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In some recent studying, I tried looked into different definitions of pain.

I stumbled across this illuminating paper (full pdf is free). it is really worth the read, i found... In the paper, Cohen et al define pain as

"A mutually recognizable somatic experience that reflects a person’s apprehension of threat to their bodily or existential integrity." (2018)

It also discusses limitations to the much-used IASP definition of pain from 1979:

 "An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage"

The critique is that this definition has problems like:

1) priviledging the outside observer of pain because objectivity is required
2) compulsory linking of pain with "tissue damage" (which can disenfranchise people experiencing chronic pain with tissue damage)
3) "described" priviledges verbal communication, whereas most communication (in general and around pain) occurs non-verbally.
4) even though it seems to emancipate us from body-mind dualism, the Note of Usage talks about pain arising for "psychological" reasons which can perpetuate the erroneus belief that pain is either "real" (in the body) or "imagined" (in the mind).

Would do you guys think about the problem of defining pain? Any thoughts on the Cohen-article?

Ps attached the pdf.


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  • 3 weeks later...

I read the article quickly - so not in full detail. It is written by professionals, for whom the topic is obviously important. But my question is WHY? I get the impression is that this detailed analysis of the definition of pain, is a substitute for what they REALLY want to do, which is to find the biological mechanisms underlying the different types of pain. They hope that subdividing the idea of pain will be a guide to finding the different mechanisms. In this, they are being met from the opposite direction by the medics, and clinical and basic scientists working on the underlying mechanisms of pain. My view, is that in the end it is the latter approach that will provide the anwers that the writers of this document are seeking. But there is clearly still a long way to go in this.

If anyone is interested in the mechanisms of chronic, central or centralised pain, and the distinction from tissue-damage pain, I recommend Youtube videos by Daniel J Clauw, who produces annual update videos on chronic pain - e.g. this one (https://www.youtube.com/watch?v=lW8tdfbtj70) - in spite of sound problems in the firs several minutes (you have to read the text instead). He has lots of other videos too.


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