What’s the connection between physical and emotional health?

Dear “Solace”,  

You’re not alone in noticing a relationship between your emotions and physical pain. The brain treats emotional and physical pain similarly, so strong emotions can make you more sensitive to pain. Chest pain is a common anxiety symptom, since the body’s stress response causes muscles to tighten and the heart to beat faster.  

Although your friend referred to “emotional shock,” your experience might be closer to a stress response from social anxiety. “Emotional shock” is the physical and emotional response that can happen after an unexpected or traumatic event. The body isn’t able to handle the flood of emotions, so it freezes. Since you feel this pain frequently after receiving criticism, it might be caused by anxiety about being perceived negatively by others. If you think this is impacting your day-to-day functioning, you might consider speaking with a mental health provider to best determine how to address what you’re experiencing. 

Why can an emotional response cause physical pain?  

It’s common for strong emotions to cause a physical response, including chest and arm pain. When you’re anxious, your body’s stress response causes your muscles to tighten up, which can cause painful tension in the chest. Stress also causes your heart to beat more strongly, which can add to the effect of tight muscles and contribute to chest pain.  

Stress and physical pain go hand in hand in other ways as well. That’s because they’re processed by the same parts of the brain. If you’re frequently stressed, your brain can become more sensitive to pain, meaning you could feel pain more intensely.  

Besides chest and arm pain, other types of physical pain or symptoms that can appear as the result of an emotional response include:  

• Stomachache
• Digestive issues, including diarrhea
• Nausea
• Muscle pain in the legs and neck
• Headaches
• Dizziness 

List adapted from VeryWell Mind 

What physical conditions may cause chest pain?  

Although chest pain is often caused by stress, it can also be associated with physical conditions, including a heart attack. You’re at greater risk of experiencing a heart attack if you’re older than 45 for people assigned male at birth and older than 55 for people assigned female at birth. Other risk factors include smoking tobacco or having high blood pressure. If you experience unusually severe chest pain, go to an emergency room as soon as possible to rule out more serious conditions. 

How can you treat physical pain linked to an emotional response?  

You may be able to immediately address emotion-related pain by using strategies that calm down your body's stress response. These include:  

• Deep breathing: this can counteract the stress response. Consider the box breathing method, where you inhale for a count of four, hold your breath for a count of four, and then exhale for a count of four.
• Mindfulness exercises: like naming five things you can see, hear, touch, and smell. Research shows that mindfulness activities can actually calm the parts of the brain associated with pain.
• Visualizing: in your mind, picture a place where you feel comfortable and safe. This may help to make you feel calmer. 

How does fear of negative criticism relate to social anxiety?  

Fear of being perceived negatively by others is one of the main features of Social Anxiety Disorder (SAD). People with SAD often have strong stress responses to anything they view as criticism or negative evaluation, since it reinforces their fears about interacting with others. If you have low self-esteem, receiving criticism can feel like a justification of your negative self-thoughts. That said, this understanding of how other’s words affect you could be an opportunity to think about the way you view yourself, and how that could impact how you receive criticism. 

Does it matter who is saying the negative comment?  

Do you notice stronger physical pain after talking to certain people? The same criticism might cause a different emotional response when it comes from different people. Frequently being criticized by someone can make their criticism more painful. It could make you more likely to perceive their words negatively. You might consider thinking about whether the people around you support your well-being, and how their presence might be shaping your physical and emotional experiences. 

Although immediate symptom relief is helpful, addressing the root cause of this pain can make it less frequent. Consider working with a mental health provider who can help you identify the negative feelings that may be causing this pain. Together, you can work on replacing these thoughts with more supportive and healthier alternatives. 

Hopefully, it provides you with some solace to know that it's common to experience chest and arm pain in response to emotions. This pain could be a sign of a strong anxiety response to how you believe others see you. Examining your relationships with the people around you and how you view yourself might be a helpful step to identifying the root cause of this concern.