e-book Feeling Pain and Being in Pain (MIT Press)

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In this book, leading philosophers and scientists offer a wide range of views on how to conceptualize and study pain. The essays include discussions of perceptual and representationalist accounts of pain; the affective-motivational dimension of pain; whether animals feel pain, and how this question can be investigated; how social pain relates to physical pain; whether first-person methods of gathering data can be integrated with standard third-person methods; and other methodological and theoretical issues in the science and philosophy of pain. Search Search.

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The Neuroscience of Pain: Translating Science to the Patient

Overview Author s. Summary What does feeling a sharp pain in one's hand have in common with seeing a red apple on the table? Let us first discuss reflection-based reasons for action. Reflection-based motivation is not so much about our internal conscious experience, but more about updating world models we have formed and attaching value or disvalue to certain outcomes. We do not desire to believe that the world is going well according to our goals, we want it to actually go well.

And even if most humans will end up valuing pleasure for its own sake, some of us may set different goals and neither party would be making any sort of mistake. By contrast, while one may be able to affect whether need-based desires arise at all, once they do arise, there is no choice about the issue and we cannot help but be affected by them.

Next to the preference architecture that forms our goals, we have a visceral and primitive model-free 17 motivational system that operates through cravings. This system forms our need-based motivation and often produces impulsive behavior. Pleasure does play an important role in how cravings arise, as it seems that cravings are indeed usually triggered when we think about pleasure or are confronted with stimuli associated with pleasure.

But the need-based reasons that motivate our pursuit of pleasure, moment-by-moment, are not based on intrinsic desirability of future pleasures acting at a distance, but the same process that makes up our aversion to both physical and psychological pain. According to tranquilism, cravings to get rid of pain and cravings to experience pleasure are bad for the same reason, because they represent non-acceptance of the current experience.

This perspective is supported by us being equally tempted to end cravings for pleasure by actually attaining the pleasure in question, as by just distracting us with some other kind of pleasure or even just sleep as a form of non-consciousness. For instance, if I have a craving for the state of being drunk but believe that this is not a good direction to take to accomplish my goals, I may instead engage in socializing to distract myself from my craving for alcohol.

All these acts have the same motivation: All need-based reasons for action are cravings, they all constitute suffering. Cravings are famously near-sighted. Rather than being about maximizing long-term well-being in a sophisticated manner, cravings are about immediate gratification and choosing the path of least resistance. We want to reach states of pleasure because as long as we are feeling well, nothing needs to change. However, our need-based motivational system is rigged to make us feel like things need to change and get better even when, in an absolute sense, things may be going reasonably well.

We quickly adapt to the stimuli that produce pleasure. To end this discussion with a concrete example, consider the following thought experiment. Suppose we now learn that there is an opportunity nearby for us to experience the most intense pleasure we have ever experienced.

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The catch is that in order to get there, we first have to leave the comfortable blankets and walk through the cold for a minute. Furthermore, after two hours of this pleasure, we will go back to sleep and, upon waking up again, are stipulated to have no memories left of the nightly adventure. Do we take the deal? It is possible for us to pursue this opportunity out of reflection-based motivation, if we feel as though we have a self-imposed duty to go for it, or if it simply is part of our goal to experience a lot of pleasure over our lifetime.

Murat Aydede (ed.), Pain: New Essays on its Nature and the Methodology of its Study - PhilPapers

It is also possible for us to pursue this opportunity out of need-based motivation, if we start to imagine what it might be like and develop cravings for it. Finally, it also — and here is where tranquilism seems fundamentally different from hedonism — seems not just possible, but perfectly fine and acceptable, to remain in bed content with the situation as it is. If staying in bed is a perfectly comfortable experience, the default for us will be to stay. This only changes in the case that we hold a preference for experiencing pleasure, remember or activate it and thus form a reflection-based desire, or if staying in bed starts to become less comfortable as a result of any cravings for pleasure we develop.

To conclude, an account inspired by hedonism might suggest that pleasure is intrinsically desirable, and that this either automatically makes us desire pleasure perhaps also in a reflection-based sense , or that something would have to be wrong with us if we did not desire pleasure. It seems perfectly plausible that people can upon reflection decide to not want to pursue pleasure as a central goal in their life or not want to pursue reducing suffering without thereby committing any kind of mistake. This section explains why, if one accepts tranquilism, all forms of non-consciousness should plausibly be thought of as equally valuable as craving-free experiences, say, intense pleasure or complete meditative peace of mind.


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  • Theories of the value of experiences, such as tranquilism and hedonism, face the question of the value of states that are not experiences, such as dreamless sleep or unconsciousness. Tranquilism lends support to the Epicurean position on death and non-existence. Thus it is of no concern either to the living or those who have completed their lives. For the former it is nonexistent, and the latter are themselves nonexistent. However, under the assumption of a view like tranquilism which actually seems to capture the way Epicurus was thinking about happiness and suffering very closely , 23 the Epicurean position becomes perfectly consistent.

    Given a tranquilist conception of the relative value of different experiences, there are no experiences that are good in themselves , no experiences whose absence could constitute a form of disvalue. This has interesting implications for non-experienced states of affairs, i. If something is only regarded as problematic if it is experienced as such, there lies no problem in non-consciousness.

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    While the formulation of tranquilism cf. In this section, I consider some common objections to the tranquilist account of the value of different experiences and provide my replies to them. Tranquilism is based on the position that cravings play the central role in need-based motivation. One could for instance argue that, if tranquilism says that suffering is bad for us because it corresponds to a first-person evaluation of an experience -component needing to end or change, perhaps happiness might correspond to a first-person evaluation of an experience as something to continue or intensify.

    And if cravings are pictured as an arrow of volition pointing away from the current experience, perhaps happiness could be pictured as an arrow pointing towards it, or as a loop of volition. And perhaps there is a case to be made for viewing happiness as satisfied cravings, based on which one could argue that simply distracting oneself from cravings does not produce an equally good or equally desirable result.

    To elaborate on point two, let us first consider culinary or sexual pleasures: these versions of happiness may indeed be regarded as fulfilled cravings of some kind, a point that is supported by the example of people who — for no apparent reason besides anticipation of pleasure — postpone addressing their hunger cravings during the day in order to receive extra enjoyment from dinner at a fancy restaurant. But then there are also positive feelings where it clearly seems false that they come as satisfied cravings or come with an evaluative need or desire to have the experience continue.

    Take contentment induced by sleeping pills, for instance. This experience seems to decidedly lack such a component even though many sleeping pills are dangerously addictive , illustrated by people rarely being tempted to fight falling asleep because of how well they are feeling. This suggests that many flavors of happiness, such as meditative tranquility or drug-induced contentment for instance, do not seem to vary in intensity depending on how strong our cravings were before the experience started, or how strong the cravings would be if the experience abruptly ended.

    go to site Instead, these states of contentment seem to come with a sense — not in degrees, but either on or off — that no cravings can possibly arise, that no pains can possibly affect us. Inspired by tranquilism, one could argue that what all positive experiences — all instances of happiness — have in common is that they play a functional role that prevents or protects against the formation of cravings.

    While it interesting that proponents of tranquilism seem to give different accounts of suffering and happiness than proponents of hedonism, it remains unclear to what extent this reflects different takes on introspection or different empirical predictions, or whether we are rather dealing with different interpretations of the same picture. Perhaps some versions of hedonism could agree with many or most of the descriptive points proponents of tranquilism make, but state normatively that we should regard happiness as more valuable than states of non-consciousness, and that being a little happy is much worse than being very happy.

    Such a position would further have to stipulate how pleasure is to be compared to states of contentment, especially if one assumes that the two states relate to cravings in different ways.

    Breathlessness: From Symptom to Experience

    While it would be very interesting and possibly highly illuminating to learn more about the phenomena we introspectively label as pain, pleasure, happiness and suffering, it should be noted that neuroscience by itself cannot give us any direct answers to normative questions — it can only answer empirical subquestions if they are formulated precisely enough. Neuroscientific findings can sometimes give us very strong nudges in certain directions, but there may be instances where different aspects of what is going on can be emphasized or de-emphasized by different people — in the same way people's taste or aesthetics can differ.

    This is an unusual perspective. After all, comparing the experience of eating pizza to eating potatoes, many people 24 are likely to prefer the former: Pizza gives them the more pleasurable experience, and they are more likely to develop strong cravings for pizza. Proponents of tranquilism are not denying that some experiences can give us more pleasure than others, but they would counter that this point is not always relevant. A blanket assessment on which is the more valuable eating experience is based on a comparison between the two experiences from an outside perspective, where the pleasures during both meals are being compared to one another and where we may develop cravings or reflection-based desires for one meal but not the other.

    For the experiential moments in question, there is no such outside perspective. During the meal, from a first-person point of view, the ongoing moment is all there is, and the person eating potatoes instead of pizza may not be thinking about any alternatives. Tranquilism zooms in on how each state is evaluated subjectively and directly. Assuming that one forgets everything else around and is fully absorbed in an experience, with no need for anything about it to be different, no longing for richer or different taste, it is accurate to say that the immediate, subjective evaluation of the experience is that it is flawless.

    And the fact that the experience of eating something different might score higher on a scale of pleasure intensity simply does not play a role according to this perspective — it may be true, but it is as as irrelevant to the value of an experience as e. And admittedly, goal and intelligence preservation are convergent instrumental goals for rational agents, so it makes sense to have an intuitive aversion to losses of this sort.

    The same goes for the happy pig in comparison with an ordinary human.

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    Many people, in fact, believe that animals have it better than humans because they live in the moment. How can there be no relevant difference between these experiences and mere states of contentment? Tranquilism is not a standalone moral theory committed to the claim that nothing besides suffering cravings is of moral concern.

    Again, tranquilism zooms in on an experience and omits everything else beyond it. If we only consider experiential moments in isolation, and not what they might mean to us in terms of purpose and life goals, the Tranquilist perspective becomes more intuitive. And to the extent that we want to honor what these experiences mean to us in terms of purpose and life goals, we should perhaps be talking about whether accomplishing these goals is intrinsically valuable — something that is outside the scope of this paper.

    One way in which depression can manifest itself is through complete apathy or inertia.

    Is this an example of a negative state that is nevertheless free of cravings — something that would contradict the tranquilist account?