Pain

There is a large amount of evidence of placebo and nocebo effects showing that one’s expectation of a forthcoming pain can influence the subsequent experience of pain. Here I shall not discuss the implications of these findings for the nature of pain, but focus instead on the nature of pain anticipation itself. This notion indeed remains poorly analysed and it is unclear what type of anticipatory state it involves. I shall argue that there is more to pain anticipation than a (...) mere combination of anticipatory beliefs and fears. When the impending damage is imminent, pain anticipation involves a distinctive sui generis mental state, which I call nociceptive prediction. One then anticipates the forthcoming event under the pain mode. After analysing its points of similarities and differences with pain, I shall argue that nociceptive prediction is best understood in imperative defensive terms. (shrink)

This paper considers masculinity in two twentieth-century historical novels set in the eighteenth century: Andrew Miller’s Ingenious Pain (1997) and Hilary Mantel’s The Giant, O’Brien (1998). It argues that both novels create protagonists who embody masculine-coded attributes, including resistance to pain and bodily size and strength, and that, in both novels, earning potential is concomitant with such attributes. Complicating matters, however, the very exaggeration of stereotypical masculine characteristics in these texts causes each man to seem something other and less than (...) a man—ranging for both, at different times, from monstrous to pathetically weak (and childlike, or even womanish) victim. Qualities associated with manhood, therefore, paradoxically deny the men more agency than they allow in these stories set in the eighteenth century, inhibiting them from enjoying ideal manhood and making them the property of other men. (shrink)

This study was planned as cross-sectional, single group, preliminary, and final test in order to evaluate the pain behaviors and the effecting factors during the aspiration and positioning of intubated and sedated patients who received treatment in the adult intensive care unit. The study was carried out with 91 patients, who were under treatment in the 3rd level intensive care unit of a state hospital in Edirne between the dates of 13.11.2017 and 12.01.2018. The data were collected by patient information (...) Form, Critical Care Pain Observation Tool (CPOT), RAMSAY Sedation Scale (RSS), and Data Observation Registry. The study found that the pain level during the aspiration was higher than the pain level during the positioning (p < 0,05). The pain level of intensive care patients during aspiration and position was found to be higher compared to the pain level before the aspiration and position in this study (p < 0,05). When the RSS point averages of the patients during the aspiration and position were looked at, it was determined to be lower compared to before aspiration and position, and it was found out that the sedation level of patients decreased while their pain levels increased (p < 0,05). In conclusion, it is recommended that the nurses working in the intensive care unit follow up the intubated and sedated patients, their pain behaviors, and the affecting factors with valid and reliable measurement tools and organizing in-service trainings for nurses about this. (shrink)

Over one in five adults in the United States and around the world are estimated to live with chronic pain. How are we to attend well to persons living with pain? This is a difficult, pressing question for both healthcare institutions and Christian communities, and it is only made more complex both by the contemporary opioid crisis and by how experiences of pain and addiction are shaped in the American context by race, gender, and class. Attending faithfully to persons in (...) pain demands thoughtful, creative resources on both practical and conceptual levels. In this special issue of Christian Bioethics, eight scholars from different disciplines—Sarah Barton, Farr Curlin, Jaime Konerman-Sease, Brett McCarty, Joel Shuman, Devan Stahl, John Swinton, and Emmy Yang—engage the meaning of attending to persons in pain for Christian bioethics and for faithful Christian practice. (shrink)

This investigation develops in three steps. First, we seek to complexify the opioid crisis in a way that helps us to see how the issues of misguided desire and misplaced attachments are fundamentally important for a theological account of opioid addiction.1 Second, acknowledging the connections between pain and opioid addiction, we explore some of the ways in which our understanding of pain can influence our understanding of and responses to opioid use. Finally, we offer some tentative reflections on the theological (...) and ecclesial dimensions of the opioid crisis which hold the potential to influence the nature of a Christian response to the issues. Having laid out these steps, we argue for the church’s calling, where she complexifies the narratives about the opioid crisis and provides individuals suffering from opioid use “homeful” encounters with God and the community. (shrink)

I argue here that the ways we experience, think about, and treat pain are bound up with sociocultural and technological phenomena that shape our desires and expectations. I propose a way of imagining caring for and offering healing to those who suffer pain informed by the Christian theological tradition. This way does not aspire to replace the care and healing made possible by modern medicine, but rather to place it within the common life of a community of mutual love, hospitality, (...) and reciprocal care. (shrink)

Women’s pain remains underappreciated, undertheorized, and undertreated in both medicine and theology. The ascetic practices of women in pain, however, can help Christians understand and navigate their own pain and suffering, particularly because they are experienced in the context of chronic illness and disability. In what follows, I argue that Christians would do better to view the pain that accompanies disability and chronic illness as a potential resource for spiritual practice rather than an example of sin or evil. I begin (...) with a brief overview of the most common theological explanations for the relationship between disability and sin within contemporary Christian writings on disability. What is often neglected in these conversations is the acknowledgment of pain in the disability experience. Likewise, discussions of evil often attempt to explain the existence of pain and suffering, but rarely address the practical realities of pain. As a way to begin to remedy the lack of attention to the experience of chronic pain for those living with illness and disability, I consider what it would mean to live faithfully with pain by examining the lives of three holy women who provide examples of what it means to interpret, manage, and share their pain within the body of Christ. (shrink)

For most of the past generation, clinicians have been taught to treat patients' pain until the patient says it is relieved. The opioid crisis has forced both clinicians and patients to reconsider that approach. This essay considers how Christians in particular might assume and seek to overcome their experiences of persistent pain. Wise and faithful responses to pain, especially chronic pain, can take their bearings from how early Christians made sense of the place of both medicine and suffering in a (...) faithful life. This results in not asking medicine to resolve persistent pain, especially not through the use of opioids. Resisting the impulse to medicalize chronic pain will require patience on the part of those who suffer, and both patience and fortitude on the part of the clinicians to whom they present. (shrink)

Eliminating pain is problematic when it comes to caring for people with disabilities or chronic pain. This paper locates the drive to completely eliminate pain as a project of the Enlightenment and contrasts it with the tradition of interpreting suffering throughout the Christian tradition. I introduce Jane Austen’s novel Mansfield Park as a way to continue the tradition of interpretative suffering after the Enlightenment. Using textual analysis of Jane Austen’s Mansfield Park, I demonstrate how the novel’s heroine, Fanny Price, is (...) able to resist the drive to eliminate pain through her contemplative reflection on suffering which allows her to participate in right relationships with others and God. Finally, I offer twenty-first century applications of Mansfield Park by addressing changes we can make in the church and the clinic to understand better the role pain plays in Christian life and community. (shrink)

Sensory-perceptive activity expresses the attributes of real objects and provides information connected to both external and internal reality. Perception helps us embed the information taken from sensations, helping us form the perceptive image that must be completed by each individual in their existence. Practically, perception facilitates the adaptation to reality depending on the experiences of each individual. A method that patients may learn to control their various perceptions is self-regulation by mental images, and here we can consider various approaches to (...) the mental image. Mental imagery is important for the perception of pain, being an easy method to manage pain. Here we can also describe the pain of the ‘phantom member,’ whom certain people that have amputated members still perceive, and which consists of cortical processing of pain, without being triggered by pain receptors, because they lack it. The data described herein confirms and helps us contour the fact that the image of a sensory circumstance may influence neuronal processes which create real sensory experiences. (shrink)

In this piece I discuss two ways in which providers may become able to treat patients better. The first is for them to encourage all medical parties, including medical students, to always speak up. The second is to take initiatives to learn of pain that patients feel but neither show nor spontaneously report. They may refer to this pain as invisible pain, often bitterly, in that others not seeing their pain judge them wrongly and harshly. Providers, once seeing this pain, (...) are encouraged to then take additional measures to try to alleviate it. Clinical examples provided to illustrate the range of treatments providers may add are post-traumatic stress disorders, problems involving substance use, and hoarding disorders. Similar concerns regarding people who are deaf and hard of hearing are also addressed. (shrink)

abstract: Anaxagoras is notorious for his view that every perception is accompanied by pain but that not all concurrent pains are distinctly felt by the perceiving subject. This thesis is reported and criticized by Aristotle's heir Theophrastus in his De Sensibus. Traditionally, scholars believe that Theophrastus rejects Anaxagoras's thesis of the ubiquity of pain as counterintuitive, with the appeal to unfelt pain looking like a desperate category mistake given that pain is nothing but a feeling. Contra the traditional view, this (...) paper argues that Theophrastus neither aims to defend ordinary phenomenology nor is bothered by the concept of unfelt pain; instead, he develops a series of new Aristotelian arguments to defend a controversial, optimistic picture about the distribution of affective qualities in animal life. More than a supplement to Aristotle's psychology, his engagement with Anaxagoras reveals an important yet often ignored ethical concern behind the Peripatetic philosophy of perception. (shrink)

The mask's role is central to the superhero narrative. The mask is a non-human identity, which replaces the civilian, human one; sometimes forever. It is what happens to the majority of Gotham's villains. While Batman can take off his mask and at least pretend to be Bruce Wayne, many of his enemies do not have the same privilege. For characters like Two-Face, Joker, Zsasz, and Clayface, the mask is carved directly into their bodies. Like masks, scars can replace one's identity, (...) but deeply and sometimes irreversibly. Bodies and masks play a central role in ancient primitive cultures, especially during initiation rituals. The two elements are distinct, but closely linked. Wearing a mask always implies a modification of the body, or at least of the way it is perceived. Furthermore, marks left on the body, whether temporary like a face paint or definitive like a tattoo, perform a similar function to that of the mask: they replace the individual's identity and communicate a message. The initiation ceremonies destroy a previous identity to create a new one. While an individuum is a Leib, a living body that is becoming and escapes an ultimate meaning, by inflicting pain and scars, the initiation rituals aim to reduce the body to a stable dimension. First an ecstasy, induced by drugs and fasting, and through the infliction of physical pain, shatters the previous identity. The Leib is reduced to the passivity of flesh. Then a new identity is literally written on the body through scars or tattoos, thus receiving an "ultimate" sense and giving him/her a role and a place within society. The scar is a new identity, like a mask carved directly on the body. (shrink)

Résumé La croyance que l'on est (ou pas) dans un état de douleur est singulière en ceci qu'elle semble pouvoir être qualifiée d'infaillibilité ou d'incorrigibilité logique, de même que le cogito. Mais comment se peut-il que l'existence d'une croyance (vraie) et l'existence du fait qui est l'objet de cette croyance puisssent constituer la même existence? Je propose ici une réponse à cette question. Parfois, une croyance peut être un désir.

Mental health has become a key concern within social discourse in recent years, and with it, the discussion about the lived experience of pain. In dealing with this experience there has been a shift away from merely relying on medical care towards more holistic approaches involving community support, public awareness, and social change. However, little if any attention has been paid in this context to the contribution of aesthetic experience engendered by art that expresses and publicly shares with others the (...) lived experience of pain. With reference to Phantom Limb, an art exhibition curated by Euan Grey and held at the Victoria Galleries and Museum Liverpool in 2016, I argue that aesthetic experience plays a crucial role in making sense of pain and suffering, thus breaking new ground in the appreciation of the significance of art for public mental health and holistic approaches towards patients. (shrink)

Open peer commentary on the article “Kaleidoscope of Pain: What and How Do You See Through It” by Maja Smrdu. Abstract: Relational dynamics are the vital cornerstone for a holistic understanding of chronic pain, particularly for a 5E stance. Enactivism and Buddhism prove most expedient to examine such dynamics in a theoretical and practical fashion.

Open peer commentary on the article “Kaleidoscope of Pain: What and How Do You See Through It” by Maja Smrdu. Abstract: Pain remains an unintelligible mystery. Given Smrdu’s efforts to expand the horizons for dealing with chronic pain, I re-present some constructivist ideas regarding communication, including commonly assumed features of communications between patients and clinicians, in particular sharing experience and understanding.

Open peer commentary on the article “Kaleidoscope of Pain: What and How Do You See Through It” by Maja Smrdu. Abstract: Welcoming Smrdu’s proposal to shed light on the experience of pain through the lens of phenomenology and enactivism, I offer two suggestions that may support the kind of 5E approach to pain she develops. First, I argue that a shift from the biopsychosocial model to a phenomenological 5E theory requires understanding “experience” as functioning as both explanans and explanandum. Second, (...) I suggest that comparing varieties of pain - including mental pain - may help further elucidate the different dimensions that shape the experience of pain according to the 5E approach. (shrink)

Context: Among the many theories of pain, the biopsychosocial explanation of pain remains the most established in medicine. However, the three components are unevenly represented, with emphasis on the biological component. From this perspective the experience of pain may considered as an epiphenomenon. Problem: I empirically investigated the characteristics of pain (especially chronic pain) and investigated how these characteristics relate to existing conceptualizations of pain. Method: A case-study approach was used to demonstrate different ways of understanding and describing pain. Case-study (...) data were collected by two co-researchers through a series of clinical and research-focused phenomenological interviews with eleven people experiencing chronic pain. The aim of the analysis was to explore and evaluate empirical support for the 5E theory of pain. Results: The findings point to the insufficiency of the biopsychosocial approach to understanding pain and support a qualitatively different approach to its investigation. The enactivist and phenomenological approach, and the “horizons of attending to experience,” may open new perspectives on pain perception. Implications: Enactivism and phenomenology offer important theoretical advancements. A shift away from biological or biologically oriented approaches (e.g., biomedical and biopsychosocial models) is necessary to better understand the complexity of first-person experience of chronic pain. The shift is needed because of the complex and overwhelming nature of (chronic) pain, which cannot be described by (any) three components. However, understanding the process of constant interaction between somebody in pain and herself, and with her environment, meaning understanding the dynamic of how pain is embodied, embedded, enacted, extended and emotive, can bring a new level of understanding of pain and patients who suffer. “Horizons of attending to experience” are an additional offering for the holistic approach to understanding patients in pain, and to facilitate better coping. Constructivist content: When studying phenomena of consciousness such as pain, an enactivist and phenomenological approach should be considered, consistent with the constructivist approach. (shrink)

Chronic pain is one of the most disabling conditions globally, yet we are still missing a satisfying theoretical framework to guide research and clinical practice. This is highly relevant as research and practice are not taking place in a vacuum but are always shaped by a particular philosophy of pain, that is, a set of implicitly or explicitly prevailing assumptions about what chronic pain is and how it is to be addressed. In looking at recent history, we identify a promising (...) trend from neuro-centrism to the application of the biopsychosocial model. Unfortunately, due to its limited theoretical foundation, the biopsychosocial model is too often implemented in a reductionist, fragmented, and linear manner. In particular, it remains too vague concerning the relationship between involved biological, psychological, and social processes. Sanneke de Haan prominently labeled this the integration problem. In this paper, we introduce five different facets of the integration problem that every philosophy of pain needs to address: (i) ontological, (ii) conceptual, (iii) explanatory, (iv) methodologicalMethodological, and (v) therapeutic. We develop an enactive theory of chronic pain and outline how far it provides solutions to these different integration challenges. (shrink)

This study explores the relation between pain sensitivity and the cognitive processing of words. 130 participants evaluated the pain-relatedness of a total of 600 two-syllabic nouns, and subsequently reported on their own pain sensitivity. The results demonstrate that pain-sensitive people associate words more strongly with pain than less sensitive people. In particular, concrete nouns like ‘syringe’, ‘wound’, ‘knife’, and ‘cactus’ are considered to be more pain-related for those who are more pain-sensitive. These findings dovetail with recent studies suggesting that certain (...) bodily characteristics influence the way people form mental representations (Casasanto, 2009). We discuss three mechanisms which could potentially account for our findings: attention and memory bias, prototype analysis, and embodied cognition. We argue that, whereas none of these three accounts can be ruled out, the embodied cognition hypothesis provides a particularly promising view to accommodate our data. (shrink)

The meaning-maintenance model posits that any violation of expectations leads to an affective experience that motivates compensatory affirmation. We explore whether the neural mechanism that responds to meaning threats can be inhibited by acetaminophen, in the same way that acetaminophen inhibits physical pain or the distress caused by social rejection. In two studies, participants received either acetaminophen or a placebo and were provided with either an unsettling experience or a control experience. In Study 1, participants wrote about either their death (...) or a control topic. In Study 2, participants watched either a surrealist film clip or a control film clip. In both studies, participants in the meaning-threat condition who had taken a placebo showed typical compensatory affirmations by becoming more punitive toward lawbreakers, whereas those who had taken acetaminophen, and those in the control conditions, did not. (shrink)

I borrow part of the title of my paper from Susan Sontag. In 2003, a year before her death, Susan Sontag published an essay entitled Regarding the Pain of Others. There she takes up the subject of the moral significance of presenting the views of war, violent human death exposed to the lenses of cameras. Her approach to the contemporary issue of mediatisation through the image of the sight of human suffering provokes a question: Do we need teleethics today, the (...) ethics of remote moral relations? Using the method of comparative analysis in the area of cultural determinants of ethics, I draw attention to the contemporary challenges that the culture of late modernity imposes on the morality of everyday life. My thesis is this: The images of human suffering provided by the media reveal the imperfection of our morality. As moral subjects, we are not prepared to respond to the suffering of human beings absent from face-to-face relationships. So, we need teleethics. The paper is devoted to this issue. (shrink)

This paper proposes a unified reading of pleasure's nature and value in Plato's _Philebus_. It also explains how the proposed reading illuminates certain claims about pleasure across the corpus that initially seem to be in some tension: (i) that pleasure is not the good; (ii) that pleasure is choiceworthy and an aspect of the best human life; and (iii) that pleasure is dangerous and tends to make us into bad people who live badly.

This book exploits the power of phenomenological methods to access and describe lived moral experiences of pain and suffering for patients, their families and the wider community. Creating new fields of communication for patients, their family members and health professionals in shared decision making processes, this book builds on knowledge about suffering to help and guide correct action in preventing and relieving chronic pain and improving systems of care. It offers a new phenomenology for understanding moral experience in serious illness (...) and suffering, and its implication for policy, practice and research. A series of applied chapters, looking at individual experiences of suffering and care experiences, present some areas of ethical inquiry, including: pain and suffering maternal care ethics evaluation and moral deliberation about treatment options decision-making and moral agency end-of-life experiences of care. Exploring how moral phenomenology could provide fruitful alternatives to traditional frameworks in bioethics, this is an important addition to the literature. It will be of interest to scholars and students of bioethics and phenomenological methods in the health and human services. (shrink)

Discussions concerning the modularity of the pain system have been focused on questions regarding the cognitive penetrability of pain mechanisms. It has been claimed that phenomena such as placebo analgesia demonstrate that the pain system is cognitively penetrated; therefore, it is not encapsulated from central cognition. However, important arguments have been formulated which aim to show that cognitive penetrability does not in fact entail a lack of modularity of the pain system. This paper offers an alternative way to reject the (...) modularity of the pain system, which is independent from, but consistent with, the presence of cognitive penetration. It is proposed that, given the current knowledge regarding the functioning and the structure of the pain system, there are good reasons to accept that certain central cognitive mechanisms are part of the pain system. It is argued that such a ‘cognitive constitution’ of the pain system entails that the pain system is not modular. (shrink)

Why is unpleasant pain bad for us? Evidently because of how it feels. This bit of commonsense is a challenge for well-being perfectionism, since pain doesn’t look anything like failure to fulfill human nature. Here, I sketch a new version of perfectionism that avoids this problem. To explain what is basically good for us, it appeals to the capacities whose functioning defines who we are, or our subjective nature, instead of human nature. I argue that these capacities have a telic (...) structure, so that practical reason, for example, constitutively aims at competently realizing valuable ends that are in harmony. According to telic perfectionism, we do well when such formal aims are realized and badly when they’re frustrated. Crucially, our subjective nature is defined not only by how we reason but also by how we feel. And valenced experience, too, has built-in directionality, according to the most plausible views about the nature of pleasure and pain. The phenomenal character of unpleasant pain is inseparable from its setting for us the end of eliminating itself. As long as we are in pain, then, the formal aim of our self-defining capacity for valenced experience is frustrated. For telic perfectionism, unpleasant pain is thus robustly bad for us, and the explanation of its badness makes essential reference to how it feels. (shrink)

A protocol of a systematic review of philosophical work on mental pain.

This article discusses the ways in which the practical benefit of poetry, as a source of healing power to reduce distress, is enhanced through incorporating a detailed analysis of literary texts and their sources that relate to the author's depiction of the human predicament and suggestions for liberation from it. This article focuses on two Romantic poems as case studies, Percy Bysshe Shelley's “Mutability” (1816) and John Keats's “Ode on Melancholy” (1820), to highlight an effective way of inspiring students to (...) recognize the poets’ representations of anxiety and their poems’ therapeutic effects. By pointing out the limitations of recent studies promoting the curative power of poetry, the article examines precise literary aspects of the two works, which facilitate the relief from inner affliction for readers as they discuss in detail the concept of affliction in its association with the realities of instability and depression. It suggests a method of providing poetry education that reveals the paradox of suffering and self-remedy and thereby reinforces comprehension. (shrink)

ABSTRACT:Biomedical and philosophical traditions postulate the experience of pain either as quantifiable or as sociocultural phenomena. This critical assessment offers a close reading of Lara Parker’s Vagina Problems: Endometriosis, Painful Sex, and Other Taboo Topics (2020) and Abby Norman’s Ask Me About My Uterus: A Quest to Make Doctors Believe in Women’s Pain (2018), analyzing the authors’ use of language as a tool to comprehend and communicate pain. Norman’s and Parker’s memoirs narrate the lived experience of endometriosis, a condition diagnosed (...) almost exclusively in women and characterized by chronic pain. The essay looks at how metaphors are employed in living and narrating endometriosis in medical, social, and cultural settings that are highly skeptical of women’s pain and trace a shift in the use of pain metaphors towards an acceptance of the pain experience, which is conceptualized as empowering by the climax of the narrative. (shrink)

This goal of this thesis in the philosophy of nature is to move us closer towards a true biological science of consciousness in which the evolutionary origin, function, and phylogenetic diversity of consciousness are moved from the field’s periphery of investigations to its very centre. Rather than applying theories of consciousness built top-down on the human case to other animals, I argue that we require an evolutionary bottomup approach that begins with the very origins of subjective experience in order to (...) make sense of the place of mind in nature. To achieve this goal, I introduce and defend the pathological complexity thesis as both a framework for the scientific investigation of consciousness and as a lifemind continuity thesis about the origins and function of consciousness. (shrink)

Thermal comfort and thermal pain are two independent phenomena studied by different disciplines. The research field of thermal comfort deals with the adaptation of perception of thermal conditions at the workplace. That of thermal pain with sensory and emotional perceptions of painful heat stimuli and its adaptation.

The very idea of humanity seems to be in crisis. Born in the ashes of devastation after the slaughter of millions, the liberal conception of humanity imagined a suffering victim in need of salvation. Today, this figure appears less and less capable of galvanizing the political imagination. But without it, how are we to respond to the inhumane violence that overwhelms our political and philosophical registers? How can we make sense of the violence that was carried out in the name (...) of humanism? And how can we develop more ethical relations without becoming parasitic on the pain of others? Through a critical exploration of violence and the sacred, Ecce Humanitas recasts the fall of liberal humanism. Brad Evans offers a rich analysis of the changing nature of sacrificial violence, from its theological origins to the exhaustion of the victim in the contemporary world. He critiques the aestheticization that turns victims into sacred objects, sacrificial figures that demand response, perpetuating a cycle of violence that is seen as natural and inevitable. In novel readings of classic and contemporary works, Evans traces the sacralization of violence as well as art’s potential to incite resistance. Countering the continued annihilation of life, Ecce Humanitas calls for liberating the political imagination from the scene of sacrifice. A new aesthetics provides a form of transgressive witnessing that challenges the ubiquity of violence and allows us to go beyond humanism to imagine a truly liberated humanity. (shrink)

Introduction: Wellbeing policy analysis is often criticized for requiring a cardinal interpretation of measurement scales, such as ranking happiness on an integer scale from 0-10. The commonly-used scales also implicitly constrain the human capacity for experience, typically that our most intense experiences can only be at most ten times more intense than our mildest experiences. This paper presents the alternative “heavy-tailed valence” (HTV) hypothesis: the notion that the accessible human capacity for emotional experiences of pleasure and pain spans a minimum (...) of two orders of magnitude. Methods: We specify five testable predictions of the HTV hypothesis. A pilot survey of adults aged 21-64 (n = 97) then tested two predictions, asking respondents to comment on the most painful and most pleasurable experiences they can recall, alongside the second most painful and pleasurable experiences. Results: The results find tentative support for the hypothesis. For instance, over half of respondents said their most intense experiences were at least twice as intense as the second most intense, implying a wide capacity overall. Simulations further demonstrate that survey responses are more consistent with underlying heavy-tailed distributions of experience than a “constrained valence” psychology. Discussion: A synthesis of these results with prior findings suggests a “kinked” scale, such that a wide range of felt experience is compressed in reports at the high end of intensity scales, even if reports at lower intensities behave more cardinally. We present a discussion of three stylized facts that support HTV and six against, lessons for a future survey, practical guidelines for existing analyses, and implications for current policy. We argue for a dramatic increase in societal ambition. Even in high average income countries, the HTV hypothesis suggests we remain far further below our wellbeing potential than a surface reading of the data might suggest. (shrink)

The pain-assessment literature often claims that pain is subjective. However, the meaning and implications of this claim are left to the reader’s imagination. This paper attempts to make sense of the claim and its problems from the history and philosophy of science perspective. It examines the work of Henry Beecher, the first person to operationalize “pain” in terms of subjective measurements. First, I reconstruct Beecher’s operationalization of “pain.” Next, I argue this operationalization fails. Third, I salvage Beecher’s insights by repositioning (...) them in an intersubjective account. Finally, I connect these insights to current pain-assessment approaches, showing that they enrich each other. (shrink)

Olfactory Virtual Reality (OVR) for Wellbeing and Reduction of Stress, Anxiety and Pain - Journal of Medical Research and Health Sciences.

Future-bias is the preference, all else being equal, for negatively valenced events be located in the past rather than the future, and positively valenced ones to be located in the future rather than the past. Strong risk aversion is the preference to pay some cost to mitigate the badness of the worst outcome. People who are both strongly risk averse and future-biased can face a series of choices that will guarantee them more pain, for no compensating benefit: they will be (...) pain pumped. Thus, combining these preferences is rationally impermissible. Dougherty (2011) argues that this gives us reason to think that future-bias is rationally impermissible. This argument, and a similar one presented by Greene and Sullivan (2015), relies on the idea that if several preferences are not rationally combinable, then in the absence of some explanation of why they are not combinable, we should conclude that (at least) one of them is rationally impermissible. We take up this question by, inter alia, reflecting on the empirical results of a study we ran that probes people’s risk averse and future-biased preferences. We argue that the data, in conjunction with other considerations, suggests that we should not infer from the irrationality of the combination of these preferences to the irrationality of one of the preferences singly. We also argue that given the descriptive data about these preferences, there is no reason to think that, if one of them is rationally impermissible, then it is future-bias. (shrink)

This article argues that cruelty, as a willingness to see or orchestrate the suffering of others, is not an unfortunate side-effect of neoliberal theories put into practice but is constitutive of the neoliberal project from its theoretical inception. Drawing on Lisa Duggan’s concept of ‘optimistic cruelty’ and treating the canonical texts of neoliberal economic theory as literary artefacts, the article develops this argument through a close reading of one of the central architects of the neoliberal project, the philosopher and economist (...) Friedrich Hayek. The first part of the article examines how Hayek attempts to justify the brutality of the market order he imagines – the catallaxy – by arguing that this brutality is the natural consequence of the spontaneous evolutionary processes that move civilisation forward. The second part brings to the fore the eugenicist undertones that suffuse this vision, despite Hayek’s apparent rejection of Social Darwinism. I analyse how Hayek’s market order operates through a series of disciplinary and biopolitical technologies that use pain, frustration, punishment and stigmatisation to eliminate bad habits, practices and subjectivities. These cruel mechanisms enable the catallaxy to sort between productive and unproductive lives to ensure that available resources are directed towards the former – even if it means that the others might be left to die. As such, cruelty is an affective atmosphere that permeates the catallaxy. (shrink)