On the Leading Role of Prolactin in Masochism

LIST OF QUESTIONNAIRE ITEMS most closely correlated in their profiles with the profile of the ELEVATED prolactin markers

Following each questionnaire item is the correlation of its profile with the profile of the ELEVATED PROLACTIN SCALE. (See our post vk.com/wall-168821911_138144)

1. I sometimes enjoy being humiliated and even experiencing moderate pain. 0.928
2. I sometimes like to hurt myself. 0.883
3. I sometimes catch myself enjoying playing a dependent role in relationships with strong and aggressive people, being a little capricious and provocative. 0.883
4. Sometimes I want my partner to punish me. 0.877
5. I easily and secretly enjoy surrendering to confident, aggressively assertive people who don’t back down. 0.842
6. Fear can be “sweet” — at least for me — you feel fear, and then bliss spreads through the body. 0.822
7. I’ve experienced a strange psychological illusion: I look in the mirror and for a few seconds I don’t see myself (other reflected objects are visible, but not me, although I should be). 0.813
8. I have masochistic tendencies. 0.811
9. There is a certain masochism in my character: sometimes I like to engage in self-deprecation. 0.811
10. In relationships with dominant people, I like to play the role of the submissive victim. 0.804
11. I often enjoy the sensation of pain — for the moments of bliss that follow. 0.799
12. After experiencing pain, I almost always get a pleasant, blissful “aftertaste.” 0.799
13. Pain is often associated with bliss that follows it. 0.786
14. To be especially persistent in achieving something, I need to feel aggressive pressure from outside. 0.765
15. Sometimes the future seems to “spill over” into the present — I start to feel a moment a few seconds before it happens, clearly and certainly, as if it’s already happened. 0.764
16. Sometimes I can’t swallow liquid — there’s a “lump in the throat.” 0.759
17. I rather like it when I’m periodically “pushed,” when someone shows some persistence toward me. 0.756
18. I have fantasies involving ideas of self-torment and self-destruction. 0.753
19. Bowing deeply to the strong and ruling is not a sin. 0.745
20. Sometimes I’m haunted by obsessive images from my imagination. 0.737
21. I need to be in a dependent position to maintain the goodwill of someone who supports me. 0.734
22. Quite often I enjoy provoking anger in someone I like. 0.730
23. Sometimes I deliberately provoke criticism directed at me. 0.725
24. Sometimes I hear what seems like a rustle of thoughts in my head, sometimes indistinct, sometimes turning into intelligible words — they echo obsessively after my thoughts. 0.723
25. I usually expect others to take the lead and guide me. 0.723
26. I often feel drawn in my thoughts toward death and nonexistence, and I want to think about it for a long time, as the best way out and the best revenge on myself and others. 0.716
27. In a team where hierarchical relationships are developed, I feel: 1) Uncomfortable. 5) Comfortable. 0.711
28. Sometimes the surrounding space and objects appear strangely distorted. 0.709
29. In unpleasant events, I often see the hand of fate. 0.709
30. I experience daily something like a slight unpleasant trembling or involuntary muscle vibrations in my neck or hands. 0.708
31. Alongside general weakness and decreased muscle tone, I sometimes also have slurred speech — it becomes a little hard to pronounce words clearly. 0.696
32. I often compare myself to others in my thoughts. 0.696
33. Sometimes my eyes dry up quickly on the street, causing stinging. 0.696

34. What feeling do you experience more often? 1) Guilt 5) Compassion -0.787
35. I feel immediate sharp hatred toward any attempt at authoritarian rudeness or coercion. -0.751
36. I always strongly reject any attempt to blur, equalize, or merge the concepts of good and evil. -0.744
37. I really dislike being “put in my place” from above. -0.724
38. I sleep well and peacefully, without insomnia or waking up at night. -0.708
39. It’s true that I’ve never experienced visual hallucinations. -0.698
40. I find it extremely unpleasant to feel dependent on anyone. -0.690
41. Attempts to influence me not by persuasion but by orders and coercion almost always cause strong or even angry inner protest. -0.687
42. I’m well aware of my physical “self,” and never lose the sense of its integrity. -0.705

It is easy to see that the overwhelming majority of questions positively correlated with prolactin characterize masochism in meaning.

In the literature discussing the functioning of the endogenous opioid system, there is often an opinion that masochistic pleasure is due to increased production of endogenous opioids and the subsequent dopamine release triggered by their surge.
Our results seem to challenge this opinion, refuting it specifically in terms of dopamine’s role. Namely, it is not dopamine that accompanies endogenous opioids in “relabeling” pain and humiliation as pleasure — but prolactin.
And as is known, prolactin and dopamine are negatively correlated (due to dopamine lowering prolactin).
But is it too soon to write dopamine out of this equation?
There is also feedback — elevated prolactin can stimulate dopamine release [1].

So, it may be assumed that the final link in the masochistic chain is still increased dopamine release. However, prolactin plays the key role in this chain.
What causes it to rise in response to pain or humiliation remains a great mystery. And, it seems, not yet revealed in any scientific publication.

It seems that even the problem has not yet been posed in neuroscience.
Well, now we’re posing it. Hopefully, someone will hear it.
The second point we’d like to emphasize — the obviously suppressive effect of prolactin on the insular cortex.
Possibly, it is this that largely achieves the analgesic effect.
But we have not encountered mentions in the scientific literature about the suppressive role of prolactin in relation to the insular cortex either — although this is an extremely important point and perhaps explains a great deal.
Relevant studies are necessary. We hope they will confirm the conclusions of our questionnaires.

REFERENCES:

1. Gubernatorov E.E., Gerasimov G.A. Dopaminergic control of prolactin secretion regulation (Review of experimental and clinical studies). Problems of Endocrinology. 1994;40(5):55-59.

P/S
In short, the overall situation might look like this.
Pain signals, in some as-yet-unknown way (as of today—unidentified and unstudied), lead to a sharp increase in the release of the hormone prolactin into the bloodstream from the anterior pituitary. Dopamine stands guard at these gates, but it is inert and allows the excessive release of prolactin into the blood, reacting slowly.

Then prolactin, again in some as-yet-unknown way, inhibits the activity of the insular cortex, predominantly its right hemispheric half—mainly responsible for the subjective perception of pain at the conscious level (in the same right cortex, activity in this area is accompanied by increased cerebral blood flow). It’s possible that the inhibition of the insular cortex occurs via prolactin receptors in this region—note that these receptors have not yet been identified there, mainly because the insular cortex is deeply buried in the brain and thus hard to measure.

As a result of this inhibition of the insular cortex, a subjective pain relief effect is achieved.

But that’s not all—the chain doesn’t end there. The sharply elevated prolactin in the blood eventually triggers the production of additional, above-normal dopamine (the mechanics of this were studied back in the 1990s; see the link in the root post).

The dopamine surge produces two effects at once—first, it creates a rush of pleasure, acting on the reward center in the basal ganglia. This is where masochism and its reinforcement in the subject’s behavior come from. This is also where the fusion of good and evil in the subject’s consciousness arises (see question #3 in the second list of questions in the root post).

Finally, the excessively released dopamine reaches the portal system of the anterior pituitary, where, acting on dopamine D2 receptors in the pituitary’s portal vessels, it narrows their lumen, thereby cutting off the prolactin supply to the blood.

Quite a thrilling story. Let’s also add that, from an evolutionary standpoint, this role of prolactin—simultaneously providing pain relief and reinforcing passive-submissive behavior—may have arisen and been fixed during evolution because prolactin surges sharply during the third trimester of pregnancy in women, when a woman is least able to defend herself and is objectively forced into a subordinate role, while also experiencing nausea from toxicosis (and the nausea response is amplified by the insular cortex—thus it needs to be suppressed somehow—so prolactin learned to do that, along with pain relief and increased tolerance for a submissive, subdominant position, all in one package—just by suppressing the functions of the insular cortex).