Painkillers reduce empathy

There’s this strange thing, pain contagion. When we see or hear about others in pain we share an aspect of what it feels like as if we were in pain ourselves–usually completely unconsciously but sometimes we might notice a tingle, a pain or we might squirm with displeasure. This is an aspect of somatic empathy. It informs us about suffering around us which –as animals—is essential survival information. Without pain contagion we are less able to empathise, less able to understand how others feel.

A small proportion of people (1-2%) don’t experience pain contagion and so are unable to share how others feel. They can work it out mentally and express cognitive empathy, but they can’t have any kind of shared experience of anyone else’s discomfort. At the other extreme, a similarly small percentage of people experience excessive pain contagion and find themselves in discomfort much of the time simply from what is happening to others around them. Such a person is unable to watch a violent film as it impinges on them physically.

Most of us experience moderate pain empathy along with other species of mammals and birds. Pain empathy is how animals know others are suffering.

This is all well and good but recent research has discovered that painkiller medications reduce our ability to feel how others feel. Researchers are concerned that the current increase in the use of painkillers (i.e. the painkiller epidemic both prescription and non-prescription) is producing a society without empathy.

How do painkillers reduce empathy?

In order to self-regulate we need to feel what is going on inside of us. The ability to do this is called interoception – a buzzword in health and well-being. We can sense physical and emotional dynamics. If I feel thirst I drink. If I feel scared, I remove myself from the scary situation. Without a sense of fear or thirst, I would die quite quickly. Feeling what is going on inside of us is essential for keeping us healthy and safe.

When we witness pain, our minded body simulates that same pain. If I watch someone stub their toe, my same toe tingles. If you watch someone be hit on the head, your head may feel weird for a split second. The reason for pain contagion is complex but –putting it very simply—the way perception works is that it is embodied. We translate what we sense in the outside world into internal 3D experience. This produces somatic empathy – a shared experience.

When we take painkillers to numb pain, we reduce internal sensations from the body to the brain and therefore also become less able to feel pain empathy with others. We not only kill our own pain but the ability to share others’ pain.

And we are not talking about super strong painkillers such as ketamine or heroin. The humble paracetamol readily available over the counter is sufficient to take the edge off empathy.

Engel, C. Another Self: how your body helps you understand others. ISBN 9781-80049-280-6 (UK book, US book)

Engel, C. Wild Health: how animals keep themselves healthy in the wild and what we might learn from them. ISBN 9781-80049-278-3

Mischkowski D, Crocker J, Way BM. From painkiller to empathy killer: acetaminophen (paracetamol) reduces empathy for pain. Soc Cogn Affect Neurosci. 2016 Sep;11(9):1345-53.