Pain: An unpleasant topic (original) (raw)

The Unpleasantness of Pain

The Unpleasantness of Pain, 2018

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.

The Determinants of Pain Revisited: Coordinates in Sensory Space

Pain Research and Management

Ron Melzack recognized that the gate control hypothesis of 1965 was incomplete. This led to the publication of a book chapter that would someday be referred to by some as 'the classical view' of pain mechanisms. However, this paper presented some conceptual problems for research on pain mechanisms by using the term 'motivational-affective' to define a determinant of pain. To facilitate research and eventually improve practice, the determinants of pain need to be identified and quantified more clearly. In the present article, three critical dimensions of sensory experience that define pain and related sensory experiences are identified: sensory salience, affect and motivational dominance. The authors show that each of these dimensions can be measured and are mediated by specific neurophysiological mechanisms. Pain and other somatic sensations emerge from the conjoint actions of these neurophysiological systems and fall within unambiguously defined coordinates of the t...

Evaluativist Accounts of Pain's Unpleasantness

In Jennifer Corns (ed.) Routledge Handbook of the Philosophy of Pain, 2017

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.

Unpleasant subjective emotional experiencing of pain

Indian Journal of Palliative Care, 2013

The field of pain medicine that once began as a supportive and compassionate care, adding value to the management of acute and chronic ailments, has now transformed into a vital and essential specialty with structured training programs and service units with professionals dedicating their careers to it. The expansion of understanding of the direct relationship of pain relief to the quality of life, uncovering of neuronal pathways, and technological advances in imaging as well as in interventional techniques have all contributed to this phenomenal growth. However, there is a growing concern whether the training programs and the specialized practitioners are gradually limiting their skilled inputs primarily within the sensory realm of the pain experience with sophisticated interventional techniques and relegating its subjective and emotional dimensions to perfunctory realms within the schema of service provision. While the specialty is still young, if we can understand the inherent aspect of these dimensions within the pain experience and acknowledge the gaps in service provision, it may be possible to champion development of truly comprehensive pain relief programs that responds effectively and ethically to a patient's felt needs. This article attempts to position the subjectivity of pain experience in context and surface the need to design complete systems of pain relief services inclusive of this dimension. It presents authors' review of literature on perspectives of 'unpleasant subjective emotional experiencing of the pain" to elucidate possible clinical implications based on the evidences presented on neuro-biology and neuro-psychology of the pain experience; the aim being to inspire systems of care where this dimension is sufficiently evaluated and managed.

Suffering as an independent component of the experience of pain. European Journal of Pain, 2015

European Journal of Pain, 2015

Background: Pain has consistently been viewed as containing two dimensions, a sensory (intensity) and an emotional (unpleasantness). It has been suggested that pain involves higher order cognitive processes that go beyond unpleasantness. We therefore aimed at extending the assessment of pain by introducing an additional dimension of pain-related suffering and identifying noxious stimulation protocols that are most adequate for its psychophysical and psychophysiological characterization. Methods: Twenty-four healthy volunteers received separate series of tonic and phasic noxious mechanical stimuli. Visual analogue scales were used to rate intensity, unpleasantness and suffering and psychophysiological measurements such as heart rate, skin conductance and corrugator electromyography were recorded. Acoustically evoked startle responses were measured in part of the assessments to obtain additional indicators of pain aversiveness. Results: Spearman's correlation coefficients and partial correlations analyses as well as principal component analyses confirmed that suffering constitutes an integral component of pain processing that is distinct from intensity and unpleasantness. Tonic, rather than phasic, stimulation method was more effective in eliciting pain and suffering and under this condition startle responses where higher during long compared to short stimuli. Conclusions: These results suggest that in acute pain, suffering is a constitutive dimension that might even be more crucial in clinical states of pain.

What Makes Pains Unpleasant?

Philosophical Studies, 2013

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 pains being constituted by experiential commands. I claim that such “noncognitivist” accounts fail to accommodate unpleasant pain’s reason-giving force. What I argue is needed 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.

Behavioral neuroscience of psychological pain

Neuroscience and biobehavioral reviews, 2015

Pain is a common word used to refer to a wide range of physical and mental states sharing hedonic aversive value. Three types of pain are distinguished in this article: Physical pain, an aversive state related to actual or potential injury and disease; social pain, an aversive emotion associated to social exclusion; and psychological pain, a negative emotion induced by incentive loss. This review centers on psychological pain as studied in nonhuman animals. After covering issues of terminology, the article briefly discusses the daily-life significance of psychological pain and then centers on a discussion of the results originating from two procedures involving incentive loss: successive negative contrast-the unexpected devaluation of a reward-and appetitive extinction-the unexpected omission of a reward. The evidence reviewed points to substantial commonalities, but also some differences and interactions between physical and psychological pains. This evidence is discussed in relati...

Bad by Nature: An Axiological Theory of Pain

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.