A broken heart (or heartbreak) is a common metaphor used to describe 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, 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.
Philosophical views 
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."
Religious views 
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.
In classical references 
This biblical reference highlights the issues of pain surrounding a broken heart:
- Psalm 69:20 Insults have broken my heart and left me weak, I looked for sympathy but there was none; I found no one to comfort me.
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.
- Proverbs 18:14 The spirit of a man will sustain his infirmity; But a broken spirit who can bear?
- Psalm 34:18 The Lord is near to the brokenhearted and saves the crushed in spirit.
Plays of William Shakespeare feature characters dying from a broken heart, such as Ahenobarbus 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'.
Broken heart syndrome 
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.
Psychological and neurological understanding 
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.
See also 
- Green, Terisa (2003). The tattoo encyclopedia: a guide to choosing your tattoo. Simon and Schuster. p. 113.
- Jeffrey Moussaieff Masson, General McCarthy: When Elephants Weep: The Emotional Lives of Animals ISBN 0-385-31428-0
- "What Should We Do When Our Hearts Are Broken?". Buddhist Teachings Distribution Foundation. Retrieved 2009-03-04.
- G. Blakemore Evans, ed., The Riverside Shakespeare (1997) p. 426
- Stein, Rob (February 10, 2005). "Study Suggests You Can Die of a Broken Heart". Washington Post. Retrieved 2006-09-23.
- ""Broken Heart" Syndrome: Real, Potentially Deadly but Recovery Quick". Johns Hopkins Medicine. February 9, 2005. Retrieved 2006-09-23.
- Diane Swanbrow (25 March 2011). "Study illuminates the 'pain' of social rejection". University of Michigan News Service. Retrieved 3 Nov 2011.
- Kross, Ethan; Berman, Marc G; et al (12 April 2011). "Social rejection shares somatosensory representations with physical pain." (free PDF). Proceedings of the National Academy of Sciences 108 (15): 6270–5. doi:10.1073/pnas.1102693108. PMID 21444827. Retrieved 3 Nov 2011.
- MacDonald, G; Leary MR (2005). "Why does social exclusion hurt? The relationship between social and physical pain." (free PDF). Psychological Bulletin 131 (2): 202–223. doi:10.1037/0033-2909.131.2.202. PMID 15740417. Retrieved 7 May 2012.
- Rowe, Dorothy (1983). Depression: The Way Out of Your Prison. pp. 210–229.
- Rowe, Dorothy (5 June 2010). "Why on earth would I want to be young?". Daily Telegraph. Retrieved 3 Nov 2011. "I never again want to discover that 'heartbreak' and 'heartache' aren't empty clichés but words, first, for the knife in the heart that follows the discovery of betrayal, and, second, for the dull ache of the heavy stone above my heart."
- "Overview of Somatoform Disorders". Merck Manual of Home Health. "Stress can cause physical symptoms even when no physical disorder is present....Sometimes a physical symptom appears to be a metaphor for an emotional experience, as when people with a "broken heart" have chest pain."
- Emery, Robert; Coan, Jim (March 2010). "What causes chest pain when feelings are hurt?". Scientific American Mind.
- Eisenberger NI, Lieberman MD (July 2004). "Why rejection hurts: a common neural alarm system for physical and social pain" (free PDF). TRENDS in Cognitive Sciences 8 (7): 294–300. doi:10.1016/j.tics.2004.05.010. PMID 15242688. Retrieved 7 May 2012.
- Eisenberger, NI; Lieberman, MD; Williams, KD; Forgas, JP; Von Hippel, W (2005). "Why It Hurts to Be Left Out: The Neurocognitive Overlap Between Physical and Social Pain". The social outcast: Ostracism, social exclusion, rejection and bullying. pp. 109–127. ISBN 1-84169-424-X.
- Media related to Broken hearts at Wikimedia Commons