I searched for a more recent research article in the area of pain/ostracism and came across this paper. It’s open access with the full text freely available. And it’s not a terribly difficult read.
I’ve had a sustained interest in the areas of psychic pain and physical pain for a good number of years. I’m not entirely sure why. Probably because of:
- spending decades with the heroin-injecting patient population, and the methadone maintenance population, where both physical and psychic pain are rather central as a topic;
- spending decades with patients experiencing severe multi-generational abuse and neglect as completely common throughout their lives, and ultimately living on the street or correctional settings;
- my background in behaviorism specifically applied to drug use onset and progression (Pavlovian models and models of reinforcement);
- my more recent interest in the Adverse Childhood Experiences (ACEs) literature;
- even more recently doing some experimental work in the ACEs area highlighting neglect as a contextual factor that gives active forms of trauma a much fuller potency for later impact;
- reading the acetaminophen literature, given its interesting usefulness (no addiction potential) as an experimental probe in management of depression, other mood problems, and the psychic pain of ostracism,
- and my multi-year interest in clinician burnout, including the phenomena of clinician avoidance of painful, but best-practice, counseling techniques.
Here are some interesting highlights from this 2023 research article.
First, a definition:
Ostracism (ie, being ignored/excluded) is a form of social adversity that powerfully impacts health and well-being.
Next, a main finding:
For individuals with histories of more lifetime ostracism, encountering a single episode of ostracism led to greater pain sensitization relative to the control condition, whereas no experimental effect was observed for individuals with little lifetime exposure to ostracism.
I found the next two sentences about practical application especially interesting, given the importance of pain-sensitivity (aka “hyperalgesia”) in the context of opioid use, physical opioid dependence, chronic opioid use disorders, and medication maintenance strategies with opioids such as methadone, suboxone, etc.
These findings indicate that acute experiences of ostracism may be accompanied by periods of hyperalgesia for people who are chronically ostracized, implicating ostracism as a potential social moderator of pain sensitization. People who are stigmatized may therefore experience enhanced pain burden with repeated and accumulating experiences of ostracism.
Overall, the authors highlight how chronic ostracism leads to increased pain sensitivity. And thus, the pain of ostracism is greater in the context of a specific ostracising event for those individuals.
I’m sure the reader can imagine a range of relevant interactions for this factor in our work overall, including: the problems of those with neglect in their ACEs who later develop SUDs; ACOAs who later develop SUDs, the cost and benefit of participation in recovery fellowships generally; the importance of selecting a recovery fellowship specifically; self-efficacy and social support during early recovery in a society that might not be supportive, what it’s like to be a clinician in our field….The list goes on and on.
Reference
Nanavaty N, Walsh KT, Boring BL, Ganesan A, Carter-Sowell AR, Mathur VA. Acute Ostracism-Related Pain Sensitization in the Context of Accumulated Lifetime Experiences of Ostracism. J Pain. 2023 Jul;24(7):1229-1239. doi: 10.1016/j.jpain.2023.02.021.
Suggested Reading
Recovery Review 