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The Pain We Share: Global Events and Personal Pain

Illustration by Bryce Hendry, copyright 2024.

How do people experience and process the pain they feel from global events – for example, natural disasters, wars, shootings? Are people’s responses to these events as individual as their pain from injuries or illness can be? This post asks questions about the pain we share. It starts from a premise of pain’s decisive individuality in asking how “big” events affect individuals’ pain.

For a decade I’ve been studying a shift in the understanding of pain among doctors and patients that happened in America after 1945. Before then, pain was thought of as a straightforward, hard-wired nervous system event; after 1945 it became a complex, individual, subjective, and variable condition that was deeply informed by personal history and circumstances.

In short, pain evolved from a marker of disease to become a disease in its own right. Chronic pain was a growing clinical challenge while managing short-term pain after surgery, injury, or illness improved steadily after 1900, for which much credit goes to aspirin and opiates. Nothing to date has altered my view that this change in pain’s clinical and social status happened, that it continues, and that it is consequential. Lately, though, I’ve been looking at other parts of pain’s history, looking away from pain’s individuality to its wider dimensions.

Here’s a starting-point question: How do global events – natural disasters, wars -- echo in people’s lives to produce pain?

If that question has any merit, there should be case studies that include experiences and expressions of individual pain. One such candidate is the George Floyd summer of 2020. In late May, two months of a marauding pandemic collided with the mass gut-punch of a slow-rolling public murder.

My plan for this exploratory essay is to define some terms, touch on the intersection of Floyd’s death with COVID-19, and describe how neuroscience may hold the key to understanding the pain we feel when the world intrudes.

Defining Terms

Think of pain in three forms … or two-and-a-half.  

Closest to our bodies and a sense of ourselves is physical pain. Its sometimes-mysterious origins and wide personal variability hint at its complexity. Marcel Proust wrote, “to kindness, to knowledge, we make promise only; pain we obey.”

Next is social pain. Social psychologist Naomi Eisenberger defines social pain as “…the unpleasant experience that is associated with actual or potential damage to one’s sense of social connection or social value…” These are the hurt feelings that arise within circles of family, friends, work, and romance that are provoked by “exclusion, rejection, perceived unfairness, loss of status, and negative social evaluation.” Social pain results as well from systemic exclusion or rejection that people endure based on membership in a group – a related topic that’s well beyond this post.

Last is what I am calling shared pain. This is the pain people feel from massive events -- natural calamities, wars, environmental collapse, political chaos, industrial horrors, shooting outbursts, and turmoil in popular culture. Shared pain might be a subset of social pain – hence the two-and-a-half hedging above. Like physical pain, shared pain can fluctuate and can be acute or chronic. Are people’s sensitivities to shared pain as idiosyncratic as bodily pain can be? How do personal histories and attributes contribute to shared pain? What new vocabularies and concepts might help us understand shared pain?

In 1996 anthropologist Arthur Kleinman et al. described social suffering as the outcome of “what political, economic, and institutional power does to people, and, reciprocally, from how these forms of power themselves influence responses to social problems.”

Four years ago, America experienced an intense round of shared pain and social suffering.

A Case Study for the Ages

In May 1992, as Houston resident George Floyd and some friends sat chatting on their last day as high school juniors, Floyd surprised his buddies by getting serious. “I’m going to be big,” he said. “I’m going to touch the world.” Dreams of fame in sports or music spurred Floyd on until their failure to come true dragged him down.

Twenty-eight years later, and three days after America’s COVID-19 death toll reached 100,000, “… footage spread of Minneapolis police officer Dreek Chauvin kneeling on George Floyd’s neck, killing the unarmed Black man who asphyxiated and expired.”

The George Floyd nightmare overflows with pain. By May 2020, COVID had scrambled everyday life beyond recognition. For all the talk of “being in this together” that we heard in Spring 2020, the Minneapolis footage delivered a brutal jolt of real-world barbarity.  

In my lifetime the only event that rivaled the intensity of the Floyd summer had been the aftermath of the Kent State and Jackson State campus murders in May 1970.

I was a very different person then, and the events are very different, but not all from that time is unrecognizable. Both times the world felt like it was coming unhinged. COVID “had left [Floyd] jobless and listless, a shadow of the gregarious man his friends and family once knew.” He struggled with economic marginality, substances, and dreams that didn’t happen. Floyd “had always seemed to be trying to go somewhere, to find something different, to outrun his circumstances in order to reach a better place.”

The horror of Floyd’s murder, a tsunami of needless racist rage, was hard to overstate. The overlap of COVID-19 and Floyd produced an emotional firestorm whose rage was unsustainable exactly because it was so intense. In September 2020, a public health executive wrote that “Mr. Floyd’s death feels different because it represents a cumulative injury on top of the sustained acuity of health inequities playing out in horrifying details through the COVID-19 pandemic.”

The George Floyd summer generated millions of tweets along with plenty of blog posts, journalism, and scholarship. Two sociologists pored through some 20,000 tweets whose hashtags were associated with both Floyd and COVID. Their research began from an understanding that “social media content both reflect and construct the social meanings of topics and events.”



What’s Your Brain Got to Do With It?

A lot, when it comes to pain. Neuroscience is uncovering how our nervous systems process painful stimuli; much remains unknown. But the brain circuits that produce feelings of individual pain appear to shape our experiences of social pain. Is the same true for shared pain? Not to get too far in front of the evidence, but why would our brains develop new circuitry for a form of human experience those brains have dealt with forever?

We may not need to look beyond a few million years of evolution to see how systems for dealing with individual and social pain have converged. “Social pain is a human, and perhaps primate, adaptation in which separation, rejection, exclusion, and isolation trigger the same affective [our feelings] neural circuits as physical pain …” There is a growing body of research to suggest “a possible overlap in the neural circuitry underlying physical and social pain.”

How this works is still to be figured out. But neuroscientists know that pain involves numerous brain regions and many millions of circuits.

Now let’s look in the opposite direction.

Know Your Exposome

I didn’t make the connections at first. But two books have helped me start to grasp possible ties among individual, social, and shared pain.

The first is Rupa Marya and Raj Patel’s Inflamed: Deep Medicine and the Anatomy of Injustice (2022). It’s a powerfully argued study of the formative links among health, illness, and the larger world. Marya and Patel define the exposome as “the sum of lifetime exposures to nongenetic drivers of health and illness, from conception to death.” It’s a social analogue to billions of neuronal connections in the brain. Perhaps a steady stream of life events and conditions shape our perceptions of, and responses to, events at every scale.

Theirs is a sharply political view of disease and health. Marya and Patel locate disease causality “…in the multidimensional spaces around and beyond the individual body – in histories, ecologies, narratives, and dynamics of power. The inflammatory diseases we are seeing today are not the cause of the body’s dysfunctional reactions. They are the body’s correct responses to a pathological world.” In this view, “…your physiological state is a reaction to social and environmental factors. Racial violence, economic precarity, industrial pollution, poor diet, and even the water you drink can inflame you.”

So how to reconcile the role of billions of brain circuits with the exposome and its large-scale systems?  

That’s where the second book comes in.

Economists Anne Case and Angus Deaton traced one set of lines between people’s lives and the exposome. Their Deaths of Despair and the Future of Capitalism (2020) defined deaths of despair as those caused by drug overdoses, alcoholic liver disease, and suicide, and the book provoked intense debate.

Their perspective challenged economic orthodoxy. They argued that “it is the loss of meaning, of dignity, of pride, and of self-respect that comes with the loss of marriage and of community that brings on despair, not just or even primarily the loss of money.”

For Case and Deaton, drugs’ biochemical properties don’t cause addiction. The conditions of people’s lives are the main cause. “It is impossible to understand drug use without understanding the environments in which users live, and how those environments are treating them and have treated them in the past. As one physician put it to us, biographies matter.”

The two books are helping me think about shared pain.

Shared pain raises questions about power, global events, widely disparate life circumstances, and of limits to personal and collective agency. Shared pain is about how the whole world seeps through cells and tissues and systems of our bodies and lives.

Case and Deaton put “loss of meaning” at the top of their list of experiences that produce despair, far ahead of financial troubles. Across pain’s history, questions of meaning reverberate. From the combat zone to the football pitch to the high school cafeteria, the question of what our pain means is near to the experience but far from clear.


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