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1. Article, 2. Rejection is the same to the brain as physical pain, 3. Why does it cause the same pain in the brain?

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Anyone who lived through high school gym class knows the anxiety of being picked last for the dodgeball team. The same hurt feelings bubble up when you are excluded from lunch with co-workers, fail to land the job you interviewed for or are dumped by a romantic partner.

Rejection feels lousy.

Yet for many years, few psychologists tuned into the importance of rejection. "It's like the whole field missed this centrally important part of human life," says Mark Leary, PhD, a professor of psychology and neuroscience at Duke University. That's changed over the last decade and a half, as a growing number of researchers have turned their eyes toward this uncomfortable fact of life. "People have realized just how much our concern with social acceptance spreads its fingers into almost everything we do," he says.

As researchers have dug deeper into the roots of rejection, they've found surprising evidence that the pain of being excluded is not so different from the pain of physical injury. Rejection also has serious implications for an individual's psychological state and for society in general. Social rejection can influence emotion, cognition and even physical health. Ostracized people sometimes become aggressive and can turn to violence. In 2003 Leary and colleagues analyzed 15 cases of school shooters, and found all but two suffered from social rejection ( Aggressive Behavior, 2003).

Clearly, there are good reasons to better understand the effects of being excluded. "Humans have a fundamental need to belong. Just as we have needs for food and water, we also have needs for positive and lasting relationships," says C. Nathan DeWall, PhD, a psychologist at the University of Kentucky. "This need is deeply rooted in our evolutionary history and has all sorts of consequences for modern psychological processes."

Pain in the brain

As clever as human beings are, we rely on social groups for survival. We evolved to live in cooperative societies, and for most of human history we depended on those groups for our lives. Like hunger or thirst, our need for acceptance emerged as a mechanism for survival. "A solitary human being could not have survived during the six million years of human evolution while we were living out there on the African savannah," Leary says.

With today's modern conveniences, a person can physically survive a solitary existence. But that existence is probably not a happy one. Thanks to millions of years of natural selection, being rejected is still painful. That's not just a metaphor. Naomi Eisenberger, PhD, at the University of California, Los Angeles, Kipling Williams, PhD, at Purdue University, and colleagues found that social rejection activates many of the same brain regions involved in physical pain ( Science, 2003).

To study rejection inside an fMRI scanner, the researchers used a technique called Cyberball, which Williams designed following his own experience of being suddenly excluded by two Frisbee players at the park. In Cyberball, the subject plays an online game of catch with two other players. Eventually the two other players begin throwing the ball only to each other, excluding the subject. Compared with volunteers who continue to be included, those who are rejected show increased activity in the dorsal anterior cingulate and the anterior insula - two of the regions that show increased activity in response to physical pain, Eisenberger says. As far as your brain is concerned, a broken heart is not so different from a broken arm.

Those findings led DeWall, Eisenberger and colleagues to wonder: If social rejection aches like physical pain, can it be treated like physical pain? To find out, they assigned volunteers to take over-the-counter acetaminophen (Tylenol) or a placebo daily for three weeks. Compared with the placebo group, volunteers who took the drug recounted fewer episodes of hurt feelings in daily self-reports. Those reports were backed by an fMRI study, which found that people who had taken acetaminophen daily for three weeks had less activity in the pain-related brain regions when rejected in Cyberball, in contrast to those taking a placebo ( Psychological Science, 2010).

The same patterns are seen in situations of real-world rejection, too. University of Michigan psychologist Ethan Kross, PhD, and colleagues scanned the brains of participants whose romantic partners had recently broken up with them. The brain regions associated with physical pain lit up as the participants viewed photographs of their exes ( Proceedings of the National Academy of Sciences, 2011).

The link between physical and social pain might sound surprising, but it makes biological sense, DeWall says. "Instead of creating an entirely new system to respond to socially painful events, evolution simply co-opted the system for physical pain," he says. "Given the shared overlap, it follows that if you numb people to one type of pain, it should also numb them to the other type of pain."

Lashing out

Being on the receiving end of a social snub causes a cascade of emotional and cognitive consequences, researchers have found. Social rejection increases anger, anxiety, depression, jealousy and sadness. It reduces performance on difficult intellectual tasks, and can also contribute to aggression and poor impulse control, as DeWall explains in a recent review ( Current Directions in Psychological Science, 2011). Physically, too, rejection takes a toll. People who routinely feel excluded have poorer sleep quality, and their immune systems don't function as well as those of people with strong social connections, he says.

Even brief, seemingly innocuous episodes of rejection can sting. In one recent study, Williams, Eric Wesselmann, PhD, of Purdue University, and colleagues found that when participants passed a stranger who appeared to look "through" them rather than meeting their gaze, they reported less social connection than did people who made eye contact with a passing stranger ( Psychological Science, 2012).

In fact, it's remarkably hard to find situations in which rejection isn't painful, Williams says. He wondered whether people would be hurt if they were rejected by a person or group they disliked. Using his Cyberball model, he found that African- American students experienced the same pain of rejection when they were told that the people rejecting them were members of the Ku Klux Klan, a racist group. In other studies, participants earned money when they were rejected, but not when they were accepted. The payments did nothing to dampen the pain of exclusion. "No matter how hard you push it, people are hurt by ostracism," he says.

Fortunately, most people recover almost immediately from these brief episodes of rejection. If a stranger fails to look you in the eye, or you're left out of a game of Cyberball, you aren't likely to dwell on it for long. But other common rejections - not being invited to a party, or being turned down for a second date - can cause lingering emotions.

After the initial pain of rejection, Williams says, most people move into an "appraisal stage," in which they take stock and formulate their next steps. "We think all forms of ostracism are immediately painful," he says. "What differs is how long it takes to recover, and how one deals with the recovery."

People often respond to rejection by seeking inclusion elsewhere. "If your sense of belonging and self-esteem have been thwarted, you'll try to reconnect," says Williams. Excluded people actually become more sensitive to potential signs of connection, and they tailor their behavior accordingly. "They will pay more attention to social cues, be more likable, more likely to conform to other people and more likely to comply with other people's requests," he says.

Yet others may respond to rejection with anger and lashing out. If someone's primary concern is to reassert a sense of control, he or she may become aggressive as a way to force others to pay attention. Sadly, that can create a downward spiral. When people act aggressively, they're even less likely to gain social acceptance.

What causes some people to become friendlier in response to rejection, while others get angry? According to DeWall, even a glimmer of hope for acceptance can make all the difference. In a pair of experiments, he and his colleagues found that students who were accepted by no other participants in group activities behaved more aggressively - feeding hot sauce to partners who purportedly disliked spicy foods, and blasting partners with uncomfortably loud white noise through headphones - than students accepted by just one of the other participants ( Social Psychological and Personality Science, 2010).

Social pain relief

It may take time to heal from a bad break-up or being fired, but most people eventually get over the pain and hurt feelings of rejection. When people are chronically rejected or excluded, however, the results may be severe. Depression, substance abuse and suicide are not uncommon responses. "Long-term ostracism seems to be very devastating," Williams says. "People finally give up."

In that case, psychologists can help people talk through their feelings of exclusion, DeWall says.

"A lot of times, these are things people don't want to talk about," he says. And because rejected people may adopt behaviors, such as aggression, that serve to further isolate them, psychologists can also help people to act in ways that are more likely to bring them social success.

The pain of non-chronic rejection may be easier to alleviate. Despite what the fMRI scanner says, however, popping two Tylenols probably isn't the most effective way to deal with a painful episode of rejection. Instead, researchers say, the rejected should seek out healthy, positive connections with friends and family.

That recommendation squares with the neural evidence that shows positive social interactions release opioids for a natural mood boost, Eisenberger says. Other activities that produce opioids naturally, such as exercise, might also help ease the sore feelings that come with rejection.

Putting things into perspective also helps, Leary says. True, rejection can sometimes be a clue that you behaved badly and should change your ways. But frequently, we take rejection more personally than we should. "Very often we have that one rejection, maybe we didn't get hired for this job we really wanted, and it makes us feel just lousy about our capabilities and ourselves in general," Leary says. "I think if people could stop overgeneralizing, it would take a lot of the angst out of it."

Next time you get passed over for a job or dumped by a romantic partner, it may help to know that the sting of rejection has a purpose. That knowledge may not take away the pain, but at least you know there's a reason for the heartache. "Evolutionarily speaking, if you're socially isolated you're going to die," Williams says. "It's important to be able to feel that pain."
Kirsten Weir is a freelance writer in Minneapolis.

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Researchers have found evidence that the pain of being excluded is not so different from the pain of physical injury.

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1. Article, 2. Social media and heartbreak hurts our brains the same as physical pain does, 3. How does heartbreak lower our IQ?

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We all know that rejection hurts, but neuroscience has concluded that it does in fact, literally, hurt. While the brain does not process emotional pain and physical pain identically, the reaction and cascading events are very similar, and a natural chemical (painkiller mu-opioid) is released during both events. For example, when someone feels physical pain, opioids are released in the brain so that the significance of the pain is inhibited. We now know this same experience occurs when an individual feels slighted or rejected by others.
Rejection And Resiliency In The Age Of Social Media
Despite emotional wounds being invisible, anguish, distress and stress are becoming more and more common. As we are now rejected frequently with small snubs like unfollowing on Twitter, swiping left on Tinder, not liking an Instagram post, not matching on a dating site or being alone during the holidays, these emotions are felt more often. Social media and constant contact to millions of people at any moment-although further distances between personal connections-inherently mean that more people can reject us, even if it's as small as not liking our social media post when we liked theirs.

Research out of the University of Michigan suggests that not only does the brain process rejection like it does physical injury, but that personality traits such as " resilience" are vital to how we process pain. The brain's natural painkilling response varies between humans, with some releasing more opioids during social rejection than others, meaning that some have a stronger-or more adaptive--protective ability. When mu opioid is released, there is a trigger in two areas of the brain: One (the amygdala) processes the strength of the emotion, and the other (the pregenual cingulate cortex) determines how your mood changes because of the event. Therefore, the more opioid released, the greater reduction in pain--and possibly a greater experience of pleasure when someone feels that they've been socially accepted or validated.

A step further, and it could be argued that those prone to social anxiety, panic attacks and depression release less opioid, and therefore take longer and do not recover as well from negative social experiences. These individuals may also struggle to gain as much pleasure from social support as those who get more opioid in the pregenual cingulate cortex.
Heartbreak Can Lower Your IQ
Heartbreak, loss or being left out are particularly difficult to process for humans as social creatures. But the impact is not only limited to how the brain processes the emotions and pain associated with rejection. There is also evidence that suggests not being able to " think straight " is a real outcome of feeling rejected.

According to research from Case Western Reserve University, exposure to rejection led participants in a study to have an immediate drop in reasoning by 30% and in IQ by 25%. It was also determined that feelings of rejection led participants to become more aggressive and exhibit less self-control.
How Can We Learn To Cope Better?
So what are we to do when we feel slighted by those we love or those we don't even know but affect us via social outlets? First, realize we are probably taking it too personally. We are all busy, we all have many forms of communication and social feeds bombarding us with stimuli, and we are often selective in what we are able to get to first. Think of it like a triaging system we do internally that puts our most important "to do" items and closest connections first. It could therefore be as simple as someone hasn't seen your interaction or post, as there are so many feeds flooding them at any given moment. There are also individual and demographic differences in how people interact (these often come in the form of those who troll pictures and post but never interact with anyone).

It is also important to remember that we recall emotional rejection more strongly than physical pain, and it can therefore cause longer-term sensitivity. When this happens, seek out validation and reminders of the positive impact we have on others or who cares about us. During the holidays, this can mean making proactive plans with friends or reaching out to those we love but are often too busy to connect with closely. Most importantly, it is important to allow the feelings to be processed and respected, but not to assign to much value to them, as they will subside, and our bodies will cope with emotional rejection over time, just as it does physical pain.

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Rejection And Physical Pain Are The Same To Your Brain

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We all know that rejection hurts, but neuroscience has concluded that it does in fact, literally, hurt. While the brain does not process emotional pain and physical pain identically, the reaction and cascading events are very similar, and a natural chemical (painkiller mu-opioid) is released during both events. For example, [...]

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1. Article, 2. Argues the chemicals which trigger same reaction, 3. Chemical aspect of reaction.

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1. Article, 2. The mapping of the brain and the activity within it, 3. How the brain translates rejection.

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Being cut from a team. Learning on social media how a friend hosted a party and didn't invite you. Seeing your ex-partner across the restaurant enjoying a romantic dinner with someone new. All these forms of social pain are hurtful, and scientists have found the ache is indeed real.

Studies have identified that the brain processes social pain similarly to physical pain, and they believe it's an evolutionary response . For early humans, being part of a group meant having access to increased safety and resources. Being rejected by the group left a person alone and vulnerable. Thus, humans evolved to seek social acceptance while perceiving social rejection as a threat to well-being. Associating exclusion with pain served to motivate humans to avoid threats to their social ties.

In both instances, pain activation is meant to elicit our own escape, or in the instances of self-induced pain, to stop the harmful behavior. Then, the memory of pain serves as a warning against repeating the risky behavior in the future. And although the memory of physical pain can fade , studies have found it's not the same with social pain, which can linger over time and reactivate with memory triggers.

Ongoing research has found it doesn't take much for those hurt feelings to ignite. A person doesn't even have to exist in real life to be able to spark hurt feelings. In a 2003 study in , researchers connected participants to a fMRI to see how they would respond to a virtual social snub.

In the simulation, the participant was playing catch with two virtual people. Soon, the virtual players excluded the participant and began throwing to only each other. The virtual players weren't even real, but participants' fMRIs showed an increased blood flow to the anterior cingulate cortex (ACC) - the part of the brain that registers physical pain - during this exclusion, and that the ACC was also more active. The authors concluded that the right ventral prefrontal cortex, involved in processing risk and fear, helps regulate the distress of social exclusion by disrupting the ACC.

The participants were then subject to stimulation such as light physical pain (a hot touch on the left arm) as well as pictures of friends. When a picture of their ex appeared on the screen, they were asked to think about the breakup. Sure enough, the scans showed a neurological overlap between the physical and social pain. The study concluded that "social rejection and physical pain are similar not only in that they are both distressing, they share a common representation in somatosensory brain systems as well."

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No matter who you are, rejection hurts. Scientists are able to map the very-real processes behind our social aches - and learn how similar they are to physical pain.

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1. article, 2. how our heart and head are interrelated, 3. what role does social media play in rejection?

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Sadness Love in Ending of Relationship Concept, Broken Heart Woman Standing with a Red Rose on Hand, ... [+]
Getty

Rejection hurts.

Whether you've been told 'no thank you' for a job opportunity, become estranged from a partner or friend, or even been unfollowed on a social media or dating site, your brain has to process being rejected. And neuroscience suggests that it literally - hurts.

Although the brain does not process emotional pain and physical pain identically, research on neural pathways suggests there is substantial overlap between the experience of physical and social pain. The cascading events that occur and regions activated in our brains - and therefore our reactions to the acute pain - appear to be .

Further, it seems the impact may not be limited to just how the brain processes the emotions and pain associated with rejection, but that real heartbreak can actually take a toll on your IQ. According to research from Case Western Reserve University, exposure to rejection led participants in a study to have an immediate drop in reasoning by 30% and in IQ by 25%.

Thus, a broken heart really does hurt. And it really can take a while to heal.
What's Going On In Your Head - And Heart?
Because humans are social creatures by nature, heartbreak, loss, and the feelings associated with being left out are particularly difficult to process. And because emotional wounds are invisible, anguish, distress, and stress can be difficult to understand and explain to our peers.

However, social rejection from potential partners and online activity are becoming more and more commonplace. As we are now rejected frequently with small snubs like unfollowing on Twitter, swiping left on Tinder, not receiving likes on an Instagram post, not matching on a dating site or being alone during the holidays, these emotions are felt more often. Social media and constant contact to millions of people at any moment - although further distances between personal connections - inherently mean that more people can reject us, even if it's as small as not liking our social media post when we liked theirs.

Research out of the University of Michigan suggests that not only does the brain process rejection like it does physical injury, but that personality traits such as " resilience " are vital to how we process pain. The brain's natural painkilling response varies between humans, with some releasing more opioids during social rejection than others, meaning that some have a stronger - or more adaptive - protective ability.

When mu opioid is released, there is a trigger in two areas of the brain, one (the amygdala) processes the strength of the emotion, and the other (the pregenual cingulate cortex) determines how your mood changes because of the event. Therefore, the more opioid released, the greater reduction in pain - and possibly a greater experience of pleasure when someone feels that they've been socially accepted or validated.

Similar to results from physical pain studies, researchers also found that the anterior cingulate cortex (ACC) and the right ventral prefrontal cortex (RVPFC) were more active when feeling loss or exclusion. And the greater one's anxiety, the greater the activity in the ACC. However, a systematic review published in Brain Imaging And Behaviorconcluded that the neural network for psychological pain includes the thalamus, anterior and posterior cingulate cortex, the prefrontal cortex, cerebellum, and parahippocampal gyrus. Suggesting that there is a deeply complex and interconnected series of regions that process and express pain.

Additionally, thanks to functional magnetic resonance imaging (fMRI) studies, it is also possible to now see the neural overlap both in how we process and experience pain - emotional and physical.

That said, work at both Dartmouth and the University of Colorado - Boulder reveals that there are in fact two distinct brain patterns for processing pain if you get granular enough. With enough future work in pain management, these researchers hope to tease out the differences enough to personalize treatment plans in the future.
How Can You Improve Your Coping Mechanisms To Feel Less Pain?
So what are we to do when we feel slighted by those we love or rejected in a social situation? First, realize you are probably taking the event too personally. That's not a knock to you - it's just a product of all humans thinking more about themselves than anyone else does. In fact, almost 80% of anyone's thoughts are about themselves. So in this fast-paced world with a million distractions, chances are the slight wasn't personal.

Second, understand that we're all basically using a triaging system that puts our most important 'to do' items and closest connections first. It could therefore be as simple as someone hasn't seen your interaction or post, as there are so many feeds flooding them at any given moment. There are also individual and demographic differences in how people interact (these often come in the form of those who scroll pictures and posts but never interact with anyone).

Third, it is important to remember that we recall emotional rejection more strongly than physical pain, and it can therefore cause longer-term sensitivity. When this happens, seek out validation and reminders of the positive impact we have on others or talk to someone you know who cares about us.

During holidays, this can mean making proactive plans with friends or reaching out to those we love but are often too busy to connect with closely. Most importantly, it is critical to allow the negative feelings to be respected and processed - but not to assign to much value to them. Remember, they will subside, and our bodies will cope with emotional rejection over time, just as it does physical pain.

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Emotional & Physical Pain Are Almost The Same - To Your Brain

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Rejection hurts. Whether you've been told 'no thank you' for a job opportunity, become estranged from a partner or friend, or even been unfollowed on a social media or dating site, your brain has to process being rejected. And neuroscience suggests that it literally - hurts.

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1. article, 2. the mental affects of rejection, 3. how detrimental can social rejection be to our mental health?

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The psychologist Naomi Eisenberger describes herself as a mutt of a scientist. Never quite fitting the mould of the fields she studied - psychobiology, health psychology, neuroscience - she took an unusual early interest in what you might call the emotional life of the brain. As a doctoral student at the University of California, Los Angeles (UCLA), Eisenberger found it curious that we often describe being rejected in terms of physical pain: 'My heart was broken', 'I felt crushed', 'He hurt my feelings', 'It was like a slap in the face'. More than metaphors, these expressions seem to capture something essential about how we feel in a way that we can't convey directly. And you'll find similar ones not just in English but in languages all over the world. Eisenberger wondered why. Could there be a deeper connection between physical and emotional pain?

In a landmark experiment in 2003, Eisenberger and her colleagues had test subjects strapped with virtual-reality headsets. Peering through goggles, the participants could see their own hand and a ball, plus two cartoon characters - the avatars of fellow participants in another room. With the press of a button, each player could toss the ball to another player while the researchers measured their brain activity through fMRI scans. In the first round of CyberBall - as the game became known - the ball flew back and forth just as you'd expect, but pretty soon the players in the second room started making passes only to each other, completely ignoring the player in the first room. In reality, there were no other players: just a computer programmed to 'reject' each participant so that the scientists could see how exclusion - what they called 'social pain' - affects the brain.

Physical pain involves several brain regions, some of which detect its location, while others, such as the anterior insula (AI) and the dorsal anterior cingulate cortex (dACC), process the subjective experience, the unpleasantness, of pain. In fMRI scans of people playing CyberBall, Eisenberger's team saw both the AI and the dACC light up in participants excluded from the game. Moreover, those who felt the most emotional distress also showed the most pain-related brain activity. In other words, being socially rejected triggered the same neural circuits that process physical injury, and translate it into the experience we call pain.

At the time, this was a radical idea - and it still is. It essentially suggests that the brain makes no distinction between a broken bone and an aching heart. Rejection, it tells us, actually hurts. For Eisenberger, this overlap between physical and social pain transcends scientific interest. 'It reveals something to people that they probably already knew but maybe were afraid to believe,' she told Edge magazine in 2014. 'It's not just in our head. It is in our head because it's in our brain.'

Since the original CyberBall experiment, a number of studies have replicated and extended its results. Researchers have found, for example, that social rejection doesn't have to be explicit to trigger the brain's pain mechanism: just seeing a picture of your ex-partner or even a video of disapproving faces activates the same neural pathways as physical pain does. At one point, Eisenberger and her team posed a seemingly daft question: if physical and emotional pain are related, could a painkiller relieve heartache? In the study that followed, some participants took two daily doses of Tylenol (a common painkiller) for three weeks while others took a placebo, and each group recorded their day-to-day emotions in a diary. By the end of the experiment, the Tylenol group reported less distress and showed less brain activity in the pain regions after being rejected than the placebo group.

That's not the end of emotional pain, of course, and you can surely do better than pop a pill each time the world snubs you. Still, the Tylenol study reveals something remarkable about rejection: that it can spill beyond our emotional lives and into our physical selves. In fact, in recent years social rejection has emerged as key to a number of discoveries across psychology, neuroscience, economics, evolutionary biology, epidemiology and genetics, forcing scientists to rethink what makes us sick or healthy, why some people live long while others die early, and how social inequalities affect our brains and bodies.

According to Eisenberger, the significance of social pain goes back to evolution. Throughout history, we depended on other people for survival: they nurtured us, helped to gather food and provide protection against predators and enemy tribes. Social relationships literally kept us alive. Perhaps, then, just like physical pain, the pain of rejection evolved as a signal of threat to our lives. And perhaps nature, taking a clever shortcut, simply 'borrowed' the existing mechanism for physical pain instead of creating a new one from scratch, which is how broken bones and broken hearts ended up so intimately interconnected in our brains.

What's remarkable about this connection is how even trivial slights can 'get under the skin', as researchers put it. During CyberBall, being ignored by people you didn't know and couldn't even see was enough to trigger an ancient pain response designed to keep you alive. And simply watching videos of disapproving faces produced the same effect. But what about major blows to our need to belong? Intuitively, you'd expect that, the more significant the rejection, the stronger the ensuing pain - but this is not what researchers find. It turns out that something else happens too, when we get rejected - by spouses, bosses, peers, at work, at school, at home - and it can help us understand not only our struggle for acceptance but the often longing desperation that comes with it.

Roy Baumeister is a social scientist who has spent 30 years studying self-esteem, decision making, sexuality, free will and belonging. In a series of experiments conducted with colleagues since the late 1990s, Baumeister found that following social rejection people become significantly more aggressive, prone to cheating and risk-taking, and unwilling to help others. But despite their swift change in behaviour, the socially rejected subjects showed no evidence of actually feeling hurt. This puzzled the researchers: it went against their predictions that rejection would trigger negative emotions, which, in turn, would trigger aberrant behaviour. In this case, Baumeister says, 'the emotion never showed up'.

In one study, he and his team divided undergraduates into groups of four to six, gave them some time to mingle, then separated them and asked each one to pick two other students as partners on the next task. Some participants were told that everyone had picked them, while others were told that no one had. In the end, when all the students rated their feelings, the rejected group showed no change in emotions: instead of feeling upset, they seemed to have become emotionally numb.

The same thing happened over and over, no matter how the researchers simulated rejection or measured emotion. They thought that perhaps the hurt feelings were there but the students felt too embarrassed to admit them. So in another experiment the participants had to rate how they felt about a fellow student who was in significant pain after a leg injury or a romantic breakup. The researchers reasoned that, even if the students couldn't face their own emotions, they should still be able to feel for someone else. Once again, though, the socially rejected showed much less empathy, which led to the conclusion that their emotions had indeed shut down.

Baumeister calls this phenomenon ego-shock - an allusion to the physical numbness that can follow injury. Cutting yourself on a tin of tuna, for example, you might feel nothing at first; it's as if for a brief moment your body shuts down to shield you against the pain. When you get rejected, Baumeister says, your psyche might similarly freeze up to protect you against the onslaught of emotional pain. Rejection, it seems, doesn't always hurt; sometimes it goes beyond hurt, leaving us unable to feel anything at all.

What is identity but the slow, lifelong accretion of gazes: us looking at ourselves being looked at by others?

In one study, Baumeister asked participants to write about a major blow to their self-worth and describe their immediate reaction. Peer rejection was, by far, most frequently recounted, followed by academic and romantic rejection. Moreover, compared with minor incidents, the aftermath of major threats provoked significantly different responses in the subjects. They were more likely to become disoriented and paralysed, as well as lose their ability to think straight and make decisions. They felt removed from their bodies, as if looking at things from a distance. The world appeared to them unfamiliar and strange. This limbo state doesn't normally last beyond a few minutes. Eventually, people collect themselves, and remember who and where they are.

However fleeting, such moments of shock, of utter unguardedness, reveal something about rejection and belonging that normally remains hidden. We are more than social animals. We don't just live with others but also through them and in them. They place us and ground us into the world. When they see us, they identify us. After all, what is identity but the slow, lifelong accretion of gazes: us looking at ourselves being looked at by others? What we see is, largely, what they see, or what we think they see. And when they turn away, when we become unseen, in a way we cease to be.

Rejection doesn't have to come from family, or even people you know, to do harm. Nor does it have to be particularly overt. In insidious forms, it lurks woven into the very fabric of society. In an interview for Radio Boston in 2012, Jerome Kagan, a psychologist at Harvard University, and a pioneer in child development and personality studies, said: 'The best predictor today in Europe or North America of who will be depressed is not a gene and it's not a measure of your brain; it's whether you're poor.' Kagan's statement echoes something researchers have long known: that poor people have poorer health. It's an argument that makes intuitive sense. Poverty, after all, entails a host of risk factors - child maltreatment, drug abuse, crime, unemployment, bad nutrition, inadequate health care - that have been linked to various physical and mental illnesses.

But debilitating as it is, poverty doesn't tell the whole story. In developed countries in particular, as average incomes and living standards have steadily improved, health problems have continued to beset enormous numbers of people - and not just the poor. Consider the Whitehall studies: between 1967 and 1970, the epidemiologist Michael Marmot at University College London Medical School and his team collected data on 18,000 men from the British civil service (based at Whitehall, London). After following them for 10 years, they found that unskilled workers at the bottom of the hierarchy died at about three times the rate of senior administrative staff at the top. Access to healthcare - free then as it is now - could not explain the dramatic difference in mortality between the employment ranks. What's more, a similar pattern emerged not just at the extremes but at all levels of the pecking order: the lower your status at work, the shorter your life.

Mounting evidence over the past two decades has established low socioeconomic status as a key predictor of early mortality and poor health, including cardiovascular disease, arthritis, diabetes, respiratory illnesses, cervical cancer, schizophrenia, substance abuse and anxiety. And as with the Whitehall studies, the negative health effects extend beyond the poor to everybody on the social ladder. The link between health and social status - whether you measure it by income, education or occupation, or even by where people think they stand in relation to others - has appeared with remarkable consistency in studies of thousands of US adolescents, South Koreans, African Americans, and older adults in the UK. According to Marmot's data, 'if everyone in England had the same death rates as the most advantaged, a total of between 1.3 and 2.5 million extra life years would be enjoyed by those dying prematurely each year.'

Not all researchers share Marmot's view, or his urgency. Some claim that socioeconomic status doesn't cause ill health, but that ill people, having a harder time in school or at work, simply tend to 'drift' to the bottom of the social ladder. The inequality researchers Richard Wilkinson and Kate Pickett in the UK disagree. In their book The Spirit Level (2009), they argue that drift cannot explain the well-documented pattern observed between countries: namely, that more unequal societies, with presumably steeper social hierarchies and bigger status differences, exhibit worse health outcomes. There seems to be something about our social position, they say, that gets under our skin.

But what? How could your social status make you sick? Access to resources - a natural suspect - doesn't explain the ubiquity of status effects on health. While those at the very bottom might suffer from inadequate hygiene, nutrition and health care, these factors can't account for the health gaps found across the social ladder. The privileged might seem like a different species at times but neither their doctors nor their food and certainly not their toiletries come infused with magical properties inaccessible to most in the middle. And yet the middle suffers more depression, diabetes and early death than those in the upper echelons of society.

One possible reason, according to Wilkinson and Pickett, is 'status anxiety'. The core insight here is that social status carries an implicit judgment of one's value to society. The higher up the ladder you are, the more respect and admiration you command from those around you. By contrast, being lower down the hierarchy implies a failure to live up to society's standards of success. It is to be judged as lacking and seen as inferior; in other words: to be rejected. The rejection might be implicit but, if anything, that makes it even more pernicious because it goes unquestioned: we often accept social inequality the way we inhale polluted air, or we justify it as a matter of merit. So if you find yourself near the bottom, you can feel worthless, hopeless and helpless.

The harm goes beyond emotions. A growing number of researchers now recognise that threats to our social identity, such as being negatively evaluated by others, can tamper with crucial neurobiological systems. Studies of animals in subordinate rank and people exposed to negative evaluation (for example, after giving a speech to an audience) suggest that social rejection triggers inflammation - the body's innate response to injury. Just as with physical threats, social ones can signal mortal danger, setting off a defensive immune attack against microbial intruders. While the process helps to fight infection, according to George Slavich, director of the UCLA Laboratory for Stress Assessment and Research, in cases of social rejection the effect can get out of hand, spiking inflammation to dangerous levels. Chronic inflammation, in turn, has been linked to diabetes, cardiovascular disease, some cancers, Alzheimer's, arthritis, depression and others. Fuelled by the social rejection that pervades low status, it can also help to explain that elusive link between poor health and social inequalities.

The unsettling thing about social status is that it's always relative. Where you stand on the social ladder has less to do with your actual circumstances than your comparative position in relation to everyone else on the ladder. Inevitably, this ranking produces more losers than winners, not unlike in sports, where second best is never good enough: there's only one gold medal in an Olympics game, and everything else feels like a consolation. Here's how Wilkinson and Pickett put it: 'Whether people live in a shack with an earth floor and no sanitation or in a three-bedroom house with fridge, washing machine and television, low social status is experienced as overwhelmingly degrading.'

The most unequal countries had twice the levels of mental illness and obesity as the most equal ones

Climbing the ladder doesn't necessarily solve the problem; it might just raise the bar. Say you jump a few rungs, landing at the top of your peer group. You gaze down from this new perch and think how far you've made it. But then you realise that your reference point has now shifted: you've moved up to a new social group and the top has been pushed higher. A successful venture capitalist once told me that, despite its outward glamour, Silicon Valley hides a lot of misery. His explanation: no matter how much you achieve, someone is always above you. Status, it seems, is a game you can never win because the target keeps moving, a game in which every success can also be a failure, and every winner - a loser.

Does all this mean we are doomed, bar the lucky few at the top? After all, dominance systems are how we organise social experience, whether we're talking about bees, chimpanzees or humans. But if we can't abolish hierarchies, perhaps we can flatten them? Wilkinson and Pickett argue that, apart from lifting the bottom, greater equality will spark a chain of positive changes across society. In one study, the two researchers measured the average income per person in 21 rich nations against an index of each country's health and social problems, and found no connection between the two. But when they ranked the countries from the most equal (eg, Japan and the Scandinavian nations) to the least (eg, the UK, Portugal and the US), a clear pattern emerged that could not be chalked up to chance: the most unequal countries had twice the levels of mental illness and obesity as the most equal ones; three to five years lower life expectancy; six to 10 times higher teenage birthrates; up to 12 times increased incidence of homicide, and markedly lower literacy.

One way to account for the benefits of greater equality might be that it dissolves the boundaries between groups, promoting social mixing and integration. For a long time, researchers have known that socially integrated people enjoy better health and longevity than socially isolated ones, but until recently it wasn't clear why. Was it that social relationships improved people's health or that healthy people simply had better social lives? The data was too limited to tell until the mid-1980s, when well-designed longitudinal studies enabled scholars to track thousands of people over several decades. These rich datasets, combined with stronger theoretical frameworks, provide plenty of evidence for the damaging effects of social isolation.

In 2015, the psychologists Julianne Holt-Lunstad and Timothy Smith of Brigham Young University in Utah looked at 70 studies that collectively followed more than 3 million older adults for an average of seven years. The researchers found that social isolation increased a subject's likelihood of being dead at the end of the study by 29 per cent. This result held true even when the researchers controlled for the participants' initial health status. Other studies have linked social isolation to coronary heart disease, stroke, dementia and Alzheimer's - some of the leading causes of death and disability in the world today.

Despite advances in research, it's still unclear exactly what counts as social isolation. Usually, it's seen as an objective deprivation, most acutely affecting the elderly as they retire, survive family members, stop driving, fall ill or become too frail to take part in social activities. Pooled data from a number of studies shows that as many as 40-50 per cent of over-80s report social isolation. However grim that figure, the flip side is that half of the very old continue to live well-integrated, healthy lives. Some of these seniors actually expand their social networks as time previously spent on work gets freed up for volunteering and socialising. Crucially, belonging to a social network gives elderly people a sense of purpose, and motivates them to take better care of themselves. By maintaining relationships or forging new ones, seniors benefit from what researchers call social support - whereby other people step up to provide information, help around the house or a shoulder to cry on, making it easier to weather difficult times. Giving rather than receiving social support is another antidote. In a study of 423 married older couples, helping out family, friends and neighbours (emotionally and in practical ways) predicted lower mortality rates five years later.

The quality of these connections counts, too. Some seniors thrive by nurturing fewer but deeper links, while others will find greater enjoyment still in solitude. Of course, none of this is to deny the deleterious effects of social isolation or question the plight of the elderly. But it does suggest a crucial difference between an objective state and subjective experience. The two are doubtless related, but being alone is not the same as feeling alone. According to Louise Hawkley, a research scientist at NORC at the University of Chicago, and the late John Cacioppo, a neuroscientist at the University of Chicago who studied this issue for more than two decades: 'People can be a social outcast in their own minds even while living among others.'

And it is in our minds, perhaps, that rejection reveals itself at its most insidious - not in the pricks of pain it sends through our skulls, nor in the havoc it wreaks on our bodies. In the mind, rejection can live on, fed by nothing more than our own twisted imaginations. To perceive yourself as isolated means to be rejected over and over, even when in reality no one is slighting you. It is to be, at once, the one rejected and the one who rejects. This is how rejection ultimately hurts us - by making us hurt ourselves, complicit in its cruel act.

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Health warning: social rejection doesn't only hurt - it kills | Aeon Essays

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The brain makes no distinction between a broken bone and an aching heart. That's why social exclusion needs a health warning

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1. article, 2. other background facts about rejection and the affects it has on us mentally, 3. how it is easier to relive social pain vs physical pain?

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Key points

fMRI studies show that an experience of rejection and an experience of physical pain can both activate the same areas of the brain.

Humans have a fundamental need to belong to a group, making rejection all the more painful.

Being asked to recall a recent rejection has made people score significantly lower on subsequent IQ tests.

We know that rejection really hurts, but it can also inflict damage to our psychological well-being that goes beyond emotional pain. Here are 10 lesser-known facts that describe the effects rejection has on our emotions, thinking, and behavior.

Why rejection hurts as much as it does

1. Rejection piggybacks on physical pain pathways in the brain. fMRI studies show that the same areas of the brain become activated when we experience rejection as when we experience physical pain. This is why rejection hurts so much (neurologically speaking). In fact our brains respond so similarly to rejection and physical pain that...

2. Tylenol reduces the emotional pain rejection elicits. In a study testing the hypothesis that rejection mimics physical pain, researchers gave some participants acetaminophen (Tylenol) before asking them to recall a painful rejection experience. The people who received Tylenol reported significantly less emotional pain than subjects who took a sugar pill. Psychologists assume that the reason for the strong link between rejection and physical pain is that...

3. Rejection served a vital function in our evolutionary past. In our hunter/gatherer past, being ostracized from our tribes was akin to a death sentence, as we were unlikely to survive for long alone. Evolutionary psychologists assume the brain developed an early warning system to alert us when we were at risk for ostracism. Because it was so important to get our attention, those who experienced rejection as more painful (i.e., because rejection mimicked physical pain in their brain) gained an evolutionary advantage-they were more likely to correct their behavior and consequently, more likely to remain in the tribe. This probably also explains why...

4. We can relive and re-experience social pain more vividly than we can physical pain. Try recalling an experience in which you felt significant physical pain and your brain pathways will respond, "Meh." In other words, that memory alone won't elicit physical pain. But try reliving a painful rejection (actually, don't-just take my word for it), and you will be flooded with many of the same feelings you had at the time (and your brain will respond much as it did at the time, too). Our brain prioritizes rejection experiences because we are social animals who live in "tribes." This leads to an aspect of rejection we often overlook...

5. Rejection destabilizes our "need to belong." We all have a fundamental need to belong to a group. When we get rejected, this need becomes destabilized and the disconnection we feel adds to our emotional pain. Reconnecting with those who love us, or reaching out to members of groups to which we feel strong affinity and who value and accept us, has been found to soothe emotional pain after a rejection. Feeling alone and disconnected after a rejection, however, has an often overlooked impact on our behavior...

6. Rejection creates surges of anger and aggression. In 2001, the Surgeon General of the U.S. issued a report stating that rejection was a greater risk for adolescent violence than drugs, poverty, or gang membership. Countless studies have demonstrated that even mild rejections lead people to take out their aggression on innocent bystanders. School shootings, violence against women, and fired workers going "postal" are other examples of the strong link between rejection and aggression. However, much of that aggression elicited by rejection is also turned inward...

7. Rejections send us on a mission to seek and destroy our self-esteem. We often respond to romantic rejections by finding fault in ourselves, bemoaning all our inadequacies, kicking ourselves when we're already down, and smacking our self-esteem into a pulp. Most romantic rejections are a matter of poor fit and a lack of chemistry, incompatible lifestyles, wanting different things at different times, or other such issues of mutual dynamics. Blaming ourselves and attacking our self-worth only deepens the emotional pain we feel and makes it harder for us to recover emotionally. But before you rush to blame yourself for...blaming yourself, keep in mind the fact that...

8. Rejection temporarily lowers our IQ. Being asked to recall a recent rejection experience and relive the experience was enough to cause people to score significantly lower on subsequent IQ tests, tests of short-term memory, and tests of decision-making. Indeed, when we are reeling from a painful rejection, thinking clearly is just not that easy. This explains why...

9. Rejection does not respond to reason. Participants were put through an experiment in which they were rejected by strangers. The experiment was rigged-the "strangers" were confederates of the researchers. Surprisingly, though, even being told that the "strangers" who had "rejected" them did not actually reject them did little to ease the emotional pain participants felt. Even being told that the strangers belonged to a group they despised such as the KKK did little to soothe people's hurt feelings. Still, the news is not all bad, because...

10. There are ways to treat the psychological wounds rejection inflicts. It is possible to treat the emotional pain rejection elicits and to prevent the psychological, emotional, cognitive, and relationship fallouts that occur in its aftermath. To do so effectively we must address each of our psychological wounds (i.e., soothe our emotional pain, reduce our anger and aggression, protect our self-esteem, and stabilize our need to belong).
See also: Copyright 2013 Guy Winch

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Research finds that rejection affects intelligence, reason, and more.

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1. article, 2. human perception of rejection on the brain, 3. which chemicals react to rejection and physical pain?

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