{"id":8067,"date":"2026-07-19T14:34:17","date_gmt":"2026-07-19T12:34:17","guid":{"rendered":"https:\/\/blueportance.com\/knowledge-base\/expert-guides\/understanding-pain\/psychological-pain\/"},"modified":"2026-10-25T22:43:28","modified_gmt":"2026-10-25T21:43:28","slug":"psychological-pain","status":"publish","type":"page","link":"https:\/\/blueportance.com\/en\/knowledge-base\/expert-guides\/understanding-pain\/psychological-pain\/","title":{"rendered":"KB 3_Expert Guide_01_Understanding Pain_09_Psychological Pain"},"content":{"rendered":"\n\n<style>\n    body{font-family:Arial,sans-serif;line-height:1.65;padding:20px;color:#333}\n    .bp-q-breadcrumb{font-size:.85rem;color:#6b7280;margin:0 0 20px}\n    .bp-q-breadcrumb a{color:#2a7fba;text-decoration:none}\n    h1{color:#0e2a47;font-size:1.8rem;line-height:1.25;margin:0 0 22px}\n    h2{color:#1a4d72;margin-top:42px;line-height:1.3}\n    h3{color:#0e2a47;margin-top:28px}\n    p{margin:0 0 16px}\n    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a:hover{text-decoration:underline}\n  <\/style>\n<style>\n.bp-bdc-breadcrumb{max-width:900px;margin:0 auto;padding:20px 16px 0;font-size:.85rem;color:#6b7280;}\n.bp-bdc-breadcrumb a{color:#2a7fba;text-decoration:none;}\n.bp-bdc-breadcrumb a:hover{text-decoration:underline;}\n<\/style>\n\n<nav class=\"bp-bdc-breadcrumb\" aria-label=\"Breadcrumb\">\n<a href=\"\/en\/\">Blue Portance<\/a> \u2192 <a href=\"https:\/\/blueportance.com\/en\/knowledge-base\/\">Knowledge Base<\/a> \u2192 <a href=\"https:\/\/blueportance.com\/en\/knowledge-base\/expert-guides\/understanding-pain\/\">Understanding Pain<\/a> \u2192 Psychological Pain\n<\/nav>\n\n<div class=\"bp-bdc-header-card\">\n  <div class=\"bp-bdc-kicker\">Blue Portance Expert Guides<\/div>\n  <div class=\"bp-bdc-rule\"><\/div>\n  <div class=\"bp-bdc-dossier-title\">Understanding Pain<\/div>\n  <div class=\"bp-bdc-dossier-subtitle\">The biological, mechanical, and neurophysiological mechanisms of pain.<\/div>\n<\/div>\n\n<p class=\"bp-bdc-dossier-link\">\n  This article is part of the Expert Guide\n  <a href=\"https:\/\/blueportance.com\/en\/knowledge-base\/expert-guides\/understanding-pain\/\">\u201cUnderstanding Pain\u201d<\/a>.\n<\/p>\n\n<span class=\"bp-pillar-badge\">Reference article \u2014 Blue Portance Knowledge Base<\/span>\n\n<h1>Psychological Pain: An Invisible but Very Real Form of Suffering<\/h1>\n\n<div class=\"bp-bdc-epistemic\">\n  <strong>Epistemic note<\/strong> \u2014 This article distinguishes three levels: the early clinical description of moral pain, the contemporary experiences grouped under the notions of psychological pain or social pain, and the neural mechanisms studied through brain imaging. The fact that certain brain regions overlap during physical pain and during social rejection does not mean that these experiences are identical. The available data show both partly shared networks and finer-grained neural representations that remain distinct.\n<\/div>\n\n<section class=\"bp-summary\">\n  <p>\n    <strong>Summary<\/strong> \u2014 Psychological pain refers to intense inner suffering linked in particular to loss, rejection, humiliation, loneliness, or certain psychiatric disorders. It is neither made up nor a mere weakness of character. As early as 1835, Joseph Guislain described a \u201cmoral, intellectual, or cerebral pain,\u201d which he called phrenalgia. Neuroscience now shows that certain experiences of rejection or loss engage brain networks that are also involved in the affective dimension of physical pain. This overlap nevertheless remains partial: physical pain and psychological pain are two different experiences, which can interact without merging into one.\n  <\/p>\n<\/section>\n\n<nav class=\"bp-bdc-toc\" aria-label=\"Table of contents\">\n  <h2>Table of Contents<\/h2>\n  <ul>\n      <li><a href=\"#pourquoi-cet-article-est-il-important\">Why does this article matter?<\/a><\/li>\n      <li><a href=\"#1-la-douleur-psychique-existe-t-elle-vraiment\">1. Does psychological pain really exist?<\/a><\/li>\n      <li><a href=\"#2-que-montrent-reellement-les-neurosciences\">2. What does neuroscience actually show?<\/a><\/li>\n      <li><a href=\"#3-pourquoi-une-perte-ou-un-rejet-peuvent-ils-faire-mal\">3. Why can a loss or a rejection \u201churt\u201d?<\/a><\/li>\n      <li><a href=\"#4-une-souffrance-psychique-peut-elle-modifier-le-corps\">4. Can psychological suffering change the body?<\/a><\/li>\n      <li><a href=\"#5-quand-la-douleur-psychique-devient-elle-durable\">5. When does psychological pain become long-lasting?<\/a><\/li>\n      <li><a href=\"#6-douleur-psychique-depression-et-anxiete-est-ce-la-meme-chose\">6. Psychological pain, depression, and anxiety: are they the same thing?<\/a><\/li>\n      <li><a href=\"#7-pourquoi-reconnaitre-cette-douleur-change-t-il-notre-regard\">7. Why does recognizing this pain change the way we see it?<\/a><\/li>\n      <li><a href=\"#a-retenir\">Key takeaways<\/a><\/li>\n      <li><a href=\"#questions-frequentes\">Frequently asked questions<\/a><\/li>\n      <li><a href=\"#douleur-physique-et-douleur-psychique-peuvent-elles-s-entretenir\">Can physical pain and psychological pain sustain each other?<\/a><\/li>\n      <li><a href=\"#references-scientifiques\">Scientific references<\/a><\/li>\n  <\/ul>\n<\/nav>\n\n<h2 id=\"pourquoi-cet-article-est-il-important\">Why does this article matter?<\/h2>\n\n<p>\n  When someone has a fracture, a burn, or inflammation, the reality of their pain is rarely questioned. When they describe suffering caused by bereavement, a breakup, humiliation, or rejection, the reaction is sometimes different: \u201cit\u2019s only psychological,\u201d \u201cyou need to move on,\u201d or \u201cit\u2019s all in your head.\u201d\n<\/p>\n\n<p>\n  This opposition rests on a confusion. Every conscious experience, whether physical or psychological, involves the brain. Saying that suffering is \u201cin the head\u201d therefore makes it neither imaginary nor voluntary. The real question is not whether it exists, but what distinguishes it from physical pain and why it can become so intense.\n<\/p>\n\n<blockquote>\n  Suffering can be invisible and leave no identifiable lesion, yet still profoundly alter sleep, attention, emotions, behavior, and the functioning of the body.\n<\/blockquote>\n\n<p>\n  To study it rigorously, however, two opposite shortcuts must be avoided: reducing psychological pain to a mere metaphor, or claiming that it is biologically identical to physical pain. Clinical history and neuroscience point to a more nuanced position.\n<\/p>\n\n<h2 id=\"1-la-douleur-psychique-existe-t-elle-vraiment\">1. Does psychological pain really exist?<\/h2>\n\n<p>\n  Psychological pain refers to an experience of inner suffering that may accompany a loss, a break in social bonds, a sense of abandonment, humiliation, overwhelming guilt, depression, or certain melancholic states. It mainly concerns the affective and existential dimension of experience, rather than a signal coming from damaged tissue.\n<\/p>\n\n<div class=\"bp-definition\">\n  <strong class=\"bp-def-source\">A necessary distinction<\/strong>\n  <p>\n    The definition of pain proposed by the IASP refers to an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage <span class=\"bp-inline-ref\">(Raja et&nbsp;al., 2020)<\/span>. Psychological pain is therefore not automatically the same as pain in the strict nociceptive or clinical sense. It is a form of suffering, some of whose affective and brain mechanisms may nevertheless overlap with those of physical pain.\n  <\/p>\n<\/div>\n\n<p>\n  This terminological caution in no way diminishes the reality of the experience. Intense psychological suffering can take over consciousness, disrupt sleep, reduce the capacity to act, and change appetite, concentration, and social relationships. In some severe depressive states, it can become the central feature of the clinical picture.\n<\/p>\n\n<h3>A clinical insight formulated as early as the 19th century<\/h3>\n\n<p>\n  This insight is not new. As early as <strong>1835<\/strong>, the Belgian physician <strong>Joseph Guislain<\/strong> described, in his <em>Trait\u00e9 des phr\u00e9nopathies<\/em> [Treatise on Phrenopathies], a \u201cmoral, intellectual, or cerebral pain\u201d \u2014 <strong>phrenalgia<\/strong> \u2014 which he considered capable of constituting, on its own, an entire illness <span class=\"bp-inline-ref\">(Guislain, 1835; Masson &amp; Muirheid-Delacroix, 2014)<\/span>.\n<\/p>\n\n<p>\n  Guislain therefore did not reduce this experience to ordinary sadness. He described suffering capable of invading thought and profoundly altering the person\u2019s relationship with themselves and with the world. Psychiatry would later develop the notion of <strong>moral pain<\/strong>, notably in the description of melancholia.\n<\/p>\n\n<p>\n  What has changed since the 19th century is therefore not the clinical insight, but our ability to study this suffering. Brain imaging now makes it possible to observe the neural networks engaged during certain experiences of rejection, loss, or exclusion.\n<\/p>\n\n<div class=\"bp-figure\">\n  <img decoding=\"async\" src=\"https:\/\/blueportance.com\/wp-content\/uploads\/IX.1.From-phrenalgia-to-neuroscience.png\" alt=\"Timeline showing how the understanding of psychological pain evolved from Joseph Guislain\u2019s phrenalgia to contemporary neuroscience.\" loading=\"lazy\">\n<\/div>\n<p class=\"bp-figure-caption\">\n  <strong>Figure 1 \u2014 From phrenalgia to neuroscience.<\/strong> As early as 1835, Joseph Guislain described a \u201cmoral\n  pain\u201d (phrenalgia). Modern neuroscience then made it possible to objectively document the brain networks involved\n  in this suffering.\n<\/p>\n\n<h2 id=\"2-que-montrent-reellement-les-neurosciences\">2. What does neuroscience actually show?<\/h2>\n\n<p>\n  In the early 2000s, several studies sought to determine whether the suffering caused by social exclusion or the breaking of a bond engaged brain regions similar to those observed during physical pain.\n<\/p>\n\n<h3>Social exclusion studied through brain imaging<\/h3>\n\n<p>\n  In 2003, Eisenberger, Lieberman, and Williams used a virtual game called <em>Cyberball<\/em>. Participants believe they are tossing a ball back and forth with two other people, and are then gradually excluded from the game. This exclusion is accompanied by increased activity in certain regions, notably the dorsal anterior cingulate cortex and the anterior insula, which were then often associated with the affective component of pain <span class=\"bp-inline-ref\">(Eisenberger et&nbsp;al., 2003)<\/span>.\n<\/p>\n\n<p>\n  This study helped popularize the idea of a \u201ccommon system\u201d for physical pain and social pain. It did not, however, demonstrate that the two experiences were identical: the regions observed are also involved in attention, in detecting important events, and in processing negative emotional states.\n<\/p>\n\n<h3>The suffering linked to a romantic breakup<\/h3>\n\n<p>\n  In 2011, Kross and colleagues studied people who had recently gone through a breakup they had not wanted. Participants looked at a photograph of their former partner while recalling the rejection, and then, in another condition, received a painful heat stimulus. The authors observed an overlap between certain activations produced by physical pain and those linked to reliving the romantic rejection <span class=\"bp-inline-ref\">(Kross et&nbsp;al., 2011)<\/span>.\n<\/p>\n\n<p>\n  These results suggest that certain forms of intense social suffering may recruit systems involved in salience, negative affect, and certain components of bodily pain. They are not enough, however, to conclude that the brain \u201cmakes no difference\u201d between a burn and a breakup.\n<\/p>\n\n<div class=\"bp-controversy\">\n  <h3>Same regions does not mean same experience<\/h3>\n  <p>\n    A brain region never performs just one function. Activation of the insula or the cingulate cortex during two experiences therefore does not prove that they rely on an identical mechanism. Conventional imaging methods detect large areas of activity; they do not necessarily describe the most precise neural patterns within those areas.\n  <\/p>\n<\/div>\n\n<h3>Finer-grained neural signatures remain distinct<\/h3>\n\n<p>\n  In 2014, Woo and colleagues re-examined this question using multivariate methods capable of comparing brain activation patterns with greater precision. They showed that, despite a coarse anatomical overlap, heat pain and social rejection rely on partly distinct neural representations <span class=\"bp-inline-ref\">(Woo et&nbsp;al., 2014)<\/span>.\n<\/p>\n\n<p>\n  The most rigorous conclusion is therefore the following: physical pain and psychological pain can engage certain shared networks, notably those that evaluate threat, salience, and distress, but they do not constitute one and the same biological experience.\n<\/p>\n\n<div class=\"bp-figure\">\n  <img decoding=\"async\" src=\"https:\/\/blueportance.com\/wp-content\/uploads\/IX.2.Physical-pain-and-psychological-pain-partial-overlap-of-brain-networks.png\" alt=\"Comparison of brain networks involved in physical and psychological pain, showing shared areas and partly distinct neural signatures.\" loading=\"lazy\">\n<\/div>\n<p class=\"bp-figure-caption\">\n  <strong>Figure 2 \u2014 Physical pain and psychological pain: a partial overlap.<\/strong> Some brain regions are\n  shared by both experiences, but their neural signatures remain partly distinct\n  (Woo et al., 2014).\n<\/p>\n\n<h2 id=\"3-pourquoi-une-perte-ou-un-rejet-peuvent-ils-faire-mal\">3. Why can a loss or a rejection \u201churt\u201d?<\/h2>\n\n<p>\n  Human beings depend deeply on their social bonds. From childhood onward, safety, emotional regulation, and a large part of learning rely on the presence of others. In adulthood, belonging to a group, emotional relationships, and social recognition continue to play a major role in psychological balance.\n<\/p>\n\n<p>\n  Several authors have proposed that the alarm systems linked to separation or rejection may have partly built, over the course of evolution, on circuits already involved in protecting bodily integrity <span class=\"bp-inline-ref\">(Eisenberger, 2012)<\/span>. This hypothesis could explain why everyday language spontaneously uses bodily expressions: \u201ca broken heart,\u201d \u201ca deep wound,\u201d \u201cgrief that hurts.\u201d\n<\/p>\n\n<div class=\"bp-controversy\">\n  <h3>An evolutionary hypothesis, not direct proof<\/h3>\n  <p>\n    It is plausible that the suffering associated with separation served a protective function by favoring the maintenance of social bonds. This interpretation nevertheless remains an explanatory hypothesis. Imaging data show functional associations; on their own, they cannot reconstruct the evolutionary history of these mechanisms.\n  <\/p>\n<\/div>\n\n<p>\n  Psychological pain can thus be understood as an alarm signal concerning not the integrity of a tissue, but the affective, relational, or existential integrity of the person. Like any alarm signal, it can be appropriate to a real situation, become disproportionate, or persist beyond the event that triggered it.\n<\/p>\n\n<div class=\"bp-figure\">\n  <img decoding=\"async\" src=\"https:\/\/blueportance.com\/wp-content\/uploads\/IX.3.Why-does-the-brain-produce-psychological.png\" alt=\"Evolutionary hypothesis showing psychological pain as an alarm signal that may help protect essential social bonds.\" loading=\"lazy\">\n<\/div>\n<p class=\"bp-figure-caption\">\n  <strong>Figure 3 \u2014 Why does the brain produce psychological pain?<\/strong> A widely discussed hypothesis\n  holds that it is an alarm system that favors the protection and restoration of the social bonds\n  essential to survival.\n<\/p>\n\n<h2 id=\"4-une-souffrance-psychique-peut-elle-modifier-le-corps\">4. Can psychological suffering change the body?<\/h2>\n\n<p>\n  Drawing a strict opposition between body and mind does not reflect how biology works. Intense psychological suffering engages the autonomic nervous system, the hormonal stress systems, attention, memory, and behavior. It can therefore be accompanied by genuine bodily manifestations.\n<\/p>\n\n<table aria-label=\"Possible manifestations of intense psychological suffering\">\n  <thead>\n    <tr>\n      <th>Domain<\/th>\n      <th>Possible manifestations<\/th>\n    <\/tr>\n  <\/thead>\n  <tbody>\n    <tr>\n      <td><strong>Sleep<\/strong><\/td>\n      <td>Difficulty falling asleep, waking during the night, unrefreshing sleep<\/td>\n    <\/tr>\n    <tr>\n      <td><strong>Autonomic system<\/strong><\/td>\n      <td>Palpitations, chest tightness, sweating, bodily tension, a feeling of a lump in the throat<\/td>\n    <\/tr>\n    <tr>\n      <td><strong>Cognitive functions<\/strong><\/td>\n      <td>Rumination, difficulty concentrating, slower decision-making<\/td>\n    <\/tr>\n    <tr>\n      <td><strong>Behavior<\/strong><\/td>\n      <td>Social withdrawal, reduced activity, avoidance, loss of initiative<\/td>\n    <\/tr>\n    <tr>\n      <td><strong>Bodily perception<\/strong><\/td>\n      <td>Fatigue, muscle tension, digestive problems, amplification of preexisting pain<\/td>\n    <\/tr>\n  <\/tbody>\n<\/table>\n\n<p>\n  These manifestations do not prove that psychological suffering is the sole cause of a physical symptom. They do show, however, that psychological experience transforms the overall state of the body and can influence the way bodily signals are perceived and regulated.\n<\/p>\n\n<h2 id=\"5-quand-la-douleur-psychique-devient-elle-durable\">5. When does psychological pain become long-lasting?<\/h2>\n\n<p>\n  Acute psychological pain can be an understandable reaction to a loss or to a threatening event. In many cases, it evolves with time, social support, and the person\u2019s coping capacities. But it can also persist, particularly when the event goes on, recurs, or reactivates earlier experiences.\n<\/p>\n\n<p>\n  Several mechanisms may then help sustain it: rumination keeps attention focused on the loss; disrupted sleep reduces the capacity for emotional regulation; social withdrawal decreases opportunities for support and positive experiences; hypervigilance increases sensitivity to signs of rejection or threat.\n<\/p>\n\n<div class=\"bp-recognize\">\n  <h3>What can help keep the suffering going<\/h3>\n  <ul>\n    <li>the recurrence or persistence of the threatening situation;<\/li>\n    <li>isolation and the loss of social support;<\/li>\n    <li>rumination and attention constantly drawn back to the event;<\/li>\n    <li>lack of sleep and exhaustion;<\/li>\n    <li>the gradual avoidance of activities, places, or relationships;<\/li>\n    <li>coexisting depression, anxiety disorder, or psychological trauma.<\/li>\n  <\/ul>\n<\/div>\n\n<p>\n  This course does not mean that the person \u201cchooses\u201d to remain in their suffering. It reflects the establishment of biological, cognitive, emotional, and social loops that reinforce one another.\n<\/p>\n\n<div class=\"bp-figure\">\n  <img decoding=\"async\" src=\"https:\/\/blueportance.com\/wp-content\/uploads\/IX.4.When-psychological-pain-persists-cascading-effects.png\" alt=\"Cascading effects of persistent psychological suffering on stress, sleep, cognition, emotions, behavior and social functioning.\" loading=\"lazy\">\n<\/div>\n<p class=\"bp-figure-caption\">\n  <strong>Figure 4 \u2014 The consequences of prolonged psychological pain.<\/strong> When it persists, psychological\n  suffering can gradually affect cognitive, emotional, bodily, and social functioning.\n<\/p>\n\n<h2 id=\"6-douleur-psychique-depression-et-anxiete-est-ce-la-meme-chose\">6. Psychological pain, depression, and anxiety: are they the same thing?<\/h2>\n\n<p>\n  No. Psychological pain describes a dimension of lived suffering. Depression and anxiety disorders are broader clinical entities, defined by several symptoms, a duration, and a functional impact. A person can experience intense psychological pain without having major depressive disorder; conversely, depression can combine moral pain, loss of interest, slowing down, fatigue, sleep disturbances, and feelings of worthlessness.\n<\/p>\n\n<p>\n  The notion of psychological pain should therefore not serve as a general diagnostic label. Above all, it helps recognize an often-underestimated experience: that of inner suffering which can become as all-consuming and disabling as bodily pain.\n<\/p>\n\n<div class=\"bp-controversy\">\n  <h3>What should not be claimed too quickly<\/h3>\n  <ul>\n    <li><strong>\u201cPsychological pain is imaginary\u201d:<\/strong> it corresponds to a real conscious experience, capable of having significant biological and functional effects.<\/li>\n    <li><strong>\u201cIt is identical to physical pain\u201d:<\/strong> the two experiences may share certain networks, but their neural signatures and their causes remain distinct.<\/li>\n    <li><strong>\u201cAll emotional suffering is an illness\u201d:<\/strong> grief, sadness, and distress can be normal human responses to certain events.<\/li>\n    <li><strong>\u201cBrain scans can measure a person\u2019s suffering\u201d:<\/strong> imaging provides information about groups and mechanisms; it does not provide an individual thermometer of psychological pain.<\/li>\n  <\/ul>\n<\/div>\n\n<h2 id=\"7-pourquoi-reconnaitre-cette-douleur-change-t-il-notre-regard\">7. Why does recognizing this pain change the way we see it?<\/h2>\n\n<p>\n  Recognizing psychological pain first of all helps move beyond a sterile opposition between \u201creal\u201d suffering and \u201cpsychological\u201d suffering. An experience does not need to be visible on an X-ray to be genuine. It needs to be heard, described, and placed back in its context.\n<\/p>\n\n<p>\n  This recognition also avoids reducing the person to a lack of willpower. Persistent suffering changes the resources available for acting, concentrating, sleeping, working, or maintaining relationships. Telling someone to \u201cpull themselves together\u201d does not eliminate the mechanisms that sustain this suffering.\n<\/p>\n\n<p>\n  Finally, distinguishing physical pain from psychological pain without setting them against each other paves the way for a more complete understanding of chronic situations. Prolonged bodily pain can impair sleep, independence, work, and relationships; conversely, psychological suffering can increase hypervigilance, reduce modulation capacities, and amplify the perception of physical symptoms.\n<\/p>\n\n<div class=\"bp-figure\">\n  <img decoding=\"async\" src=\"https:\/\/blueportance.com\/wp-content\/uploads\/IX.5.Physical-pain-and-psychological-pain-two-different-realities-in-interaction.png\" alt=\"Comparison of physical pain and psychological pain showing their different origins and functions as well as their possible interactions.\" loading=\"lazy\">\n<\/div>\n<p class=\"bp-figure-caption\">\n  <strong>Figure 5 \u2014 Physical pain and psychological pain: two interacting realities.<\/strong> They have neither the\n  same origin nor the same function, but they can influence each other and contribute to the persistence of\n  suffering.\n<\/p>\n\n<div class=\"bp-takeaway\">\n  <h2 id=\"a-retenir\">Key takeaways<\/h2>\n  <ul>\n    <li>Psychological pain is a real experience of inner suffering, even when no bodily lesion is visible.<\/li>\n    <li>As early as 1835, Joseph Guislain described a \u201cmoral, intellectual, or cerebral pain,\u201d which he called phrenalgia.<\/li>\n    <li>Social rejection and the breaking of a bond can engage certain regions that are also involved in the affective dimension of physical pain.<\/li>\n    <li>This overlap remains partial: physical pain and psychological pain have finer-grained neural representations that are partly distinct.<\/li>\n    <li>Intense psychological suffering can alter sleep, attention, behavior, and the body\u2019s overall state.<\/li>\n    <li>Psychological pain is not synonymous with depression, even though it can be a major dimension of it.<\/li>\n    <li>Recognizing this suffering makes it possible to take it seriously without confusing it with nociceptive or neuropathic pain.<\/li>\n  <\/ul>\n<\/div>\n\n<section class=\"bp-faq\">\n  <h2 id=\"questions-frequentes\">Frequently asked questions<\/h2>\n\n  <details>\n    <summary>Is psychological pain imaginary?<\/summary>\n    <div class=\"faq-content\">\n      No. It corresponds to a genuine conscious experience that can affect sleep, attention, emotions, behavior, and bodily functioning. Being invisible does not make it any less real.\n    <\/div>\n  <\/details>\n\n  <details>\n    <summary>Why do we speak of \u201cmoral\u201d pain?<\/summary>\n    <div class=\"faq-content\">\n      The expression belongs to the history of psychiatry. As early as 1835, Joseph Guislain described a \u201cmoral, intellectual, or cerebral pain,\u201d or phrenalgia, to designate deep mental suffering distinct from a bodily lesion.\n    <\/div>\n  <\/details>\n\n  <details>\n    <summary>Does the brain treat a breakup like a physical injury?<\/summary>\n    <div class=\"faq-content\">\n      Not exactly. Some regions can be engaged in both situations, notably those linked to distress and salience. But studies analyzing the finest patterns of activity show partly distinct representations.\n    <\/div>\n  <\/details>\n\n  <details>\n    <summary>Are psychological pain and depression synonyms?<\/summary>\n    <div class=\"faq-content\">\n      No. Psychological pain refers to a dimension of suffering. Depression is a broader clinical syndrome combining several symptoms over a certain period of time. Psychological pain can exist without clinical depression, and depression can include intense moral pain.\n    <\/div>\n  <\/details>\n\n  <details>\n    <summary>Can psychological pain make physical pain worse?<\/summary>\n    <div class=\"faq-content\">\n      Yes, indirectly. Lack of sleep, hypervigilance, stress, withdrawal from activity, and difficulties with emotional regulation can increase the vulnerability of the nervous system and amplify the perception of preexisting bodily pain. This interaction is the subject of the next article.\n    <\/div>\n  <\/details>\n<\/section>\n\n<div class=\"bp-cta\">\n  <h2 id=\"douleur-physique-et-douleur-psychique-peuvent-elles-s-entretenir\">Can physical pain and psychological pain sustain each other?<\/h2>\n  <p>\n    The next article explains how prolonged bodily pain can disrupt psychological balance, and how psychological suffering can in turn alter the perception and regulation of pain.\n  <\/p>\n  <a href=\"https:\/\/blueportance.com\/en\/knowledge-base\/expert-guides\/understanding-pain\/adaptive-pain-loops\/\">Read the next article \u2192<\/a>\n<\/div>\n\n<div class=\"bp-cta\">\n  <h2 id=\"vous-cherchez-a-comprendre-ce-qui-entretient-vos-douleurs-en-position-assise\">Trying to understand what keeps your sitting-related pain going?<\/h2>\n  <p>\n    The analysis is based on location, stresses, mechanical variability, and the mechanisms likely to combine.\n  <\/p>\n  <a href=\"https:\/\/blueportance.com\/en\/personalized-pain-analysis\/\">Analyze my situation \u2192<\/a>\n<\/div>\n\n\n<p class=\"bp-note\">\n  <strong>Note:<\/strong> this content presents general knowledge and cannot be used to establish a diagnosis. Intense or persistent psychological suffering, or suffering accompanied by suicidal thoughts, requires prompt evaluation by a healthcare professional or an emergency service.\n<\/p>\n\n<section class=\"bp-references\">\n  <h2 id=\"references-scientifiques\">Scientific references<\/h2>\n\n  <h3>Clinical history and definition<\/h3>\n  <ol>\n    <li>Guislain J. <em>Trait\u00e9 sur les phr\u00e9nopathies ou doctrine nouvelle des maladies mentales.<\/em> [Treatise on phrenopathies, or a new doctrine of mental illnesses.] Bruxelles : \u00c9tablissement encyclographique ; 1835.<\/li>\n    <li>Masson M, Muirheid-Delacroix B. <em>La douleur morale : historique et devenir d&#8217;un concept clinique.<\/em> [Moral pain: history and future of a clinical concept.] Annales M\u00e9dico-Psychologiques. 2014;172(2):139\u2013145.<\/li>\n    <li>Raja SN, Carr DB, Cohen M, et al. <em>The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises.<\/em> Pain. 2020;161(9):1976\u20131982. doi:10.1097\/j.pain.0000000000001939.<\/li>\n  <\/ol>\n\n  <h3>Social pain and neuroscience<\/h3>\n  <ol start=\"4\">\n    <li>Eisenberger NI, Lieberman MD, Williams KD. <em>Does rejection hurt? An fMRI study of social exclusion.<\/em> Science. 2003;302(5643):290\u2013292. doi:10.1126\/science.1089134.<\/li>\n    <li>Kross E, Berman MG, Mischel W, Smith EE, Wager TD. <em>Social rejection shares somatosensory representations with physical pain.<\/em> Proceedings of the National Academy of Sciences USA. 2011;108(15):6270\u20136275. doi:10.1073\/pnas.1102693108.<\/li>\n    <li>Woo CW, Koban L, Kross E, et al. <em>Separate neural representations for physical pain and social rejection.<\/em> Nature Communications. 2014;5:5380. doi:10.1038\/ncomms6380.<\/li>\n    <li>Eisenberger NI. <em>The pain of social disconnection: examining the shared neural underpinnings of physical and social pain.<\/em> Nature Reviews Neuroscience. 2012;13(6):421\u2013434. doi:10.1038\/nrn3231.<\/li>\n<\/ol>\n  <h3>Further reading<\/h3>\n  <ul>\n    <li>Iannetti GD, Salomons TV, Moayedi M, Mouraux A, Davis KD. <em>Beyond metaphor: contrasting mechanisms of social and physical pain.<\/em> Trends in Cognitive Sciences. 2013;17(8):371\u2013378.<\/li>\n  <\/ul>\n<\/section>\n\n<p class=\"bp-copyright\">\n  \u00a9 Gil Ayache. The concepts, diagrams, terminology, and principles presented on this page constitute a work protected by copyright. They are made available to Blue Portance under an intellectual property license agreement, without transfer of economic rights or of authorship.\n<\/p>\n\n\n","protected":false},"excerpt":{"rendered":"<p>Blue Portance \u2192 Knowledge Base \u2192 Understanding Pain \u2192 Psychological Pain Blue Portance Expert Guides Understanding Pain The biological, mechanical, and neurophysiological mechanisms of pain. This article is part of the Expert Guide \u201cUnderstanding Pain\u201d. Reference article \u2014 Blue Portance Knowledge Base Psychological Pain: An Invisible but Very Real Form of Suffering Epistemic note \u2014 [&#8230;]\n","protected":false},"author":6,"featured_media":0,"parent":8012,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"_yoast_wpseo_title":"Psychological Pain: Invisible but Real | Blue Portance","_yoast_wpseo_metadesc":"Psychological pain is a real, intense inner suffering. 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