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Wednesday, March 30, 2011
Monday, March 28, 2011
Social rejection shares somatosensory representations with physical pain
Ethan Krossa,1, Marc G. Bermana, Walter Mischelb, Edward E. Smithb,c,1, and Tor D. Wagerd
Department of Psychology, University of Michigan, Ann Arbor, MI 48109; bDepartment of Psychology, Columbia University, New York, NY 10027; cNew York State Psychiatric Institute, New York, NY 10032; Department of Psychology, University of Colorado, Boulder, CO 80309-0345
Contributed by Edward E. Smith, February 22, 2011 (sent for review October 05, 2010)
How similar are the experiences of social rejection and physical pain? Extant research suggests that a network of brain regions that support the affective but not the sensory components of physical pain underlie both experiences. Here we demonstrate that when rejection is powerfully elicited—by having people who recently experienced an unwanted break-up view a photograph of their ex-partner as they think about being rejected—areas that support the sensory components of physical pain (secondary somatosensory cortex; dorsal posterior insula) become active. We demon- strate the overlap between social rejection and physical pain in these areas by comparing both conditions in the same individuals using functional MRI. We further demonstrate the specificity of the secondary somatosensory cortex and dorsal posterior insula activity to physical pain by comparing activated locations in our study with a database of over 500 published studies. Activation in these regions was highly diagnostic of physical pain, with positive predictive values up to 88%. These results give new meaning to the idea that rejection “hurts.” They demonstrate that re- jection and physical pain are similar not only in that they are both distressing—they share a common somatosensory representation as well.
This research is helpful in demonstrating to the jury, neuro-scientifically, the similarities between emotional and physical pain. There are no pain pills for emotional pain, however. Emotional loss physically hurts. These finding support the interesting research on embodied cognition.
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Thursday, March 24, 2011
This week it will be one year since President Barack Obama signed the Affordable Care Act (ACA) into law. Despite all the controversy that preceded the bill’s passage, most health policy experts confidently predicted that the public would soon embrace the legislation.
To back up these predictions, they pointed out that Medicare was quite controversial when it was established in the 1960s, but rapidly grew in popularity. Much the same happened more recently with Medicare Part D, the law championed by President George W. Bush to extend Medicare coverage to medications.
Recent polls belie these predictions, however, as support for health care reform has hit an all-time low. Why has the ACA failed to capture public support? Our research provides a novel explanation, one that pundits have failed to recognize to date.
Obama’s health reform bill is unpopular not simply because it is complicated, nor simply because it costs government money at a time when people are in a mood to balance the budget. Instead, it is unpopular in large part because it no longer feels inevitable.
And the key to gaining widespread support for Obama’s signature piece of domestic legislation is not to help the public better understand the intricacies of the bill, but instead to convince the public that the bill is here to stay.
Uncertainty can play a large role in reducing support for legislative actions. Consider a study we conducted, in which we asked people to imagine their local government had recently passed a bill to lower the speed limit, legislation spurred on by new evidence that such a law would save lives. The people we surveyed embraced the new rule, feeling thankful that legislators were paying attention to public safety.
However, in assessing public attitudes toward this bill, we conducted an experiment in which we told some of the people we surveyed that the legislature was about to pass the law but hadn’t yet voted on it – that is, it wasn’t officially a law yet. These people, in contrast to the first group, felt strongly that such legislation would be heavy-handed and paternalistic.
The same bill, when passed into law, was viewed more favorably than when it was merely pending legislation.
What about health care reform then? It has passed into law. Shouldn’t it be gaining in popularity?
Not if people don’t believe the bill is the law of the land. When the Republican-led House voted to repeal the bill, Washington insiders recognized the action as a symbolic gesture with no legislative consequence.
But many Americans thought this vote had actual legal implications. In fact, recent polls show that a fifth of the American public currently believe the ACA has been repealed, and another fifth is unsure if the bill still stands as law. This misperceived state of affairs provides no reason for these Americans to embrace a law they believe no longer stands.
Recent court rulings have created even greater uncertainty about the legal standing of the ACA. While most rulings have focused solely on the constitutionality of the health insurance mandate, one judge went as far as to opine that the entire law should be voided. This has left even more people wondering where the bill stands: as current law, pending law or past law?
Behavioral science has shown us that most people find uncertainty to be a very difficult pill to swallow, especially when it surrounds a proposed change to their lives. Half-hearted attempts at change often produce knee-jerk, negative reactions; people are not inclined to adapt to a change that may never occur or seems unlikely to stick. These are the types of situations most likely to breed backlash.
But when the uncertainty is removed, backlash reactions tend to dissipate and sometimes even reverse. When people know what cards they have been dealt – when they feel confident about what to expect in the future – people tend to begin the process of rationalizing the change and adapting to it.
The real battle over health care reform in the next few months will extend beyond the specifics of budget debates and regulatory wranglings. Instead the fate of health care reforms stands mainly on how soon, if ever, the public comes to feel that the legislation is enduring. If the permanence of the Affordable Care Act continues to feel unsettled, that will become a self-fulfilling prophecy.