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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 phenomenon:

M. Rothen, B. Meier, Why vicarious experience is not an instance of synesthesia  

 

Related synesthesia types:

Mirror touch


This page last updated: 01 September 2021

15 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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  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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