How to Get Over Someone: A Strategy for Coping with Heartbreak Based on the Evolutionary History of Hiccups
By Maria Popova
Long before he became the world’s most beloved neurologist, Oliver Sacks was a twenty-seven-year-old medical resident on his first hospital post when an operation left one of his patients with an unstoppable hiccup. Already a bridge figure between medicine and literature, he found himself haunted by a Somerset Maugham short story about a man who dies of hiccups after a woman casts a spell on him. Fearing his patient might suffer the same fate unless something jolted his brain out of the spasmodic loop, Oliver suggested something radical yet emblematic of what would become his lifelong gift for harmonizing the physiology of the body and the poetry of the mind: bringing in a hypnotist. His colleagues were skeptical bordering on scornful. But the patient had been hiccuping for six days straight and no medical intervention had worked. Oliver recounts in his magnificent more-than-memoir:
To our amazement, he was able to get the patient “under” and then to give him a posthypnotic command:
“When I snap my fingers, you will wake up and no longer have hiccups.”
The patient woke up, free from hiccups, and they never recurred.
Why the strange mental intervention was so effective in abating this debilitating reflex of the body, and how it contours the most effective strategy for waking up from the trance of heartbreak, is rooted deep in our evolutionary history.

A hiccup is an involuntary sharp inspiration of air as the epiglottis — the flap of skin in the back of the throat — shuts, producing the hic sound for which the spasm is named. Like our limbs carry the genetic blueprint of our dorsal fins, like our tailbones encode our primate ancestry, hiccups reminds us of where we came from. Although our basic neural infrastructure for breathing evolved from that of fish, the hiccup’s distinctive pattern of nerve and muscle activity is an inheritance from the tadpole stage of our amphibian ancestors. Tadpoles use both their gills and their lungs to breathe, pumping water into the mouth and across the gills but keeping it from entering the lungs by flapping the glottis to seal the breathing tube — one long hiccup.

While our bodies evolved beyond recognition from the tadpole, our brains maintained the neural circuitry of this dual process — most likely, to help nursing infants manage breathing and suckling simultaneously. The vestigial gills of human embryos are no longer present in most adults, but the neuroanatomy of gilled breathing remains and is activated by certain stimuli to cause hiccups — eating too much or too fast, drinking carbonated beverages, being exposed to a rapid temperature change, undergoing extreme stress.
This is why, despite the panoply of folk remedies and pop culture myths for stopping hiccups, ranging from backbends to biting into lemon, the most effective way is simply to reset the brain out of its evolutionary time machine by making a more complex demand of its neural circuits. (For me, doing a bit of calculus invariably stops a spell of hiccups.) Although physical interventions like controlled breathing can sometimes help, it is rather the cognitive demand they make with the focus they require that interrupts the spasms.
A paradox of the human animal is that while we have not fully outgrown the bodily vestiges of our evolutionary inheritance, we have also paid a heavy price for our growing mental complexity. (“Never say higher or lower,” Darwin scribbled in the margin of a natural history book, arguing with the author about the so-called higher animals. “Say more complicated.”) As we rose from the oceans and crawled onto the land, then climbed the trees to learn to be social, then back came down to walk upright beneath a canopy of one hundred trillion synapses, we became creatures capable of love, which made us capable of loss — this is the price of consciousness.

The experience of heartbreak — a recursive mental gasp for reciprocity that is no longer available, or perhaps never really was — is essentially an emotional hiccup: a spasm of thought that feels involuntary, interrupts healthy functioning, and causes debilitating discomfort you are unable to will away. Like the ceaseless hiccups of Oliver’s patient, it is abated only by a mental reset — by setting the mind on a different track of focus that demands enough of its cognitive resources to displace the loop of rumination. It hardly matters what it is — beginning an absorbing new project (this is what the bird divinations did for me), learning a new language or a new craft (this is how ceramics came into my life), training for a triathlon or taking up the cello or going down a delicious rabbit hole about the impossibility of bats or the invention of the bicycle or the chemistry of blue (this is how I wrote Traversal). What does matter is to remember that all feeling floats on a current of thought coursing through the brain at eighty feet per second. Divert the current and the charge of the feeling dissipates — perhaps not to perfect neutrality, but to something bittersweet and bearable, like the memory of childhood, like the body remembers its gills.













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