No pain, no social gains: A social-signaling perspective of human pain behaviors

Abstract

In this review article, we describe a social-signaling perspective of human pain and pain empathizing behaviors which is based on the premise that pain percepts evolved to serve both intrapersonal as well as interpersonal, communicative functions. This perspective offers a generative framework for understanding the natural origin and proximate expression of felt pain and pain empathizing behaviors. The basic thesis is that humans evolved sensory-behavioral heuristics for perceiving and inhibiting exogenous and endogenous pain sensations as part of more general expressive styles characterized by the demonstration of vulnerability gestures (i.e., trustworthiness cues) versus empowerment gestures (i.e., capacity cues), and these styles ultimately facilitate broader self-protection and social novelty-seeking life-history behavior strategies, respectively. We review the extant literature on how social contextual factors (e.g., audience characteristics) and how structural and functional components of individual’s social network appear to influence the expression of pain behaviors in ways that support basic predictions from the social-signaling perspective. We also show how the perspective can be used to interpret conventional findings of sex differences in pain percepts and pain empathizing behaviors and for predicting how the situational context and individual’s peer networks modulate these differences in vitro and in vitro. We conclude the article by describing how pain researchers may better understand how varying levels and divergent directions of changes in affect tend to co-occur with systematic changes in internal vs external pain sensitivities, and thus why, from an evolutionary perspective, pain may occur in the presence and absence of physical tissue damage.

Keywords: Pain behaviors; Psychology; Social support; Sex differences; Communication

Core tip: This article introduces a social-signaling perspective of pain and pain empathizing behaviors, which hypothesizes that both exogenous and endogenous pain percepts evolved as part of more general expressive heuristics for demonstrating basic trait impressions (e.g., empowerment vs vulnerability cues) to different types of affiliates. Prototypical sex differences in pain sensitivity/empathizing may then reflect specialized expressive styles for regulating distinct relationship dynamics throughout humans’ natural history. We show how the perspective accounts for several findings on how social contextual factors (e.g., audience characteristics) and how structural and functional components of the individual’s social network appear to influence contemporary pain expression.