The Science of Heartbreak

[Dr Georgianna Donadio, PhD]

With the annual celebration of Valentine’s Day upon us – evoking romantic love and couples with stars in their eyes - it may be a good time to look at the other end of the spectrum – heartbreak. Having been in nursing and medical practices over 45 years, I have often heard patients share their painful stories of heartbreak and the pain and disappointment from a romantic relationship. They express fear of not being able to trust or love someone again after they have had such an experience. And, for a while at least, view love and trust through somewhat jaded eyes.

When we are hurt, betrayed, wounded or deceived, the experience cuts us deeply. Our sense of belonging or joining with another is shattered. Our foundation or moorings are lost, with the impact affecting us physically and emotionally. If we felt we loved the other person, the experience shatters our sense of well-being and stability. We would like to just “put it behind us” and move away from the pain into a safe harbor and a place of comfort that takes away the pain.

Recent research can now explain why heartbreak is so painful and why it can be so hard to bounce back from the experience. Helen Fisher, Ph.D., biological anthropologist, is a research professor and member of the Center for Human Evolution Studies in the Department of Anthropology, Rutgers University and chief scientific adviser to the Internet dating site Chemistry.com (a division of Match.com). She has written five books on the evolution and future of human love, sexuality, marriage, gender differences in the brain and how your personality type shapes who you are and who you love.

Dr. Fisher has done extensive field research which grants us an excellent understanding of what heartbreak is and how we can mitigate its negative effects.

Brain Issues

Dr. Fisher’s research on heartbreak demonstrates there are areas of the brain – the caudate nucleus and the ventral tegmental area – whose neurological and physiological involvement in loving is more deep-seated, serving as an actual drive far more powerful and urgent than has been previously believed or demonstrated. Dr. Fisher says that romantic love experiences “are way below the emotional center and in fact are not emotions at all, but rather a powerful drive and need that is shared by all human beings.”

Her research team, which has conducted thousands of brain imaging studies both in the U.S. and in China, has confirmed something that is now being increasingly acknowledged: just how important it is for human beings “to be in relationships where they experience reward for their feelings and efforts toward the significant other.”

Additional studies have demonstrated that the same portion of the brain, the anterior insula, is the location of experiencing both the physical pain and emotional pain of heartache. In 2010, a study conducted at the University of Kentucky, College of Arts and Sciences, examined the connection and possible overlap between physical pain and emotional pain.

Below are excerpts from an earlier blog post I wrote on the subject:

Quote

"This study had 62 participants who were filling out the “Hurt Feeling Scale”, a self-assessment tool which measures an individual’s reaction to distressing experiences. In addition, the study was using doses of the active ingredient in Tylenol, acetaminophen, as part of its protocol.

The researchers separated the study volunteers into two groups. The first group, after filling out their self-assessment tools, were given 1,000 mg of the acetaminophen. This is a dose that is equal to one Extra Strength Tylenol. The control group however, received a placebo instead of the acetaminophen. You might have learned about placebos already, but this particular result was truly unique.

The finding from this study showed that the control group without the acetaminophen, after three weeks, did not experience any change in the amount of intensity of “hurt” feeling during the three-week period. However, the group that did receive the active ingredient reported a noticeable reduction of “hurt” feelings on a regular, day-today basis.

The outcomes were so interesting that the researchers started a second study cohort group of 25 different volunteers, but this time upped the amount of acetaminophen to 2,000 mg daily and added computer games that were designed to create social rejection and a feeling of isolation in the participants. Also new to the study was MRI scanning which were able to identify when the participants had feelings of social rejection occur.

Now here is the “gold” of this research – the outcomes demonstrated that the area of the brain where emotional discomfort is felt is the same location that the physical pain is experienced in. This would explain why the group that was taking the acetaminophen, while having not physical pain, reported less feelings of hurt and rejection than the group that was not taking the acetaminophen but rather a placebo substance.

Geoff MacDonald, PhD, an associate professor of psychology at the University of Toronto who is an expert in romantic relationships, co-authored this study. MacDonald states that our brain pain centers cannot tell the difference between physical pain and emotional pain...

While Tylenol is not recommended to be used routinely as it can lead to liver and digestive system disturbances, knowing that it can take away the pain of a broken heart, it may soon be that our therapists as well as our physicians will recommend that we “take two Tylenol and call me in the morning” for heartache as well as for headache!"

If you want to understand more about this fascinating subject visit, Dr. Helen Fisher, where a book list on her research is available.

[K. Everly, BSN, RN]

That’s definitely fascinating and I’m glad to have read this to have a more clear understanding of how visceral and even physical the pain of heartbreak can be.

I hope that this type of research leads to the study of alternative pain relief methods, because the idea that people might take 1,000mg of Tylenol a day for weeks is a scary. And you know people - if you tell them 1,000mg they will think 2,000 mg is better, and if you tell them to DC it after a week they will think two weeks is better.

[LibraNurse27, BSN, RN]

So interesting. And makes sense that people frequently come to the hospital for physical complaints after recently experiencing emotional pain.

[HomeBound]

Very interesting.

This has been an ongoing thing--research into "lessening" traumatic experiences. Propranolol is also one of the drugs that can be used after a traumatic experience to lessen or even erase the memory of the event.

A quick story about a true case of Takasubos. I was working ICU and a comfort care patient, 92yo male--deaf and suffering from advanced dementia--married to his spouse for 62 years. She was at his bedside---seemingly fine, healthy for her age--but she would not go home nor would she stop holding his hand.

For all appearances, he had no idea she was there, and he was very comfortable as his O2 sats were dropping to levels where he was not quite aware of his situation. He was DNR/DNI, clearly.

We were moving him to a quieter place and she said to me, "I can't live without him."

About 15 minutes after we moved them to another floor, a code was called to the room I recalled was the pts. I said to my colleague---"Geez. We told them he is DNR. I wish that Med Surg nurses here would not call codes on DNR patients (as they were known to do)."

When we arrived, we found the patient lying quietly with a smile and he was still breathing, no distress.

It was her. She was being coded on the floor next to her husband. He had no clue she was dying.

We coded her for 15 minutes and never got her back. An hour later, he passed quietly as well.

In this scenario--would it have been ethical to give her propranolol or any other type of drug to "ease her suffering" by "lessening" the psychological pain she was feeling---so that it would not convert into real, physical pain and life threatening illness?

This is my opinion---

I believe it is unethical and unnatural to "lessen" these experiences because they feel bad or they may lead to what happened to this woman.

Humans are wired this way for a reason. Animals have it as well. Grief and pain exist for many reasons---for learning lessons about the choices that we've made, for remembering loved ones lost, for being able to connect and truly love, to make educated decisions moving forward based on painful experiences of the past.

I find it disturbing that some people are so weak and emotionally crippled anymore that they can't even find it in themselves to grieve honestly (and for however long it takes)---or take a painful lesson of rejection by a significant other and turn those things into character building experiences.

I miss my dad every single day. Every day. I still find myself picking up the phone to call him for some stupid thing that happened to me that day. My heart hurts every time this happens. My heart hurts for everything that I didn't get to say, the things that I should have done, the things he would never see that I accomplished.

And guess what. This teaches me to tell those that I still have that I love them and need them. It teaches me that I need other people in my life to share things with---and even though yeah---I know they might die or leave me or reject me or hurt me---I need to do this anyway to be healthy.

It is unhealthy, unethical and unnatural for someone to turn to drugs to make it so that their life has no teaching moments that may produce pain.

[Dr Georgianna Donadio, PhD]

Thank you all for your comments and contribution. Yes, indeed there is an actual "broken heart" syndrome which explains how grieve translates into our hearts failing us. Isn't nature amazing?!