This is a chapter from somewhere around the middle of

The Emotion Machine (a sequel to The Society of Mind)

Being in Pain

When we our betters see bearing our woes,
We scarcely think our miseries our foes.
Who alone suffers suffers most i'th' mind,
Leaving free things and happy shows behind;
But then the mind much sufferance doth o'erskip
When grief hath mates, and bearing fellowship.
How light and portable my pain seems now,
When that which makes me bend makes the King bow.
--(Edgar, in King Lear; 3,6)

What happens when you stub your toe? You’ve scarcely felt the impact yet, but you catch your breath and start to sweat–because you know what’s about to come. A dreadful ache will tear at your gut and sweep your other goals away, dispersed by the need to escape from that pain.

You can usually muzzle a pain for a time, by trying to think about something else. You can even make your hurting hurt less, by thinking about the pain itself. Focus your full attention on it. Evaluate its intensity. Or try to regard its qualities as interesting novelties. Such strategies work for a moment or two–but they rarely help over longer times because pain, like a sick or spoiled child, keeps on griping and complaining. You can try to ignore it, but that won’t work. Whatever diversions you attempt, that pain will tear you back again.

There's another trick you can try to use, when a certain part of your body aches. It's called a ‘counter-irritant': you can pinch yourself in some other place. Why should a second pain offset the first–rather than simply make things worse? Sometimes several pains do sum; two injured teeth hurt more than one. But perhaps, when those pains are of different kinds (or occur in suitably different locations) your mental ‘pain-machine’ can’t decide where to focus. So, if you can manage to get it confused, you may be able to gain some relief.

We all agree that it doesn’t feel good when you pinch your finger or stub your toe. "Why are we cursed," pain’s victims ask, "with such a displeasing experience?" Yet we ought to be thankful that pain evolved–because it saved our ancestors' lives –but instead of being grateful for this, people always complain about it. Here are a few of the useful ways that pain protects us from injury.

Pain forces you to quickly retreat from whatever is causing the injury.
It imposes on you an insistent goal: to terminate the painful state.
It focuses your attention on the body-part that is being harmed.
Pain makes you learn, for future times, not to repeat the same mistake.

Pain leads to cascades of other effects: It narrows all your interests. It disrupts your other plans and desires, by filling you mind with fear and distress. It makes you hold still the injured part, to help it to rest and repair itself. And as though you've regressed to childhood, pain makes you cry out and quest for help,

In the popular view, pleasure and pain are opposites–but in some of their ways, they seem almost the same.

Pleasure makes you want to approach–where pain would impel you to withdraw.
Just as with pain, you focus your mind on the part that’s engaged.
But unlike pain, pleasure wants you to expose that body-part to even more.
Instead of hoping for it to end, it wants to maintain that pleasant state.
Pleasure makes you learn, for future times, to keep repeating the same mistake.

We’ll come back to this in {Pleasure and Pain}.

'Hurting' describes a Disruption Cascade.

Whatever the cause of an ache or pain, the results are usually much the same: to ‘focus’ certain parts of your mind while disrupting much of what remains. We know a lot about how this changes us, but not much about how it accomplishes this.

To induce you to act with appropriate speed, pain tends to render you fearful and weak, while replacing most of your regular goals by that powerful wish to get rid of the pain. As these effects spread through your mind, they alter your thinking to such an extent that you seem, to your friends, to have been replaced by a different personality. To yourself, of course, you may seem the same: you seem still to possess the very same Self, with its memories and abilities. But you won’t have much chance to use that old ‘you’ until you can manage to change back again.

Normally, our minds are engaged with many different processes. Those processes sometimes cooperate, but they also often clash and conflict. This is because we never have time to do everything that we want to do–so we have to find ways to compromise. When new goals or ideas occur to us, we may have to abandon some other ambitions–or just put those new ideas aside. Most times, we don’t ‘mind’ those frustrations much, because we feel that we’re still in control, and free to make our own decisions–and if we do not like the result, we’re still ‘free’ to go back and try something else. But when an aching pain intrudes, those projects and plans get shoved aside–as though by an external force–and we’re left only with hasty and desperate schemes for finding ways to escape from the pain. Pain’s urgency helps in emergencies–but if it cannot be soon relieved, it moves on toward increasing unpleasantness.

Suffering starts after Pain turns on and seizes control of (or starts to suppress) resources that other processes need. Then some of those other processes look for alternative ways to carry on–and in doing so, they attempt to usurp resources that yet other processes need. This will lead, if the pain persists, to an ever increasing 'cascade' of frustrations, and 'system failures that disrupt large parts of how you normally think. Suffering comes when we’re robbed of choice. Whatever else you may try to do, while struggling to regain your mind, pain interrupts with its own demands and finds yet more ways to make you fail. Terms like ‘hurting’ and ‘suffering’ are evoked by other parts of your mind whose job it is to represent the effects of those shattered activities. [See ‘Appreciating Agony’.]

What machinery in the brain is responsible for this cascade that we call suffering? The answer to this is still unknown, although scientists know a good deal about the first few events that result when part of your body is injured. First, the injured cells release some chemicals that cause certain special types of nerves to send signals to the spinal cord. There, certain neural networks send more signals up to the brain, by way of various circuits that are affected by other conditions.

However, we know far less about what happens then to cause what we call ‘suffering’. There could be some clues in a rare condition called "Pain Asymbolia" in which the patient feels something like pain, but does not find that feeling unpleasant–and may even laugh in response to it. This has been found to occur after damage to certain parts of the brain, but this doesn’t seem to tell us much about what controls those great cascades, because those same location are also involved with many other functions. No brain centers have yet been found which when stimulated, causes pain. We do know that certain regions do become more active when we’re feeling pain, but Ronald Melzack and Patrick Wall, founders of one modern theory of pain, cautiously note that:

"An area within the functionally complex anterior cingulate cortex has a highly selective role in pain processing, consistent with an involvement in the characteristic emotional/motivational component (unpleasantness and urgency) of pain." [Ronald Melzack and Patrick Wall, 'Pain Mechanisms: A New Theory", Science, 150 p.975, 1965]

However, we know little about how those brain centers work and; in any case, the effects of pain are so widespread that Melzack and Wall go on to say,

"The concept [of a pain center] is pure fiction unless virtually the whole brain is considered to be the ‘pain center’ because the thalamus, the limbic system, the hypothalamus, the brain stem reticular formation, the parietal cortex, and the frontal cortex are all implicated in pain perception."

But it doesn't help us much to know which parts of the brain are involved with pain–without knowing more about what each part does, and how it affects the other ones. (Thus, we can’t explain how an athlete runs, just from knowing which muscles are used–because those same muscles are used in different ways whenever we walk, or stand, or dance.) What’s more, as Daniel Dennett says our reactions to pain are affected by all sorts of other mental conditions: [Dennett, page 206 of the important paper that he humorously entitled "Why you can’t build a machine that feels pain."]

"Real pain is bound up with the struggle to survive, with the real prospect of death, with the afflictions of our soft and fragile and warm flesh. ... There can be no denying (though many have ignored it) that our concept of pain is inextricably bound up with (which may mean something less strong than essentially connected with) our ethical intuitions, our senses of suffering, obligation, and evil."

Why does Pain Hurt?

What makes pain so disagreeable? Why does pain make us uncomfortable? When you ask questions like that, you usually get this kind of reply:

"I don’t like pain because it hurts. Nothing could be simpler than that. Hurting is just the way pain feels."

Some philosophers like to insist that we're not yet prepared to explain such things:

Before you could start to understand pain -- or any other emotion or feeling–you'd first have to solve the mind-body problem. But all our best thinkers have failed at this; none have even got to first base.

Other philosophers argue that we can’t ever expect to know such things.

Subjective feeling like hurting and pain are things that science can never explain, because they are ‘irreducible’. Science can only account for things in terms of other, simpler things. But any such process must come to an end when it comes to the things that are simplest of all–so that nothing remains to reduce them to. This is the case for feelings like pain–which aren’t made of simpler parts but, like atoms, are simply present or not.

The idea that atoms were ‘indivisible’ was useful in the early years of the science of Physical Chemistry. It led to discovering 'basic laws'–about (among other things) mass and charge–which enabled us to discover more about the nature of molecules. By analogy then, one might also insist that psychology, too, should seek to find features that can't be 'reduced' to other simpler things. However, it is always risky to assume that something is irreducible. When later experiments came to reveal that atoms themselves have smaller par, this soon led to new sets of ‘basic laws' which helped to explain more about mass and charge, and told us much more about molecules.

I see no reason to suspect that feelings are simple or basic at all. On the contrary, I’ll argue that most of the things that seem ‘basic’ to us–such as feelings, emotions, and consciousness–are actually extremely complex. What’s more, knowing this should encourage us–because it means that they can be understood, if we’re stubborn enough to keep working at it. That expression "irreducible’ is just a discouraged equivalent to "I have decided to no longer think about it." I won’t adopt that policy and we’ll more about this in {Feelings}.

The Relations of Mental and Physical 'Pain'

Critic: "Aren’t you taking too narrow a view? Physical pain is only one kind–and perhaps not so important as those psychical pains, which come to rule so many lives, and even drive some to suicide. How does your theory begin to explain all those other kinds of agonies that come, for example, from loneliness, disloyalty or betrayal, rejection, humiliation and shame, and failure in general? All those forms of suffering are in the end, very much the same. Shouldn't a good theory explain them all–considering how similar they are? When we recognize that we are ‘hurting’, we’re funneling together many different kinds of recognitions–for example:

The pain of losing a long term companion.
The pain of watching the pain of others.
The pain of sleep deprivation
The pain of humiliation and perceived failure.
The pain of excessive and prolonged stress.

Are mental and physical pains the same? No, because they don’t feel quite the same–but yes, because they have so much in common–at less ‘sensory’ but more 'functional’ levels. They have similar, larger, more prolonged effects on what happens to the rest of your mind, and thus can lead to some same results. What does it mean, for example, when someone says (about a purely social encounter), "It felt like something tearing my gut." Sometimes when we say things like "X is like Y" this sometimes means that X and Y appear to have similar properties. . However, when we look more closely at ‘appear’ we see that there may be another level: it could mean, instead, that "X and Y have similar effects on other parts of my mind." I’ll argue in {B-brains} that in this sense "It felt like something tearing my gut" could be seen as abbreviation for something more like, "That social encounter aroused more or less the same set of recognizers that fire up when I have a bellyache." In other words, certain parts of your brain have recognized similar patterns of activity in other parts in the brain–and you end up using the same words for them.

However, when you try to say more, you find that the finer details of your mental states seem virtually indescribable. This is because, of course, that our ‘awareness’ just doesn’t provide those details. The trouble is that it is easy for certain parts of our brains to recognize some large-scale effects of various states, but it would be much harder for them also to discern the inner ‘architectures’ of those states. There’s a big difference between recognizing and explaining: to recognize something, it may be enough just to notice the presence of certain features. To explain, however, you need to go deeper into the processes that produced those features. However, this need not interfere with everyday social communication. One can often resort to ‘empathy’–by giving out clues about features that can enable another other person to recognize similar states of mind–and thus have a sense of what you feel ‘like’.

Why is hurting so hard to describe?

"As he thought of it, a sharp pang of pain struck through him like a knife and made each delicate fiber of his nature quiver. His eyes deepened into amethyst, and across them came a mist of tears. He felt as if a hand of ice had been laid upon his heart." --Oscar Wilde [in The Picture of Dorian Grey]

We have many words for types of pain–like stinging, throbbing, piercing, shooting, gnawing, burning, aching, and so on. Of course, words never capture the actual thing–so Wilde had to use analogies. As ‘like a knife’ or ‘a hand of ice’–those are things we all can feel. So, though Wilde can’t say how hurting feels, he still can describe what hurting is like, and how people look when they’re suffering. Dorian Grey felt no physical pain, but was terrified about growing old–which meant hideous, wrinkled, and worst of all, having his hair lose its beautiful gold.

What makes hurting so hard to describe? Is this because such feelings are fundamental–so basic, primitive, and essential–that there’s nothing more to be said about them? No, it's precisely the opposite; feelings are simply not simple at all; they’re immensely intricate processes. They flood with so many things to say that we can only use words to summarize them, in terms of those clumsy analogies–because we can’t describe what feelings are; we only can say what they are like. Until we learn more about how they work and what they do, feelings will still seem mysterious.

Q: Still, even if that idea were right–that what we call feelings are highly complex–then what makes them seem so simple to us?

That’s because it’s so hard to describe them–which in turn is because we’ve all grown up without good models of our minds–without any knowledge about their parts, or about how those parts are organized. Furthermore, there’s nothing inside us to tell us more about those structures. So, naturally, when you try to describe the states and processes in your mind, you find that you’re stuck with no place to start. In such a fix, there’s nothing to do–except to use words as diverting tricks.

One way to describe our feelings with words, is to think of them as though they were ‘things’–as objects rather than processes. This makes us inclined to describe them in terms of features, attributes, and qualities. You might describe hurting as like a balloon that dilates in your mind until there's no more room. Or you might think of your mind as squeezed from outside. But ‘hurting’ is not a ‘thing’ that you ‘feel’–like touching an object that’s soft or hard. Instead, it’s a different way to think: one in which your misery stems from your new deficiency of ‘freedom of choice.’ Suddenly, your usual thoughts become utterly futile; there’s no point to using your usual ways to reason, analyze, and reflect, because none of these will do any good.

Critic: I didn’t interrupt before, but I sometimes can’t tell what you’re talking about. I know that you don’t like to make definitions, but lately you seem to be making distinctions with words like pain, hurt, suffer, and misery–which some people use interchangeably.

Sometime those words seem synonymous. Yet other times we can clearly distinguish different kinds of phenomena. For example, after you take an opiate drug, you’re sometimes still able to ‘feel’ the pain, yet now you don’t seem to ‘mind it’ (just as with pain asymbolia). Then we find ourselves saying things, like "I still feel the pain but it no longer hurts"–so now ‘pain’ and hurt’ are not synonyms any more. In the next few sections, I’ll try to use "pain" for the sensations that come shortly after an injury. I’ll use "hurting" for the cascade of unpleasant effects that come soon thereafter, and I’ll use "suffering" for what happens when certain parts of our minds describe what has happened in those other parts.

However, it won’t really help much just to try to use those old words more carefully. Our real problem is that we don’t even have a clear idea of the "architecture" of those processes. So whichever words we use, we still better ideas about how and why pain sometimes leads to the great changes in how we think that we describe as ‘suffering’–and why others seem to know what we mean when we talk about such things. Only once we have some theories about what’s involved in this–theories that are also confirmed by experiments–only then will it be time to assign some better, new words to them. Our next few sections will try to describe in more detail how the phenomenon we call ‘suffering’ might result from that great disruption cascade.

Q: Well, even if your theory is right about how that cascade of processes works, still, why doesn't all that machinery work, without it making us feel so uncomfortable? How can you explain that one most basic thing, which is why we have feelings at all?

We’ll discuss this in {The Zombie Machine}–where we’ll see why feelings are not mere ‘accessories’.


From Pain to Suffering

"The restless, busy nature of the world, this, I declare, is at the root of pain. Attain that composure of mind which is resting in the peace of immortality. Self is but a heap of composite qualities, and its world is empty like a fantasy." –Buddha [His Life and Teachings]

Yesterday Joan tripped on a step. She didn't suspect that she’d injured herself–but today she has just became aware of a terrible pain in her knee. She's been working on an important report and tomorrow she plans to deliver it. "But if this keeps up," she hears herself think, "I won't be able to take that trip." She tries to make herself get back to work, but shortly she moans and drops her pen. "I really have to get rid of this." She gets up to visit her medicine shelf, to find a pill that could bring some help, but a stab of pain makes her sit back down, and instructs her not to use that leg. She clutches her knee, catches her breath, and tries to think about what to do next–but the pain fills up her mind so much that she can't seem to focus on anything else.

How does Pain Focus Attention?

How does Joan know where her pain is located? That’s easy to do for a place on the skin–because we each possess ‘maps’ of our surfaces, in several different parts of the brain, which tell us different things about where each external sensation "is". There are several of these in the cerebral cortex, and yet more of them in the cerebellum; they look like tiny, flattened-out people.

We’re worse at locating interior pains, because we have no good maps of our insides. Perhaps such maps did not evolve because we wouldn’t have had much use for them: to shield an injured intestine or spleen, one must guard the entire abdomen–so all one actually needs to know is that one has a bellyache. [Similarly, one may find it hard to distinguish an earache from a headache–but in either case, you'll hold your head still.] The brain itself has no sense of pain; it never hurts when you pinch it or tear it. To be sure, that might affect how you think, but you'd never say, "There's a pain in my brain," because you have no spatial sense about the locations of mental events.

Joan cannot keep from paying attention to the body-part that’s being harmed. But what does 'paying attention' mean? That concept is so familiar to us that we almost always take it for granted. We think of ‘attention’ as concentration–or alertness, or focus, or mindfulness–and we all think of these as positive terms. But actually, those words are names for perhaps our most grave limitation: You're always 'involved’ with one thing or another, or sometimes several at a time, but you never can turn your attention to everything else that is happening. We’ll discuss this more in {The Parallel Paradox}.

What is attention and how does it work? What selects or constrains what you focus on? In our everyday psychology, we tell ourselves stories about such things. Sometimes you think of the things ‘on your mind’ as though they were characters in a play; then ‘attention’ might seem to resemble a beam that lights up just certain parts of that stage. We'll focus more closely on this idea in the section called {Cartesian Pain}.

For Joan's pain to be useful to her, it must make her inclined to do something about it. First, it must focus her thoughts on that knee–but that, alone, would not be enough; it must also postpone her other plans, and obstruct her desires for all other pleasures. "Get rid of Me," Joan’s pain demands, "and get your mind back to its Normal State." Her pain has imposed an imperative goal–and until she can manage to satisfy it, she won’t be able to write that report, or plan that trip to deliver it.

This raises many important questions. What does it mean to ‘have a goal'? How do goals work, and how do we make them? What are their structural representations? How are they stored, and later retrieved? How many goals can a person pursue, and how do we know what to do to achieve them? We’ll attend to these questions in the section on {Goals}. What makes some goals seem more urgent than others? We'll discuss this in {Central Processes.}.

The Cascade of Suffering

To love is to suffer. To avoid suffering one must not love. But then one suffers from not loving. Therefore, to love is to suffer; not to love is to suffer; to suffer is to suffer. To be happy is to love. To be happy, then, is to suffer, but suffering makes one unhappy. Therefore, to be happy one must love or love to suffer or suffer from too much happiness. –Sonja, in Woody Allen’s "Love and Death."

What do we mean by ‘suffering’? I suspect that we tend to use this word when we try to describe what happens when pain starts to interfere with our other mental processes. Then, when those try to persevere, we get overwhelmed by a great cascade.

With each disturbance of Joan’s resources, her processes look for alternatives. But that will undermine other procedures, which in turn will attempt to seize other resources. Normally this spreading would stop–but so long as the pain refuses to leave, the quality of the victim’s thought may continue to deteriorate. Then goals that seemed easy in normal times become increasingly hard to achieve. It becomes harder and harder to concentrate–except on the pain and the trouble it’s caused– and the prospects of failure keep looming more large. [Pain interferes with our positive feelings, and our representations of situations get clouded with pessimistic projections. "My rivals will think the worse of me." "I’ll default on responsibilities." I’ll fail to help the ones I love."]

'Suffering', 'anguish', and 'torment' are among the words that come to mind when our other systems recognize this disabling sequence of retrogressions. Here are a few of the many complaints that come with that cascade of suffering:

Frustration at not achieving goals.
Annoyance at losing mobility.
Vexation at not being able to think.
Dread of becoming disabled and helpless.
Shame of becoming a burden to friends.
Remorse at dishonoring obligations.
Dismay about the prospect of failure.
Chagrin at being considered abnormal.
Resenting the loss of opportunities.
Fears about future survival and death.

Critic: I agree that these all come with suffering. But that doesn’t explain what suffering is. Yes, shame, resentment, remorse, and fear–all are involved with reactions to pain. But ‘to suffer’–well, isn’t that something else, some very special kind of sensation?

Suffering isn’t that simple sensation that comes when you pinch or prick your skin. It isn’t a clear-cut event at all, but more like a throng of malfunctioning processes in which various agencies struggle to function while being deprived of required resources. To be sure, this cascade may be started by pain, but then in involves much more than that because as it turns your mind into a mess, this is detected by yet other systems. These then try to describe their own distress and start to transmit their own requests–and thus contribute even more to that growing cascade of disruption. "Suffer" is one of our names for this flood of failure, resentment, distress, and distraction that steals your mind away from you, and from everything else that you wanted to do.

While suffering, you continue to think, but not in your normal, competent way. Once torn away from your regular thoughts, you’re left to reflect on your state of impairment. But usually that doesn’t help; awareness of your dismal condition only tends to make things worse. Pain, in effect, deprives you of freedom, by taking away your control of attention.

Neurologist: I like your ideas about that cascade, but you haven’t presented much evidence. How could you show that these guesses are right?

It would be hard to prove them correct today, but easier in future years, when our scanners improve to show more details about what happens inside our brains. Then, perhaps we'll actually see those cascades.

Holistic Thinker: Well I don't believe a word of this stuff. I’m certainly not just some porridge of processes. When you talk about parts, you keep missing the whole–of how suffering reaches right into the soul.

Overriding Pain

Some of pain's effects are so quick that they’re done before you’ve had ‘time to think’. If Joan had happened to touch something hot, she might have jerked her arm away before she even noticed it. But when a pain comes from inside, it follows you wherever you go, and your reflexes offer you no escape. In such a case, Joan needs a plan. To solve her problem she needs good ideas. But thinking is hard when pain ‘takes charge’ and deprives you of mental resources you need. Persistent pain can distract us so much that it thwarts all attempts to escape from it. Then we’re trapped in a terrible circle. When pain gets too good at its principal job–of focusing you on your injury–you may need some way to override pain, to regain control of the rest of your mind.

Now if Joan wants enough to cross that room, she can probably do it ‘in spite of the pain’–at the risk of further injury. Competitive athletes like runners and wrestlers learn to keep going in spite of pain. Professional boxers and football players are trained to take blows that may damage their brains. [Arm-wrestling story here?] Then, how do we override pain’s effects? Everyone knows some makeshift ways. We see some of these as commendable, while others are seen as execrable. Your view may depend on which culture you’re in.

"About that time, G. Gordon Liddy began a new exercise in will power. He would burn his left arm with cigarettes, then matches and candles to train himself to overcome pain, because "something had to be done to arrest the tide of national disorder and weakness." Years later, Liddy assured Sherry Stevens that he would never be forced to disclose anything he did not choose to reveal. He asked her to hold out a lit lighter. Liddy put his hand in the flame and held it there until the smell of burning flesh caused Stevens to pull the flame away." –Larry Taylor [in "G. Gordon Liddy, Agent from CREEP]

Usually when you attend to a pain, that makes the pain seem more intense–and this in turn intensifies your goal of getting rid of it. However, as Daniel Dennett notes, a person can focus on the pain in a different, peculiarly detached way:

"If you can make yourself study your pains (even quite intense pains) you will find, as it were, no room left to mind them: (they stop hurting). However studying a pain (e.g., a headache) gets boring pretty fast, and as soon as you stop studying them, they come back and hurt, which, oddly enough, is sometimes less boring than being bored by them and so, to some degree, preferable." [in "Why a Machine Can’t feel Pain, page 206?]

If you can deeply involve yourself with other distracting activities, then a pain may seem to feel less intense. We all have heard those anecdotes about wounded soldiers who continue to fight without noticing pain–and only later succumb to shock, after the battle is lost or won. So the goal to survive, or to save one's friends, may be able to override everything else. On a smaller scale, with a mild pain, you can just be too busy to notice it. Then, in some sense, the pain is still there but it doesn’t seem to bother you much. Similarly, you may not notice that you’ve become sleepy until you perceive that you’re starting to yawn–and your friends may have noticed this long before. (In my case, I first sense grammatical errors,) We'll return to awareness in {Consciousness-2}

Dennett argues that "a crucial part of the problem of pain is that we have a baffling variety of such untutored, unstudied accounts of pain phenomena," and he concludes that

"Whatever the ‘correct’ philosophical analysis is of the variety of first person pain reports, it must have room for the fact that focusing attention can obtain relief."

Aaron Sloman, too, observes how other processes in our minds can alter how we’re affected by pain:

"Some mental states involve dispositions, which, in particular contexts would be manifested in behavior, and if the relevant behavior does not occur then an explanation is needed (like the person who is in pain not wincing or showing the pain or taking steps to reduce it). The explanation may be that he has recently joined some stoic-based religious cult, or that he wants to impress his girl friend, etc." [Posted to the Internet newsgroup, 20 Jul 1996, by Aaron Sloman,]

This also applies to the treatment of pain-ridden people.

"The degree of awareness of one's own pain may vary from a near denial of its presence to an almost total preoccupation with it, and the reasons for attending to pain may vary. Pain itself may become the focus of the self and self-identity, or may, however uncomfortable, be viewed as tangential to personhood. One of the most powerful influences on the way in which symptoms are perceived and the amount of attention paid to them is the meaning attributed to those symptoms." –[Osterweis, M., Kleinman, A., and Mechanic, D. Pain and disability: Clinical, Behavioral, and Public Policy Perspectives. National Academy Press, Washington, DC, 1987]

Prolonged and Chronic Suffering

When an injured joint becomes swollen and sore, and the slightest touch causes fiery pain, it's no accident that we say it's 'inflamed'. What could be the value of this, once the damage is already done? Well, it makes you learn to protect that site; thus helping that injury to heal. But Joan’s sore knee kept getting worse until it hurt her all the time, whether it was touched or not–and one wonders what could be the value of that? One could argue that persistent pain helps to make you feel sick and thus slows you down. But it’s hard to defend the dreadful effects of those chronic pains that never end.

Some people view their suffering as related to their moral worth. They find themselves asking questions like, "What did I do to deserve this?" Then if those victims are lucky enough to find answers that justify punishment, it may bring some relief to be able to say, "Now I can see why it serves me right!" But other victims find no such escape, and find that everything’s gone from their life. Yet others find ways to see suffering as occasions to show what they can accomplish, or even as a gift that can help them to cleanse or renew their characters. Here is a fragment of how F. M. Lewis described these positive attitudes:

"Becoming an invalid can be a blow to a person's self-esteem. However, for some patients, the sick role is seen as an elevation in status–deserving the nurturance and concern of others. The ability to assign meaning to an illness or to symptoms has been found to enhance some patients' sense of self-mastery over a problem or crisis." [F.M. Lewis, "Experienced personal control and quality of life in late stage cancer patients. Nursing Research, 31(2) 113-119, 1982]

Thus some people manage to adapt to conditions of chronic intractable pain. They work out new ways to make themselves think, rebuild their lives around those techniques, and adjust to their disabilities. Hear Oscar Wilde describe how he deals with his inescapable suffering:

"Morality does not help me. I am one of those who are made for exceptions, not for laws. Religion does not help me. The faith that others give to what is unseen, I give to what one can touch, and look at. Reason does not help me. It tells me that the laws under which I am convicted, and the system under which I have suffered are wrong and unjust. But, somehow, I have got to make both of these things just and right to me. I have got to make everything that has happened to me good for me. The plank bed, the loathsome food, the hard ropes, the harsh orders, the dreadful dress that makes sorrow grotesque to look at, the I silence, the solitude, the shame--each and all of these things I had to transform into a spiritual experience. There is not a single degradation of the body which I must not try and make into a spiritualizing of the soul." [extracted b Frederic Rzewski from Oscar Wilde's letter to Lord Alfred Douglas, written during the author's imprisonment in Reading.]

In recent years, research on pain relief has progressed so that now we have more advanced techniques–first for assessing degrees of pain and then for successfully treating it. It is only now being recognized that some very young children are also in pain, and we can expect that with more research we’ll also learn how to rehabilitate those people, too.

Still, many never find relief–either by mental or medical means–and their miseries never cease. True, we have drugs that sometimes can suppress some of pain’s most cruel effects. But it’s fair to complain that, in this domain, evolution has not done well for us. This problem frustrates theologians: How to justify a universe in which people are made to suffer so much? What functions could such suffering serve? Why could we not have evolved a scheme that is less disposed to destroy us?

One answer might be that chronic pain did not evolve by adaptive selection, but simply arose as a 'programming bug’ of the sort that we mentioned in {Adult Emotions}–that is, as one of those troubles that always "turn up" whenever you try to improve old programs. Our ancestral ways to react to pain have not been debugged to work so well with the reflective thoughts and farsighted plans that evolved in our latest models of brains. However, we’ll propose a more technical answer in {Zombie Machines}, where we’ll argue that the precursors of what we call ‘suffering’ may have had to evolve because those were the simplest way to maintain a high priority on abating pain. It was only later, when we became smarter, that disadvantages came to the surface. Evolution never had any sense of what was likely to come next–so it didn't prepare for intelligence.

Creationist: So your theory of why those systems prolong our anguish beyond any apparent purpose amounts to saying nothing more than "that’s just the way things turned out to be." That’s the folly of a typical scientist’s matter-drenched philosophy. Your hubris closes your eyes to the fact that everything has a Purpose.


I cannot weep, for all my body's moisture
Scarce serves to quench my furnace-burning heart;
Nor can my tongue unload my heart's great burden,
For self-same wind that I should speak withal
Is kindling coals that fires all my breast,
And burns me up with flames that tears would quench.
To weep is to make less the depth of grief.
Tears then for babes; blows and revenge for me!
Richard, I bear thy name; I'll venge thy death,
Or die renowned by attempting it. Richard, in King Henry the Sixth, Part III

Grief resembles chronic pain. When you suffer the loss of a long-time friend, it feels like losing a part of yourself. Indeed, this is more than a metaphor, because grief must involve our reactions to losing the use of some mental resources! Consider those parts of your intellect, which have over time become specialized for sharing ideas with some person you love. But now, the signals those brain-parts transmit will never again receive any replies–just as would happen with losing a limb. This could be why it takes so long to put to rest the loss of a friend.

Gloucester: Be patient, gentle Nell; forget this grief.
Duchess: Ah, Gloucester, teach me to forget myself!
Henry the Sixth part II

Nell can’t comply with Gloucester’s advice. She has no way to simply ‘forget’, for those records are stored in no single place. The links of affection are too broadly dispersed for any resource to erase all at once. Besides, you may not wish to lose what still remains, as Aristotle says in Rhetoric, and this can make our mournful feelings mixed:

There is grief, indeed, at his loss, but pleasure in remembering him and, as it were, seeing him before us in his deeds and in his life. –Rhetoric, Book I

So Constance can say, in the play King John,

Grief fills the room up of my absent child,
Lies in his bed, walks up and down with me,
Puts on his pretty looks, repeats his words,
Remembers me of all his gracious parts,
Stuffs out his vacant garments with his form;
Then have I reason to be fond of grief.

Thus Shakespeare shows how people clutch their griefs, and squeeze them till they change to joyful shapes.