Mental States & Perfection

SUFFERING

THE SCIENCE OF SUFFERING


A comic from 1982 jokes of the psychological nature of pain and suffering.  To view other comics by this artist, click the picture.

"Pain and the Functions of the Ego"
from David Bakan's 1968 book Disease, Pain, and Sacrifice:  Toward a Psychology of Suffering

David Bakan argues that pain is not necessarily a physiological reality but a psychological construct.  To make this point, Bakan makes reference to H. K. Beecher's 1957 survey of pain entitled "The measurement of pain," which was published in Pharmacological Reviews issue 9.  Beecher concludes from his study of material from 687 sources that "[p]ain cannot be satisfactorily defined, except as every man defines it introspectively for himself."  Bakan uses this conclusion of Beecher to lay the basis for his argument that pain is an individual, psychological reality and not a physiological one, since, as Beecher concludes, pain is solely subjectively defined. 

Bakan also points to the September 6, 1965 debate between Brand Blandshard of Yale University's Philosophy Department and B. F. Skinner of Harvard University's Psychology Department, using Blandshard's refutation of the behaviorist position on the basis of pain:
                       
The most obvious [difficulty of the behaviorist position] is that the experience of pain, for example, is self-
                              evidently not the same thing as a physical movement of any kind...their identification is a confusion [that] can
                              be shown in various ways...If pain were any kind of physical motion, we could ask what its direction and
                              velocity were, wheras it makes no sense to talk of the direction and velocity of a toothache.  On the other
                              hand, we speak of pain as dull or excruciating, while a dull or excruciating motion is meaningless again.
Thus, Bakan, with the aid of Blandshard, concludes that because pain cannot be described as a physical motion with velocity or direction and because in the description of pain the adjectives used are ones that qualify and not quantify, pain cannot be described as being physiological.  Pain must psychological for Bakan. 

Moreover, Bakan defines pain as being "...the psychic manifestation of telic decentralization."  He elucidates on this definition further when writing that:
                       
Pain, having no other locus but the conscious ego, is almost literally the price man pays for the possession of
                              a conscious ego....There is some reason to believe that the higher up in the evolutionary scale the organism is,
                              the more likely that organism is to possess anything that can be identified as pain.  It has even been suggested
                              that observed group differences in pain thresholds may be explained in terms of different degrees of development
                              of consciousness among groups.  Certainly the most effective devices available for the elimination of pain are
                              exactly those which eliminate consciousness entirely.
                              A certain degree of psychological development is a prerequisite for being able to experience pain.  Puppies
                              raised under conditions of stimulus deprivation, which has been demonstrated to have the effect of keeping
                              animals from developing psychologically, show no pain reaction even when subject to flame and pin pricks.
Therefore, for Bakan, pain is a "psychic manifestation" in that it is found in those animals, specifically man, which possess a conscious ego.  By relying on the need for a conscious ego for the existence of pain, Bakan makes pain solely a psychological construct, denying any physiological explanations. 

The Physiology of Pain
from the June 18, 2005 "How you feel pain" by MayoClinic.com

To understand the physiological nature of pain, three main points will be discussed:
                       
1.    How pain messages travel through the body
                              2.    How a person reacts to pain messages
                              3.    How a person feels chronic pain

1.    How pain messages travel through the body

Three parts of the body are necessary for pain messages:  peripheral nerves, spinal cord, and brain.  Peripheral nerves extend throughout all of a person's body, and those nerves that end with nociceptors detect potential or actual damage to tissues.  The greatest concentration of these receptors in the body is in the fingers and toes.  When a harmful stimulus is detected by the receptor, a pain message in the form of an electric impulse along a peripheral nerve to the spinal cord and brain. 

The peripheral nerves enter the spinal cord at places called dorsal horns.  There neurotransmitters are released to activate other nerve cells in the spinal cord, which further processes the information from the nociceptors and transmits the information to the brain.

When the information first arrives in the brain, it arrives at the thalamus, which forwards the information to three more regions of the brain:  the physical sensation region (somatosensory cortex), the emotional feeling region (limbic system), and the thinking region (frontal cortex).  The brain responds to the pain by sending messages back to the spinal cord to moderate the pain.

Illustration showing how pain messages travel

2.    How a person reacts to pain messages

The brain can do more than just react to the perceived pain--it can signal nerve cells to release natural pain killers, such as endorphins and enkephalins.  These natural pain killers reduce the pain message of the peripheral nerves.

Additionally, how one reacts to pain involves several psychological factors, which, as was discussed earlier, Bakan believed to be the sole source of pain.  Factors that can heighten or reduce pain messages are:
                            -Emotional and psychological state
                            -Past memories of pain experiences
                            -Upbringing
                            -Attitude
                            -Expectations
                            -Beliefs and values
                            -Age
                            -Gender
                            -Social and cultural influences

Examples of these factors influencing a person's pain messages would be an athlete who believed in the training philosophy of "no pain, no gain."  Such an athlete, would thus be able to endure more pain than others.  Another example is a child who experiences the probe of a dentist for the first time, which could lead to a heightened pain message, especially if the child was told of dentist horror stories.

3.     How a person feels chronic pain

Pain is viewed as chronic, and thus an illness itself, when it lasts six months or longer.  This pain may be constant, or it may come and go. 

Chronic pain can be caused by several things, some of which may be a chronic condition or an incident that damages a peripheral or spinal nerve, which is called neuropathic pain.  Chronic pain can at times baffle doctors, such as when there is no evidence of disease or damage to tissues to link to the pain. 

Sensitization, the process by which a painful condition is severe and disproportionate to the disease or original injury, is normally assumed by doctors to have a partial cause in chronic pain. 

 

To view the source article and for more information, click here.
Additional sites with information on pain and pain management:
        MedlinePlus:  Pain

          American Pain Society
          American Pain Foundation
          American Chronic Pain Association

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