Pain perception arises from a complex interaction between a nociceptive stimulus and different emotional and cognitive factors, which appear to be mediated by both automatic and controlled systems. Previous evidence has shown that whereas conscious processing of unpleasant stimuli enhances pain perception, emotional influences on pain under unaware conditions are much less known. The aim of the present study was to investigate the modulation of pain perception by unconscious emotional pictures through an emotional masking paradigm. Two (...) kinds of both somatosensory (painful and non-painful) and emotional stimulation (negative and neutral pictures) were employed. Fifty pain-free participants were asked to rate the perception of pain they were feeling in response to laser-induced somatosensory stimuli as faster as they can. Data from pain intensity and reaction times were measured. Statistical analyses revealed a significant effect for the interaction between pain and emotional stimulation, but surprisingly this relationship was opposite to expected. In particular, lower pain intensity scores and longer reaction times were found in response to negative images being strengthened this effect for painful stimulation. Present findings suggest a clear pain perception modulation by unconscious emotional contexts. Attentional capture mechanisms triggered by unaware negative stimulation could explain this phenomenon leading to a withdrawal of processing resources from pain. (shrink)

Pain assessment in fish is particularly challenging due toBioscience Building, Liverpool, L69 7ZB their evolutionary distance from humans, their lack of audible vocalization, and apparently expressionless demeanour. However, there are criteria that can be used to gauge whether pain perception occurs using carefully executed scientific approaches. Here, the standards for pain in fish are discussed and can be considered in three ways: neural detection and processing of pain; adverse responses to pain; and consciously experiencing (...) class='Hi'>pain. Many procedures that we subject fish to cause tissue damage and may give rise to the sensation of pain. Fish are popular as pets, in animal exhibits, and as experimental models, but are also cultured or caught for food. There is little legislation for the protection of fish welfare. Many countries are now exploring the welfare cost to fish, and current practices may need to be reviewed with respect to the current evidence for fish perceiving pain. (shrink)

Pain, suffering and positive emotions in patients in vegetative state/unresponsive wakefulness syndrome (VS/uws) and minimally conscious states (MCS) pose clinical and ethical challenges. Clinically, we evaluate behavioural responses after painful stimulation and also emotionally-contingent behaviours (e.g., smiling). Using stimuli with emotional valence, neuroimaging and electrophysiology technologies can detect subclinical remnants of preserved capacities for pain which might influence decisions about treatment limitation. To date, no data exist as to how healthcare providers think about end-of-life options (e.g., withdrawal of (...) artificial nutrition and hydration) in the presence or absence of pain in non-communicative patients. Here, we aimed to better clarify this issue by re-analyzing previously published data on pain perception (Prog Brain Res 2009 177, 329–38) and end-of-life decisions (J Neurol 2010 258, 1058–65) in patients with disorders of consciousness. In a sample of 2259 European healthcare professionals we found that, for VS/uws more respondents agreed with treatment withdrawal when they considered that VS/uws patients did not feel pain (77%) as compared to those who thought VS/uws did feel pain (59%). This interaction was influenced by religiosity and professional background. For MCS, end-of-life attitudes were not influenced by opinions on pain perception. Within a contemporary ethical context we discuss (1) the evolving scientific understandings of pain perception and their relationship to existing clinical and ethical guidelines; (2) the discrepancies of attitudes within (and between) healthcare providers and their consequences for treatment approaches, and (3) the implicit but complex relationship between pain perception and attitudes toward life-sustaining treatments. (shrink)

Pain is commonly explained in terms of the perceptual activity of a distinct sensory modality, the function of which is to enable us to perceive actual or potential damage to the body. However, the characterization of pain experience in terms of a distinct sensory modality with such content is problematic. I argue that pain is better explained as occupying a different role in relation to perception: to indicate when the stimuli that are sensed in perceiving anything by (...) means of a sensory modality exceed a significant level of intensity. Viewing the system underlying pain experience as an integral and functionally integrated feature of all the senses provides a new perspective on the diverse forms of pain, what it is like to experience pain and the contrasting natures of pain and pleasure. (shrink)

[Penultimate draft] I present the perceptualist/representationalist theories of pain in broad outline and critically examine them in light of a competing view according to which awareness of pain is essentially introspective. I end the essay with a positive sketch of a naturalistic proposal according to which pain experiences are intentional but not fully representational. This proposal makes sense of locating pains in body parts as well as taking pains as subjective experiences.

Pain, suffering and positive emotions in patients in vegetative state/unresponsive wakefulness syndrome (VS/UWS) and minimally conscious states (MCS) pose clinical and ethical challenges. Clinically, we evaluate behavioural responses after painful stimulation and also emotionally-contingent behaviours (e.g., smiling). Using stimuli with emotional valence, neuroimaging and electrophysiology technologies can detect subclinical remnants of preserved capacities for pain which might influence decisions about treatment limitation. To date, no data exist as to how healthcare providers think about end-of-life options (e.g., withdrawal of (...) artificial nutrition and hydration) in the presence or absence of pain in non-communicative patients. Here, we aimed to better clarify this issue by re-analyzing previously published data on pain perception (Prog Brain Res 2009 177, 329–38) and end-of-life decisions (J Neurol 2010 258, 1058–65) in patients with disorders of consciousness. In a sample of 2259 European healthcare professionals we found that, for VS/UWS more respondents agreed with treatment withdrawal when they considered that VS/UWS patients did not feel pain (77%) as compared to those who thought VS/UWS did feel pain (59%). This interaction was influenced by religiosity and professional background. For MCS, end-of-life attitudes were not influenced by opinions on pain perception. Within a contemporary ethical context we discuss (1) the evolving scientific understandings of pain perception and their relationship to existing clinical and ethical guidelines; (2) the discrepancies of attitudes within (and between) healthcare providers and their consequences for treatment approaches, and (3) the implicit but complex relationship between pain perception and attitudes toward life-sustaining treatments. (shrink)

I argue that pain sensations are perceptual states, namely states that represent (actual or potential) damage. I defend this position against the objection that pains, unlike standard perceptual states, do not allow for an appearance-reality distinction by arguing that in the case of pain as well as in standard perceptual experiences, cognitive penetration or malfunctions of the underlying sensory systems can lead to a dissociation between the sensation on the one hand, and what is represented on the other (...) hand. Moreover, I refute the objection that the allegedly weak correlation between pain and bodily damage forces intentionalist accounts of pain to postulate so many malfunctions (misrepresentations respectively) that such accounts become implausible. I also rebut Murat Aydede’s objection that our linguistic practice supposedly shows that there is a conceptual difference between standard perceptual experiences and pain sensations by challenging Aydede’s premise that we always withdraw standard perceptual reports in case of counterevidence, while we never do that with pain reports. At the end, I propose an explanation as to why we do not express perceptual reports of (potential) bodily damage in objectivist, but in mental terms. (shrink)

Postulating the subcortical organization of human consciousness provides a critical link for the construal of pain in patients with impaired cortical function or cortical immaturity during early development. Practical implications of the centrencephalic proposal include the redefinition of pain, improved pain assessment in nonverbal humans, and benefits of adequate analgesia/anesthesia for these patients, which certainly justify the rigorous scientific efforts required. (Published Online May 1 2007).

Based largely on the so-called problem of “asymmetry in concept application”, philosopher Murat Aydede has argued for a non-perceptual view of pain. Aydede is of course not denying basic neurobiological facts about neurons, action potentials, and the like, but he nonetheless makes a strong philosophical case for pain not being the perception of something extramental. In the present paper, after having stated some of the presuppositions I hold as a physician and pain researcher, and after having shortly (...) described Aydede’s critique of perceptual theories of pain, I make a constructive proposal centred around the concept of pain as the perception of some-one, not some-thing. In doing so, I propose that there often is a problematic duality at work when we think about pain, namely the mental/extramental duality. This pre-reflective mindset creates difficulties when reflecting over pain. Instead, I propose the body/world duality as being more helpful. Two neologisms, cosmoception and egoception, are presented as an alternative to the twin concepts of exteroception and interoception. It is argued that the new concepts have the advantage of not pushing our thought into a mental/extra-mental dichotomy. Hence, when in pain, I get epistemic access to the body that is I, to how I fare in this world. From that perspective, pain is not the perception of something, but of someone–namely, the self. In the final part of the paper, this proposal is discussed in dialogue with a paper from phenomenological thinker Jennifer Bullington. (shrink)

Nicholas Everitt; VIII*—Pain and Perception, Proceedings of the Aristotelian Society, Volume 89, Issue 1, 1 June 1989, Pages 113–124, https://doi.org/10.1093/ar.

Nicholas Everitt; VIII*—Pain and Perception, Proceedings of the Aristotelian Society, Volume 89, Issue 1, 1 June 1989, Pages 113–124, https://doi.org/10.1093/ar.

The ArgumentPain has important biomedical socioanthropological, semiotic, and other facets. In this contribution pain and the experssion of pain are looked at from the perspective of evolutionary biology, utilizing, among others, cross-cultural data from field work in Melanesia.No other being cares for sick and suffering conspecifics in the way humans do. Notwithstanding aggression and neglect, common in all cultures, human societies can be characterized as empathic, comforting, and promoting the health and well-being of their members. One important stimulus (...) triggering this caring response in others is the expression of pain. The nonverbal channel of communication, particularly certain universal — i.e., culture-independent facial expressions, gestures, and body postures, convey much of the message from the painstricken person to the group.These behaviors signal the person's physical and psychical pain, sadness, grief, and despair in ways very similar to the signs given by infants and small children: the body loses tonus and sinks or drops to the ground, the gestures are those of helplessness. Pain and grief may be so strong that control is lost not only over the body's posture but also over the mind's awareness. In such cases the afflicted person may carry out actions endangering himself or others. In general, these behavior patterns resemble those of infants in situations of distress and danger, and it is not surprising that the response of the members of the group is basically parental: taking care, assisting and consoling.Perceptive and behavioral patterns which developed in the course of avian and mammalian phylogeny to serve the well-being of the young have proven, as was shown by Eibl-Eibesfeldt, to be powerful building blocks for actions in other spheres of human interaction. Love is one such field, the reactions to a conspecific suffering pain is another. (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)

Pain perception is influenced by several factors, and among them, affect, sex, and perception of bodily signals are assumed to play a prominent role. The aim of the present study is to explore how sex, cardiac interoceptive accuracy, and the interaction of the latter two influence the perception of experimentally induced pain. We investigated a large sample of young adults (n= 159, 50.9% female, age: 23.45, SD = 3.767), assessing current positive and negative affective state with the Positive (...) and Negative Affect Schedule (both involved as control variables), cardiac interoceptive accuracy with the mental heartbeat tracking task, and pain sensitivity with electrical stimulation on the back of the dominant hand, applying a repeated-measures staircase protocol. Males showed a significantly higher pain threshold and tolerance level than females, whereas cardiac interoceptive accuracy was not associated with pain sensitivity. The impact of sex × cardiac interoceptive accuracy interaction was significant for pain threshold only, while pain tolerance was predicted only by sex. According to these findings, the associations between pain sensitivity, cardiac IAc, and sex might be more complicated than it was supposed in previous studies. Interactions between factors impacting pain perception appear worthy of further investigation. (shrink)

One of the most promising trends both in the neuroscience of pain and in psychiatric treatments of chronic pain is the focus on mental imagery. My aim is to argue that if we take these findings seriously, we can draw very important and radical philosophical conclusions. I argue that what we pretheoretically take to be pain is partly constituted by sensory stimulation-driven pain processing and partly constituted by mental imagery. This general picture can explain some problematic (...) cases of pain perception, for example, phantom-limb pain, and it also has important consequences for some recent philosophical debates about the nature and content of pain. (shrink)

The topic of pain and suffering is complex and requires a holistic vision. This article begins by clarifying concepts to understand pain as a biological, psychological, and social phenomenon that has an evolutionary history whose maximum expression arises in humans. Established this common ground, it explores altruism and animal cooperation as incipient phenomena of care for the other, though contextual. Then it points out that the difference with humans is that they perceive caring for the weak, innocent, and (...) marginalized as a moral duty and a path of personal flourishing. Finally, in the face of human weakness and from Christian theology, God shows with deeds a path of care for the weak by making himself weak, suffering and remaining innocent. (shrink)

According to the increasingly popular perceptual/representational accounts of pain (and other bodily sensations such as itches, tickles, orgasms, etc.), feeling pain in a body region is perceiving a non-mental property or some objective condition of that region, typically equated with some sort of (actual or potential) tissue damage. In what follows I argue that given a natural understanding of what sensory perception requires and how it is integrated with (dedicated) conceptual systems, these accounts are mistaken. I will also (...) examine the relationship between perceptual views and two (weak and strong) forms of representationalism about experience. I will argue that pains pose very serious problems for strong representationalism as well. (shrink)

Health care providers are expected both to relieve pain and to provide anticipatory guidance regarding how much a procedure is going to hurt. Fulfilling those expectations is complicated by the cognitive modulation of pain perception. Warning people to expect pain or setting expectations for pain relief not only influences their subjective experience, but it also alters how nociceptive stimuli are processed throughout the sensory and discriminative pathways in the brain. In light of this, I reconsider the (...) characterization of placebo analgesia as pharmacologically inert and the use of it as deceptive. I show that placebo analgesia exploits the same physical mechanisms as proven analgesics and argue that it should be utilized to relieve pain. Additionally, I describe factors to help identify situations in which clinicians have the obligation to disclose the potential for pain coupled with ways of mitigating the risk of high-intensity pain by setting positive expectations. (shrink)

Pain has not only sensory, but also emotional and cognitive, components. Some studies have explored the effect of pain on time perception, but the results remain controversial. Whether individual pain-related emotional and cognitive factors play roles in this process should also be explored. In this study, we investigated the effect of electrical stimulation–induced pain on interval timing using a temporal bisection task. During each task session, subjects received one of five types of stimulation randomly: no stimulus (...) and 100 and 300 ms of non-painful and painful stimulation. Pain-related emotional and cognitive factors were measured using a series of questionnaires. The proportion of “long” judgments of a 1,200-ms visual stimulus duration was significantly smaller with 300 ms painful stimulation than with no stimulus and 100 ms and 300 ms non-painful stimulation. The point of subjective equality did not differ among sessions, but the average Weber fraction was higher for painful sessions than for no-stimulus session. The pain fear score correlated positively with the PSE under 100 ms non-painful and painful and 300 ms painful stimulation. Pain catastrophizing and pain anxiety scores correlated significantly with the WF under no stimulus and 100 ms non-painful stimulation, respectively. These results suggest that electrical stimulation–induced pain affects temporal sensitivity, and that pain-related emotional and cognitive factors are associated with the processing of time perception. (shrink)

Chronic pain affects a large part of the population causing functional disability, being often associated with coexisting psychological disorders, such as depression and anxiety, besides cognitive deficits, and sleep disturbance. The world elderly population has been growing over the last decades and the negative consequences of chronic pain for these individuals represent a current clinical challenge. The main painful complaints in the elderly are related to neurodegenerative and musculoskeletal conditions, peripheral vascular diseases, arthritis, and osteoarthritis, contributing toward poorly (...) life quality, social isolation, impaired physical activity, and dependence to carry out daily activities. Organ dysfunction and other existing diseases can significantly affect the perception and responses to chronic pain in this group. It has been proposed that elderly people have an altered pain experience, with changes in pain processing mechanisms, which might be associated with the degeneration of circuits that modulate the descending inhibitory pathways of pain. Aging has also been linked to an increase in the pain threshold, a decline of painful sensations, and a decrease in pain tolerance. Still, elderly patients with chronic pain show an increased risk for dementia and cognitive impairment. The present review article is aimed to provide the state-of-art of pre-clinical and clinical research about chronic pain in elderly, emphasizing the altered mechanisms, comorbidities, challenges, and potential therapeutic alternatives. (shrink)

Table of Contents: Olivier Massin, 'Pleasure and Its Contraries'; Colin Klein, 'The Penumbral Theory of Masochistic Pleasure'; Siri Leknes and Brock Bastian, 'The Benefits of Pain'; Valerie Gray Hardcastle, 'Pleasure Gone Awry? A New Conceptualization of Chronic Pain and Addiction'; Richard Gray, 'Pain, Perception and the Sensory Modalities: Revisiting the Intensive Theory'; Jonathan Cohen and Matthew Fulkerson, Affect, Rationalization, and Motivation; Murat Aydede, 'How to Unify Theories of Sensory Pleasure: An Adverbialist Proposal'; Adam Shriver, 'The Asymmetrical Contributions (...) of Pleasure and Pain to Subjective Well-Being'. (shrink)

Over the past few years, over a dozen states have proposed, and almost as many have passed, something referred to as the Pain-Capable Unborn Child Protection Act, a piece of legislation that makes abortion impermissible once fetal pain is possible and that further stipulates the fetus can feel pain at or before 20 weeks of gestation. Some very important questions immediately relevant to the abortion debate, perhaps even to the more complex issue of fetal rights, are raised (...) by this legislation, especially because it would impinge on the second-trimester abortion rights guaranteed by Roe. We first inquire whether the claim of fetal pain perception at or before 20 weeks is true and how such a claim should be substantiated. Next, we inquire whether the fetal capacity to experience pain, at whatever stage of development, reflects on the morality of abortion and whether it should be at all relevant to determining its legality. Finally, we would like to explore the implications that a commitment to a pain-related or sentience criterion of rights might have for a pro-life agenda. (shrink)

Everyone knows what is feels like to be in pain. Scraped knees, toothaches, migraines, giving birth, cancer, heart attacks, and heartaches: pain permeates our entire lives. We also witness other people - loved ones - suffering, and we 'feel with' them. It is easy to assume this is the end of the story: 'pain-is-pain-is-pain', and that is all there is to say. But it is not. In fact, the way in which people respond to what (...) they describe as 'painful' has changed considerably over time. In the eighteenth and nineteenth centuries, for example, people believed that pain served a specific (and positive) function - it was a message from God or Nature; it would perfect the spirit. 'Suffer in this life and you wouldn't suffer in the next one'. Submission to pain was required. Nothing could be more removed from twentieth and twenty-first century understandings, where pain is regarded as an unremitting evil to be 'fought'. Focusing on the English-speaking world, this book tells the story of pain since the eighteenth century, addressing fundamental questions about the experience and nature of suffering over the last three centuries. How have those in pain interpreted their suffering - and how have these interpretations changed over time? How have people learnt to conduct themselves when suffering? How do friends and family react? And what about medical professionals: should they immerse themselves in the suffering person or is the best response a kind of professional detachment? (shrink)

The measurement of pain depends upon subjective reports, but we know very little about how research subjects or pain patients produce self-reported judgments. Representationalist assumptions dominate the field of pain research and lead to the critical conjecture that the person in pain examines the contents of consciousness before making a report about the sensory or affective magnitude of pain experience as well as about its nature. Most studies to date have investigated what Fechner termed “outer (...) psychophysics”: the relationship between characteristics of an external stimulus and the magnitude and nature of pain experience. In contrast, Fechner originally envisioned that “inner psychophysics” should investigate the relationship between physiological states and subjective experience. Despite the lack of established research tradition, inner psychophysics has a potential utility in elucidating underlying mechanisms for the production of phenomenal self-report. We illustrate this, using causal modeling analyses of the accuracy of self-reported pain ratings from our laboratory. We submit that the results are inconsistent with representationalist assumptions. Converging trends from several domains of consciousness studies seem to suggest that we need to abandon the unquestioned doctrine of representationalism and search for a more viable framework for understanding the generation of subjective self-report. (shrink)

Perception is one of the most pervasive and puzzling problems in philosophy, generating a great deal of attention and controversy in philosophy of mind, psychology and metaphysics. If perceptual illusion and hallucination are possible, how can perception be what it intuitively seems to be, a direct and immediate access to reality? How can perception be both internally dependent and externally directed? Perception is an outstanding introduction to this fundamental topic, covering both the perennial and recent work on the problem. Adam (...) Pautz examines four of the most important theories of perception: the sense datum view; the internal physical state view; the representational view; and naïve realism, assessing each in turn. He also discusses the relationship between perception and the physical world and the issue of whether reality is as it appears. Useful examples are included throughout the book to illustrate the puzzles of perception, including hallucinations, illusions, the laws of appearance, blindsight, and neuroscientific explanations of our experience of pain, smell and color. The book covers both traditional philosophical arguments and more recent empirical arguments deriving from research in psychophysics and neuroscience. The addition of chapter summaries, suggestions for further reading and a glossary of terms make Perception essential reading for anyone studying the topic in detail, as well as for students of philosophy of mind, philosophy of psychology and metaphysics. (shrink)

When you suffer a pain are you suffering a sensation? An emotion? An aversion? Pain typically has all three components, and others too. There is indeed a distinct sensory system devoted to pain, with its own nociceptors and pathways. As a species of somesthesis, pain has a distinctive sensory organization and its own special sensory qualities. I think it is fair to call it a distinct sensory modality, devoted to nociceptive somesthetic discrimination. But the typical (...) class='Hi'>pain kicks off other processes too. For one it can grab your attention in a distinctive way, alerting you to its presence and sometimes obliging you to focus attention on the damaged member. Intense pain can eliminate your ability to think about anything else. Pain typically has direct and immediate motivational consequences: one wants it to stop, has an incentive to do whatever one can to reduce it, and is gratified by its termination. As these desires and motives collide with neural reality, emotional components of mental anguish, anxiety, and dread arise. The suffering involved in suffering from pain has multiple strands: it is not just the painfulness of the sensation, or the frustration of the desire that it end, but also the anguish over the possibility that it will never end, and the impossibility, if the pain is sufficiently intense, of focusing one’s attention on anything else. (shrink)

Though pain scientists now understand pain to be a complex experience typically composed of sensation, emotion, cognition, and motivational responses, many philosophers maintain that pain is adequately characterized by one privileged aspect of this complexity. Philosophically dominant unitary accounts of pain as a sensation or perception are here evaluated by their ability to explain actual cases—and found wanting. Further, it is argued that no forthcoming unitary characterization of pain is likely to succeed. Instead, I contend (...) that both the motivating intuitions behind unitary accounts and the wide range of pain phenomena are best accommodated by a componential view of pain that does not privilege any single component as necessary or sufficient. (shrink)

A foundational assumption of contemporary cognitive science is that perceptual processing involves inferential transitions between representational states. However, it remains controversial whether accounts of this kind extend to modalities whose perceptual status is a matter of debate. In particular, it remains controversial whether we should attribute inferential mechanisms to the sensory processing underpinning (human) pain experiences. This paper argues that, contrary to recent proposals in the philosophy and science of pain, pain processing is not mediated by inferential (...) transitions. To this end, I show that standard motivations for inferentialism—including appeal to underdetermination, illusion, cue combination, cognitive penetration, perceptual constancy, and invariance—do not carry over to pain. Instead, I suggest that pain’s sensory processing may be better characterised as an idiosyncratic form of transduction, distinguishing it both from paradigmatic perceptual modalities and canonical transducers. (shrink)

BackgroundThis article aims to contribute to a better conceptualization of pain and suffering by providing non-essential and non-naturalistic definitions of both phenomena. Contributions of classical evidence-based medicine, the humanistic turn in medicine, as well as the phenomenology and narrative theories of suffering and pain, together with certain conceptions of the person beyond them are critically discussed with such purpose.MethodsA philosophical methodology is used, based on the review of existent literature on the topic and the argumentation in favor of (...) what are found as better definitions of suffering and pain.ResultsPain can be described in neurological terms but cognitive awareness, interpretation, behavioral dispositions, as well as cultural and educational factors have a decisive influence on pain perception. Suffering is proposed to be defined as an unpleasant or even anguishing experience, severely affecting a person at a psychophysical and existential level. Pain and suffering are considered unpleasant. However, the provided definitions neither include the idea that pain and suffering can attack and even destroy the self nor the idea that they can constructively expand the self; both perspectives can b e equally useful for managing pain and suffering, but they are not defining features of the same. Including the existential dimension in the definition of suffering highlights the relevance of suffering in life and its effect on one’s own attachment to the world. An understanding of pain and suffering life experiences is proposed, meaning that they are considered aspects of a person’s life, and the self is the ever-changing sum of these experiences.ConclusionsThe provided definitions will be useful to the identification of pain and suffering, to the discussion of how to relieve them, and to a better understanding of how they are expressed and experienced. They lay the groundwork for further research in all these areas, with the twofold aim of a) avoiding epistemological mistakes and moral injustices, and b) highlighting the limitations of medicine in the treatment of suffering and pain. (shrink)

This chapter focuses specifically on the case of pain. Despite traditional opposition to the representational thesis, the latter has won widespread assent. The most important early proponents of the representational thesis were David Armstrong and George Pitcher, both of whom held that pain is a form of perception. Following Armstrong and Pitcher, intentionalists have traditionally held that the experience of pain has a content with roughly the following form: there is a disturbance with such-and-such features at location (...) L. Since the internal states associated with the experience of pain arguably track local physical properties of disturbances, it seems that the tracking intentionalist must identify the pain qualities represented by pain experience with these physical properties. But there are at least two important objections to the identification of pain qualities with local physical properties of disturbances. (shrink)

The essential logical deficiency of the perceptual theory of pain, as I tried to show in my paper,1 is that feeling pain cannot be perceiving anything. The conceptual framework that would make it possible for us to understand “feel” in this use to be a perception concept does not exist. The concept of a glimpse, which George Pitcher relies upon to supply this framework,2cannot begin to do so because it is a secondary perception concept entirely dependent upon that (...) of seeing. This primary concept of visual perception is tied up with actions and supporting concepts like looking, glancing, gazing, glimpsing, watching, and the like. These are different ways in which one's visual perceiving may be characterized. Without the primary concept and the actions connected with it, there would be nothing to characterize. The word “feel” in contexts involving pain is not a perception concept and efforts to make it one are doomed to fail. The supporting actions and concepts do not exist. (shrink)

When one contrasts pain with the classic five senses, discussions generally focus on vision, which is taken as the paradigmatic example of perception. An intentionalist might argue that if the phenomenal difference between feeling and seeing bodily disturbances cannot be explained at the level of the content, it can be so at the level of the mode of presentation, and more particularly at the level of the structure of the spatial phenomenology of pain. Here I will argue that (...) the spatial phenomenology of pain shares some key features with touch by contrast to sight, but these similarities should not make us neglect major differences between these two types of bodily sensations. I shall then draw the consequences of these differences for the awareness of one’s body as one’s own. In brief, to fix the boundaries of the body that one experiences as one’s own, one must answer two questions: where does the body stop, and the rest of world start? and what matters for self-preservation? I will suggest that touch primarily answers the first question, whereas pain primarily answers the second question. (shrink)