Klein, Colin - An Imperative Theory of Pain

03/07/2008

Journal of Philosophy, Oct 2007

Author begins with discussing the problems with pain for intentionalism, which is the theory that the mental qualities of a thought are exhausted by its intentional content. The problem with pain is that its representational content seems to be a small part of the qualitative aspect of pain that we feel. Thus there have been theories that take pains as primitive, or those that take them as jointly (representational) intentional and also primitive. Author proposes that pains are intentional, just that the content is an imperative, not a representation.

There are some good examples of imperative sensations, or sensations with imperative content, for instance hunger, sleepiness, itching. These are usually positive-- that is, requiring that the subject do something. They also don't particularly represent the world a certain way, author claims. (pg519) Author puts forth pains as imperatives in the negative sense-- to avoid doing the thing that causes pain. He makes two 'notes': the first is that common locutions say that there are pains in places. Instead, it would be more apt to say there are pains when one does things. Secondly, pains are usually received when 'moving in the world', not being 'static and idle'. (pg521-2). Author's last claim is that the imperative account is all 'there is to say about pain'. (pg522)

Author then discusses two objections to the imperative account of pain.
Objection 1: Pain is a report of tissue damage in the body. Author calls this a myth and points out that the imperative account gives indirect evidence for tissue damage, and that is all that is necessary. Author has 3 replies:
1) Pain often comes without tissue damage (pg523)
2) Pain often is unreliable when reporting tissue damage (pg524)
3) Pain as information would fail as a protective mechanism (pg525-6) This is because information can be used and interpreted in all varieties of ways, while pain needs to be a command against all sorts of actions.

Objection 2: Morphine Pain
There are many cases of people reporting feeling pain but also 'not minding it', or quite content with it. This threatens the imperative theory because if you don't feel the imperative, you shouldn't feel the pain. Author points out that such patients are unmotivated by any imperative, not just those of pain. (pg529) Author draws a distinction:
Primary affect of pain: immediate unpleasantness of pain
Secondary affect of pain: emotional responses evoked by pain, like anxiety, concern, etc.
Author proposes that morphine eliminates the secondary affect, but not the primary, and that both have different imperatives. The secondary is more complex, while the primary is usually just avoidance of the kinds of things that cause the pain. The prediction is that morphine patients, then, would avoid those kinds of things but without the usually care and concern. Author claims that this is confirmed in observation. (pg 529-30)

Author concludes by discussing open areas of discussion: general pain not associated with action: headache, menstrual pain, etc. Also the qualitative differences in pains: sharp, dull, shooting. Another open area is psychological and emotional pain. Another is attention and pain-- the relationship and powers they have over each other.