Pain Asymbolia and Higher-Order Theories of Consciousness

I was reading this NDPR review of  Feeling Pain and Being in Pain (reviewed by Murat Ayede, who wrote the pain entry at SEP). It is a nice review and actually convinced me to buy the book. This is mostly because it reminded me of something I had heard about a long time ago but forgotton. That is a condition called pain asymbolia where a patient is able to report that they are in pain, even saying what kind of pain it is (i.e. burning vs. piercing, etc) and yet they do not find it to be unpleasent, nor are they extremely motivated to have it stop. In fact they are completely indifferent to it. Some even laugh or giggle when they are exposed to pain-inducing stimuli (like being pricked with a needle or shocked)!

I started to think about this condition from the point of view of the higher-order theory of consciousness, as I tend to do. On Rosenthal’s version of the higher-order theory a conscious pain is a pain that I am conscious of having. Pain states are first-order representational states that represent some property in the world in virtue of having a distinctive sensory quality, just like all sensory mental states. The words for the sensory qualities (e.g. ‘red’ ‘green’ ‘hot’ ‘cold’ ‘burning’ ‘shooting’, etc) have their extensions fixed via the conscious occurences of the the states. We use this as a way to single out some set of states for further examination, so there is a role for introspection to play. But then we investigate these states using the third-person tools of science and we learn things about them that might be suprising to the ordinary person. One of these is that they can occur unconsciously. They occur even though the subject denies that they occur. So, in the priming studies I talked about earlier, people deny that they see anything, but none the less we cans how that they did see it and that it has an effect that is predicable and noticable. This confirms a prediction that higher-order theories make and so counts as empirical evidence in support of these kinds of theories.

But what then does it mean to have a sensory quality on Rosenthal’s account? As I have shown before this is where Rosenthal invokes his homomorphism theory. A state represents red if it has a properety which is homomorphic to the property that physical objects have in virtue of which they cause that kind of experience in us. The physical color properties form a family of properties that vary from each other in sytematic ways. So physical red is more similar to physical pink than it is to physical green, etc. ‘physical red’ etc pick out some physical property (probably wavelength of light reflected, or something). The mental color properties form a family that preserves the homomorphisms found between the physical color properties. So, the property that is the mental representation of red (the red sensory quality) is a physical property that is more like mental pink than it is to mental blue, etc. These mental properties have the function of making the organism conscious of the physical color properties.

But all of these states can occur unconsciously. When they do there is nothing that it is like for the organism to have those states. So, a creature who is is a mental state with a red sensroy quality will be conscious of the physical color property. It will respond in all the normal ways it has in its reprotaire vis a vis the physical property of red. When the creature is in addition conscious of itself as being in that state (i.e. the state with the red sensory quality, i.e. the state with the property that is more like mental pink than mental blue, etc) it will then be like seeing red for the creature.

The same story is told in the case of pain. There is a family of physical properties which we have homomorphic mental qualities that represent them. The physical properties are bodily conditions. So, the mental sensory quality ‘stabbing pain’ is homomorphic to the physical damage prduced by stabbing injuries. ‘Burning pain’ homomorphic to tissue damage produced by burning damage, etc.  So a mental state has a painful sensory quality if it is a mental state that has a proprty that is more like sharp stabbing pain than it is like dull throbbing pain, etc. These states can occur unconsciously and when they do they are bad for the organism. They have all of their regular causes and effects. So, an unconscious pain will produce wincing and shrieks and crys and will interupt concentration and etc. All the while though, there will be nothing that it is like for the creature that has this pain. It will not feel painful to the creature, even though it is acting like it is in pain. When the creature becomes conscious of the mental state with the painful quality it will then become painful for the creature.

At first glance it might seem like pain asymbolia is a counter-example to an account like Rosenthal’s (in fact I think the author of the book and Ayede agree on this, though neither mentions higher-order theories explicitly, or at least Ayede doesn’t…I will have to wait to get the book to find out about the author (whose name escapes me right now). The reason is as follows. The subjects with pain asymbolia report that they are in pain and can indentify the particular sensory quality that the pain has. This is good evidence that the pain is a conscious pain. This means, according to what we have been saying so far, that they must be conscious of themselves as being in a state that is more like pinching than it is like breaking, etc. They have he requisite higher-order thought (ex hypothesi) but lack the painful what it’s like for them to have the conscious pain.

But this is too quick. In the first place it is not the case that the subjects report that there is nothing that it is like for them to have the conscious pain. It is, presumably, like something for them to percieve the bodily damage, no? It is presuambly like being stuck with a needle, but not in a a bad way for these subjects. Now there is no mystery as to why this happens to these people. They have a specific type of brain damage and so are clearly lacking a certain kind of information. So Rosenthal can say that the subject is conscious of the first-order pain state as a state that is more like piercing than burning, etc, but not conscious of it in respect of its negative affect.

But now notice that he can no longer have his objection to my argument that beliefs must be qualitative as well…or so I’ll argue in the next post….I have to go and wash some dishes 😦

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8 thoughts on “Pain Asymbolia and Higher-Order Theories of Consciousness

  1. So I have worked with such an individual in a group home setting, and of course when I first encountered this young lady I was horrified to see that when she was in pain or subjecting herself to painful and unpleasant situations that she more or less was bent over laughing in near hysterics. I was informed that it was due to her inappropriate response to pain. I recently spoke to a psychologist at work who informed me that there was some neurological damage that contributed to this behaviour. I thought that this was a condition that was only limited to people with developmentally disabled individuals. I see that this was an error on my part. So professor I thinK that maybe that philosophers such as yourself and others will see that there is functionality in all aspects of sense experiences whether you can decipher it or not in your lifetime. If a child could not tell that the stove was hot and thereby be a detriment, then it would perhaps disgard its mother’s warning and continue to be injured. I find this to be interesting because it shows that there is a reason and functionality for all senses.

  2. You are absolutly right Chrissy, there is a functionality for pain. It is actually extremely important. People born with an insensitivity to pain often do not live past their 20’s.But that is different than pain asymbolia where the patient says they are in pain but doesn’t seem to care about it. That makes it seem like there are two aspects to pain 1. a sensory aspect and 2. a painful aspect…so these people have the pain but do not experience it AS a warning…

  3. I thought of you when I got in an argument with someone who said that (conscious) pain was not an intentional state. I just wrote about it here.

    I am starting to like the HOR view more even though your terminology still drives me nuts (analyzing consciousness of X by saying it involves being conscious of a representation of X).

    We’ve missed you over at philbrains…

  4. Hey Eric, thanks for the comment and the sentiment!

    I am glad to hear that you are turning to the Darkside 🙂 Though that is not exactly what we say…consciousness of x is just sensing x (so to be conscious of red is just to [….fill in what we know about visual processing…]. That itself can occur consciously or not. So a sensing of red that is itself conscious is analyzed in terms of my being conscious of the representaion…but if you mean by ‘consciousness of x’ “conscious experience of x” then yeah…but hey don’t blame us for this!!! This is the way that the language has been used since the 1500’s…it’s a mess!!!

    I’m gonna check out your post over at brains…

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