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David Baxter PhD

Late Founder
The pain (and science) of a heartbreak
By Jim Thornton
Sun., April 19, 2009

Love is powerful, but its dissolution is more potent still

"It's not you," said Julia.

"The timing, well, it's just that the timing..."

I don't remember all the banality that followed, clich?s stutter-stepping through the lips of a person I'd known so intimately the day before. I felt numb and dissociated. Like when I'd been in a car wreck as a boy, I understood only that something awful had just blindsided me.

Julia fled the restaurant right after her coup de grace. It was Valentine's Day, and the place was jammed with celebrating couples. Eventually, I managed to stand up. I moved outside and wandered the streets for hours in a fugue state fueled by shock.

We had first met nearly a year before at a public lecture on the novels of D.H. Lawrence. The finer points of "Women in Love" escaped me entirely, so distracted was I by the high cheekbones, gray eyes, long, blond hair in a French twist, the figure both voluptuous and athletic. Her beauty seized me and would not let go.

With my previous girlfriends, sex had been exhilarating recreation, as fun as a high-speed water slide. Alas, the thrills always seemed to wane as I grew accustomed to the curves of the course. This did not happen with Julia. Sometime around our 6-month mark, it dawned on me: We'd stopped having sex and begun making love, a distinction that had previously seemed like something fabricated by relationship "experts."

As we neared our first anniversary, I found myself bonded in ways I'd never felt with another human being. Julia was the smartest, most fascinating woman I'd ever met. She made me feel that I was intelligent, witty, attractive, worthy ? in short, one of life's winners.

Looking back, it's hard to imagine a better setup for a crash.

Over the past decade, evolutionary psychologists, neuroscientists, and pharmaceutical researchers alike have begun to shed fascinating new light on heartbreak. The forces that bind two people in union are powerful, but love's dissolution is more potent still ? a trauma to the brain and body that in some cases can be all but indistinguishable from mental illness.

For example, in a study in the Journal of Personality and Social Psychology, researchers found that of 114 Americans who had been romantically rejected in the 8 weeks prior to the study, 40 percent remained clinically depressed ? 12 percent moderately to severely so.

"A heart broken from love lost rates among the most stressful life events a person can experience," says David Buss, Ph.D., the author of The Evolution of Desire: Strategies of Human Mating." "It's exceeded in psychological pain only by horrific events, such as the loss of a child."

The end of a long-term relationship can be extraordinarily traumatic, especially for a man whose mate cheats on him, suddenly announces she wants a divorce, or dies. Researchers have discovered that the flood of stress hormones accompanying such events can weaken the heart, one reason laymen and clinicians alike have dubbed the phenomenon Broken Heart Syndrome.

But even when the heart is not literally broken, heartbreak can still prove lethal in other ways. Rejected men kill themselves at three to four times the rate that spurned women do. And the mix of grief and alcohol almost certainly dispatches a legion more men through car crashes, fights, and assorted misadventures, even though they aren't called suicides on death certificates.

So why does heartbreak hurt so badly? To answer that, you have to first understand what you're really losing.

Lust, attraction and attachment
Love may seem like a solitary force, but experts now know that at least three drives goad our urge to mate. Each of these largely independent puppet masters steers our actions through various neurotransmitters and pathways in the brain.

The most primitive of these drives is lust, which propels us to seek sex with a range of partners. Lust is fueled mainly by testosterone in men and women alike. Scanning with functional magnetic resonance imaging (fMRI) has pinpointed two brain regions strongly associated with this hormone of horniness: the hypothalamus, deep in our ancient "reptilian" brain, and the nearby amygdala, a key to the processing and memory of strong emotions.

The second and arguably more potent of our reproductive drives is known simply as "attraction" in birds and mammals, and "romantic love" in humans. Unlike lust's procreate-with-everyone approach, romantic love is a system that focuses our energies intensively and selectively on a preferred mate. It's what we feel, in other words, when we meet "the one" and become determined to win her heart. From an evolutionary perspective, it's a highly adaptive drive that keeps our eyes on the prize and prevents us from squandering time and resources on suboptimal prospects.

Neuroimaging studies of men and women who are "madly in love" reveal significantly elevated activity in the brain area known as the ventral tegmental area, or VTA. "This is a very primitive part of the brain that appeared quite early in our evolution," says Lucy Brown, Ph.D., a research neuroscientist at Albert Einstein College of Medicine, in New York. Cells in the VTA make and distribute dopamine, a neurotransmitter critical to motivation and reward. Dopamine drives us to look for food, water, sex, and love ? and when our search pays off, it rewards us. "Dopamine," says Brown, "seems to convey a basic message when love is requited: 'This is good,' it tells us. 'This is a key to our survival.'"

Our third system is called "attachment" in animals, and "companionate love" in humans. Though arguably less flamboyant than the other two, this drive is critical in cementing the bonds vital to cooperative parental care. In fairy tales, attachment is the "happily ever after" part; in real life, it often unravels after the kids are raised.

Attachment is not an all-or-nothing proposition, but a gradual process that appears to be likely facilitated by two other hormones that flood the brain during intimacy: oxytocin, dubbed the "cuddle compound," and vasopressin, a tension-taming peptide that thus far has no catchy nickname.

In an attempt to clarify what happens when attachment is broken, Todd Ahern, Ph.D.(c), a neuroscience researcher at the Yerkes National Primate Research Center, in Atlanta, examined the impact of sudden mate removal on the behavior of the male prairie vole, a highly social rodent known to form monogamous bonds. "Males who were able to stay with their female partners showed no problems on standard tests we use as models for depression," he says. "But the males whose honeys were plucked away performed much worse." When the heartbroken voles were given a drug that counteracts a potent stress hormone, their performance normalized. The voles that were allowed to keep their mates, on the other hand, showed no benefits from this drug. The emerging hypothesis, Ahern says, is that separation's effects are twofold: It leaves males bereft of stress-relieving compounds ? like oxytocin ? and spikes their level of stress hormones. The result is heartbreak and, in some cases, depression.

As intriguing as such new discoveries are, researchers concede they are just beginning to fathom the shifting interplay of genes, brain chemicals, and neural pathways involved. "Love is a bouillabaisse in the brain," says Helen Fisher, Ph.D., a professor of anthropology at Rutgers University and a preeminent researcher in the biology of love, "and we're not even close to knowing everything that goes into the soup."

The pain of heartbreak
Perhaps if Julia had rejected me earlier or later on in the relationship, my heartbreak might have taken a different form. All I know is that the ingredients in my own brain soup were bubbling on high boil the day she dumped the cauldron in my lap.

In the days, weeks, and months following my St. Valentine's Day massacre, it's hard to say what hurt more. Moodwise, a persistent despondency alternated with sharp spikes of anxiety, a tag team that made it all but impossible for me to sleep or eat. Providing running commentary on these feelings was a nonstop flood of intrusive thoughts and images that assaulted me both day and night.

When scenes of Julia fornicating with somebody new arose unbidden in my mind, I was overcome with rage and fantasies of revenge. Other times, I'd suddenly find myself reliving memories of her in her sweetest, most endearing, most vulnerable moments. The urge to once again comfort Julia and make her happy became, if anything, an even worse torment than thoughts of strangling her.

When I found myself cataloging her perfections, I tried, in vain, to negate each one with a flaw. But these, too, served only to make her more human and endearing.

Obsessive despair is endlessly inventive ? it has a genius for knowing what a sufferer least wants to hear. It's like being trapped in a box with a loudspeaker that amplifies your own voice, continuously broadcasting your shortcomings. Nothing I would do could make me shut up.

On a parallel track to all of this ran the feverish schemings of an addict. Cravings for a Julia fix could be set off by almost anything ? a whiff of her perfume, a once-shared haunt, songs on the radio, a car that vaguely resembled hers. I couldn't escape even in sleep ? I had recurring dreams that she'd never left, dreams that turned to nightmares at the moment of waking.

After 2 months of this, I tried to replace Julia with another woman. The woman was kind and pretty, but her smell was cloying in its sweetness. Once when she hugged me, it was all I could do to keep from spitting on her. She wasn't Julia, and that was something I couldn't forgive.

While Julia and I were together, I'd desired her intensely for the pleasure she brought me. In her absence, pleasure now seemed the merest of trifles. What I craved from her now was a cure for the pain.

It's easy to see why natural selection would favor our ancestors' capacity to feel love's rewards ? what Fisher has called "the mind/body opium" of romantic triumph. Much harder to understand is why they would also have passed down such a capacity for suffering when love fails.

"Just as evolution has installed reward mechanisms that flood our brains with pleasure when we are successful in love," explains Buss, "so it has equipped us with brain circuits that deliver searing psychological pain when we fail."

Intuitively, this doesn't seem to make any sense. Given how incapacitating heartbreak can be, wouldn't we be better off inheriting bounce-back genes ? the kind that could let us shrug off rejection and move on without missing a beat? As every weeping reject asks himself endlessly, what possible good can come from such persistent pain?

"There's a knee-jerk bias we have that only 'feel-good' states are adaptive, and things that make us feel bad are pathological," says Matthew C. Keller, Ph.D., an assistant professor of psychology at the University of Colorado at Boulder. "But there are actually many unpleasant states ? pain, fever, nausea, and diarrhea, for example ? that definitely don't feel good but are nevertheless highly adaptive."

Protest and surrender
In the book A General Theory of Love, three research psychiatrists say romantic rejection triggers a two-phased response in humans as well as many other mammals. During the initial protest stage, our brains are flooded with extra dopamine, norepinephrine, and similar excitatory compounds ? leaving us more obsessed, energized, and desperately in love than ever. Such "frustration attraction" provides extreme motivation to regain our beloved.

"When something is enormously important to us, it makes sense that we don't give up too easily," says Arthur Aron, Ph.D., a professor of social psychology at Stony Brook University.

With the help of fMRI scanning, Aron, Fisher, and Brown have begun to reveal the relentless neural pathways that goad such efforts. Early scans of volunteers who were "truly, madly, deeply" in love showed activation patterns reminiscent of getting a cocaine hit. A follow-up study of heartbroken individuals who had been recently dumped by mates they still adored showed activity in some of the same basic regions lit by an addiction. But it had shifted slightly ? to regions seen in compulsive gamblers craving a big win.

In other words, we seem to become as desperate as junkies deprived of a fix. For a while, at least, says Fisher, neurons that have become accustomed to love's chemical rewards become even more active when such rewards are delayed. The system curbs itself only when the hit never comes, and then the hopelessness of heartbreak's second phase, resignation, sets in.

With the abandonment of hope often comes deep pessimism and self-recrimination over the many ways we've screwed up. Though it's highly unpleasant at the time, evolutionary biologists suspect such forced introspection is necessary for us to learn from our loss. "When you've suffered a major setback in life," says Keller, "it's actually unhealthy to feel optimistic. The pain and obsessive thoughts of heartbreak force us to gear back and really think things through, examine our strategies and mistakes before we rush out and try again."

Another hallmark of this stage: crying. Emotional tears are linked to the brain's limbic system, the locus of emotional regulation. No one knows for sure what this means, or even if crying is therapeutic. A 2008 University of South Florida study, however, found that nearly 90 percent of surveyed Dutch adults said crying brought them some degree of relief from sadness.

Tears may serve another critical purpose, as well ? a signal to your friends and loved ones that you need their social support. "Research has shown," says Keller, "that crying triggers empathic behavior in friends ? it makes them want to help the person who is suffering."

Perhaps the most perplexing of all of heartbreak's symptoms is dramatic weight loss, which seems, anecdotally at least, to plague more men than women. One leading theory is that it allowed our ancestors to hunker down and survive on reduced resources while still laid low by grief. In ancient times, hunting was surely a treacherous affair, demanding peak concentration. Addled by heartbreak, the loss of appetite might have been a saving strategy: Lose some pounds, but not your life.

In modern times, of course, a new advantage to this has emerged for many of us, one that nature almost certainly did not predict. To wit, for those of us inclined to fatten in contentment, there's nothing like the loss of love to steer us back to fighting weight.

"Ever has it been," wrote Kahlil Gibran, "that love knows not its own depth until the hour of separation." In my case, the poetry of Philip Milito comes closer to the mark: "We desire, the way a twice-poisoned dog eyes a third piece of meat."

This hunger overwhelmed my capacity to resist more times than I care to remember. Sometimes I'd call Julia late at night, hoping she'd mistake my beer-slurred bravado for something else ? what, exactly, I'm not sure. The first few times I called, she answered her phone and seemed, for a minute or two, almost kind. She'd reaffirm that it wasn't me ? that the two of us had just met at the wrong stage of life.

From there, it would invariably deteriorate. I'd ask her as calmly as I could to give me a second chance, and when she answered no, I'd plead my case with increasing desperation. Each time, it ended in the same humiliation: me begging and in tears, she composed but unmovable.

Eventually, she stopped answering her phone altogether.

So I'd cruise by her apartment sometimes late at night, checking for bedroom lights and strange vehicles in her parking lot. During the last episode of quasi-stalking, I climbed her steps and raised my hand to knock on her door. But something stopped me, though I'm not sure what. As irrevocable as the loss of her love was, perhaps I knew I could still lose much more.

The last time I saw Julia was at a reservoir that we used to visit together. I was playing volleyball with some friends when she arrived with a guy I'd never seen before. With one arm, he carried a cooler and beach towel. His other arm held her bikinied waist tightly against him. He seemed composed entirely of muscle and jawbone. I despised him intensely, but I hated her more.

It's been said that the opposite of love is not hate but indifference. For one final moment, our eyes locked together. Mine continued to burn with devotion and enmity. But Julia's eyes looked back at mine with neither pity nor pique, just something close to absolute disregard. In that horrible instant, I had my first hope that one day I could join her there.

Coping with rejection
With the exception of antidepressants, which have been shown in clinical trials to reduce severe heartbreak symptoms in some patients, modern researchers concede that they've added nothing revolutionary to the cumulative wisdom of the ages. What has begun to emerge from the lab, however, is a better understanding of which age-old strategies really do work best ? and why.

Take, for example, a tactic that's been around for millennia but was recently codified in self-help manuals as the "no contact" rule. The idea is simple enough: Have absolutely nothing to do with your erstwhile lover. To many a heartbroken guy, such advice makes plenty of sense, at least in moments of rationality. But then emotions take over, urging the exact opposite course. So which should we listen to, the brain or the heart?

The brain, says Fisher, without hesitation. "You need to treat heartbreak like the addiction it is," she explains. "This means no interaction, no calls, no letters, no checking up on their Facebook page, no going to the gym where she's likely to be."

Resist, too, an ex's offer to remain friendly. "If the person who dumped you wants to remain friends," says Fisher, "tell her fine ? in 3 years. For now, you need time and space to get over her."

Whether your own healing interlude requires 3 years or 3 weeks, exile more than just the woman from your life. Eliminate all of her cards, gifts, phone messages, and belongings ? in short, any reminders that she once shared your life. "Otherwise," says Fisher, "it's like trying to quit drinking while lining up bottles in front of your face."

And speaking of booze, drinking to obliterate the memory of a lost love is a classic coping strategy employed by men. Trouble is, it simply doesn't work. In fact, as most anyone who's cried in his beer knows, it usually makes matters worse. For one thing, alcohol is a depressive drug. So if you're already sad to start with, you're just going to descend into an even deeper melancholy.

As a 2008 study in the journal Drug and Alcohol Dependence noted, comparatively small doses of alcohol have also been shown to increase impulsive, aggressive, and socially inappropriate behaviors by disabling the brain systems that normally hold these behaviors in check. Moreover, alcohol is particularly effective at eroding good intentions when, as the authors put it, "the inhibition of a response is in conflict with a strong instigation to display the response." Translation: When you're heartbroken but sober, you think, I want to call her so much, but I know this will only end up making me feel worse. Two beers later, you think, Where's the phone?

Exercise is an all-around safer and more effective heartbreak balm. As I mentioned earlier, romantic rejection floods our brains with stress hormones such as norepinephrine, priming us for fight or flight. It probably also slashes serotonin, Fisher says, inviting both depression and obsessive thoughts to lay siege in our brains. Exercise, however, sops up stress ? possibly by elevating serotonin ? and adds a bonus dose of feel-good endorphins in the process.

Working out with good friends, Fisher adds, likely bolsters other brain hormones laid low by rejection. These include oxytocin as well as vasopressin, both of which solidify social ties and provide a comforting sense of connectedness to others. In small but significant ways, the void created by your beloved's exit slowly fills with new relationships.

One relationship many guys believe will help them most is with a new sex partner. How legitimately helpful this is remains quite controversial. "For men," says Buss, "my speculation is that the best cure for heartbreak is indeed a new love. Or, if that's not possible, sometimes new sex will do in the meantime."

Other researchers, however, have their doubts, especially during the protest stage when you feel such a deep attachment to the one who's spurned you. "If you're still madly in love," says Fisher, "nobody else looks good to you."

Moving on
I do not mean to give a false sense of heartbreak's trajectory here. As most sufferers learn firsthand, you can adhere to all the proven strategies in the world and yet still go for weeks or months without the slightest sense of forward progress. Then one day, abetted by the slow drip of time and the steadfastness of your friends, you notice you've managed a whole minute of thought that doesn't center on your former beloved. At the instant of this realization, of course, your suffering resumes full-blown, worse than before. More time passes, and more wise counsel.

Then, at some indefinite point much later, you find that you've passed an hour free of your ghost. Your weight loss levels off. The scale reveals you've even gained back a fractional pound of the 20 you've shed. You glimpse your face in a mirror, feel a tad less stupefied by the ugliness you see.

Once again, the respite doesn't last long. Something will remind you of her. In this regard, the world remains a minefield for a very long time. Even when you can go a whole week without her cohabitating in your skull, you're not safe. Perhaps, like me, you'll cross paths with her, despite all your best efforts at absolutely no contact. Maybe she is with another guy, and maybe the two of them look smitten. You thought you were finally getting over her, and now you see you're not even close.

But you are getting closer. The pain may feel indistinguishable from before, but something's changed. A scab torn off reveals new callus. The wound still hurts, but it's no longer fresh nor quite so deep.

And so it goes, the spinning lathe that slows so gradually you cannot discern the moment it's stopped.

At the end of Friday's 5,000-yard swim practice, I climb into the hot tub to relax with my teammates. I'm adjusting a bag of ice on my shoulder when a woman I've never seen before today steps out of the pool and approaches us. Through the cathedral windows, the setting sun silhouettes her lithe physique in orange light. For the first time in ages, my heart speeds up at the sight of a female body.

She's absolutely beautiful: curvaceous but sleekly muscular, hazel eyes, long, lustrous brown hair, full lips. I'm sure I've seen hundreds of objectively beautiful women in the year and a half since Julia's rejection. But this is the first one who has stirred me. I first noticed her while swimming today's practice ? and, in fact, crashed into the wall while ogling her under water. This is the reason for the ice on my shoulder.

"Hi," she says to us all. As she slips into the Jacuzzi, her thigh brushes my knee, and I wonder if I'll need to move my bag of ice. "I'm Jenny," she says. "I usually swim with the morning group."

My buddies immediately fall over themselves to impress her. I've all but forgotten how to flirt, so I just say hi and try to enjoy the banter.

A guy named Mike points out that morning practice starts at 5 a.m. "How can you stand to get up that early just to go swimming in the dark?" he asks Jenny.

She smiles and shrugs girlishly. "I admit," she says, looking at the sunset, "the view is more enjoyable this time of day."

"You should come in the evening more often," I say, glancing toward her. "Give us a view to enjoy."

Corny as it is, my compliment actually makes her blush. Months later, when we are lying in bed together and I am happier than I can ever remember being, Jenny tells me it was this compliment that lit the spark for her.

During the worst of my heartbreak, I was convinced I'd never again be anything but damaged goods. I didn't see it at the time ? perhaps we're constructed so we can't see it ? but a broken heart becomes annealed through its loss. When we finally do emerge able to move on, we find ourselves wiser, blessed with more empathy, and unblinded to the power love holds in our lives. We are built to love and to love again, says Helen Fisher, words that resonate with my own experience.

I know now that nothing will chase all traces of Julia from my heart. But with a new love, I do not mind. I'm grateful, in fact, and I only hope she has forgiven me as I have finally forgiven her.

How love can mess with your head
Sure you loved her with all your heart, but your brain played a big role, too. When you're in love, your brain's ventral tegmental area churns out dopamine, the hormone that teaches junkies to crave crack. From there, dopamine travels to your prefrontal cortex and cingulate cortex, where it joins its cousin chemical, norepinephrine, to create a "lover's high." Couple this hit with the warm feelings created when your hypothalamus secretes oxytocin and vasopressin, and you have the recipe for a full-blown addiction. That's why you're in trouble if your drug ever decides to pack her bags and walk out the door.

Should you take her back? What to do when your old flame flares up again
She didn't just break your heart ? she put it through the meat grinder. And now? She claims she made a big mistake. Before you risk having your emotions butchered all over again, ask yourself these critical questions.

  • What do I miss about her? "Often, people will name their partner's small, strange quirks as the things they miss most," says Ty Tashiro, Ph.D., a psychologist at the University of Colorado. "But those mundane details indicate that they miss familiarity and comfort the most, not the specific person."
  • Why did we break up? If the problem was a clash of personalities, tell her you're better off apart. "Traits like extroversion or being high-strung or neurotic almost never change," says Tashiro. And that goes for your next relationship, too: Watch for a pattern of initially exciting but ultimately doomed mismatches.
  • How much have I been sleeping? Insomnia is a major side effect of heartbreak, and it can impair your ability to view her objectively. "The less you sleep, the less control you have over your emotions," says David Sbarra, Ph.D., assistant professor of psychology at the University of Arizona. Consider seeing a psychologist who uses cognitive behavioral therapy, a multi-pronged approach that can help solve your sleep problems.
 
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