It Hurts So Good

Come on, baby.  Make it hurt so good.
Sometimes problems don’t resolve as they should,
so you gotta make it hurt so good…


And not because the self-inflicted physical pain doesn’t hurt, but because when the physical pain stops, so does emotional pain.  Euphoria sets in like a runner’s high, an intense love-making, lust-maddening session, or a mind-altering substance.

Also known as “pain offset relief,” this phenomenon explains that when a person deliberately hurts themselves in such a way that the integrity of their skin is damaged (like bloodletting or burning), they still register that physical pain as something undesirable, but the moment that physical pain stops, they are filled with intense relief not only because the physical hurt has stopped, but emotional pain has as well.  What’s interesting is that studies done with people who do not deliberately self-injure as a means of coping indicate that they also feel very good after the physical pain has stopped.  Cornell reports the same: pain offset relief appears to be a near- universal phenomenon experienced by nearly all living creatures, not an abnormal psychological or biological feature that predisposes some people to self-injury… Once again, this work indicates that people who engage in self-injury are not “wired differently” to “like pain.” People who engage in self-injury simply tap into a natural and powerful relief mechanism that all people (and other organisms) have access to.

Moreover, according to Cornell, “researchers have discovered that there is a large degree of ‘neural overlap’ between physical pain and emotional pain (in particular, areas called the ‘anterior cingulate cortex’ and the ‘anterior insulsa’).”  Of course I had to turn to Robert M. Sapolsky’s book to see what it has on the anterior cingulate cortex (ACC).  The ACC’s function revolves around processing and recognizing sensory information about your body (is my heart beating really fast? why does my stomach feel weird?) and identifying anomolies in patterns and causality (behavior X yields Y but why not every time?).  Sapolsky notes that “unexpected pain is at the intersection of those two roles of the ACC” and it seriously wants to know what the pain signifies and what can be done to make the pain end (the placebo effect comes into play here) (528, 529).  The ACC’s role in recognizing and wanting to dispel emotional pain facilitates its role in empathy.

A person who is affected by seeing signs of pain in someone else has an activated ACC.  In fact, “the more painful the other person’s situation seems to be, the more ACC activation.  The ACC is also central in doing something to alleviate someone else’s distress” (530).  It also explains why some people can look at other people’s choices and avoid making the same choices if the outcomes are undesirable.  Now I’m wondering if I’ve got a hyperactive ACC because whenever my favorite people are in duress, I feel compelled to do something to help them feel better (or not do what they did to land themselves in whatever world of dismay).

But what does the purpose of the ACC, a highly engaged ACC, have to do with pain offset relief exactly?  My interpretation is that because this part of the frontal cortex has a duty to let you know when some aspect of your existing is amiss or inconsistent, it seeks to and is amenable to any course of action that will make things the way they’re supposed to be, which is homeostasis.  Things aren’t too hot or cold, they’re just right.  You’ve forgotten you have body parts because they don’t hurt.  You feel okay, steady because there’s no reaction to unpleasant stimuli (that would bring about physical or emotional distress or both).


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