Feeling the pain of others

HOW do you react when you see somebody else in pain? Most of us can empathize with someone who has been injured or is sick – we can quite easily put ourselves “in their shoes” and understand, to some extent, what they are feeling. We can share their emotional experience, because observing their pain activates regions of the brain which are involved in processing the emotional aspects of pain.

But can seeing somebody else in pain actually cause pain in the observer? People with mirror-touch synaesthesia are known to experience touch sensations when they see others being touched, and this may also extend to pain in such individuals. There are also several anecdotal cases of patients who experience pain in the absence of noxious stimuli. And a new study by British psychologists now provides evidence that a significant minority of healthy people can also experience pain when seeing others’ injuries. 

Jody Osborn and Stuart Derbyshire of the University of Birmingham recruited 108 participants, and showed them static images (below) and film clips depicting painful events. The participants were asked to report anything they felt while viewing the images, and to rate the level of disgust, unpleasantness, sadness and fear elicited by each, using a questionnaire. They were also asked to report the level of empathy they felt for the person in each photograph.

Thirty one of the 108 participants, or about one third of the group, reported feeling pain in response to one or more of the images or clips. The sensations they felt were most often described as “tingling”, followed by “aching”. Other descriptions included “sharp”, “shooting”, “throbbing”, “stabbing” and “tender”. The pain was described as lasting for “a few seconds”, “fleeting”, or “for a split second as soon as the picture appeared.” The black and white photograph of the athlete with a broken leg generated the most pain responses, and the highest pain intensity. In every case, the pain they felt was in the same location as that of the observed injury. For example, when they saw the image of the finger injury, they marked a cross on the finger of a diagram in the questionnaire.

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Ten of these “pain responders” were then selected for a functional neuroimaging study, along with another ten non-responders, who acted as controls. The twenty participants then had their brains scanned whilst viewing the same images and film clips. These experiments confirmed the behavioural data – in the responder group, observing the images and film clips was correlated with strong activation of the so-called pain matrix, a diffuse network of brain areas which includes the anterior cingulate cortex, insula and prefrontal and somatosensory cortices. In the non-responders, those components of the matrix involved in emotional responses to pain (the cingulate and prefrontal cortices) were activated, but those which process sensory signals (the insula and somatosensory cortex) were not.

These experiments provide convincing evidence that a significant minority of otherwise healthy people experience not just the emotional component of pain, but also the sensory one, when they observe others in pain. When asked about the pain they experience when observing somebody else in pain, all thirty one responders spoke about it as if it was normal, and assumed that their experiences were representative of the population as a whole. Interestingly, no significant relationship was found between the reported levels of pain intensity and empathy, or feelings of disgust or unpleasantness. So although many will readily share the emotional perspective of someone seen to be in pain, and empathasize with them, this is in most cases unrelated to any sensory experience.

It is unclear why observing pain elicited pain in some participants but not others. The pain responders were found to have a stronger emotional response to the images and film clips of injuries, and this was associated with stronger activation of the pain matrix components involved in processing the emotional content of the stimuli. They also reported higher levels of empathy with the people depicted in the photos and films. It is therefore possible that this increased emotional response may drive a secondary reaction in the somatosensory areas. Conversely, the pain experienced by the responders may be dependent on a stronger somatic response, which drives a secondary emotional response.

Osborn and Derbyshire are now investigating whether responders can see things from others’ perspective more readily than non-responders, and if they are more suggestible. Regardless of the underlying neural mechanisms or of individual differences, the knowledge that seeing others in pain can generate painful sensations in some observers may provide insights into the mechanisms of functional pain. It could also help researchers to gain a better understanding of conditions such as chronic pain and fibromyalgia, in which there is often no identifiable physical cause for the symptoms.

Related:


Osborn, J., & Derbyshire, S. (2009). Pain sensation evoked by observing injury in others. Pain. DOI: 10.1016/j.pain.2009.11.007.

17 thoughts on “Feeling the pain of others

  1. I wonder if there have been any studies done to correlate this pain empathy with syndromes like fibromyalgia or other “non-obviously-caused” pain syndromes (i.e., chronic back pain and the like)? It would be interesting to see if it correlated with these syndromes one way or the other, though I suspect that suggestibility might be higher for both groups.

  2. Fascinating. I wonder (slightly of topic maybe); some people are notoriously bad at keeping left from right, do those people have a higher chance of experiencing mirrored mirror-touch synaesthesia? If so, it would provide a great way to find out more about cognitive, top-down effects on synaesthetic experience!

  3. This is so interesting! My husband could never understand why I couldn’t watch videos of people falling or getting hurt. All I could say was “It hurts to watch!”… he didn’t believe me that it actually hurt me, physically. Thank you!

  4. Neuroscience is like the new frontier. I, too, am deeply sensitive to things I see. I actually don’t even like to be touched alot, because I pick up things from people, both sensory and other information I don’t care to know. I have trouble filtering it out. I have no idea why I am like this, but I presume something triggered it when I was young.
    I don’t think of it as mysterious, just unexplained at this time. I also have a very strong kinesthetic sense, highly sensitive, but I have no idea if the two are related. My belief is that we will eventually understand how extraordinary our capabilities are, as well as how to more consciously make use of them, through the exploration and study of neuroscience.
    Thanks for the great site!

  5. I’m not convinced. Maybe I should read the study for details, but let me say this: Often, studies that look at correlations following the logic “insula lit up –> the subject is feeling pain“ fail to show that insula always responds only to pain. Cause if not, then “insula lights up” could just as well imply that “the subject is feeling cold” (for example).
    The only remedy for that, as far as I know, is to do an adaptation study. For example, subjects would first watch painful pictures, then experience pain themselves. The responders should show decreased activity in the insula when experiencing physical pain (because they adapted/got used to the pain by watching painful images).

  6. Did the researchers control for subjects who did and did not have previous serious injuries (e.g. fractured arm). I would imagine pictures and videos of injuries would elicit more empathy from people who had gone through similar painful experiences, perhaps activating already sensitized pain networks in the brain.

  7. How is this different from what Ramachandran describes in Phantoms of the Brain where he talks about experiments where, with a little bit of work, people can “feel” on their arm, the touching of the table (that their arm is under)?
    I assume it is different, but I’m wondering how.

  8. Not to scare him/her, but Mikhu’s comments are interesting because when I was in the late stages of my nervous breakdown/psychotic episode, I had the ability to pick up other people’s emotions. Anxiety from other people would make me so anxious that I had to leave the room full of anxious people in my group therapy sessions at the mental hospital.

  9. I can barely watch a movie or telvision show where someone falls or gets hit. I feel pa[n in my legs whenever I see someone get hurt. Photographs do not bother me, but video is painful to watch. It seems to get worse with age. I thought I was the only one with this problem. My kids think I am crazy.

  10. Fascinating! I don’t experience physical pain, but I cringe and wince or close my eyes and sometimes have to leave the room when there are pictures of injuries being shown. I’ll have tears in my eyes and start begging for someone to stop if they’re describing a painful injury. So I don’t think feeling the physical pain is necessary for a strong emotional reaction, but it’d be interesting to see more details on the pain-feelers.

  11. I am linking to another post here because I think there is a good deal of synchronicity between your posts.
    There is very new research (in mice) with promising results for feeling another’s pain. I have left a comment there about empathy- which interests me because I am researching emotional processing. Empathetic arousal modes include mimicry, conditioning(which linked post research supports with neuroimaging data) and direct association. I’m excited about the direction of this research.

  12. i’m glad i found this research of yours… i first heard it on the news here in the Philippines; and i said, hey! that’s me. so, i looked, of course… well, i’m more interested to know how to manage or at least lessen the pain i feel every time i see someone in pain. it’s nice to know i’m not the only one because it batters my self-confidence. i already fainted twice… i’m trying so hard not to have a third one. but there’s no escaping it because it’s kinda part of my job. you see, i’m a nurse… and yeah, this is a major problem. i don’t know how long it would take for me to get used to all of it. i am hoping that your research will somehow help me find answers to this problem.

  13. I have heard of this problem, I exhibit these behaviors responding to pain in others as well, but 100% more on the emotional side. Seeing a woman cry over the loss of a child, HER agony and despair become MINE. A lost child in the store, HER fear and hysteria become MINE. A beloved pet dies, I am hysterical holding my own pet. I can’t watch the news, read the paper, see any dramas that have any kind of tragedy. I will be saddened almost depressed and may cry for days. My empathy is on a different level that I DO NOT LIKE and is very difficult to explain to others. Does anyone have any information on this topic?

  14. I expierience the exact physical pain that somebody else is having. If my husbands knee hurts so does mine, my friends daughter hurt her tricep and mine hurts also, when my husbands drummer shoulder hurts mine hurts also and usually it happens without me even knowing the other person is hurting until later and then i put two and two together. It only happens with people that are very close to me. My daughter also feels others pain sometimes but not as much..she is only 15. Does anybody know why this happens?

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