The Concept of Pain

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 ...

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).

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)

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...

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 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.

The paradox of pain refers to the idea that the folk concept of pain is paradoxical, treating pains as simultaneously mental states and bodily states. By taking a close look at our pain terms, this paper argues that there is no paradox of pain. The air of paradox dissolves once we recognize that pain terms are polysemous and that there are two separate but related concepts of pain rather than one.

By definition, pain is a sensory and emotional experience that is felt in a particular part of the body. The precise relationship between somatic events at the site where pain is experienced, and central processing giving rise to the mental experience of pain remains the subject of debate, but there is little disagreement in scholarly circles that both aspects of pain are critical to its experience. Recent experimental work, however, suggests a public view that is at odds with this conceptualisation. (...) By demonstrating that the public does not necessarily endorse central tenets of the “mental” view of pain (subjectivity, privacy, and incorrigibility), experimental philosophers have argued that the public holds a more “body-centric” view than most clinicians and scholars. Such a discrepancy would have important implications for how the public interacts with pain science and clinical care. In response, we tested the hypothesis that the public is capable of a more “mind-centric” view of pain. Using a series of vignettes, we demonstrate that in situations which highlight mental aspects of pain the public can, and does, recognize pain as a mental phenomenon. We also demonstrate that the public view is subject to context effects, by showing that the public’s view is modified when situations emphasizing mental and somatic aspects of pain are presented together. (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.

The standard view in philosophy treats pains as phenomenally conscious mental states. This view has a number of corollaries, including that it is generally taken to rule out the existence of unfelt pains. The primary argument in support of the standard view is that it supposedly corresponds with the commonsense conception of pain. In this paper, we challenge this doctrine about the commonsense conception of pain, and with it the support offered for the standard view, by presenting the results of (...) a series of new empirical studies that indicate that lay people not only tend to believe that unfelt pains are possible, but actually, quite common. (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)

Pain is the most prominent member of a class of sensations known as bodily sensations, which includes itches, tickles, tingles, orgasms, and so on. Bodily sensations are typically attributed to bodily locations and appear to have features such as volume, intensity, duration, and so on, that are ordinarily attributed to physical objects or quantities. Yet these sensations are often thought to be logically private, subjective, self-intimating, and the source of incorrigible knowledge for those who have them. Hence there appear to (...) be reasons both for thinking that pains (along with other similar bodily sensations) are physical objects or conditions that we perceive in body parts, and for thinking that they are not. This apparent paradox is one of the main reasons why philosophers are especially interested in pain. One increasingly popular but still controversial way to deal with this apparent paradox is to defend a perceptual or representational view of pain, according to which feeling pain is in principle no different from undergoing other standard perceptual processes like seeing, hearing, touching, etc. But there are many who think that pains are not amenable to such a treatment. Although it was the treatment of pain as a sensory-discriminative experience that had dominated the philosophical discussions throughout most of the twentieth century, attention to pains’ affective-motivational dimension has gained prominence in recent years. (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)

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)

In a series of articles in this journal, Michael Tye and Paul Noordhof have sparred over the correct explanation of the putative invalidity of the following argument: the pain is in my fingertip; the fingertip is in my mouth; therefore, the pain is in my mouth. Whereas Tye explains the failure of the argument by stating that “pain “creates an intensional context, Noordhof maintains that the “in” in ‘the pain is in my fingertip’ is not spatial, but has state-attributing character. (...) In this paper, we offer a third account, explaining the failure of the argument through state-attributing pragmatic implicatures. Empirical evidence is provided in support of this account. (shrink)

This is a Letter to Editor of _Pain_ recommending revision of a pain term ('nociplastic pain') recently added to the IASP Pain Terms. (With a response from the Taxonomy Committee, Eva Kosek et al. PAIN: June 2018 - Volume 159 - Issue 6 - p 1177–1178.

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)

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)

[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.

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)

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.

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)

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)

The standard view of pains among philosophers today holds that their existence consists in being experienced, such that there can be no unfelt pains or pain hallucinations. The typical line of support offered for this view is that it corresponds with the ordinary or commonsense conception of pain. Despite this, a growing body of evidence from experimental philosophers indicates that the ordinary understanding of pain stands in contrast to the standard view among philosophers. In this paper, we will survey this (...) literature and add to it, detailing the results of seven new studies on the ordinary understanding of pain using both corpus analysis and questionnaire methods. (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)

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)

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)

Pain asymbolia is a rare condition caused by brain damage, usually in adulthood. Asymbolics feel pain but appear indifferent to it, and indifferent also to visual and verbal threats. How should we make sense of this? Nikola Grahek thinks asymbolics’ pains are abnormal, lacking a component that make normal pains unpleasant and motivating. Colin Klein thinks that what is abnormal is not asymbolics’ pains, but asymbolics: they have a psychological deficit making them unresponsive to unpleasant pain. I argue that an (...) illuminating account requires elements of both views. Asymbolic pains are indeed abnormal, but they are abnormal because asymbolics are. I agree with Klein that asymbolics are incapable of caring about their bodily integrity; but I argue against him that, if this is to explain not only their indifference to visual and verbal threat, but also their indifference to pain, we must do the following: take asymbolics’ lack of bodily care not as an alternative to, but as an explanation of their pains’ missing a component, and claim that the missing component consists in evaluative content. Asymbolia, I conclude, reveals not only that unpleasant pain is composite, but that its ‘hedomotive component’ is evaluative. (shrink)

The unpleasantness of pain motivates action. Hence many philosophers have doubted that it can be accounted for purely in terms of pain’s possession of indicative representational content. Instead, they have explained it in terms of subjects’ inclinations to stop their pains, or in terms of pain’s imperative content. I claim that such “noncognitivist” accounts fail to accommodate unpleasant pain’s reason-giving force. What is needed, I argue, is a view on which pains are unpleasant, motivate, and provide reasons in virtue of (...) possessing content that is indeed indicative, but also, crucially, evaluative. (shrink)

In this article, I focus on what is we know when we know pain or that someone is in pain. I argue that claims of knowledge about pains are problematic because of the complex nature of the phenomenon and because of "pain" is a cluster concept.

Pain, crucially, is unpleasant and motivational. It can be awful; and it drives us to action, e.g. to take our weight off a sprained ankle. But what is the relationship between pain and those two features? And in virtue of what does pain have them? Addressing these questions, Colin Klein and Richard J. Hall have recently developed the idea that pains are, at least partly, experiential commands—to stop placing your weight on your ankle, for example. In this paper, I reject (...) their accounts. Against Klein, I use dissociation cases to argue that possession of ‘imperative content’ cannot wholly constitute pain. Against them both, I further claim that possession of such content cannot even constitute pain’s unpleasant, motivational aspect. For, even if it were possible to specify the relevant imperative content—which is far from clear—the idea of a command cannot bear the explanatory weight Klein and Hall place on it. (shrink)

Introduction to a special issue of the Journal of Consciousness Studies on Pain and the Experience of Pain.

Our preoccupation with pain can seem an eccentricity of philosophers. But just a little reflection leads one into the thickets. When I see a pencil on my desk, I’m aware of a physical thing and its objective properties; but what am I aware of when I feel a pain in my toe? A pain, perhaps? Or my toe’s hurting? But what is the nature of such things? Are they physical? Are they objective? To avoid unexperienced pains, we might say they (...) are subjective, or are themselves experiences. But do those with hurting toes therefore have experiences in their feet? The issues rapidly proliferate. Many of them are addressed in this interesting collection of original essays by philosophers, psychologists, and neuroscientists, edited by Murat Aydede. (shrink)

This paper is based on a criterion recently proposed by Richard Fumerton for demarcating philosophy of mind and cognitive science. I suggest to extend it to a demarcation criterion between philosophy and science in general, and put it in the context of the historical changes of boundaries between the philosophical and the scientifi c fi eld. I point to a number of philosophical claims and approaches that have been made utterly obsolete by the advancement of science, and conjecture that a (...) similar thing may happen in the future with today’s philosophy of mind: under the supposition that cognitive science manages to progress very successfully in a certain direction, our concepts for mental states could change, and the type of philosophical interest we put in them, thus reshaping thewhole debate on the subject. (shrink)

Can we find necessary and sufficient conditions for a mental state to be a pain state? That is, does pain have a nature? Or is the term ‘pain’ ambiguous? I argue here that our expression ‘pain’ lacks necessary use conditions if one considers a range of contexts. As use conditions constrain the reference class, I argue that ‘pain’ does not refer to a natural category, but binds together a bunch of loosely resembling phenomena. This leads to problems for scientific and (...) clinical discourse. To solve these, a method of explication is suggested, based on a discursive combination between analysis of first-person reports and theories of natural science. Lastly, I consider the ethical implications of this ambiguity that lead to a reformulation of the goal of pain science: Not alleviation of all pains ought to be our goal, but only manipulation of conscious and negatively emotionally charged pains. (shrink)

I argue that the understanding of "pain" as presented in the official medical definition by the IASP is ambiguous and likely a cluster concept.

In the opening section of this paper we spell out an account of our na ve view of bodily sensations that is of historical and philosophical significance. This account of our shared view of bodily sensations captures common ground between Descartes, who endorses an error theory regarding our everyday thinking about bodily sensations, and Berkeley, who is more sympathetic with common sense. In the second part of the paper we develop an alternative to this account and discuss what is at (...) stake in deciding between these two ways of understanding our everyday view. In the third and final part of the paper we offer an argument in favour of our alternative. (shrink)

All existing explanations of why pain is intrinsically bad are false. They all rest upon a mistaken conception of what pains are. On this false view, pain is merely a kind of sensation or feeling. The nature of a stubbed toe is exhausted by the way it stings and throbs. However, on the correct view, pains are much richer and much more complex. For example, a pain’s intrinsic properties also include its sufferer’s beliefs about the causes and implications of her (...) pain, the fear and anxiety she feels, and the way the pain compels her to contort and groan. But none of the existing accounts of pain’s intrinsic badness can place these additional properties at the source of pain’s evil. We should therefore reject them. Instead, we should adopt an account of pain’s intrinsic badness on which pains are intrinsically bad in two separate ways. One way lies in a certain conjunction of the pain’s intrinsic properties. The other lies in the way that many pains invade and seize control over a person’s mind and body. These novel accounts of pain’s nature and intrinsic badness have many important implications throughout value theory. Accepting them leads us, for example, to a new understanding of the nature and bearers of intrinsic value. (shrink)

There are good reasons for wanting to adopt an intentionalist account of experiences generally, an account according to which having an experience is a matter of representing the world as being some way or other—according to which, that is, such mental episodes have intrinsic, conceptual, representational content. Such an approach promises, for example, to provide a satisfying conception of experiences’ subjectivity, their phenomenal character, and their crucial role in constituting reasons for our judgements about the world. It promises this, moreover, (...) without incurring the difficulties that face the adverbialist and the friends of such items as qualia and “private objects”. Still, even many of those who have been persuaded of that much are inclined to make an exception of the bodily sensations, since pains and the rest have traditionally been taken to be peculiarly “blank”—instances of brute, non-conceptual feeling. In this study, I reject that tradition and argue that sensation experiences are indeed representational, and hence not in that respect exceptional. The idea that they are nevertheless distinctive in other ways vis-à-vis ordinary perceptual experiences has led intentionalists such as John McDowell to adopt an account of their content that is both mentalist and radically subjectivist: an account, in other words, that takes the items represented by such experiences to be mental and constitutively dependent on their being represented. To my mind, such subjectivism is both viciously circular—like the parallel view of colours—and at odds with the admirably intentionalist aspirations of these views. Hence I turn to consider objectivist versions of intentionalism, views that assimilate sensations to somatosensory perceptual experiences such as those that inform us of, for example, the position of our own limbs. Admittedly, these views not only risk losing the “interiority” of sensations, but I argue that they also cannot be combined with mentalism and that this generates considerable difficulties—difficulties that have either been ignored or underestimated by those working with less demanding conceptions of content. Nonetheless, I make a number of preliminary moves to show how such difficulties might be dealt with, and how the objectivist can register even the distinctively “inner” character of sensations—by, amongst other things, focussing on the peculiarities of somatosensory content. So the prospects for intentionalism about sensations are, I argue, good. (shrink)

Suppose we are able to transplant Jones's pain centres into Smith's brain. Half way through the operation we test the pain centres by stimulating them electrically in vitro. Would there be pain? Roland Puccetti argues that there would not be. Because pains must have owners and the only available candidate for that role — the excised tissue — is logically unfit to play it. He concludes that the firing of such centres in a normally functioning brain cannot be pain either (...) and that, therefore, materialism is false.So far as I can see, Puccetti's “refutation” is a series of nonsequiturs from start to finish, and that is what I mainly want to show. It will not follow, of course, that materialism is true. Indeed, I think the view which Puccetti attacks under that name is too naive to be taken seriously by anyone. (shrink)