflicts lasting physical effects on the structure of the brain itself, along with higher levels of anxiety, depression, hostility, and drug abuse. From this study, Professor Teicher was able to conclude that verbal harassment causes more than just emotional harm. More alarmingly, it can change the physical structure of the human brain, compromising its actual development. The brain scans he examined noted a reduction in the size of the hippocampus. Traumatic and highly stressful experiences produce long-term effects on the structure and functioning of the brain at the very point where the prefrontal cortex—the section of the brain where the emotions are centered—and the sector of the brain burdened with human survival converge.²⁸⁶