Philosophy of Pain

Unpleasantness, Emotion, and Deviance

David Bain, Michael Brady, Jennifer Corns

• Publisher: Routledge
• Year: 2018
• ISBN:
  9781351115841
• Edition: 1
• Topic: Philosophy
• Subtopic: Philosophy History & Theory

Over recent decades, pain has received increasing attention as philosophers, psychologists, and neuroscientists try to answer deep and difficult questions about it. What is pain? What makes pain unpleasant? How is pain related to the emotions? This volume provides a rich and wide-ranging exploration of these questions and important new insights into the philosophy of pain. Divided into three clear sections – pain and motivation, pain and emotion, and deviant pain – the collection covers fundamental topics in the philosophy and psychology of pain. These include pain and sensory affect, the neuroscience of pain, pain and rationality, placebos, and pain and consciousness.

Philosophy of Pain: Unpleasantness, Emotion, and Deviance is essential reading for students and researchers in philosophy of mind, philosophy of psychology, cognitive and behavioral psychology, as well as those in health and medicine researching conceptual issues in pain.

PART I

Pain, unpleasantness, and motivation

1 Imperativism and pain intensity

Colin Klein and Manolo Martí nez

1 Introduction

Pains vary in intensity. A good philosophical theory of pain should say something about those variations. For one, variations in the intensity of pain are, from a practical standpoint, almost as important as the presence or absence of pain itself. An ibuprofen may dull but not eliminate the pain of your sore muscles. That will have consequences for how you feel, what you do, and what your pain is like.

For another, if you don’t say something about degrees of pain, your philosophical opponents will tend to assume that you can’t. We have both recently defended versions of an imperative theory of pain.¹ On such a view, pains have imperative contents that express commands to do or avoid certain actions. For example, in Martí nez’s version, the content of pain experiences is analogous to:

See to it that this bodily state does not exist!

Similarly, in Klein’s more recent formulation (2015), a pain is an imperative along the lines of:

Protect this body part (in this manner).

On both accounts, a pain is an imperative that would be satisfied if the sufferer of pain ceased to be in a particular bodily state. That bodily state is often one that is threatening to life or health. On the whole, then, pains command us to do things that will keep our bodies intact and well-functioning. Not all pains need do so—the system might misfire in a variety of ways—but the function of the pain system is to keep us healthy.

Pains work this way because of the nature of imperatives. Imperative content prescribes some action to be taken, or some goal state to be attained. Pains are not the only sensation with imperative content. The difference between pain and many other sensations can be explained in terms of the differences in the imperatives that constitute them (Hall 2008). Itches command scratching regions rather than protecting them. Hunger commands eating rather than an action directed at a particular body part. Finally, imperative modalities differ from representational modalities like vision and touch: the latter represent features of the world and have truth-apt contents, while the former command an action and so do not have truth-apt contents.²

In defending imperativism, neither of us has said much about pain intensity. Some have suggested that this is because there is nothing to be said: imperativism, for principled reasons, cannot give a story about intensity. That would appear to be a point in favor of representationalism about pain. After all, many facts about the world vary in magnitude. If pains represent something, then it is easy to see how that something might vary in magnitude, and thereby how pains themselves might have different intensities. The imperativist—who does not think that pains are in the business of tracking properties in the world—has no corresponding facts to appeal to. At least, that’s how the objection goes.

Our opponents are too pessimistic. We can give a perfectly satisfying account of imperative intensity. We’ll present the case in two steps. First, we must establish the general fact that imperatives can vary in intensity. We’ll do that in Section 2. Along the way, we will respond to several critics of the imperative theory. Second, we must give a model for variations in intensity, in which the variations are part of the content of the imperative. Imperativism is most exciting as an intentionalist theory, one in which phenomenal properties supervene on intentional contents. Failure to reduce variations in intensity to variations in content would weaken the appeal. We give such a model in Section 3 and conclude with a few brief reflections on the naturalization of imperative intensity.

2 Imperatives come in degrees

2.1 Imperative intensity

Commands come in degrees. All things being equal, shouting:

Pass the salt now!

conveys a more urgent command than does the calm:

Please pass the salt at your earliest convenience!

We will call these variations in the intensity of the imperative. Variations in imperative intensity have practical consequences. All things being equal, a more intense imperative should be more likely to make you change your plans, to perform the commanded action sooner, to weight the commanded action higher when deliberating among mutually exclusive courses of action, and so on.

More formally, we will assume that the content of an imperative can be partially identified with a set of satisfaction conditions, here modeled as a set of possible worlds W sc.³ “Pass me the salt!” is satisfied just in case you pass me the salt. So the content of the imperative is, at a first pass, the set of worlds in which you pass me the salt. A command from a source that you take to be legitimate gives you a reason to act so as to bring about the satisfaction conditions. Such commands will thus have practical consequences for your actions.

We will treat the intensity of a command as a further weighting on the set of satisfaction worlds. At its most general, then, the proposal is this: the content of an imperative includes both a set of satisfaction worlds and a degree of intensity. Intensity simply functions as a weighting across possible worlds, dividing them into better and worse, in ways to be elaborated shortly.

Intensities might be relatively vague, as in the case of the salt commands above. Or the degree may be more precisely specified, as it is in certain more formal contexts: triage classifications in emergency rooms, the rubber stamps used by enthusiastic managers to prioritize their edicts, or the priority codes on the Autovon telephone network.

The Autovon priority system is an especially nice example of what we have in mind. The Autovon network was developed during the Cold War to provide communication during a nuclear attack. An Autovon keypad had an additional column of four keys that allowed the user to specify the precedence level of the call. The dialed number and the precedence level thus ordered the network to route the call to a certain location, with a certain precedence. (Note that the priorities relate to the routing of the calls, not to the contents of the calls themselves. The White House could use Autovon to order a pizza during a nuclear war. While the call itself would trump all others, delivery wouldn’t be high on anyone’s list of priorities.) Higher precedence calls would, if necessary, kick lower precedence calls off of the trunk to ensure that a call went through. The highest level, which would guarantee that a call would go through if any could, was restricted to the White House.⁴ We will argue that imperative intensity can be generally modeled by something like the Autovon’s ranking system. Before we get there, however, we want to say a few words about what imperative intensity is not.

2.2 What intensity isn’t

That commands can vary in intensity is, we take it, obvious enough. Further, the extension to pains seems straightforward enough: pains are imperatives; like other imperatives, they can vary in intensity, and that variation has exactly the same sorts of practical consequences. A more intense pain in your foot will, all things being equal, cause you to forgo more activities in order to tend to your foot, to tend to your foot more urgently, and so forth.

There is still work left to do to ensure that intensity can be usefully modeled. Before we do it, though, it’s worth distinguishing intensity from a few things that look a lot like intensity but aren’t. Failure to do so has, we think, led to some of the objections to the imperative account.

First, the intensity of a command ought to be distinguished from the illocutionary force of an utterance of an imperative. Imperatives can be polite or nasty; they can be phrased as requests or pleas or straightforward commands. None of these are variations in intensity per se.

Failure to distinguish the two may lead to the impression that variations in intensity are not part of the content of imperatives. In a recent paper, Cutter and Tye have objected that an appeal to intensity amounts to abandoning intentionalism. Regarding the proposal that imperatives vary in intensity, they write that:

On such a proposal, the difference between [two pains] is analogous to the difference between the following two imperative sentences:

• (Please) stop that bodily disturbance.

• Stop that bodily disturbance!!!

(Cutter & Tye 2011, p. 104)

They then object that such an account is inconsistent with intentionalism because:

[N]ow the phenomenal character of an experience does not supervene on its content alone; rather it supervenes on its content together with its degree of urgency.

(Cutter & Tye 2011, p. 104)

We agree with Cutter and Tye that the two sentences above may not differ in content. The variations in the two sentences above are variations in politeness, however, not the intensity of the imperative.⁵ More generally, two imperatives may differ in illocutionary force without differing in content. The very same command may be ordered, demanded, requested, or politely suggested. Why? Because commands are individuated by their content—on our account, the satisfaction-conditions of the command, plus a weighting over worlds—while differences in illocutionary force depend on the social circumstances under which imperatives are uttered. So the very same command, expressed in varying external circumstances, might do different things without changing in content.

There is the potential for confusion, we suggest, because sometimes facts about intensity can be expressed by uttering imperatives with the right illocutionary force—rude commands tend to express high-intensity imperatives, for example, and polite ones low intensity. But note that that’s entirely compatible with intensity being part of the content of the command. Compare: I might express the relative temperature of a 110-degree day by using a variety of choice expletives. The vigorousness of my swearing might accurately convey the degree to which some external magnitude varies. Yet my claim about the temperature still depends, in an important sense, on what I have said. So too with imperatives.

Given the potential ambiguity, though, we will separate commands (a certain type of content) from orders (a type of speech act that can convey a command). Note more generally that commands might need to be distinguished from related contents like permissives, which permit but do not obligate action (Hamblin 1987).

Second, intensity ought to be distinguished from the temporal priority or urgency of the command. Some imperatives ought to be satisfied sooner than others. This temporal ordering may depend in part upon the intrinsic content of an imperative. However, priority itself seems like an extrinsic property of imperatives. That urgent bit of dusting becomes less urgent when the house is on fire; the urgent ache in your toe suddenly becomes less so when the bear appears from behind the tree. Of course, priority depends on intensity: all things being equal, a more intense imperative should also be satisfied sooner. Our account will preserve this feature. But it also depends on what else is going on, and to which other imperatives you’re subject. So while imperative priority is tightly related to intensity, it is not the same thing.⁶ Hence, while urgency is extrinsic, intensity need not be.

Third and finally, imperative intensities are features internal to imperatives. They need not track any magnitude in the world. That should not be surprising: the imperativist account, remember, says that pains are primarily spurs to action rather than states that track the world.

Adam Pautz uses this fact to object to the imperative theory. He writes:

While negative imperatives admit of degree, it is hard to see how their degrees might match up with degrees of painfulness. What in the imperative contents of [an agent’s] two consecutive pains … might determine that the second pain was roughly twice greater than the first?

(Pautz 2010, p. 364, fn. 36)⁷

We think that this is to misunderstand the imperativist position. For all we’ve said, there’s a simple answer to this question: what determines whether one pain is twice greater than another is simply that it is twice as intense. That answer will need some refinement, but in general—the fact th...

Table of contents

• Cover
• Half-Title
• Title
• Copyright
• Contents
• Contributors
• Introduction
• PART I Pain, unpleasantness, and motivation
• PART II Pain and emotion
• PART III Deviant pain
• Bibliography
• Index