It turns out that the metaphor “heartbreak” has a genuine physiological basis, and that emotional stress inflicts pain akin to physical agony

The consumer principle “you break, you pay” applies when a customer accidentally breaks something in a shop, taking responsibility to pay the shop owner. When a child misbehaves in a shop, the bill is handed to their parents. In the case of heartbreak, whether stemming from a separation or deep disappointment, the hefty bill is presented not only to the heart but also to the brain.

In 2006, a couple of Croatian artists, whose relationship had ended, established a museum dedicated entirely to broken relationships. They wondered what to do with the objects left from their love affair. Initially, they presented them as an exhibition that traveled worldwide, inviting brokenhearted people to send in their mementos. Thousands of objects were received, and the exhibition evolved into a successful museum, attracting about 100,000 visitors in 2017 alone. It seems that the experience of a broken heart, and importantly, the quest for recovery, resonates with many of us.

Real Pain

Heartbreak is not just about the objects left behind, neither is it an empty metaphor. This is a real, intense pain that leaves an imprint on our brain. People often describe the heartbreak they feel following a painful separation in terms of physical pain: "my heart is broken," "she ripped my heart out," "he left me scarred," and so on.


לא קל לאחות לב שבור | איור: נטשה גרייגל, שאטרסטוק

 A display at the Museum of Broken Relationships in Zagreb | Photo: PR, from the museum website.

This feeling is registered tangibly in the brain. Much like when we sustain injuries, falls, or cuts, a region of the brain responsible for processing pain sensations is activated. Studies reveal that this specific region, known as the anterior cingulate cortex, also responds to emotional distress. In fact, when research participants were asked by psychologists to rank different types of emotional pain and compare them to different types of physical pain, the emotional pain of a painful separation was described as equivalent in intensity to childbirth without painkillers or to suffering associated with chemotherapy treatment for cancer.

A psychological study, repeated many times, revealed that people can experience significant heartbreak even in scenarios involving complete strangers. One such experiment was conducted in a waiting room with three individuals—the actual participant in and two planted "strangers” who received prior instructions - participants reported emotional pain upon being excluded from a simple ball game. 

The staged situation was simple: the three sit down, and one of the strangers sees a ball on the table. He throws it to the second stranger, who passes it to the study participant, who in turn passes the ball back to the first stranger. Next, the first stranger throws the ball to the second one, but now comes the surprise! Instead of being passed to the study participant, the ball returns to the first stranger, and so on; the two strangers keep passing the ball back and forth for several minutes, ignoring the study participant.

All the study participants subsequently reported that being excluded from this simple game caused them emotional pain. And indeed, it was found that such situations triggered brain responses akin to experiencing physical pain, often accompanied by changes in appetite, feelings of depression and anxiety, diminished self-confidence, and a pervasive impact on emotional well-being.


When The Heart Really Breaks

Studies of heart attacks indicate that there is a type of heart attack in which the brain inflicts harm on the heart. In Takotsubo syndrome, also known as broken heart syndrome, the heart undergoes a change in shape, elongating in response to emotional distress. This syndrome, first identified in Japan in the 1990s when researchers encountered people (mainly women) who presented symptoms resembling a heart attack, such as chest pain, shortness of breath, and fainting, but without any arterial blockage. Most patients recover within several days to a few weeks, this remains a life-threatening condition, resulting in death in a minority of cases.


לא קל לאחות לב שבור | איור: נטשה גרייגל, שאטרסטוק

It's not easy to mend a broken heart | Illustration: Natasha Grigel, Shutterstock

Patients with broken heart syndrome suffer real, dangerous damage to the heart; however, its cause is not physical but emotional. This phenomenon typically affects people who experience extreme emotions following “heartbreaking” events such as the death of a loved one, divorce, unrequited love, and more. Researchers have also found that in regions where natural disasters have occurred, there is an increase in the number of people admitted to hospitals with broken heart syndrome. There are also cases where a person’s heart responds similarly to sudden good news, such as winning the lottery.

Researchers from Switzerland searched for an explanation for this brain-heart connection: "Emotions are processed in the brain so it is conceivable that the disease originates in the brain with top-down influences on the heart," noted Dr. Jelena Ghadri from University Hospital Zurich, who took part in the research study, in an interview for the BBC. She and her colleagues compared brain scans conducted using functional magnetic resonance imaging (fMRI), of individuals with broken heart syndrome and healthy counterparts.

Their findings revealed a lower level of connectivity in the limbic system in the brains of those afflicted with broken heart syndrome. The limbic system is responsible for regulating emotional responses and facilitating communication between the amygdala, a brain region involved in emotional control processes, and the hypothalamus, which is responsible for automatic functions such as heart rate. Due to a lack of connections between these regions, it seems that patients have difficulty controlling the physiological response of their body to situations of extreme stress and sharp emotional pain.

Human Connections Heal

Sometimes it is hard to determine whom to hold accountable for the heartache we feel—the brain or the heart itself.  Nevertheless, we can all agree that situations of heartbreak involve genuine pain, which transcends mere emotional sensitivity.

Unlike physical pain, heartache cannot be alleviated with ice packs or soothing ointments. Effective solutions must be found in the social sphere. In situations of heartbreak, seek solace and support from loved ones within your family and close social circle, and endeavor to establish meaningful social connections.  Strengthening these bonds, rather than withdrawing into ourselves, facilitates the brain's recovery from crisis and its return to normal, healthy activity patterns.

Perhaps we can also take comfort in the notion that brokenness allows us to perceive the world through a different lens, adding depth and beauty to our experiences.