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Emotional IntensityPlay
Used to describe extreme emotional pain often from personal loss or failure. SlideHis anguish was palpable when he spoke of his divorce.
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Physical PainPlay
Can refer to intense physical suffering, not just emotional. SlideShe felt a sharp anguish in her side during the marathon.
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Use SparinglyPlay
A strong word, so use it only for serious and profound situations. SlideThe novel described the anguish of war survivors.