Pain and Pain Experience

Commissioned for Routledge Encylopaedia of Philosophy.

While many agree that unpleasant pains motivate, little attention has been paid to this idea’s action-theoretic significance, to what kind of motivation pains are, or to the status of the behaviour they motivate. I claim that some pain behaviour belongs to a neglected category. For it is not brute behaviour, but action; yet it is not motivated by desires or intentions, nor like other behaviour that philosophers construe as neither brute nor desire-motivated, such as habitual action. Rather it is what (...) I call “world-motivated”. This idea is a powerful antidote to the competing temptations either to overintellectualise such behaviour or, conversely, to deny its status as purposive action. And, since some views of pain’s unpleasantness capture it better than others, the world-motivated conception of pain behaviour bears not just on action theory, but on what I call the affect debate. (shrink)

This is a slightly more polished version of a presentation I wrote for the Author-Meets-Critics session on Colin's book at the Eastern APA session on Jan 4, 2017, in Baltimore. I’ve decided to post this commentary online pretty much as is -- I am afraid I don't have time to prepare a version suitable for publication. I hope the reader will find it helpful. At any rate, please treat this piece as a rough draft originally intended to be delivered to (...) a live audience. Although my commentary is mostly critical, I admire Colin's book for its originality, breadth, and depth. It stimulated my thought like no other books in recent years. (shrink)

Russell (1911/12) argued that perceptual experience grounds a species of non-propositional knowledge, “knowledge by acquaintance,” and in recent years, this account of knowledge has been gaining traction. I defend on its basis a connection between moral and epistemic failure. I argue, first, that insufficient concern for the suffering of others can be explained in terms of an agent’s lack of acquaintance knowledge of another’s suffering, and second, that empathy improves our epistemic situation. Empathic distress approximates acquaintance with another’s suffering, and (...) empathic agents who are motivated to help rather than disengage exhibit an important epistemic virtue: a variety of intellectual courage. A key upshot is that an independently motivated account of the structure and significance of perceptual experience is shown to provide theoretical scaffolding for understanding a famously elusive idea in ethics—namely, that the failure to help others stems from a kind of ignorance of their situation. (shrink)

Much of the focus on pain in the literature is the nature of pain’s badness. This paper addresses the relatively overlooked problem of intensity. I construe intensity as the degree to which pains demand involuntary attention, the degree to which a pain can’t be ignored. I use a global workspace framework to explain intensity, a view that is uniquely situated to explain the relevant empirical evidence. I construe intensity theoretically via a pain’s mode of representation, how pain is represented rather (...) than what is represented. This has the advantage of integrating the major views on pain’s badness. Novel explanations result from intensity as attentional demand and each view’s perspective on badness. (shrink)

According to pure imperativism, pain experiences are experiences of a specific phenomenal type that are entirely constituted by imperative content. As their primary argument, proponents of imperativism rely on the biological role that pain experiences fulfill, namely, the motivation of actions whose execution ensures the normal functioning of the body. In the paper, I investigate which specific types of action are of relevance for an imperative interpretation and how close their link to pain experiences actually is. I argue that, although (...) imperative theories constitute an apparently promising version of strong intentionalism, they cannot provide an imperative content that meets their own criteria of both sufficiency and necessity. I further argue that this issue cannot be solved by impure imperative theories either. (shrink)

Context Opioid treatment agreements (OTAs) are documents that clinicians present to patients when prescribing opioids that describe the risks of opioids and specify requirements that patients must meet to receive their medication. Notwithstanding a lack of evidence that OTAs effectively mitigate opioids’ risks, professional organizations recommend that they be implemented, and jurisdictions increasingly require them. We sought to identify the jurisdictions that require OTAs, how OTAs might affect the outcomes of lawsuits that arise when things go wrong, and instances in (...) which the law permits flexibility for clinicians and health care institutions to adopt best practices. -/- Methods We surveyed the laws and regulations of all 50 states and the District of Columbia to identify which jurisdictions require the use of OTAs, the circumstances in which OTA use is mandatory, and the terms OTAs must include (if any). We also surveyed criminal and civil judicial decisions in which OTAs were discussed as evidence on which a court relied to make its decision to determine how OTA use influences litigation outcomes. -/- Findings Results show that a slight majority (27) of jurisdictions now require OTAs. With one exception, the jurisdictions’ requirements for OTA use are triggered at least in part by long-term prescribing. There is otherwise substantial variation and flexibility within OTA requirements. Results also show that even in jurisdictions where OTA use is not required by statute or regulation, OTA use can inform courts’ reasoning in lawsuits involving patients or clinicians. Sometimes, but not always, OTA use legally protects clinicians from liability. -/- Conclusions -/- Our results show that OTA use is entwined with legal obligations in various ways. Clinicians and health care institutions should identify ways for OTAs to enhance clinician–patient relationships and patient care within the bounds of relevant legal requirements and risks. (shrink)

The higher-order desire theory of pain states that pain’s unpleasantness is constituted by the subject’s desire not to feel pain. The theory faces the Euthyphro problem: it fails to accommodate the intuitive datum that pain’s unpleasantness explains and justifies the desire not to feel pain. To avoid this problem, the first-order desire theory proposes that pain’s unpleasantness is constituted by the subject’s desire not to be in the bodily condition represented by the feeling of pain. This paper aims to show (...) that the Euthyphro problem, originally leveled against the higher-order theory, arises equally for the first-order theory. In particular, it either leaves the first-order desire rationally ungrounded or collapses into one of its rival theories — namely, evaluativism. I conclude that desire theories of pain misconstrue the justificatory relationship between desire and pain’s unpleasantness. (shrink)

Representing Pain: A Philosophical-Technological Project on Subjectivity in the Age of Artificial Intelligence -/- This doctoral project proposes an interdisciplinary and innovative framework to represent human pain in digital systems powered by artificial intelligence. Pain—an emblematic experience of subjectivity and existence—resists purely biomedical or computational approaches. By integrating insights from phenomenology, medical epistemology, and philosophical ontology, the project aims to develop a conceptual and technological model capable of capturing the existential and relational dimensions of pain in clinical settings. -/- Beginning (...) with a critical analysis of anamnesis and screening processes in healthcare, the research explores how digital technologies—such as natural language systems, formal ontologies, and semantic vector models—can be used to enhance clinical listening and recognize the singularity of each patient's narrative. The thesis argues that computational representation of pain is only possible if grounded in a philosophical understanding of subjectivity, language, and lived experience. -/- Structured over four years, the investigation unfolds in four phases: (1) critical literature review and philosophical problematization; (2) ontological modeling and development of a natural semantic meta-language (SLN); (3) application in clinical triage contexts, with qualitative and ethical-phenomenological validation; and (4) systematization of results and contribution to a care-centered philosophy of technology. -/- This project is not merely a dissertation: it is a philosophical effort to recover listening, the body, and language in an era of automation. It offers an original contribution to the dialogue between philosophy, health, and technology—questioning the limits and possibilities of AI in understanding human suffering. (shrink)

Most of us have experienced some, probably many, forms of bodily pain. Unless you were born with congenital insensitivity to pain, you’ve likely experienced at least toothaches, headaches, or backaches. -/- Pain experiences differ in intensity, quality, and duration. A toothache might be sharp and intense but fleeting, while a backache might be dull and aching yet more enduring. Despite these differences, there seems to be a common thread that unites toothaches, backaches, and so on—something that makes them all pains. (...) -/- This raises interesting philosophical questions: is pain physical or mental? What is the role of the pain system? And, is pain always unpleasant? -/- These questions are the focus of this essay. (shrink)

We challenge the standard interpretation of pain asymbolia (PA), a neuropsychiatric condition that causes unusual reactions to pain stimuli. The standard interpretation asserts that PA subjects experience pain but lack important features of the experience. However, we argue that the clinical evidence for PA does not support this interpretation and that the arguments put forward by the defenders of the standard interpretation end up making self-contradicting claims. Finally, we suggest that the best interpretation of the available evidence is to take (...) a deflationist stance toward PA, at least until further evidence becomes available. (shrink)

Many philosophers endorse the Transparency Thesis, the claim that by introspection one cannot become aware of one's experience. Recently, some authors have suggested that the Transparency Thesis is challenged by introspective states reached under mindfulness. We label this the Mindfulness Opacity Hypothesis. The present paper develops the hypothesis in important new ways. First, we motivate the hypothesis by drawing on recent clinical psychology and cognitive science of mindfulness. Secondly, we develop the hypothesis by describing the implied shift in experiential perspective, (...) the scope of introspectable qualities, and the level of skill. Thirdly, we defend the hypothesis against various philosophical arguments. We conclude that the Mindfulness Opacity Hypothesis is empirically and theoretically well motivated and supported. (shrink)

Evaluativism about unpleasant pains offers one way to think about unpleasant pain experience. However, extant Evaluativist views do not pay enough attention to the affective dimension of pain experience and the complex relations between the affective, evaluative and sensory dimensions. This paper clarifies these relations and provides a view which more closely reflects the phenomenology of unpleasant pains. It argues that the intentional structure of paradigmatic unpleasant pain is as follows: unpleasant pains essentially involve a proprietary intentional mode—what I call (...) affective-interoception—and a distinctive kind of evaluatively qualified sensory content. The resulting view is Affective-Evaluativism. (shrink)

Background: Patients with chronic pain face significant barriers in finding clinicians to manage long-term opioid therapy (LTOT). For patients on LTOT, it is increasingly common to have them sign opioid treatment agreements (OTAs). OTAs enumerate the risks of opioids, as informed consent documents would, but also the requirements that patients must meet to receive LTOT. While there has been an ongoing scholarly discussion about the practical and ethical implications of OTA use in the abstract, little is known about how clinicians (...) use them and if OTAs themselves modify clinician prescribing practices. Objective: To determine how clinicians use OTAs and the potential impacts of OTAs on opioid prescribing. Design: We conducted qualitative analysis of four focus groups of clinicians from a large Midwestern academic medical center. Groups were organized according to self-identified prescribing patterns: two groups for clinicians who identified as prescribers of LTOT, and two who did not. Participants: 17 clinicians from General Internal Medicine, Family Medicine, and Palliative Care were recruited using purposive, convenience sampling. Approach: Discussions were recorded, transcribed, and analyzed for themes using reflexive thematic analysis by a multidisciplinary team. Key Results: Our analysis identified three main themes: (1) OTAs did not influence clinicians’ decisions whether to use LTOT generally but did shape clinical decision-making for individual patients; (2) clinicians feel OTAs intensify the power they have over patients, though this was not uniformly judged as harmful; (3) there is a potential misalignment between the intended purposes of OTAs and their implementation. Conclusion: This study reveals a complicated relationship between OTAs and access to pain management. While OTAs seem not to impact the clinicians’ decisions about whether to use LTOT generally, they do sometimes influence prescribing decisions for individual patients. Clinicians shared complex views about OTAs’ purposes, which shows the need for more clarity about how OTAs could be used to promote shared decision-making, joint accountability, informed consent, and patient education. (shrink)

What is the function of pain? A popular view in contemporary philosophy is that the pain system is a bodily disturbance detector: pain states track/detect and represent bodily disturbances and the phenomenal character of the (sensory dimension of) pain supervenes on this representational content. The view can accommodate paradigmatic pain cases, e.g., when pain follows from stepping on a nail. Once we consider more complex pain phenomena, however, it has seemingly little to offer. In this paper, I discuss dissociation between (...) pains and bodily disturbances, variation in pain thresholds, the effects of repeated stimulation on experienced pain intensity, and the modulation of pain experience by cognitive and emotional states. I argue that these phenomena suggest that the pain system is not a bodily disturbance detector, but a sophisticated security system. (shrink)

[Special issue honoring Nikola Grahek] Representationalism in philosophy of perception has become more or less the dominant view. There are various versions of it not all of which are motivated by the same set of concerns. Different metaphysical and epistemological agendas are at work in different strands of the movement. In this paper, I will focus on what has come to be known as strong representationalism. This view has reductive and non-reductive versions, which are usually paired with realist and irrealist (...) versions respectively. First, I will develop a simple, largely empirical, argument against the realist reductive version. Later, rather more briefly, I will extend the argument to cover irrealist representationalism. (shrink)

This work proposes that pain meets the requirements of being characterized as a secondary quality, as it covers, like a color, a determined extension. The argument seeks to establish a literal pain-color analogy through an inquiry into the intensity and location of the pain. From the classic intensity/location relationship reported by patients with acute appendicitis, three degrees of pain are distinguished: mild, moderate, and severe. The objective is only achieved by examining the Body’s extensional determinations (primary quality) insofar as each (...) of these degrees of pain covers three particular measures. Once these three measures have been explored according to the perforation process (tissue damage), the work ends by identifying pain as a transcendent moment. (shrink)

The aim of the article is to introduce a new concept of “pain-related bodily doubt,” which complements current concepts currently in use, such as pain-related fear, pain catastrophizing, and pain self-efficacy. This new concept, adapted from recent philosophical work on illness experience, has the potential to positively contribute to pain research and clinical practice by providing a vocabulary for clinicians and patients to discuss implicit or tacit dimensions of pain-related experiences.

Subtitle: "Experiential understanding and the impossibility of intrinsically valuing suffering." Suffering, I argue, is bad. This paper supports that claim by defending a somewhat bolder-sounding one: namely that if anyone—even a sadistic ‘amoralist’—fully understands the fact that someone else is suffering, then the only evaluative attitude they can possibly form towards the person’s suffering as such is that of being _intrinsically against_ it. I first argue that, necessarily, everyone is disposed to be intrinsically against their _own_ suffering experiences, holding fixed (...) their specific overall degree of emotional aversiveness, because any evaluative attitude other than ‘being against’—including mere indifference—would in certain key circumstances make our suffering less emotionally aversive and thus different from the suffering experience (stipulatively) at issue. Second, fully understanding that someone else is having a given experience—Mary’s experiencing a vividly blue sky, say, or Job’s experiencing heart-rending grief—requires that we represent _experientially_ their very instance of that experience-type (it requires, in other words, token phenomenal concepts). The result is that what goes for our own suffering goes for others’, too: maintaining an accurate experiential representation of the fact that someone else is having a suffering experience with a specific degree of overall emotional aversiveness is only compatible with coming to be intrinsically against their suffering. So suffering is—‘objectively’—bad: it’s only possible to respond with indifference towards anyone’s suffering if we don’t fully understand that they are suffering in the first place. (shrink)

I explore some of the connections between Grahek's model of asymbolic pain, as developed in Feeling Pain and Being in Pain, and the contemporary intentionalist discussion over evaluativist and imperativist models of pain. I will sketch a Grahekian version of imperativism that is both true to his main insights and better at confronting some of the challenges that his theory has faced since its publication.

This paper argues in favour of the embodied approach to pain. We start by asserting that an appropriate philosophical treatment of pain must be empirically informed, rather than relying solely on the conceptual analysis typical of what we call "orthodox views of pain. " We then examine contemporary empirically informed views, specifically enactivism and eliminativism, by testing them against the aberrant pain phenomenon, namely chronic pain. This method of using fringe cases and aberrations to test philosophical theories of pain follows (...) the approach of Grahek (2007), who criticized subjectivism and objectivism based on their failure to account for pain asymbolia and congenital analgesia. We contend that the embodied approach holds an advantage over eliminativism and enactivism as it integrates the subjective, phenomenal aspect of pain-understood as a form of perceptual expectation-with the objective behavioural and neurological aspects by proposing a specific top-down connectionist cognitive architecture. We test two predictions of this approach: (1) that pain is multimodal and cognitively penetrable, and (2) that aberrant forms of pain, such as chronic pain, can be modulated not only by manipulating its immediate neurological source but also by altering the multimodal body image through virtual reality (VR) technology and our cognitive states, primarily our expectations about the environment. (shrink)

Our pains can be more or less intense, our mental imagery can be more or less vivid, our perceptual experiences can be more or less striking. These degrees of intensity of conscious experiences are all manifestations of a phenomenal property I call mental strength. In this article, I argue that mental strength is a domain-general phenomenal magnitude; in other words, it is a phenomenal quantity shared by all conscious experiences that explains their degree of felt intensity. Mental strength has been (...) largely overlooked in favor of mental states’ type, representational contents, domain-specific phenomenology, or processes such as attention. Considering mental strength in our reflections about the mind illuminates debates about the relation of representational contents and phenomenal character, and it also helps address questions about the structure and functions of consciousness. Mental strength provides a unifying construct to model what is shared in the phenomenology of different types of conscious experiences. (shrink)

Pains are unpleasant, universally unpleasant. What seems trivially true has been rejected by various pain scientists because of several phenomena which allegedly show that there can be pain which is not unpleasant. This rejection is partly based on the ambiguity of ‘pain unpleasantness’ which can be avoided by distinguishing between primary and secondary pain affect. As for the alleged counterexamples to the above, I will argue that experiences of episodic analgesia as well as the ‘pain’ experiences of some lobotomized and (...) morphine patients should not be construed as cases in which pain and unpleasantness come apart, but rather as cases in which nociceptive activity and pain dissociate. Regarding the notorious case of pain asymbolia, I will demonstrate that the behaviour of patients with this syndrome suggests that they do feel pain, and that their pain sensations are unpleasant, but much less unpleasant than the pains normal people would have if exposed to the same noxious stimuli. Adopting such an account of these phenomena allows us to retain the widely accepted IASP definition of pain, and thus avoids the issue of integrating non-unpleasant pains into a plausible definition of pain. (shrink)

The mainstream view in contemporary analytic philosophy is that perception is primarily in the business of representing the mind-independent world as it is. My dissertation explores an alternative conception: that the goal of perception is to guide successful action and that perceptions do not need to track mind-independent properties to play this action-guiding role. I focus on two types of perception: color perception and pain perception. I start with the former and advocate a pragmatist, empirically-guided approach which begins by inquiring (...) into the function of color vision. After arguing that none of the extant philosophical views of color are satisfactory, I answer the function question by focusing on systematic color perceptual phenomena investigated by psychophysicists. I argue that the human color visual system is an enhancement system: that is, its job is to help us better discriminate, track, and recognize meaningful objects, properties, and relations. I then build on this idea using the notion of ‘competence-embeddedness.’ I propose that color vision is embedded in a network of competences: the aim of color vision is to help organisms manifest these competences, and color experiences are correct when they result from competence-enhancing processing. The framework is explanatorily robust. For example, it allows me to conceptualize many textbook color illusions as special cases of successful color perception where the demands of the relevant competences clash. Finally, I use the notion of ‘competence-embeddedness’ to develop a new account of pain. I argue that the pain system is not a bodily disturbance detector, but a sophisticated, context-responsive security system whose primary goal is to help organisms manifest important behavioral and cognitive competences. (shrink)

Dysmenorrhea, or menstrual pain, is regularly suffered by 45 to 95% of menstruating women. Despite its prevalence, and despite the philosophical importance of pain as a general phenomenon, dysmenorrhea has been all but completely overlooked in contemporary analytic philosophy of mind. This paper aims at rectifying this situation. We single out three properties of what is often considered the paradigmatic case of painful experience, what we call injury-centered pains, and argue that dysmenorrhea does not have any of them, and hence (...) that it does not neatly conform to the injury-centered model of pain. This calls into question the centrality of the injury-centered model, and suggests novel research avenues within theoretical debates on affectivity. (shrink)

In 1925, David Katz published an influential monograph on touch, Der Aufbau der Tastwelt, which was translated into English in 1989. Although it is called “the world of touch,” it also discusses the thermal and the nociceptive senses, albeit briefly. In this chapter, we will follow this approach, but we will speak about “somatosensory senses” in general in order to remind ourselves that perceptions of temperatures and pains should also be considered together in this context.

Crump et al.’s contribution to assessing whether decapods feel pain raises an important question: Is pain distributed unevenly across the order? The case for pain appears stronger in Pleocyemata than in Dendrobranchiata. Some studies report pain avoidance behaviors in Dendrobranchiata (Penaeidae) shrimp, but further studies are needed to determine whether the chemicals used are acting as analgesics to relieve pain, or as soporifics to reduce overall alertness. If the latter, the most farmed shrimp species may not require the same level (...) of protection as crabs, crayfish, and lobsters. (shrink)

Davanger reviews Arne Johan Vetlesen's book "Pain in our Time" [Smerte i vår tid] (title translated from Norwegian for the purpose of this abstract).

What is the best way to account for the badness of pain and what sort of theory of welfare is best suited to accommodate this view? I argue that unpleasant sensory experiences are prudentially bad in the absence of contrary attitudes, but good when the object of positive attitudes. Pain is bad unless it is liked, enjoyed, valued etc. Interestingly, this view is incompatible with either pure objectivist or pure subjectivist understandings of welfare. However, there is a kind of welfare (...) theory that can incorporate this view of the badness of pain and which is very, very close to being a form of subjectivism. Moreover, this hybrid account of welfare is entirely compatible with the deep motivations of subjectivism. I therefore argue that those who lean towards welfare subjectivism should adopt this account of pain, and that we should revise our understanding of subjectivism to count such theories as subjective. (shrink)

I respond to an objection recently formulated by Barlassina and Hayward against first-order imperativism about pain, according to which it cannot account for the self-directed motivational force of pain. I am going to agree with them: it cannot. This is because pain does not have self-directed motivational force. I will argue that the alternative view—that pain is about dealing with extramental, bodily threats, not about dealing with itself—makes better sense of introspection, and of empirical research on pain avoidance. Also, a (...) naturalistic theory of body-involving commands falls straightforwardly out of our most prominent naturalistic metasemantic accounts, while the token-reflexive contents that would underlie self-directed motivation are more problematic. (shrink)

Recent work on pain focuses on the question ‘what makes pains unpleasant’. Second-order desire views claim that the unpleasantness of pain consists in a second-order intrinsic desire that the pain experience itself cease or stop. This paper considers a significant objection to second-order desire views by considering the case of the masochist. It is argued that various ways in which the second-order desire view might try to account for the case of the masochist encounter problems. The conclusion is that until (...) there is a convincing explanation of how second-order desire views can handle masochistic psychology, theorists should look elsewhere for an account of pains unpleasantness. (shrink)

The Life Worth Living investigates the exclusion of and discrimination against disabled people across the history of Western moral philosophy. -/- Table of Contents: Introduction: The Ableist Conflation. Part I: Pain. 1. Theories of Pain. 2. A Phenomenology of Chronic Pain. Part II: Disability. 3. Theories of Disability. 4. A Phenomenology of Multiple Sclerosis. Part III: Ability. 5. Theories of Ability. 6. A Phenomenology of Ability. Conclusion: An Anti-Ableist Future.

This article gives a short presentation of reflexive imperativism, the intentionalist theory of valence I developed with Max Khan Hayward. The theory says that mental states have valence in virtue of having reflexive imperative content. More precisely, mental states have positive valence (i.e., feel good) in virtue of issuing the command "More of me!", and they have negative valence (i.e., feel bad) in virtue of issuing the command "Less of me!" The article summarises the main arguments in favour of reflexive (...) imperativism and against other intentionalist treatments of valence. (shrink)

Various prominent theories of pain assume that it is pain’s biological function to inform organisms about damage to their bodies. I argue that this is a mistake. First, there is no biological evidence to support the notion that pain was originally selected for its informative capacities, nor that it currently contributes to the fitness of organisms in this specific capacity. Second, neurological evidence indicates that modulating mechanisms in the nociceptive system systematically prevent pain from serving a primarily informative role. These (...) considerations threaten to undermine standard perceptual and representational accounts of pain. (shrink)

This article challenges the orthodox position that some smells are pleasantly fragrant and some tactile sensations are painful. It proposes that the affective components of our experiences are a kind of illusion. Under this alternative picture, experiences that seem to have positive or negative affect never actually do. Rather, the affective component is hyper-illusory, a second-order misrepresentation of the way things actually seem to us. While perceptual hyperillusions have elicited scepticism in other contexts, affective hyperillusions can withstand common critiques. Focusing (...) on the paradigmatic affective experience — pain — the article situates the hyperillusory account within the existing scientific and philosophical literature. Several theoretical advantages of positing a hyper-illusory structure to affective experiences emerge from the discussion. (shrink)

Philosophers disagree about what the folk concept of pain is. This paper criticises existing theories of the folk concept of pain, i.e. the mental view, the bodily view, and the recently proposed polyeidic view. It puts forward an alternative proposal – the polysemy view – according to which pain terms like “sore,” “ache” and “hurt” are polysemous, where one sense refers to a mental state and another a bodily state, and the type of polysemy at issue reflects two distinct but (...) related concepts of pain. Implications with respect to issues in philosophy of pain are also drawn. (shrink)

The IASP definition of 'pain' defines pain as a subjective experience. The Note accompanying the definition emphasizes that as such pains are not to be identified with objective conditions of body parts (such as actual or potential tissue damage). Nevertheless, it goes on to state that a pain "is unquestionably a sensation in a part or parts of the body, but it is also always unpleasant and therefore also an emotional experience." This generates a puzzle that philosophers have been well (...) familiar with: how to understand our utterances and judgments attributing pain to body parts. (The puzzle is of course general extending to all sensations routinely located in body parts.) The present work tackles this puzzle. I go over various options specifying the truth-conditions for pain attributing judgments, and at the end make my own recommendation which is an adverbialist, qualia-friendly proposal with completely naturalistic credentials that is also compatible with forms of weak intentionalism. The results are generalizable to other bodily sensations and can be used to illustrate, quite generally, the viability of a qualia-friendly adverbialist (but naturalist and weakly intentionalist) account of perception. (shrink)

This is a Letter to Editor responding to another Letter by Dr. LR Bernstein (PAIN Reports 5, 2020, e814) reacting to my previous article on the IASP definition of pain that appeared in PAIN Reports 4(2019)e777.

According to pure imperativism, pain experiences are experiences of a specific phenomenal type that are entirely constituted by imperative content. As their primary argument, proponents of imperativism rely on the biological role that pain experiences fulfill, namely, the motivation of actions whose execution ensures the normal functioning of the body. In the paper, I investigate which specific types of action are of relevance for an imperative interpretation and how close their link to pain experiences actually is. I argue that, although (...) imperative theories constitute an apparently promising version of strong intentionalism, they cannot provide an imperative content that meets their own criteria of both sufficiency and necessity. I further argue that this issue cannot be solved by impure imperative theories either. (shrink)

Many people are attracted to the idea that plants experience phenomenal conscious states like pain, sensory awareness, or emotions like fear. If true, this would have wide-ranging moral implications for human behavior, including land development, farming, vegetarianism, and more. Determining whether plants have minds relies on the work of both empirical disciplines and philosophy. Epistemology should settle the standards for evidence of other minds, and science should inform our judgment about whether any plants meet those standards. We argue that evidence (...) for other minds comes either from testimony, behavior, anatomy/physiology, or phylogeny. However, none of these provide evidence that plants have conscious mental states. Therefore, we conclude that there is no evidence that plants have minds in the sense relevant for morality. (shrink)

The paper brings a challenge to Cartesian dualism, while introducing some under-explored manuscript remarks from Wittgenstein’s middle period, which are methodologically and thematically akin to some passages from Merleau-Ponty’s early period. Cartesian dualism relegates pain to mental awareness and location to bodily extension, thus rendering common localizations of pain throughout the body as unintelligible ascriptions. Wittgenstein’s and Merleau-Ponty’s attempts at doing justice to common localizations of pain are mutually illuminating. In their light, Cartesian dualism turns out to involve an objectification (...) and a deappropriation of one’s body. Moreover, Wittgenstein’s unveiling a heterogeneous multiplicity of corporeal spaces (e.g. visual-space, tactile-space, feeling-space) rehabilitates the view, reinforced by Merleau-Ponty, that corporeal pain is intimately related to corporeal localization, while corporeal space is not part of the physical space of things. (shrink)

Although pain is one of the most fundamental and unique experiences we undergo in everyday life, it also constitutes one of the most enigmatic and frustrating subjects for many scientists. This book provides a detailed analysis of why this issue is grounded in the nature of pain itself. It also offers a philosophically driven solution of how we may still approach pain in a theoretically compelling and practically useful manner. Two main theses are defended: (i) Pain seems inscrutable because there (...) exists no property that is commonly shared by all types of pain and that is at the same time particular to pain, setting it apart from other bodily sensations. This applies irrespective of whether we consider the psychological dimensions, neural networks, causal relations or biological functions of pain. Consequently, it is impossible to refer to ideal far-reaching and ideal distinct generalizations on the matter of pain. (ii) Despite this challenge, by focusing on the resemblance relations that hold across pains, we can generate scientific progress in explaining, predicting and treating pain. In doing so, the book aims to provide a clear conceptual basis for interdisciplinary communication and a useful heuristic for future research. (shrink)

The current IASP definition of pain has come under renewed criticisms recently. There is a new momentum for its revision as reflected by the fact that IASP has now a Presidential Task Force dedicated to look into whether there is enough warrant to update the definition. I critically review all the major criticisms of the current definition in detail, and raise new difficulties rarely discussed before. I show that none of the major criticisms has enough warrant to force us to (...) substantially revise the current definition. Combined with the discussion of the new difficulties, there is nonetheless a need to restate the definition using slightly different terminology that will make the original intent of the current definition clearer and more precise. A restatement of the definition is proposed and its potential is discussed in light of some empirical questions that remain. [The IASP Council has now approved a revised definition and published its rationale here: Pain 2020 Sep 1; 161(9), pp. 1976–1982. The new definition follows (most of) my recommendations.]. (shrink)

Accounts of the nature of unpleasant pain have proliferated over the past decade, but there has been little systematic investigation of which of them can accommodate its badness. This paper is such a study. In its sights are two targets: those who deny the non-instrumental disvalue of pain's unpleasantness; and those who allow it but deny that it can be accommodated by the view—advanced by me and others—that unpleasant pains are interoceptive experiences with evaluative content. Against the former, I argue (...) that pain's unpleasantness does indeed have noninstrumental disvalue; against the latter I argue both that my critics’ own desire-theoretic accounts of pain's unpleasantness cannot accommodate such disvalue, and that my evaluativist view can—either by appealing to “anti-unpleasantness” desires or by exploiting pain's perceptuality. (shrink)

Affective experiences such as pains, pleasures, and emotions have affective phenomenology: they feel pleasant. This type of phenomenology has a loopy regulatory profile: it often motivates us to act a certain way, and these actions typically end up regulating our affective experiences back. For example, the pleasure you get by tasting your morning coffee motivates you to drink more of it, and this in turn results in you obtaining another pleasant gustatory experience. In this article, we argue that reflexive imperativism (...) is the only intentionalist account of affective phenomenology—probably, the only account at all—that is able to make sense of its loopy regulatory profile. (shrink)

Experiences like pains, pleasures, and emotions have affective phenomenal character: they feel pleasant or unpleasant. Imperativism proposes to explain affective phenomenal character by appeal to imperative content, a kind of intentional content that directs rather than describes. We argue that imperativism is on the right track, but has been developed in the wrong way. There are two varieties of imperativism on the market: first-order and higher-order. We show that neither is successful, and offer in their place a new theory: reflexive (...) imperativism. Our proposal is that an experience P feels pleasant in virtue of being constituted by a Command with reflexive imperative content, while an experience U feels unpleasant in virtue of being constituted by a Command with reflexive imperative content : More of P!Less of U! If you need a slogan: experiences have affective phenomenal character in virtue of commanding us Get more of me! Get less of me! (shrink)

A collection, edited by David Bain, Michael Brady, and Jennifer Corns, originating in our Value of Suffering Project. Table of Contents: Michael Wheeler - ‘How should affective phenomena be studied?’; Julien Deonna & Fabrice Teroni – ‘Pleasures, unpleasures, and emotions’; Hilla Jacobson – ‘The attitudinal representational theory of painfulness fleshed out’; Tim Schroeder – ‘What we represent when we represent the badness of getting hurt’; Hagit Benbaji – ‘A defence of the inner view of pain’; Olivier Massin – ‘Suffering pain’; (...) Frederique de Vignemont – ‘The value of threat’; Colin Leach – ‘Bad feelings can be good and good feelings can be bad’; Tasia Scrutton – ‘Mental suffering and the experience of beauty’; Brock Bastian – ‘From suffering to satisfaction: why we need pain to feel pleasure’; Marilyn McCord Adams – ‘Pain and moral agency’; Jennifer Corns – ‘Hedonic rationality’; Jonathan Cohen & Matthew Fulkerson – ‘Suffering and rationality’; Tom McClelland – ‘Suffering invites understanding’; Michael Brady – ‘Suffering as a virtue’; Glen Pettigrove TBA. Further authors TBA. (shrink)

Tracking representationalism explains the negative affective character of pain, and its capacity to motivate action, by reference to the representation of the badness for us of bodily damage. I argue that there is a more fitting instantiation of the tracking relation – the badness for us of extremely intense stimuli – and use this to motivate a non-reductive approach to the negative affective character of pain. The view of pain proposed here is supported by consideration of three related topics: the (...) pain caused when the body is damaged, reparative pain, and the messenger-shooting objection to tracking representationalism. (shrink)

The paper aims at clarifying the distinctions and relations between pain and suffering. Three negative theses are defended: 1. Pain and suffering are not identical. 2. Pain is not a species of suffering, nor is suffering a species of pain, nor are pain and suffering of a common (proximate) genus. 3. Suffering cannot be defined as the perception of a pain’s badness, nor can pain be defined as a suffered bodily sensation. Three positive theses are endorsed: 4. Pain and suffering (...) are categorically distinct: pain is a localised bodily episode, suffering is a non-localised affective attitude. 5. Suffering can be expressed, pains cannot. As a consequence, we can have compassion for the suffering of others, not for their pains. 6. The relation between pain and suffering is akin to the relation between danger and fear, injustice and indignation, wrongdoing and guilt: suffering is the correct reaction to pain. One upshot is that both the influential view that the experience of pain is incorrigible and the influential view that the ordinary conception of pain is paradoxical are false. (shrink)