Over the past two days, I’ve sketched a picture of pains. Pains are imperatives which express commands which, when obeyed, motivate you to solve problems pertaining to bodily integrity. That fits nicely with a broad story about the bodily sensations and their role.
You might think this is missing something rather important though. Pains hurt. They feel bad. It’s because they feel bad that we’re motivated to do stuff. Anecdotal evidence aside, everyone thinks that pains hurt. Right?
I think not. I think the imperativist must deny that pains necessarily or intrinsically or constitutively feel bad: there’s nothing intrinsically bad about a command. I also think that everyone ought to deny that pains necessarily hurt. The idea that pain must hurt relies on a confusion between two phenomenal states that ought to be kept distinct. Fleshing out the distinction also both helps and clarifies imperativism. Of course, most pains hurt. Pains are also the paradigmatic thing that hurts. This is a contingent fact, but an important one. Imperativism also has something to say about why pain usually hurts.
So, there are two distinct types of phenomenal state. First, there are pains, which are imperatives that motivate you to protect your body. There is also suffering (or hurt or painfulness), which is a distinct feeling that can qualify other mental states. One can be painfully hungry, painfully tired, or painfully lonely. Suffering is a way of feeling bad. Though I’ll use the two interchangeably for convenience there are important differences (sticking your foot in a bucket of worms feels bad, but doesn’t hurt).
RM Hare noted that the English word ‘pain’ is multiply ambiguous — it can be used for the simple sensation of pain, the composite of pain and hurt, for the cause of pain, or (more rarely) for hurt alone. For the purposes of the book and these posts, I’ve been restricting ‘pain’ to the first sense. (In English, we sometimes do this by explicitly talking about physical pain) Imperativism, crucially, is a theory about pains considered as homeostatic sensations, not about suffering. Homeostatic sensations can motivate without being painful, or even unpleasant. Compare: severe hunger is extraordinarily unpleasant, and a locus of suffering. Mild hunger is none of these things. But of course mild hunger still motivates you to eat. Homeostatic sensations motivate in virtue of their imperative content, not in virtue of feeling bad.
Why think pain admits of such a distinction, though? I give several arguments in the book. Here are two quick ones.
First, I think there’s obviously a difference in the target of pain and the associated suffering. Pains motivate you to protect your body to manage threats to its physical integrity. As I argued yesterday, that is part of very old, and very adaptive, behavioural system motivated by imperative sensations. Suffering, on the other hand, motivates you to get rid of the pain. It has as its target the sensation of pain itself. It motivates different actions than pain does. Many are obviously maladaptive. The pain in my ankle might motivate me to take morphine so that I can keep exercising. That will eliminate the pain but not the problem, and let me do things that will make it worse.
The same structure holds of other painful sensations. Heartbreak should motivate me to go out and do things, to make friends, to find another. Being painfully heartbroken might also motivate me to drink gin in a dark room, or to join the French Foreign Legion, or generally to do things that eliminate the feeling of heartbreak — none of which are particularly conducive to finding a new lover.
Second, I think pain and suffering are doubly dissociable. I’ve already mentioned numerous states which can hurt but which aren’t pains. I also think that there are non-pathological cases of pains which don’t hurt. I think most very mild pains don’t hurt. As RM Hare put it in a lovely passage:
There are, in fact, small degrees of pain which are by no means disliked by everybody. Most people could draw the point of a needle rather gently across their skin (as in acupuncture) and say truthfully that they could distinctly feel pain, but that they did not dislike it. Some might say that they would rather be without it than with it; but that would apply to a great many sensations about which no philosopher, to my knowledge, takes the line that some do with pain. Most people would rather be without a feeling of giddiness (though children often induce it in themselves out of interest); but nobody says that no sense can be given to the sentence “I feel giddy, but do not dislike it.” (Hare 1964 p97)
I side with Hare. Mild pains in uncomplicated circumstances don’t really hurt. I think another clean case is the pains that precede unproblematic postural adjustment. That means that pain and suffering come apart, and should be treated as distinct. (For connoisseurs of the pain literature: this is also how I handle a lot of the evidence about the supposed distinction between “sensory” and “affective” dimensions of pain. I deny that the latter is specific to pain. )
So much for the distinction. Once we separate out suffering as a second-order state, we get as a bonus the solution to several old problems. The higher-order structure is shared (I argue) with pleasantness, and keeping that in mind lets us sort out some traditional issues surrounding masochistic pleasures.
Since the book is about pain rather than suffering, I don’t give a fleshed-out account of what suffering is. But I do think it’s an important question, and I devote the final chapter to talking about the relationship between suffering and imperativism. Imperativism might be a useful model: we could treat suffering as a second-order imperative, with the content to get rid of some first-order sensation. (How plausible this is depends on how much evaluative content is necessarily present in “feeling bad”; a second-order imperative is no more evaluative than a first-order one.)
Finally, I think imperativism might have some distinctive things to say about why pains feel bad. Imperative sensations are strongly attention-capturing and distracting. Drawing on Elaine Scarry and David Sussman’s excellent work on torture, I also suggest ways in which pains might threaten our very identity as agents. There are likely to be many overlapping reasons; one thing I didn’t discuss and need to think about more some day is how this interacts with what I think about very young children and nonhuman animals. Overall, though, I think imperativism has a number of new and distinctive things to say about these issues.
Hi Colin,
Your distinction between pain and suffering raises a few concerns, for me. It seems to me that pain only motivates one to act once it crosses a threshold into suffering. Prior to crossing that threshold, in Hare’s examples – of gentle needle pressure, etc – I would suggest these really aren’t painful, as they are aren’t strong enough to form an imperative. I would bind pain’s imperative nature and suffering together. I don’t really see how pain can exist without suffering and still motivate some protective response, unless the protective response was not really in response to the pain but rather resulting from some cognitive appraisal.
You suggest that suffering motivates one to end that suffering, whereas pain motivates one to protect the body, but I’m not sure that such a distinction can be maintained. From an evolutionary point of view, it makes little sense to me to imagine an evolving imperative to end suffering that was somehow disconnected from a relation to preserving homeostasis. I would rather suggest that suffering is a necessary though insufficient condition for pain, and is part of our body’s imperfect repertoire of attempts to preserve homeostasis. Suffering, when it accompanies pain, motivates us to end that suffering as our body’s imperfect imperative to protect the body. In a more materialist and reductive sense, there are individuals who detect noxious stimuli, as this information arrives in the somatosensory cortex, but who have lesions in the anterior cingulate gyrus and who do not experience the affective and motivational aspects, and who are quite indifferent to their ‘pain’. I would suggest such individuals do not experience pain, as I believe the imperative element of pain is constitutive of it. These individuals, if they report ‘pain’ without any distress or motivation, are, I believe, mistaken.
Seamus,
Good stuff. So a few points of disagreement. You say:
” I don’t really see how pain can exist without suffering and still motivate some protective response….”
But I disagree. I think the example of simple postural adjustment is the most telling — I’m sitting in my chair, I feel a bit of pain in my buttock, because of that pain I shift, and that’s it. There’s obviously pain there, and not obviously suffering, because the pain is so mild and easily dealt with. Again, I think the comparison with hunger is apt: everyone (I take it) thinks that mild hunger motivates without being painful, without feeling bad, etc. I was also trying to make the case using ordinary experiences, but I think once you move to (e.g) lobotomies or drug experiences you get plenty of similar cases.
As for lesion patients — I assume you’re talking about pain Asymbolia? (Though those are really more associated with insular damage than cingulate. ) I do talk about these at length in the book, since I do think they feel pain. They aren’t motivated by the primary imperative force of pain, which is a trickier case for my theory (they’re also unmoved by suffering too, but that’s less problematic). But in these cases, it seems pretty clear that the patients describe what they’re feeling as pain, and that’s good enough for me!