The Social Side of Pain: What Does it Mean to Feel Another’s Pain?

Abstract

This chapter gives an overview of the current state of the neuroscientific basis of empathy and the experience of vicarious pain; that is, an explicit sensory experience of pain when observing another in pain. We summarise the central and autonomic mechanisms that are associated with vicarious pain experience from studies using electrophysiology, electroencephalography, transcranial magnetic stimulation and functional Magnetic Resonance Imaging. While this research has given us fantastic insight into the neural mechanisms giving rise to vicarious pain experience, the mechanisms are not well contextualised in relation to the daily lived experience. We discuss the importance of social roles and context in vicarious experiences to provide insight into the aspects of life in which vicarious sensations may arise. For instance, when a parent vicariously reacts to a painful injury in their own child, this may motivate protection and nurturing. Healthcare providers who embody the pain or emotions of their client may report that this enhances intuitive and/or compassionate care. However, distressing vicarious reactivity towards the suffering of others may also ultimately disrupt the capacity to deliver compassionate care and/or lead to burnout. While several qualitative studies have characterised the experience of secondary trauma, and to a lesser degree emotion contagion in clinicians, there has been a lack of qualitative and mixed methods research in this field. In an attempt to emphasise the significance of the social context in empathic and vicarious responses, we give an overview of lived experience of vicarious pain from the perspective of a clinician who describes her experiences both with family members and patients in pain. In concluding, we draw parallels between the phenomenological lived account of vicarious pain experience and neurophysiological mechanisms, and discuss the implications of vicarious reactivity for interpersonal relationships, especially within a clinical context. Ultimately for our understanding of both the mechanisms and consequences of vicarious pains sensations future research should take advantage of mixed methods designs to triangulate the neuroscientific mechanisms with the lived experience.

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