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A broken heart (or heartbreak) is a common metaphor for the intense emotional pain or suffering one feels after losing a loved one, whether through death, divorce, breakup, physical separation, betrayal, or romantic rejection.
Heartbreak is usually associated with losing a family member or spouse, though losing a parent, sibling, child, pet, lover or close friend can all "break one's heart," and it is frequently experienced during grief and bereavement. The phrase refers to the physical pain one may feel in the chest as a result of the loss, although it also by extension includes the emotional trauma of loss even where it is not experienced as somatic pain. Although "heartbreak" ordinarily does not imply any physical defect in the heart, there is a condition known as "Takotsubo cardiomyopathy" (broken heart syndrome), where a traumatising incident triggers the brain to distribute chemicals that weaken heart tissue.
For many people having a broken heart is something that may not be recognized at first, as it takes time for an emotional or physical loss to be fully acknowledged. As Jeffrey Moussaieff Masson states:
Human beings are not always aware of what they are feeling. Like animals, they may not be able to put their feelings into words. This does not mean they have no feelings. Sigmund Freud once speculated that a man could be in love with a woman for six years and not know it until many years later. Such a man, with all the goodwill in the world, could not have verbalized what he did not know. He had the feelings, but he did not know about them. It may sound like a paradox — paradoxical because when we think of a feeling, we think of something that we are consciously aware of feeling. As Freud put it in his 1915 article The Unconscious: "It is surely of the essence of an emotion that we should be aware of it. Yet it is beyond question that we can 'have' feelings that we do not know about."
O, monks! Why should every female, male, layperson, or priest because they are hurt always consider that all things they love would one day go away from them? What is the advantage of taking the said matter into consideration? Hearken, monks! All fondness and love existing in the beings lead them to perform physical, verbal or mental bad deeds. Upon having always taken such matter into consideration, the being will be able to leave or lighten such fondness and love. O, monks! That is the advantage that every female, male, layperson, or priest should always consider that all things they love would one day go away from them.
This biblical reference highlights the issues of pain surrounding a broken heart:
In this Psalm, King David says that insults have broken his heart, not loss or pain. It is also popular belief that rejection, major or minor, can break an individual's heart. This heartbreak can be greatly increased if rejected by a loved one or someone whom you respect.
Plays of William Shakespeare feature characters dying from a broken heart, such as Enobarbus and Lady Montague—though Rosalind claims (of men at least) that 'these are all lies: men have died from time to time, and worms have eaten them, but not for love'.
In many legends and fictional tales, characters die after suffering a devastating loss. But even in reality people die from what appears to be a broken heart. Broken heart syndrome is commonly blamed for the death of a person whose spouse is already deceased, but the cause is not always so clear-cut. The condition can be triggered by sudden emotional stress caused by a traumatic breakup or the death of a loved one. Broken heart syndrome is clinically different from a heart attack because the patients have few risk factors for heart disease and were previously healthy prior to the heart muscles weakening. The recovery rates for those suffering from "broken heart syndrome" are faster than those who had heart attacks and complete recovery to the heart is achieved within two weeks.
Research has shown that a broken heart hurts in the same way as pangs of intense physical pain. A 2011 study demonstrated that the same regions of the brain that become active in response to painful sensory experiences are activated during intense experiences of social rejection, or social loss generally. "These results give new meaning to the idea that social rejection 'hurts'," said University of Michigan social psychologist Ethan Kross, lead author of the article. The Michigan research implicates the secondary somatosensory cortex and the dorsal posterior insula. Macdonald and Leary had earlier (2005) proposed the evolution of common mechanisms for both physical and emotional pain responses, and noted that multiple languages and cultures use terms like "hurt," "heartbreak," "hurt heart" or "ripped out my heart" to describe responses to social exclusion and argue that such expressions are "more than just a metaphor."
The psychologist and writer Dorothy Rowe recounted that she thought of heartbreak as an empty cliché until she experienced it herself as an adult. Heartbreak can sometimes lead people to seek medical help for the physical symptom, and may then be related to a somatoform disorder.
The neurological process involved in the perception of heartache is not known, but is thought to involve the anterior cingulate cortex of the brain, which during stress may overstimulate the vagus nerve causing pain, nausea or muscle tightness in the chest. Eisenberger and Lieberman showed that rejection is associated with activation of the dorsal anterior cingulate cortex and right-ventral pre-frontal cortex, areas established as be involved in processing of pain (including pain experienced in others through empathy). The same researchers mention effect of social stressors on the heart, and personality on perception of pain.