I am trying to figure out what the hell is going on in pain asymbolia. I talked about this briefly a couple of time before, but I still find myself puzzled by it. Here are a list of facts about pain asymbolia.
1. Pain asymbolics have damage to a specific area of the brain but are otherwise neurologically intact.
2. They are conscious of themselves as being in pain. Evidence for this is that they report that they are in pain, are able to identify it as burning, piecing, dull, etc, correctly locate where the pain seems to be and reliably report the intensity of the pain.
3. They are conscious of the pain as painful. Evidence for this is that they report that it is painful. They say that the pinpricks hurt. This means that there is something that it is like for these people; it is like being in pain for them.
4. But despite all of this pain asymbolics are completely unmoved by the sensation of pain. They do not pull their arms back when pricked or burned, they do not become anxious when approached with pain producing stimuli. They often smile while they report that the pain hurts. They say things like “oh that hurts” while laughing!
5. Pain asymbolics have the normal concept of pain. That is, they know that pain should cause screaming and pulling back of the arm, etc. But when they actually feel the pain they are amused. This is what everyone is so worried about!!??!? seems to be their reaction. This is plausibly why they often smile or laugh when poked or pricked or pinched or burned.
So what are we to make of these facts? One way to describe what is going on here is that the pain asymbolics have exactly the same pains as I do, and they are just as painful for them as my pains are for me, but since their pains are not ‘hooked up’ in the right way to other emotional/behaviorial responses they fail to experience the pains as unpleasant. They are conscious of the pain, conscious of it as painful, but not conscious of it as unpleasant. This is most likelly due to the lack of causal connections that the pain has to other emotional and behavorial responses.
Another way of describing what is going on here is to say that the pain asymbolic has access to information about the noxius stimulus but doesn’t actually have a pain experience, by which I mean a painful quale. The have some kind of quale but it isn’t the painful one OR they are like the superblindsight patient.
Which of these is right?
Richard Brown 
My vote is for the first: what pain asymbolia teaches us is that what we call ‘pain’ is actually at least two and perhaps more coinciding experiences, including the sensory recognition of damage or harm and the aversion to that. Patients with PA not only react abnormally to pain; they usually react abnormally to any sort of threat or danger, which suggests that the problem is reactive rather than sensory.
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