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 “body-centric” kind of way, while another thinks of pain in a much more “mind-centric” 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.Clinical Implications: First, by making a subject’s tacit beliefs about pain explicit it will be possible to create a more open, shared space for pain communication and support a move away from purely quantitative measures of pain towards more discursive pain narratives. Secondly, the polyeidic view might provide a mechanism for predicting who will do well or badly from cognitive interventions for pain management, allowing more efficient use of healthcare resources. Finally, the polyeidic approach might also contribute to the creation of more nuanced cognitive interventions by elucidating the pre-conscious beliefs that influence a subject’s experience of pain. (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 (at least in part) 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)

Philosophers often assume that folk hold pain to be a mental state – to be in pain is to have a certain kind of feeling – and they think this state exhibits the classic Cartesian characteristics of privacy, subjectivity, and incorrigibility. However folk also assign pains (non-brain-based) bodily locations: unlike most other mental states, pains are held to exist in arms, feet, etc. This has led some (e.g. Hill 2005) to talk of the ‘paradox of pain’, whereby the folk notion (...) of pain is inherently conflicted. Recently, several authors have rejected the paradox view, arguing instead that folk hold a univocal, bodily view (i.e. pains are properties of various body parts, not of minds). This paper presents six objections to the bodily view of the folk concept of pain. We then outline a direction for future research – the ‘polyeidic approach’ – whereby the folk notion of pain is held to encompass various divergent (potentially conflicting) strands and we suggest that certain problems surrounding the treatment and communication of pain might be usefully be viewed through the lens of the polyeidic approach. (shrink)

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)

The standard interpretation of quantum mechanics and a standard interpretation of the awareness of pain have a common feature: Both postulate the existence of an irresolvable duality. Whereas many physicists claim that all particles exhibit particle and wave properties, many philosophers working on pain argue that our awareness of pain is paradoxical, exhibiting both perceptual and introspective characteristics. In this chapter, we offer a pessimistic take on the putative paradox of pain. Specifically, we attempt to resolve the supposed paradox by (...) undermining the reasons offered for accepting the introspective side of the dualism. (shrink)

It is not uncommon to find assumptions being made about folk psychology in the discussions of phenomenal consciousness in philosophy of mind. In this article I consider one example, focusing on what Dan Dennett says about the 'folk theory of consciousness'. I show that he holds that the folk believe that qualities like colours that we are acquainted with in ordinary perception are phenomenal qualities. Nonetheless, the shape of the folk theory is an empirical matter and in the absence of (...) empirical investigation there is ample room for doubt. Fortunately, experimental evidence on the topic is now being produced by experimental philosophers and psychologists. This article contributes to this growing literature, presenting the results of six new studies on the folk view of colours and pains. I argue that the results indicate against Dennett's theory of the folk theory of consciousness. (shrink)

It is not uncommon to find assumptions being made about folk psychology in the discussions of phenomenal consciousness in philosophy of mind. In this article I consider one example, focusing on what Dan Dennett says about the 'folk theory of consciousness'. I show that he holds that the folk believe that qualities like colours that we are acquainted with in ordinary perception are phenomenal qualities. Nonetheless, the shape of the folk theory is an empirical matter and in the absence of (...) empirical investigation there is ample room for doubt. Fortunately, experimental evidence on the topic is now being produced by experimental philosophers and psychologists. This article contributes to this growing literature, presenting the results of six new studies on the folk view of colours and pains. I argue that the results indicate against Dennett's theory of the folk theory of consciousness. (shrink)