Pain and Pain Experience

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)

Commissioned for Routledge Encylopaedia of Philosophy.

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)

A collection, edited by David Bain, Michael Brady, and Jennifer Corns, originating in our Pain Project. Table of Contents: Colin Klein and Manolo Martínez – ‘Imperativism and Pain Intensity’; Murat Aydede and Matthew Fulkerson – ‘Pain and Theories of Sensory Affect’; Dan-Mikael Ellingson, Morten Kringlebach, and Siri Leknes – ‘A Neuroscience Perspective on Pleasure and Pain’; Michael Brady – ‘The Rationality of Emotional and Physical Suffering’; Jennifer Corns – ‘The Placebo Effect’; Jesse Prinz – ‘What is the Affective Component of (...) Pain?’; Adam Shriver – ‘The Unpleasantness of Pain for Humans and Other Animals’; Valerie Gary Hardcastle – ‘When is a Pain Not a Pain? The Challenge of Disorders of Consciousness’; Frédérique de Vignemont – ‘The First-Person in Pain’. (shrink)

Over recent decades, pain has received increasing attention as – with ever greater sophistication and rigour – theorists have tried to answer the deep and difficult questions it poses. What is pain’s nature? What is its point? In what sense is it bad? The papers collected in this volume are a contribution to that effort ...

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)

Despite the conceptual problems in identifying the placebo effect, an increasing number of multidisciplinary inquiries rest on the assumption that there is a distinct class of effects, placebo effects. In this chapter, I argue against this assumption. I present cases and characterizations of the placebo effect as offered in the literature, and argue that the latter are subject to insurmountable problems. Moreover, I argue that identification of placebo effects as such is not useful for the three main purposes offered in (...) the literature. I then offer suggestions for why it may remain intuitive that some effects are placebo effects and close by noting the potential benefits of ultimately explaining away these intuitions. (shrink)

This chapter (from Routledge's forthcoming handbook on the philosophy of pain) considers the question of whether people are always correct when they judge themselves to be in pain, or not in pain. While I don't show sympathy for traditional routes to the conclusion that people are "incorrigible" in their pain judgments, I explore--and perhaps even advocate--a different route to such incorrigibility. On this low road to incorrigibility, a sensory state's being judged unpleasant is what makes it a pain (or not).

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 off 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)

ABSTRACTPains 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...

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)

Bodily (dis)pleasures and emotions share the striking property of being valenced, i.e. they are positive or negative. What is valence? How do bodily (dis)pleasures and emotions relate to one another? This chapter assesses the prospects of two popular theses regarding the relation between bodily (dis)pleasures and emotions in light of what we can reasonably think about valence. According to the first thesis, the valence of bodily (dis)pleasures is explanatory prior vis-à-vis the valence of emotions. According to the second, emotions contain (...) bodily (dis)pleasures. I argue that bodily (dis)pleasures are intentional states whose valence is to be understood in terms of evaluative experience, and bring to light the similarities and dissimilarities between their intentional structure and that of emotions. On this backdrop, I offer reasons to conclude that we should adopt neither of the two theses. (shrink)

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)

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)

Some philosophers argue that pain is an object located in bodily parts because the locative form of pain report is permissible in English. To examine this argument, Liu and Klein recently argue that the linguistic argument cannot work because the locative form is impermissible in Mandarin. They are wrong, however. I demonstrate that the locative form in Mandarin is not only permissible but also common.

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.

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)

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 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)

Una de las razones fundamentales por las cuales la muerte causa dolor se debe a una comprensión equívoca acerca del sentido último de la vida humana. Además, la Modernidad se desliga, en ocasiones, de la dimensión emotiva y afectiva del ser humano. Así pues, toda terapéutica del duelo mortuorio exige reflexionar con seriedad acerca del sentido de la muerte, tarea en la cual la tradición filosófica y teológica occidental es un apoyo ineludible. En la primera parte se ha de revisar, (...) desde la perspectiva filosófica de Epicuro, la concepción de la muerte según la cual la opinión ordinaria es errada y no da cabida a una vida realizada como fundamento de la tranquilidad y la salud. En la segunda parte se esbozarán los rasgos y las notas esenciales de una concepción cristiana de la muerte a partir de la obra de San Agustín de Hipona, exponiendo algunas medidas concretas de preparación para la muerte con base en su pensamiento. (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. (shrink)

I distinguish between two claims of transparency of experiences. One claim is weaker and supported by phenomenological evidence. This I call the transparency datum. Introspection of standard perceptual experiences as well as bodily sensations is consistent with, indeed supported by, the transparency datum. I formulate a stronger transparency thesis that is entailed by representationalism about experiential phenomenology. I point out some empirical consequences of strong transparency in the context of representationalism. I argue that pain experiences, as well as some other (...) similar experiences like itches, tickles, orgasms, hedonic valence, etc., are not transparent in this strong sense. Hence they constitute empirical counterexamples to representationalism. Given that representationalism is a general metaphysical doctrine about all experiential phenomenology for good reasons, I conclude that representationalism about phenomenal consciousness is false. Then, I outline a general framework about how the introspection of phenomenal qualities in perceptual experience works in light of the transparency datum, but consistent with the rejection of strong transparency. The result is a form of qualia realism that is naturalist and intentionalist, and has close affinities to the adverbialist views developed in the latter part of the last century. I then apply this framework to pain experiences and their bodily locations. (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)

Both patients and clinicians frequently report problems around communicating and assessing pain. Patients express dissatisfaction with their doctors and doctors often find exchanges with chronic pain patients difficult and frustrating. This chapter thus asks how we could improve pain communication and thereby enhance outcomes for chronic pain patients. We argue that improving matters will require a better appreciation of the complex meaning of pain terms and of the variability and flexibility in how individuals think about pain. We start by examining (...) the various accounts of the meaning of pain terms that have been suggested within philosophy and suggest that, while each of the accounts captures something important about our use of pain terms, none is completely satisfactory. We propose that pain terms should be viewed as communicating complex meanings, which may change across different communicative contexts, and this in turn suggests that we should view our ordinary thought about pain as similarly complex. We then sketch what a view taking seriously this variability in meaning and thought might look like, which we call the “polyeidic” view. According to this view, individuals tacitly occupy divergent stances across a range of different dimensions of pain, with one agent, for instance, thinking of pain in a much more “bodycentric” kind of way, while another thinks of pain in a much more "mindcentric” way. The polyeidic view attempts to expand the multidimensionality recognised in, e.g., biopsychosocial models in two directions: first, it holds that the standard triumvirate— dividing sensory/cognitive/affective factors— needs to be enriched in order to capture important distinctions within the social and psychological dimensions. Second, the polyeidic view attempts to explain why modulation of experience by these social and psychological factors is possible in the first place. It does so by arguing that because the folk concept of pain is complex, different weightings of the different parts of the concept can modulate pain experience in a variety of ways. Finally, we argue that adopting a polyeidic approach to the meaning of pain would have a range of measurable clinical outcomes. (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)

ABSTRACTThis paper assesses whether Evaluativism, as a view about the nature of unpleasant pains, can meet a specific normative condition. The normative condition says whatever candidate state is offered as an analysis of unpleasant pain should be intrinsically phenomenally bad for its subject to be in. I first articulate a method reflecting this condition, called the normative contrast method, and then frame Evaluativism in detail. The view is then tested through this method. I show that Evaluativism can explain why cases (...) of evaluative thought, with the same contents as unpleasant pains, are not intrinsically phenomenally bad for their subjects to be in by appeal to intentional modes. However, I argue the appeal to perceptuality, which is central to this response is problematic, and therefore it remains unclear whether Evaluativism, as standardly articulated, can meet the normative condition on unpleasant pains. (shrink)

This paper assesses whether Evaluativism, as a view about the nature of unpleasant pains, can meet a specific normative condition. The normative condition says whatever candidate state is offered as an analysis of unpleasant pain should be intrinsically phenomenally bad for its subject to be in. I first articulate a method reflecting this condition, called the normative contrast method, and then frame Evaluativism in detail. The view is then tested through this method. I show that Evaluativism can explain why cases (...) of evaluative thought, with the same contents as unpleasant pains, are not intrinsically phenomenally bad for their subjects to be in by appeal to intentional modes. However, I argue the appeal to perceptuality, which is central to this response is problematic, and therefore it remains unclear whether Evaluativism, as standardly articulated, can meet the normative condition on unpleasant pains. (shrink)

Several theorists have defended that unpleasantness can be explained by appealing to (intrinsic, simultaneous, de re) desires for certain experiences not to be occurring. In a nutshell, experiences are unpleasant because we do not want them, and not vice versa. A common criticism for this approach takes the form of a Euthyphro dilemma. Even if there is a solution for this criticism, I argue that this type of approach is limited in two important ways. It cannot provide an explanation for: (...) i) the motivation, from a psychological conscious point of view, nor ii) a non-instrumental justification, for having the relevant desires. The lack of these explanations is relevant since these are precisely the type clarifications that we would expect from a theory about unpleasantness. (shrink)

In this thesis I provide an account of the unpleasantness of pain. In doing this, I shed light on the nature of pain and unpleasantness. I propose to understand the unpleasantness of pain based on the determinable-determinate distinction. Unpleasantness is a determinable phenomenal property of mental states that entails badness. I propose that an unpleasant pain experience has two phenomenal properties: i) the phenomenal property of being a pain, and ii) a phenomenal determinate property (u1, u2, u3, etc.) of the (...) unpleasantness determinable. According to this theory unpleasant pains feel bad, and this explains why we are motivated and justified in avoiding them. This explains, for example, why we are motivated and justified to take painkillers. This theory allows us to account for the heterogeneity of unpleasantness, i.e., we can explain how different unpleasant experiences feel unpleasant even if they feel so different. -/- The thesis is organised into seven chapters and divided by three main themes: i) what the unpleasantness of pain consists in, ii) how we can account for the great phenomenal diversity among experiences of unpleasantness, and iii) which cases suggest that there could be pains that are not unpleasant. Broadly, the first two chapters deal with the first theme, where I analyse two reductive accounts of unpleasantness: the content theories and the desire theories. I deal with the second theme in the third and fourth chapter, where I analyse different theories that try to account for the phenomenal property of unpleasantness. In the fifth and sixth chapter, I focus on the third theme, where I consider different cases that suggest the existence of pains that are not unpleasant. In the final chapter, I offer a conclusion of the three main themes by providing my own view on the unpleasantness of pain. (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.

The official definition of ‘pain’ by the International Association for the Study of Pain (IASP) hasn’t seen much revision since its publication in 1979. There have been various criticisms of the definition in the literature from different quarters: that the definition implies a dubious metaphysical dualism, that it requires a strong form of consciousness as well as linguistic abilities, that it excludes many vulnerable groups that are otherwise perfectly capable of experiencing pain, that it has therefore unacceptable practical as well (...) as ethical consequences, that it is unhelpful to the health-care professional as an operational definition, that it is too narrow, and many others. In my view, most of these criticisms depend on misunderstandings or on uncharitable interpretations. My aim is to go over the definition, clarify some potential ambiguities, and argue that these criticisms don’t cut much ice. At the end, I will present a few slightly reworded versions of the definition that I claim are more felicitous and capture the original intended meaning by the members of the taxonomic committee in a much better and transparent way that avoids all the major extant criticisms in the literature. (Written for interdisciplinary audiences.). (shrink)

In various papers, Colin Klein has argued that pain experiences are commands. This monograph goes well beyond the papers, re-shaping his ‘imperativist’ view, setting it within a general account of ‘homeostatic sensations’, presenting new arguments, and criticising alternatives. Original, empirically informed, clear, and often persuasive, it is a lovely book.

Evaluativism is best thought of as a way of enriching a perceptual view of pain to account for pain’s unpleasantness or painfulness. Once it was common for philosophers to contrast pains with perceptual experiences (McGinn 1982; Rorty 1980). It was thought that perceptual experiences were intentional (or content-bearing, or about something), whereas pains were representationally blank. But today many of us reject this contrast. For us, your having a pain in your toe is a matter not of your sensing “pain-ly” (...) or encountering a sense-datum, but of your having an interoceptive experience representing (accurately or inaccurately) that your toe is in a particular experience-independent condition, such as undergoing a certain “disturbance” or being damaged or in danger (Armstrong 1962; Tye 1995). But even if such representational content makes an experience a pain, a further ingredient seems required to make the pain unpleasant. According to evaluativism, the further ingredient is the experience’s possession of evaluative content: its representing the bodily condition as bad for the subject. In this chapter, I elaborate evaluativism, locate it among alternatives, and explain its attractions and challenges. (shrink)

This chapter defends an axiological theory of pain according to which pains are bodily episodes that are bad in some way. Section 1 introduces two standard assumptions about pain that the axiological theory constitutively rejects: (i) that pains are essentially tied to consciousness and (ii) that pains are not essentially tied to badness. Section 2 presents the axiological theory by contrast to these and provides a preliminary defense of it. Section 3 introduces the paradox of pain and argues that since (...) the axiological theory takes the location of pain at face value, it needs to grapple with the privacy, self-intimacy and incorrigibility of pain. Sections 4, 5 and 6 explain how the axiological theory may deal with each of these. (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)

[DOI: 10.1097/j.pain.0000000000000765] Amanda Williams and Kenneth Craig, in a recent article in the IASP official journal _Pain_ (DOI: 10.1097/j.pain.0000000000000613), have argued that it is time to revise the IASP's well-entrenched definition of 'pain'. They propose an alternative definition. We critically discuss their proposed revision and argue that it admits clear counterexamples as both sufficient and necessary conditions. We further discuss the wisdom of replacing 'unpleasant' in the IASP definition with 'distress' as Williams and Craig propose. [Craig and Williams respond to (...) our criticism in DOI: 10.1097/j.pain.0000000000000766]. (shrink)

Recent work on signaling has mostly focused on communication between organisms. The Lewis–Skyrms framework should be equally applicable to intra-organismic signaling. We present a Lewis–Skyrms signaling-game model of painful signaling, and use it to argue that the content of pain is predominantly imperative. We address several objections to the account, concluding that our model gives a productive framework within which to consider internal signaling.

will give an overview of the fascinating communication between G. W. Leibniz and Pierre Bayle on pre-established harmony and sudden change in the soul which started from Bayle’s footnote H to the article “Rorarius” in his Dictionnaire historique et critique (1697) and ended in 1706 with Bayle’s death. I will compare the views presented in the communication to Leibniz’s reflections on the soul in his partly concurrent Nouveaux essais sur l’entendement humain (1704) and argue that many topics in the communication (...) with Bayle are discussed with more details in Nouveaux essais. I also argue that the communication helped Leibniz to respond to Locke’s views concerning uneasiness in An Essay Concerning Human Understanding, II, xxi. Bayle himself, however, was not able to completely understand Leibniz’s views on spontaneity as he was unaware of the contents of the Nouveaux essais, especially the systematic role of petites perceptions in Leibniz’s philosophy of mind. I will also reflect on whether the controversy could have ended in agreement if it would have continued longer. (shrink)

In this paper the complex phenomenon of pain is discussed and analysed along different theoretical paths: cognitivism, hermeneutics, phenomenology. The neuro-cognitive approach is exemplified through Paul and Patricia Churchland’s writings; then H.-G. Gadamer’s hermeneutical approach is evaluated. While apparently opposite, they share a common assumption, namely that the body is basically to be conceived of as not really different from the Cartesian Res extensa. Some problems thus arise: in particular, the aspect of reflexivity implied in any experience of pain is (...) overlooked. Accordingly, an adequate approach to feeling pain must take the phenomenological path. This means to discuss Husserl’s but also Scheler’s and Heidegger’s contributions, in order to bring to the fore the complexity of the phenomenon of pain, which shows a particular and paradoxical structure: exposing the subject feeling pain to its own internal exteriority. (shrink)

The concepts of placebos and placebo effects refer to extremely diverse phenomena. I recommend dissolving the concepts of placebos and placebo effects into loosely related groups of specific mechanisms, including expectation-fulfillment, classical conditioning, and attentional-somatic feedback loops. If this approach is on the right track, it has three main implications for the ethics of informed consent. First, because of the expectation-fulfillment mechanism, the process of informing cannot be considered independently from the potential effects of treatment. Obtaining informed consent influences the (...) effects of treatment. This provides support for the authorized concealment and authorized deception paradigms, and perhaps even for outright deceptive placebo use. Second, doctors may easily fail to consider the potential benefits of conditioning, leading them to misjudge the trade-off between beneficence and autonomy. Third, how attentional-somatic feedback loops play out depends not only on the content of the informing process but also on its framing. This suggests a role for libertarian paternalism in clinical practice. (shrink)

Philosophers think of pain less and less as a paradigmatic instance of mentality, for which they seek a general account, and increasingly as a rich and fruitful topic in its own right. Pain raises specific questions: about mentality and consciousness certainly, but also about embodiment, affect, motivation, and value, to name but a few. The growth of philosophical interest in pain has gone hand-in-hand with the growth of pain science, which burgeoned in the 1960s. This is no accident: developments in (...) pain science have prompted philosophers to take account of empirical data, and to revisit their assumptions about pain. Pain, in short, demands interdisciplinary investigation, hence while this entry focuses on the philosophy of pain, it makes liberal reference to empirical literature along the way. This entry’s focus is on physical pains, that is pains that are felt in bodily locations, not emotional suffering more broadly, such as grief or disappointment. The entry also does not address pain’s place in ethical theories; its focus is rather on issues that arise within philosophy of mind. Even so, part of what makes pain such an interesting and important topic is that the questions it raises span boundaries, and normative questions concerning pain’s badness, on the one hand, and its value, on the other, are never far away. (shrink)

Sometimes the philosophical armchair gets bumped by empirical facts. So it is when thinking about pain. For good or ill (good, actually, as we shall see) most of us are intimately acquainted with physical pain, the kind you feel when you stand on a nail or burn your hand. And, from the armchair, it can seem blindingly obvious that pain is essentially unpleasant. There are of course unpleasant experiences that aren’t pains – nausea or itches, for example – but surely (...) there aren’t pains that don’t hurt, pains that are neutral or even pleasurable rather than unpleasant. Surely, indeed, there couldn’t be. For it is part of the very concept of a pain that a pain be unpleasant. Or so it has seemed to many. Yet over recent decades philosophers’ confidence in these putative truisms has been shaken by some fascinating cases from the clinic, the lab, and life. (shrink)