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Pain empathy

It can also be referred to as vicarious pain, indirect pain or mirror pain

It is sometimes also called mirror sensory synesthesia or synesthesia for pain, although it is generally not considered a type of synesthesia

 

What is it?

It consists of an unpleasant physical sensation felt in a specific part of the body on perceiving physical pain felt by another person: either seeing it visually, reading about it, hearing someone describe it or even just thinking about it. In each person who experiences it, the specific part of the body affected is always the same, although different people feel it in different parts of their body (some people always feel it in the back of their legs, for example, while others always feel it in their hands and feet).


It does not fulfil all the requirements to be considered a type of synesthesia and is not normally classified as such, although some opinions (CC Hart, recently Michael Banissy...) suggest it should be included as a type. However, it is estimated that it could affect between 17% and 30% of the general population, while synesthetes are considered to make up just under 4% in total)2, so it would be more logical to consider it a parallel phenomenon and not a type of synesthesia. It has some similarities to mirror touch, which affects a much lower percentage of the population and is accepted as a type of synesthesia by the vast majority of researchers (although not all). Sometimes these two phenomena are confused and we hear someone say they have mirror touch when they are actually talking about pain empathy experiences (see the chart below to find out more about the differences between the two).


People who have pain empathy have reported feeling it in the following parts of their bodies: back of the legs; groin; feet; hands and feet; spine or base of the spine; back of thighs and buttocks; shins; whole body; forearms; stomach; thighs; arms and legs and a little in the jaw; legs and stomach; arms and back; spine and back of the neck; lumbar area and legs; ankles and feet…


The type of sensations they mention, which appear to always be the same for the same person, are a kind of electric shock feeling that travels down the affected area; tingling; “waves of unpleasantness”, “a bunch of tiny paper cuts running across my skin repeatedly”, etc.


Some people say that the feeling only occurs in response to certain types of injuries (only with cuts or bleeding wounds, for example), although most do not make this distinction. It is only triggered by physical pain, not by emotional distress.


Although the phenomenon is commonly evoked on perceiving pain in strangers, it appears that the closer the affective relationship with the person who is suffering the stronger the effect is. Even people who never normally experience it can sometimes feel it in exceptional cases, when the pain in question is affecting a close family member, their SO, etc. (a classic case is the pain felt by a new father when his child is being born.)


Some people say that they also feel it in response to pain suffered by animals, although it is only evoked by some animals and not all. It seems to depend on the type of animal in question, and is more likely to occur in the case of a beloved pet.


The phenomenon described here has been related to the “mirror neurons” or “empathy neurons”, located in the premotor cortex of the brain and whose function is to reflect the activity being carried out by other people. Discovered by Giacomo Rizzolatti in 1996, mirror neurons are probably involved in mirror touch, pain empathy and mirror kinetics, although their mechanisms are not yet fully known. You can read more about mirror neurons in this article.


Differences between mirror touch and pain empathy

Mirror touch

Pain empathy

 

 

The action of touching, hitting, etc. must actually be observed visually, in real life or on film/video etc., for the mirror sensation to be felt. 

 

It is triggered not only by visually observing the pain but also by seeing its effects or consequences, hearing someone talk about it, reading about it, remembering it, anticipating it or even just thinking about it.

It occurs on seeing painful stimuli and also other types of tactile stimuli.

Examples:

Tactile actions carried out on a person causing physical pain (slaps, punches, shots, stabbing, head butts…. need I go on?)

Other types of hitting (not only blows that cause pain but also those with more pacific intentions such as a pat on the back, someone hitting a ball, etc.)

Other tactile actions in general (stroking, gentle patting, tickling, handshakes, etc.)

It only happens on perceiving physical pain (real, reported, possible or anticipated). It does not occur with other non-painful tactile stimuli such as stroking or patting.

The mirror sensation felt is located in the same part of the body as the affected part of the person being observed. It mirrors what is being observed and is not idiosyncratic. So if somebody’s knee is hit, all people who have a mirror touch reaction will feel it in their knee, or if they see someone touched on the cheek they will all feel it in their cheek.

The mirror sensation is consistently felt in a certain part of the body in particular, regardless of the bodily location of the other person’s pain perceived. It is basically idiosyncratic: some people always feel the vicarious pain in their legs, for example, while others always feel it in their groin. Some people feel it in two different parts of their body at the same time, or in rapid succession.

As it affects the same part of the body as the part observed, the mirror sensation often affects just one side or one point on the body (one hand, for example).

The mirror sensation is centred with respect to the body (groin, spine, etc.) or is symmetrical (both legs, both feet, etc.).

It is an uncommon phenomenon (estimated to affect around 1.5% of the general population)1

It is relatively common (estimated to affect between 17% and 30% of the general population)2

 

1 This figure is taken from the study by Ward, Banissy et al. 2016, Common and distinct neural mechanisms associated with the conscious experience of vicarious pain

2 The figure of 17% comes from the same study by Ward, Banissy et al. and the figure of 30% from Fitzgibbon et al. 2012, Mirror-sensory synaesthesia: Exploring ‘shared’ sensory experiences as synaesthesia 


Here are some descriptions written by people who experience pain empathy:


"[It] is a strange and discomfiting sensation. When I see another person’s wounds, I get shocks of stinging pain that shoot from my hips to my heels. It doesn’t matter if this injury is real or depicted in a film or novel; the instant I see it or read it, flashes of something akin to electricity course down my legs. If I’m deeply affected by what I see, or if I am really tired, I will also feel pain in the back of my arms and across my chest following the path of the thoracic dermatomes."

(Source: CC Hart, synesthete and medical and massage professional, in her websiteVox Synaesthetica. CC Hart calls this phenomenon “synesthesia for pain".)


“I get this, but never thought much about it. When I see someone in an unexpected fall (something I know will hurt), I get a sharp pain in my nerve endings mainly hands and feet. Like if a skateboarder fall comes up on my feed and he's flew off down a flight of stairs. I can't watch those fail videos where people are actualy hurt as I feel physical pain!”

(Source: This comment on the online debate platform Reddit/Synesthesia. 2020.)


An example of pain empathy involving animals:

“I feel pain when my dog is hurt but not my son's cat.”

(Source: This post on the online debate platform Reddit/Synesthesia. 2020.)


More links:

Another study on this phenomenonM. Rothen, B. Meier, Why vicarious experience is not an instance of synesthesia  

A recent 4-minute video giving a good overview of both pain empathy and mirror touch. "Empathy to the Extreme", a BBC Reel by Aurore DuPont Sagorin, also featuring Jamie Ward and CC Hart.

 

Related synesthesia types:

Mirror touch


This page last updated: 08 March 2023

37 comments:

  1. Thank you for posting this, I experience pain empathy and find this really interesting!

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  2. Thank you so much for this article, I always thought something was wrong with me for the pain that shoots down the back of my legs when I see or hear pain or injury, especially by animals. Thank you for helping me realize I’m not alone

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  3. Thanks for this article as I get this reaction but I don’t only get it for physical pain, but emotional pain too. Is this a different but related syndrome?

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    1. Yes, exactly, I think it would be considered different but related, probably as having a high degree of empathy that extends to people's feelings and not just the stronger impression you get from knowing about physical pain affecting someone.

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  4. I experience pain in my groin when I see someone in an accident on screen or in social media

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    1. I have exactly the same experience. Was afraid to tell anyone about it. This article helped a lot.

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  5. This runs in my family (mother's side). My mother always referred to it as "The Jetti Knees". When a close friend or relative is physical injured, our knees ache. Both of them. If it happens to strangers or people we don't care for, there is no sensation at all. But when it is a loved one, it can be debilitating. I have had to literally sit down before because I thought my knees were going to buckle out from underneath me. It's an intense neuropathic discomfort that comes in waves and then dissipates quickly. My grandmother, my mother and myself all have it.

    I'd rather not have it.

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  6. I experience this! Usually I feel an achy, almost uncomfortable numb in my knees or lower back. Other times I actually do feel the pain in the same area as the other person. Actually just watched a tiktok story about a girls brain surgery and now my lower back hurts xd

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  7. Oh, THIS is what it is. I don't feel it souch on seeing someone in pain, but if someone tells me about something that was really painful; I get a pain like this in my groins. Like a reflex twinging.

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  8. I have always had this wave of pain move through my upper thighs and move down. I’m super curious now because the same sensation happens, but more intense and in my arms as well, before I have a hot flash. So I am trying to figure out the connection there.

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    2. I thought mine was related to some kind of maternal instinct. My womb & inner thighs suddenly go weak and "feel like jelly" if I see or even hear about someone else's wound or injury.

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  9. This was really intresting but i’m still confused on what I have. If i see, hear, read or imagine something painful (it doesn’t have to be extremely painful, it can also be just a small punch on the arm or something) i can feel it in the same area as the thing i see/hear… which falls under mirror touch but I don’t really have it with gentle sensations like stroking or just touching. It also doesn’t matter if i know the person or not, i always feel the pain. I’m confused

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    1. Hi! I'm glad you found it interesting! If you often get sensations in the same part of the body as the one you are perceiving the other person's pain in, then that should be considered mirror touch, as you say, even if you don't always need a direct visual stimulus. I would say that the fact you don't get this reaction from gentle touches doesn't really matter, as that's just your brand of mirror touch - you don't get it with everything and you need the touch to be robust to cause a reaction, so someone being hit, kicked, etc. would make sufficient impression on you for you to feel it, while just gentle touches would go unnoticed in that sense. About knowing the person or not, no, that isn't necessary, mirror touch synesthesia occurs with strangers just as much as people you know. What seems to the be the deciding factor is that you recognise the subject as being human like you (or sentient, perhaps, and the closer to a human form it has the more likely it is to happen: some people get it with robots, dogs... but it would be unlikely to happen if you saw a ball hit a wall, for example - there's nothing human to identify with there).

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  10. I had an interesting experience once while in town visiting a dear friend of mine. I went with her to a chiropractic visit to discuss treatment related to a tumor she has in her brain. It was a new doctor for her, so I waited in the waiting room while she had a consultation and initial examination. While perusing the magazines, I suddenly started feeling a mild tingling in the back of my head on the right hand side close to the top of my neck. It was so distinct I could have drawn an outline of it. Immediately, I thought of my friend and wondered where exactly her tumor was. When we had a quiet moment later that afternoon, I asked her about it and told her what I'd felt. She confirmed that where I described feeling that sensation was indeed exactly where her tumor is located. She's a very special friend, and I've had empathic experiences across long distances with her before (like, dropping everything and calling her, sensing something is wrong). However, this was the first time I'd felt something so physical. How would you classify an experience like this?

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    1. Hi! I think your intuition was telling where your friend’s tumor was and you felt a great empathy with her at that particular time. Personally I’d say it’s a strong empathetic/intuitive experience with someone very close to you, the type of experience that could intensify the physical manifestation a person could automatically feel via empathy. And I think these things also strengthen the bond between you. Perhaps she had been giving you some indication of where her headaches were occurring, like touching her head, that you subconsciously picked up on and interiorised without realising, or maybe your intuition just got it right. I’ve heard of this kind of experience happening consistently with some people who work in the medical or (particularly) therapeutic field and they get it with people they don’t know too. But I think in the case of other people, when it happens occasionally, it’s more likely to happen with someone that you feel exceptionally close to. Anyhow this isn’t my speciality at all but I think your experience is very interesting and I hope everything went well for your friend and she is now OK!

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  11. Oh thank you. It is embarrassing when no one else seems to know what you are talking about- and who wants to talk about an extremely uncomfortable shocking sensation in the groin area with something as tame as a loose tooth. I am concerned as it is getting worse as time goes on…

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    1. Hi! Yes it seems so strange that the majority of other people don't experience this, doesn't it? About it getting worse over your lifetime, I hadn't really thought about that but I presume it would be logical for you to get it more if you were going through a more sensitive phase for whatever reason, if the idea of pain or your empathy for others affected you more at some stage in your life (again, for whatever reason), or perhaps if you were coming more into contact with others in painful situations, so perhaps if you were playing or watching more sport of the kind where people sometimes get hit or hurt, or had started watching "fails" videos or something like that... Anyway I don't think it should be something to worry about, as we do go through more sensitive stages which then go away again when we focus more on something else. I don't think this is likely to be a lineally-worse-over-time thing, like an illness might be for example.

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  12. Hi, this was a brilliant read and has made me think a lot more about what I experience day to day but I am still a little bit confused.

    Example: I am playing a video game and my character walk into a wall head first or into a corner hitting its head or gets hit on the head..et .. I can feel pain even if the character itself doesn’t react as if it has felt the pain but this only applies to the character that I control. And only applies to its head not any other body part .
    Also if a friend, family , or Stranger tells me they have a headache I get one to. This is only for headaches.

    I send my best wishes kat

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    1. Hi Kat and I'm glad you enjoyed the post! What you say about the video games is interesting and makes me think you perhaps have some degree of mirror touch, if you regularly feel the knock to your character's head on your own head (although that would be just pain empathy if you felt the "pain" somewhere else on your body of course). It's interesting it only happens with your own character and I think that mirrors how we usually get a much stronger physical empathetic reaction with those who are very close to us, or alternatively it shows how you are really putting yourself in your character's shoes and feeling with them. I don't play video games so I don't know how that would be, but I can imagine how that could happen if you were really into the game and "believing" in it... but not everyone would get those physical reactions. Anyhow from what you say about the headaches thing, you seem to have these reactions very much concentrated in your head... in general, with mirror touch at least, from the accounts I've read it seems that the head, face and hands are the places it tends to concentrate most.

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  13. Thanks for this interesting article! I have been wondering for a while since I discovered that three of my female friends also felt pain/unpleasant feelings under their upper thighs/in their groin. I wonder if it is more common among women and if it is more common to have the pain in the area where we four friends feel the pain?

    I also feel the same unpleasant feeling when having vertigo, or watching other people climbing cliffs, hanging out from windows high above the ground etc in films. Is that something that has been looked into?

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    1. Yes! Those are parts of the body it's often reported as being felt. At least from what I've read, I think the most common ones are groin, thighs and down the backs of your legs. That's great you can talk to friends who experience it. Whether it's more common in women, my intuition tells me that yes it is, although that doesn't count for much as perhaps a lot of men have it too but just don't like recognising it or talking about it much, so until there are some studies on that particular aspect (I'm not aware of any) then I suppose we won't know. I feel you on the vertigo thing, I get it really strong with vertigo too (I'd even say I get it stronger with watching vertigo situations than with pain situations!) There aren't any studies on that as far as I know, but if I come across any I'll comment here.

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    2. Really interesting. I’d kind of assumed everyone has it. Mine is for vertigo-type visuals in addition to pain, as well. Similar to the feeling I get from being in that situation myself. Seems to center itself primarily up the back of my legs but can go further. If I’m prepared I can stop it a bit or make it weaker mostly by not looking or withdrawing emotionally, which can work for movies. Thank you for doing this. It helps to know.

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  14. Thank
    You for
    Confirming, I’ve been feeling this sensation

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  15. In my feet l: usually when someone describes, their trauma even to me.

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  16. Thank you so much for this, thought I was losing my mind. Every time I see someone experience pain, even on a cartoon, I have what can only be described as electricity through my buttocks, its awful. So hard to Google what it was. Is it related to me living with chronic pain for 2 years, lived on pain patches and never experienced this pain reaction, since I have been pain free and on no meds for pain I have started experiencing this pain response.

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  17. Thank you for this article. I just went in a situation which was very painful. My sister in law just did a surgery as she had fibrone. After the surgery when i went to see her, i almost fainted. I could the pain that she felt just the same place as her in my body and my body was just like her. And even when my best friend was pregnant i felt all the feelings she had, nausea, diarrhoea anf each month as her belly grew my belly too grew. In some way this article help me.

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  18. "Tingle balls" is how I've always referred to this feeling. All my male friends have it. My wife gets the sensation too but no testicles are in play for her. I had it bad last night as I woke from a dream. There must be some evolutionary advantage to this sensation but have never come across any studies.

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  19. Thank you for sharing this, at 44 I am still learning about myself. I now know I have classic pain empathy I feel pain down the back of both legs when others are injured, particularly in their legs. I have always had this but have always felt kind of crazy, and another factor that made me weird.
    It is great and a relief to be able to have a common name for this and know other people have the same exact same issues.

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  20. Thanks for sharing this. I always wondered about the weird feeling I would get in my stomach whenever I saw someone in pain. Funny though, as I'm pretty sure I possess fairly low levels of empathy, and struggle to relate to others on an emotional level lol

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  21. Anyone else in australia feel this way. As id like to connect. I get the groin and back of leg pain, area of root chakra. If i see, hear of, think of, read about any painful thing someones gone or going threw , n also tears well up , my empathy n connecting with peoples pain is threw the roof. Im sure theres a positive to this somehow. Anyone found anything to put a positive spin on this....

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  22. I experience everything related to the pain empathy explanation, except that I will feel the pain in the same area on my body as the other person whom is actually in pain. This has only happened with people who are very close to me. I don't get an electric feeling in any parts of my body like some of the comments I read. I will usually just feel a flood of emotions if I see, or read about, physical injuries or what not to people or animals. In the event that hearing about or seeing an injury does make me cringe, I might get an unpleasant sensation in the same area of my body that mirrors that of said injured area. Particularly if it is a rather sensitive part of the body for sure.

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  23. After I stopped taking the anti-anxiety drug Effexor for 15 years, this pain empathy started. It’s been happening for the last 5 years. Although the whoosh of electricity is usually from my neck down, sometimes it is so strong, it nearly buckles my knees. It happens when I see someone else hurt themselves, almost hurt themselves or even tell about an experience. Yesterday, a friend told me about her mammogram and I had to tell her to stop! Is there any cure? Do I need to go back on Effexor?

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    1. Hi! Only your doctor can tell you whether it’s right to take a medication, I obviously can’t because I don’t know, but I think they’re unlikely to prescribe it for you again unless there were other anxiety-related reasons apart from the pain empathy. It’s interesting what you say, how it started when you stopped medicating, so it sounds like the drug was suppressing it in some way. I know what you mean about it being really strong and nearly buckling your knees sometimes! My own opinion is that I think there is a tendency to label this as “pain” when it is actually something different from pain, and it isn’t really necessary to think of it that way. I’ve had it all my life but I never considered it as pain, just a natural thing that happened when you saw or heard about someone hurt. Finding out that not everyone experiences it is certainly interesting, but I think one way of looking at it, which perhaps you could do too, is that it means we have a kind of special empathy with others, and we feel that physically. That’s something positive, and something fascinating, I think, which makes us rather special, with a special communication with others, and I believe it’s how we should be looking at this! About whether there is a “cure”, I'm not aware of any way to stop it happening, but reading about your case makes me think that for you at least it might be stronger when your anxiety isn’t repressed, so as you go back to normal, getting rid of your anxiety, not focusing on worries or negative feelings and feeling more relaxed in general, the strength of the experience might be reduced naturally. I’ve never heard of this being related to anxiety in general though, so it’s an interesting thought. From a logical standpoint, if someone paid less attention to others and didn’t listen so much or get very emotionally involved when they saw or heard about them being hurt or having an accident or whatever, that should stop it somewhat or reduce the intensity, so maybe that would work up to a certain point at least? Like the “imagining a shield between you and the other person” trick that I’ve heard recommended for people with too much empathy. Maybe you could look into ways to do that as a kind of “emergency” measure?

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  24. This was very interesting. I can't stand to hear someone describing being hurt. I feel an awful pain in my vaginal area. Today I had a minor surgery on my ear, and the entire time the doctor was cutting and stitching it up, I could hear it and it caused the same pain. It was the 1st time I have ever had that pain when I was the one having the accident/procedure. For me, it has to have something to do with hearing.

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  25. Thank you for this article - I've always had this and never knew others did too. I just thought there was something wrong with me.

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  26. I am glad to finally find that other people feel the same tingling/ electrical shock in the groin area when hearing about or seeing someone fall or get hurt. I first started having this issue about 6 years ago after I had a bad fall and hit my head

    I dont feel this same feeling when i hear or see something emotionally however my emotions become very sensitive
    Thanks for the artical! I now have my answer!
    Brenda

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