Perceptualists say that having a pain in a body part consists in perceiving the part as instantiating some property. I argue that perceptualism makes better sense of the connections between pain location and the experiences undergone by people in pain than three alternative accounts that dispense with perception. Turning to fellow perceptualists, I also reject ways in which David Armstrong and Michael Tye understand and motivate perceptualism, and I propose an alternative interpretation, one that vitiates a (...) pair of objections—due to John Hyman—concerning the meaning of ‘Amy has a pain in her foot’ and the idea of bodily sensitivity. Perceptualism, I conclude, remains our best account of the location of pains. (shrink)

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)

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)

According to a bodily view of pain, pains are objects which are located in body parts. This bodily view is supported by the locative locutions for pain in English, such as that “I have a pain in my back.” Recently, Liu and Klein (Analysis, 80(2), 262–272, 2020) carry out a cross-linguistic analysis, and they claim that (1) Mandarin has no locative locutions for pain and (2) the absence of locative locutions for pain puts the bodily (...) view at risk. This paper rejects both claims. Regarding the philosophical claim, I argue that a language without locative locutions for pain only poses a limited challenge to the bodily view. Regarding the empirical claim, I identify the possible factors which might have misled Liu and Klein about the locative locutions for pain in Mandarin, and argue that Mandarin has a wide range of locative locutions for pain by conducting a corpus analysis. I conclude that compared to English, Mandarin lends no less, if not more, support to the bodily view of pain. (shrink)

Philosophical considerations regarding experiential spatial content have focused on exteroceptive sensations presenting external entities, and not on interoceptive experiences that present states of our own body. A notable example is studies on interoceptive touch, in which it is argued that interoceptive tactile experiences have rich spatial content such that tactile sensations are experienced as located in a spatial field. This paper investigates whether a similarly rich spatial content can be attributed to experiences of acute, cutaneous pain. It is argued (...) that such experiences of pain do not have field-like content, as they do not present distance relations between painful sensations. (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)

Philosophical orthodoxy holds that pains are mental states, taking this to reflect the ordinary conception of pain. Despite this, evidence is mounting that English speakers do not tend to conceptualize pains in this way; rather, they tend to treat pains as being bodily states. We hypothesize that this is driven by two primary factors—the phenomenology of feeling pains and the surface grammar of pain reports. There is reason to expect that neither of these factors is culturally specific, however, (...) and thus reason to expect that the empirical findings for English speakers will generalize to other cultures and other languages. In this article we begin to test this hypothesis, reporting the results of two cross-cultural studies comparing judgments about the location of referred pains between two groups—Americans and South Koreans—that we might otherwise expect to differ in how they understand pains. In line with our predictions, we find that both groups tend to conceive of pains as bodily states. (shrink)

Two views on the nature and location of pain are usually contrasted. According to the first, experientialism, pain is essentially an experience, and its bodily location is illusory. According to the second, perceptualism or representationalism, pain is a perceptual or representational state, and its location is to be traced to the part of the body in which pain is felt. Against this second view, the cases of phantom, referred and chronic pain have (...) been marshalled: all these cases apparently show that one can be in pain while not having anything wrong in her body. Pain bodily location, then, would be illusory. I this paper I shall defend the representational thesis by presenting an argument against experientialism while conceding that the appearance / reality distinction collapses. A crucial role in such identification is played by deictics. In reporting that we feel pain here, the deictic directly refers to the bodily part as coinciding with the part as represented. So, pain location is not illusory. The upshot is that the body location is part and parcel of the representational content of pain states, a representation built up from the body map. (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.

Recent work by Stout and colleagues indicates that the neural correlates of language and Early Stone Age toolmaking overlap significantly. The aim of this paper is to add computational detail to their findings. I use an error minimisation model to outline where the information processing overlap between toolmaking and language lies. I argue that the Early Stone Age signals the emergence of complex structured representations. I then highlight a feature of my account: It allows us to understand the early evolution (...) of syntax in terms of an increase in the number and complexity of models in a cognitive system, rather than the development of new types of processing. (shrink)

We challenge an argument that aims to support Aesthetic Realism by claiming, first, that common sense is realist about aesthetic judgments because it considers that aesthetic judgments can be right or wrong, and, second, that becauseAesthetic Realism comes from and accounts for “folk aesthetics,” it is the best aesthetic theory available.We empirically evaluate this argument by probing whether ordinary people with no training whatsoever in the subtle debates of aesthetic philosophy consider their aesthetic judgments as right or wrong. Having shown (...) that the results do not support the main premise of the argument, we discuss the consequences for Aesthetic Realism and address possible objections to our study. (shrink)

Hutto and Myin claim that teleosemantics cannot account for mental content. In their view, teleosemantics accounts for a poorer kind of relation between cognitive states and the world but lacks the theoretical tools to account for a richer kind. We show that their objection imposes two criteria on theories of content: a truth-evaluable criterion and an intensionality criterion. For the objection to go through, teleosemantics must be subject to both these criteria and must fail to satisfy them. We argue that (...) teleosemantics meets the truth-evaluable criterion and is not required to meet the intensionality criterion. We conclude that Hutto and Myin’s objection fails. (shrink)

The surface grammar of reports such as ‘I have a pain in my leg’ suggests that pains are objects which are spatially located in parts of the body. We show that the parallel construction is not available in Mandarin. Further, four philosophically important grammatical features of such reports cannot be reproduced. This suggests that arguments and puzzles surrounding such reports may be tracking artefacts of English, rather than philosophically significant features of the world.

The free energy principle is notoriously difficult to understand. In this paper, we relate the principle to a framework that philosophers of biology are familiar with: Ruth Millikan’s teleosemantics. We argue that: systems that minimise free energy are systems with a proper function; and Karl Friston’s notion of implicit modelling can be understood in terms of Millikan’s notion of mapping relations. Our analysis reveals some surprising formal similarities between the two frameworks, and suggests interesting lines of future research. We hope (...) this will aid further philosophical evaluation of the free energy principle. (shrink)

Over the last fifteen years, an ambitious explanatory framework has been proposed to unify explanations across biology and cognitive science. Active inference, whose most famous tenet is the free energy principle, has inspired excitement and confusion in equal measure. Here, we lay the ground for proper critical analysis of active inference, in three ways. First, we give simplified versions of its core mathematical models. Second, we outline the historical development of active inference and its relationship to other theoretical approaches. Third, (...) we describe three different kinds of claim -- labelled mathematical, empirical and general -- routinely made by proponents of the framework, and suggest dialectical links between them. Overall, we aim to increase philosophical understanding of active inference so that it may be more readily evaluated. -/- This the final submitted version of the Introduction to the Topical Collection "The Free Energy Principle: From Biology to Cognition", forthcoming in Biology & Philosophy. (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.

In their landmark 2010 paper, “The weirdest people in the world?”, Henrich, Heine, and Norenzayan outlined a serious methodological problem for the psychological and behavioural sciences. Most of the studies produced in the field use people from Western, Educated, Industrialised, Rich and Democratic (WEIRD) societies, yet inferences are often drawn to the species as a whole. In drawing such inferences, researchers implicitly assume that either there is little variation across human populations, or that WEIRD populations are generally representative of the (...) species. Yet neither of these assumptions is justified. In many psychological and behavioural domains, cultural variation begets cognitive variation, and WEIRD samples are recurrently shown to be outliers. In the years since the article was published, attention has focused on the implications this has for research on extant human populations. Here we extend those implications to the study of ancient _H. sapiens_, their hominin forebears, and cousin lineages. We assess a range of characteristic arguments and key studies in the cognitive archaeology literature, identifying issues stemming from the problem of sample diversity. We then look at how worrying the problem is, and consider some conditions under which inferences to ancient populations via cognitive models might be provisionally justified. (shrink)

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)

Future-bias is the preference, all else being equal, for negatively valenced events be located in the past rather than the future, and positively valenced ones to be located in the future rather than the past. Strong risk aversion is the preference to pay some cost to mitigate the badness of the worst outcome. People who are both strongly risk averse and future-biased can face a series of choices that will guarantee them more pain, for no compensating benefit: they will (...) be pain pumped. Thus, combining these preferences is rationally impermissible. Dougherty (2011) argues that this gives us reason to think that future-bias is rationally impermissible. This argument, and a similar one presented by Greene and Sullivan (2015), relies on the idea that if several preferences are not rationally combinable, then in the absence of some explanation of why they are not combinable, we should conclude that (at least) one of them is rationally impermissible. We take up this question by, inter alia, reflecting on the empirical results of a study we ran that probes people’s risk averse and future-biased preferences. We argue that the data, in conjunction with other considerations, suggests that we should not infer from the irrationality of the combination of these preferences to the irrationality of one of the preferences singly. We also argue that given the descriptive data about these preferences, there is no reason to think that, if one of them is rationally impermissible, then it is future-bias. (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)

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)

Compare your pain when immersing your hand in freezing water and your pleasure when you taste your favourite wine. The relationship seems obvious. Your pain experience is unpleasant, aversive, negative, and bad. Your experience of the wine is pleasant, attractive, positive, and good. Pain and pleasure are straightforwardly opposites. Or that, at any rate, can seem beyond doubt, and to leave little more to be said. But, in fact, it is not beyond doubt. And, true or false, (...) it leaves a good deal more to be said: about the nature of sensory affect; its relations to perception, motivation, and rationality; its value; and the mechanisms underlying it. Much is said about these matters in the contributions that follow. Here, in this introductory essay, we map the dialectical landscape and locate our contributors’ papers within it. (shrink)

This work proposes that pain meets the requirements of being characterized as a secondary quality, as it covers, like a color, a determined extension. The argument seeks to establish a literal pain-color analogy through an inquiry into the intensity and location of the pain. From the classic intensity/location relationship reported by patients with acute appendicitis, three degrees of pain are distinguished: mild, moderate, and severe. The objective is only achieved by examining the Body’s extensional (...) determinations (primary quality) insofar as each of these degrees of pain covers three particular measures. Once these three measures have been explored according to the perforation process (tissue damage), the work ends by identifying pain as a transcendent moment. (shrink)

I argue that contrary to their own intentions Casser and Schiller should think that their pain-in-mouth argument is invalid. I cast doubt on whether a hole must be in a host of it but show that the crux of Casser and Schiller’s proposal does not depend on this.

The following argument is widely assumed to be invalid: there is a pain in my finger; my finger is in my mouth; therefore, there is a pain in my mouth. The apparent invalidity of this argument has recently been used to motivate the conclusion that pains are not spatial entities. We argue that this is a mistake. We do so by drawing attention to the metaphysics of pains and holes and provide a framework for their location which (...) both vindicates the argument's validity and explains why it appears invalid. To this end, we show that previously proposed explanations for the apparent invalidity of the argument fail. Moreover, we show that our account accommodates and explains seemingly opposing linguistic data. We conclude that the ‘pain-in-mouth argument’ does not undermine the view that pains are spatial entities. (shrink)

Learning is fundamentally about action, enabling the successful navigation of a changing and uncertain environment. The experience of pain is central to this process, indicating the need for a change in action so as to mitigate potential threat to bodily integrity. This review considers the application of Bayesian models of learning in pain that inherently accommodate uncertainty and action, which, we shall propose are essential in understanding learning in both acute and persistent cases of pain.

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. [The IASP Council has now approved a revised definition and published its rationale here: Pain 2020 Sep 1; 161(9), pp. 1976–1982. The new definition follows (most of) my recommendations.]. (shrink)

Objective: To determine the prevalence of the accessory sacroiliac joint (ASIJ) on both computed tomography (CT) images and dry bones and ultimately, to contribute to the literature. -/- Materials and Methods: CT images archived in the Radiology department of Gaziantep University Medical Faculty obtained from 145 individuals (104 males and 41 females) as well as 92 sacral bones were examined. -/- Results: The prevalence of ASIJ among 92 sacral bones was 15.2%. The ASIJ was more commonly (52%) located at the (...) posterior portion of the SIJ at the level of the second dorsal sacral foramen. In 48% of the bones, ASIJ was identified just above the first dorsal sacral foramen. Unilateral ASIJ was observed in 10.8% and bilateral ASIJ in 4.4% of the sacral bones. On CT images, ASIJ was found in 7.8% of the males and 7.2% of the females. The total prevalence of sacroiliac joint variations was 28.9%, and 6.8% of them were ASIJs. -/- Conclusion: It should be kept in mind that ASIJ may be a source of arthritis and chronic hip pain. The presence of ASIJ should be sought through imaging studies for early diagnosis of ASIJ. (shrink)

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)

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)

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)

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 ...

Various prominent theories of pain assume that it is pain’s biological function to inform organisms about damage to their bodies. I argue that this is a mistake. First, there is no biological evidence to support the notion that pain was originally selected for its informative capacities, nor that it currently contributes to the fitness of organisms in this specific capacity. Second, neurological evidence indicates that modulating mechanisms in the nociceptive system systematically prevent pain from serving a (...) primarily informative role. These considerations threaten to undermine standard perceptual and representational accounts of pain. (shrink)

It can seem natural to say that, when in pain, we undergo experiences which present to us certain experience-dependent particulars, namely pains. As part of his wider approach to mind and world, John McDowell has elaborated an interesting but neglected version of this account of pain. Here I set out McDowell’s account at length, and place it in context. I argue that his subjectivist conception of the objects of pain experience is incompatible with his requirement that such (...) experience be presentational, rationalizing, and classificatory. (shrink)

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)

Functionalism is often used to identify mental states with physical states. A particularly powerful case is Lewis's analytical functionalism. Kripke's view seriously challenges any such identification. The dispute between Kripke and Lewis's views boils down to whether the term ‘pain’ is rigid or nonrigid. It is a strong intuition of ours that if it feels like pain it is pain, and vice versa, so that ‘pain’ should designate, with respect to every possible world, all and only (...) states felt as pain. Hence, in order to settle the dispute, we need to check which of the two – Kripke's use of ‘pain’ as rigid, or Lewis's use of ‘pain’ as nonrigid – better meets this intuition. I show that, despite crucial differences in both their semantic and metaphysical assumptions, surprisingly, both views meet this intuition equally well. Thus it appears that this question of rigidity cannot, in principle, be solved, and so, at least with respect to this particular dispute, the jury is still out on whether mental states are identical to physical states. (shrink)

- First book to describe what pain means in vulnerable or special groups of people - Clinical applications described in each chapter - Provides insight into the nature of pain experience across the lifespan -/- This book, the third and final volume in the Meaning of Pain series, describes what pain means to people with pain in “vulnerable” groups, and how meaning changes pain – and them – over time. -/- Immediate pain warns (...) of harm or injury to the person with pain. If pain persists over time, more complex meanings can become interwoven with this primitive meaning of threat. These cognitive meanings include thoughts and anxiety about the adverse consequences of pain. Such meanings can nourish existential sufferings, which are more about the person than the pain, such as loss, loneliness, or despair. -/- Although chronic pain can affect anyone, there are some groups of people for whom particular clinical support and understanding is urgently needed. This applies to “vulnerable” or “special” groups of people, and to the question of what pain means to them. These groups include children, women, older adults, veterans, addicts, people with mental health problems, homeless people, or people in rural or indigenous communities. Several chapters in the book focus on the lived experience of pain in vulnerable adults, including black older adults in the US, rural Nigerians, US veterans, and adults with acquired brain injury. The question of what pain experience could mean in the defenceless fetus, neonate, pre-term baby, and child, is examined in depth across three contributions. -/- This book series aspires to create a vocabulary on the “meanings of pain” and a clinical framework with which to use it. It is hoped that the series stimulates self-reflection about the role of meaning in optimal pain management. -/- Meanings of Pain is intended for people with pain, family members or caregivers of people with pain, clinicians, researchers, advocates, and policy makers. Volume I was published in 2016; Volume II in 2019. (shrink)

The article reviews some analyses of temporal language in logical approaches to natural language semantics. It considers some asymmetries between past and future, manifested in language, which motivate the “standard view” of the non-reversibility of time and the persistence of the past. It concludes with a puzzle about the changing past which challenges the standard view.

One of the major concerns for the contemporary philosophy of mind involves the problem of qualia. The word qualia refers to our subjective experience of the world and includes the properties of our experience that cannot be located in the world external to our minds. For example, the ineffable feel of a blue experience when one looks at the sky, or the pain one feels when one is stuck with a pin. These sensations are the essence of our experience (...) and yet cannot be pointed to in the external world. (shrink)

We present an ontology of pain and of other pain-related phenomena, building on the definition of pain provided by the International Association for the Study of Pain (IASP). Our strategy is to identify an evolutionarily basic canonical pain phenomenon, involving unpleasant sensory and emotional experience based causally in localized tissue damage that is concordant with that experience. We then show how different variant cases of this canonical pain phenomenon can be distinguished, including pain (...) that is elevated relative to peripheral trauma, pain that is caused neuropathically (thus with no necessary peripheral stimulus), and pain reports arising through deception either of self or of others. We describe how our approach can answer some of the objections raised against the IASP definition, and sketch how it can be used to support more sophisticated discrimination of different types of pain resulting in improved data analysis that can help in advancing pain research. (shrink)

This paper examines Aristotle’s vocabulary of pain, that is the differences and relations of the concepts of pain expressed by synonyms in the same semantic field. It investigates what is particularly Aristotelian in the selection of the pain-words in comparison with earlier authors and specifies the special semantic scope of each word-cluster. The result not only aims to pin down the exact way these terms converge with and diverge from each other, but also serves as a basis (...) for further understanding Aristotle’s philosophical conception of pain. (shrink)

Understanding the nature of pain depends, at least partly, on recognizing its subjectivity (thus, its first-person epistemology). This in turn requires using a first-person experiential method in addition to third-person experimental approaches to study it. This paper is an attempt to spell out what the former approach is and how it can be integrated with the latter. We start our discussion by examining some foundational issues raised by the use of introspection. We argue that such a first-person method in (...) the scientific study of pain (as in the study of any experience) is in fact indispensable by demonstrating that it has in fact been consistently used in conjunction with conventional third-person methodologies, and this for good reasons. We show that, contrary to what appears to be a widespread opinion, there is absolutely no reason to think that the use of such a first-person approach is scientifically and methodologically suspect. We distinguish between two uses of introspective methods in scientific experiments: one draws on the subjects’ introspective reports where any investigator has equal and objective access. The other is where the investigator becomes a subject of his own study and draws on the introspection of his own experiences. We give examples using and/or approximating both strategies that include studies of second pain summation and its relationship to neural activities, and brain imaging- psychophysical studies wherein sensory and affective qualities of pain are correlated with cerebral cortical activity. We explain what we call the experiential or phenomenological approach that has its origins in the work of Price and Barrell (1980). This approach capitalizes on the scientific prospects and benefits of using the introspection of the investigator. We distinguish between its vertical and horizontal applications. Finally, we conclude that integrating such an approach to standard third-person methodologies can only help us in having a fuller understanding of pain and of conscious experience in general. (shrink)

In this article I clarify the concepts of ‘pain’, ‘suffering’. ‘pains of body’, ‘pains of soul’. I explore the relevance of an ethic to the clinical setting which gives patients a strong prima facie right to freedom from unnecessary and unwanted pain and which places upon medical professionals two concomitant moral obligations to patients. First, there is the duty not to inflict pain and suffering beyond what is necessary for effective diagnosis. treatment and research. Next, there is (...) the duty to do all that can be done to relieve all the pain and suffering which can be alleviated. I develop in some detail that individuality of pain sensitivity must be taken into account in fulfihing these obligations. I explore the issue of the relevance of informed consent and the right to refuse treatment to the matter of pain relief. And I raise the question of what conditions, if anv, should override the right to refuse treatment where pain relief is of paramount concern. (shrink)

I first offer a broad taxonomy of models of divine omnipresence in the Christian tradition, both past and present. I then examine the recent model proposed by Hud Hudson (2009, 2014) and Alexander Pruss (2013)—ubiquitous entension—and flag a worry with their account that stems from predominant analyses of the concept of ‘material object’. I then attempt to show that ubiquitous entension has a rich Latin medieval precedent in the work of Augusine and Anselm. I argue that the model of omnipresence (...) explicated by Augustine and Anselm has the resources to avoid the noted worry by offering an alternative account of the divide between the immaterial and the material. I conclude by considering a few alternative analyses of ‘material object’ that make conceptual room for a contemporary Christian theist to follow suite in thinking that at least some immaterial entities are literally spatially located when relating to the denizens of spacetime. (shrink)

It is common to characterize pain with touch-related terms, like ‘cutting’, ‘pressing’, ‘sharp’, and ‘pulsing’, or temperature-related terms, like ‘hot’ or ‘burning’. This suggests that many pains are phenomenally multimodal because they are experienced as having some tactile-like or thermal-like character. The goal of this chapter is to investigate the structure of phenomenally multimodal pain experiences. It is argued that the usual accounts of multimodal structure proposed in investigations regarding exteroceptive experiences cannot be plausibly applied to multimodal experiences (...) of pain. Instead, an alternative framework is proposed which characterizes the structure of tactile-like and thermal-like pains by referring to the notion of crossmodal correspondences. (shrink)

Most modern writers accept that a privation theory of evil should explicitly account for the evil of pain. But pains are quintessentially real. The evil of pain does not seem to lie in an absence of good. Though many directly take on the challenges this raises, the metaphysics and axiology of their answers is often obscure. In this paper I try to straighten things out. By clarifying and categorizing the possible types of privation views, I explore the ways (...) in which privationists about evil are—or should or could be—privationists about pain’s evil. (shrink)

There is little more common in ethics than to think pain is intrinsically bad and pleasure is intrinsically good. A Humean-style error theory of the axiology of pain and pleasure is developed against these commonsense claims. We defend the thesis that the value of pain and pleasure is always contingent and only instrumental. We survey prominent theories of both intrinsic value and pain/pleasure, all of which assume that pain and pleasure are intrinsically valuable. We base (...) our error theory on counterexamples to this assumption, upon which these theories falter, and a theory of pain and pleasure which derives their value solely from their evolutionary function. (shrink)

Is a phenomenal pain a conscious primitive or composed of more primitive phenomenal states? Are pain experiences necessarily or only contingently unpleasant? Here, I sketch how to answer such questions concerning intra-phenomenal metaphysics using the example of pain and unpleasantness. Arguments for a symmetrical metaphysical independence of phenomenal pain and unpleasant affect are presented, rejecting a composite view like the IASP definition and dimensional views. The motivating intuition of these views is explained by common binding mechanisms (...) in consciousness and characterized as fallacious if generalized. There are, however, underlying commonalities between pain perception and unpleasant affect, e.g. formal content or evolutionary ancestry. (shrink)

Since nothing about God is passive, and the perception of pain is inherently passive, then it seems that God does not know what it is like to experience pain. Nor would he be able to cause us to experience pain, for his experience would then be a sensation (which would require God to have senses, which he does not). My suggestion is that Berkeley avoids this situation by describing how God knows about pain “among other things” (...) (i.e. as something whose identity is intelligible in terms of the integrated network of things). This avoids having to assume that God has ideas (including pain) apart from his willing that there be perceivers who have specific ideas that are in harmony or not in harmony with one another. (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.