Translating Pain

Our friend Seamus Barker sent us this post on his recent presentation at an international conference:

Translating Pain: Translating Between Science and the Humanities

Translating-Pain1.jpg

Last week I had the pleasure of presenting at a conference at Monash University in Australia, convened in partnership with Warwick University in the UK, entitled Translating Pain: an International Forum on Text, Language and Suffering.

One of the central questions asked by the conference was whether pain, suffering and trauma can be represented as such – in the historical record, linguistically, or by other means of expression, or whether rather these experiences cannot be adequately later rendered into a communicable form. This question has been widely addressed, and so this conference framed it afresh by using the theme of “translation” to further complexify the issue of pain and its representation (for the fascinating range of papers that responded to these questions, see the conference’s program).

My paper, entitled Pain: Always Already a Translation sought to perform its own act of translation – between the discourses of Clinical Neuroscience and Hermeneutical Phenomenology (which comes out of European, or “Continental,” Philosophy).

Clinical Neuroscientist and Physiotherapist (and one of my PhD supervisors) Lorimer Moseley, and David Butler state that the conditions necessary and sufficient for pain are such that:

“We will experience pain when our credible evidence of danger related to our body is greater than our credible evidence of safety related to our body”.

Moseley points out that in making this appraisal, the brain draws on all available information to hand, including somatosensory data, but also thoughts, past experiences, and beliefs. This gestalt is further coloured by emotions. As we know, this all occurs instantaneously, preconsciously, and without direct volition. According to Moseley and Butler, it seems it is this level of appraised danger to the body that precedes and determines the immanent experience of pain.

 Already a Translation

From this starting point, I put forward the idea that “pain is always already a translation”. Ever since the “linguistic turn” in 20th Century Philosophy, most philosophers have accepted the idea that our access to reality is structured by language. When I see a tree, a chair, or a table, I cannot help but recognize the tree as a tree, the chair as a chair, the table as a table, even when no words enter my mind. I cannot help but see the world as divided up into units, units which, even when they are very practical, still require some underlying concept. We perceive the world always already as divided into different things, a differentiating effect which emerges through the structuring properties of language.

For Moseley and Butler, it seems that before the individual feels pain, they must interpret what counts as “credible”, what counts as “evidence”, and what counts as “danger”, even if none of this occurs in conscious awareness. At the conference I suggested that such an appraisal of danger to the body must be grounded, at least partially, in complex conceptual categories that emerge through language. But, this implicit, preconscious interpretation of being-in-danger is not pain. Pain is the translation of this prior moment of (pre-conscious, non-volitional and instantaneous) interpretation.

The question then remains as to whether pain can be translated back into its “original” – into the interpretation of being-in-danger. Butler and Moseley’s DiMs and SiMs can be understood as attempting this backwards translation, but it seems possible that there will always be an excess of meaning, an irreducible gap in the translation, as some part of our mind remains divided from us – not fully knowable or controllable – even as this part of our mind interprets our Being-in-danger. This was the point that interested the linguists, historians, literary scholars and philosophers in the room, although for those of us who have worked in pain and been exposed the ideas of Explain Pain, it’s not a big stretch.

Heidegger, potentiality and projections

Another idea that I found even more interesting emerged from my grappling with Heidegger’s notion of “projection”. For Heidegger, we are defined by our potentiality – by the fact that, in each instant, multiple potentialities for future Being-in-the-World present themselves, always as a background, implicit Understanding (Verstehen). For Heidegger, it is a problem that we frequently fail to recognise the true and the false potentialities available to us, as well as the true and false circumscriptions to those potentialities. Heidegger calls this future-orientated sense of multiple potentialities “projection”, and for him it is “projection” that is constitutive of our Being.

I would suggest that pain, when defined as resulting from the appraisal of danger, arises out of the interpretation of the future-orientated relationship of Being to lifeworld. Which is to say, pain can be understood, philosophically, to arise out of “projection” (in the Heideggerian, not psychoanalytic, sense). “Danger” does not describe tissue damage, or even the perception of tissue damage, but rather – by its definition – always something that relates to the future. And if we think of Butler and Moseley’s oft-quoted examples of badly injured soldiers who feel no pain while they are concentrating on escaping the battlefield alive, or of boxers who feel no pain while they believe they will win the bout, it seems that we interpret in a very complex and holistic (but preconscious) way what our potentialities for Being are, and that pain always reflects this understanding of our possible futures. You could say (and I did) that pain is always already the translation of our projected possibilities, in their opening, and in their closing.

I hope my conference paper helped translate some of the exciting work coming from the clinical and scientific worlds into a language meaningful to scholars from the Arts and Humanities. Equally, I hope that such conversations continue to develop, as abstract philosophical and linguistic approaches also show how they can usefully impact on scientific and clinical thinking.

– Seamus Barker

 

s200_seamus.barkerSeamus Barker is completing a PhD in Medical Humanities at the University of Sydney, in the Centre for Values, Ethics and the Law in Medicine (VELiM), under Dr Claire Hooker, and is also supervised by Professor Lorimer Moseley at the University of South Australia. He is investigating what is at stake – ethically, philosophically, and pragmatically – in the discrepancies between the different narratives that account for pain, coming from science, medicine, and from personal accounts. He has worked as a Physiotherapist for over ten years in various pain clinics in Australia and the UK. Please contact at sbar0177@uni.sydney.edu.au or tweet to @sbpainphysio

11 Responses to “Translating Pain”

  1. EG Physio

    Hi Seamus,

    “‘Danger’ does not describe tissue damage, or even the perception of tissue damage, but rather – by its definition – always something that relates to the future”.

    You mention the future. Time only arises with self-consciousness (as does space and causality). It’s the self which should hold centre stage in Mosely/Butler’s statement about danger, not time. I feel like you have it the wrong way around, though I agree with you in essence.

    In my ‘Self Matters’ post on here, I challenged the statement that “We will experience pain when…”. A body alone won’t register pain, only a self will. I gave plenty of examples to prove this. Neither David nor Lorimer commented on it, but hopefully you might.

    Regards, EG

    Reply
    • seamusbarker

      Hi EG,

      Thanks for your comments, and I enjoyed reading your article on ‘Self Matters’.

      I haven’t put “time at the centre” of Butler and Moseley’s statement about danger, but I would suggest that a temporal aspect is one necessary part of a conceptualisation of pain (since the word “danger” involves, in its definition, a temporal aspect). As I wrote above:

      “I would suggest that pain, when defined as resulting from the appraisal of danger, arises out of the interpretation of the future-orientated relationship of Being to lifeworld.”

      I don’t believe we should narrowly put ‘the self’ at the centre, because, as one of the commenters on your post wrote, this is reproducing the idea of the isolated Cartesian ego. I’m not sure I’m convinced that in moments when self-consciousness recedes so too does pain. This idea makes self-awareness a necessary condition for pain, which, looking at infants and animals, wouldn’t appear to be the case. Although, interestingly, self-consciousness does require a sense of the future possibilities available to the self.

      I personally don’t think a recession of the self explains why the soldier in battle feels no pain. I think that scenario occurs because the ‘self’ makes a holistic appraisal of danger, not just danger related to a particular body-part. I would suggest the individual also makes an interpretation of the possibilities available for negotiating that totality of danger. Based on that idea, if the soldier were to feel pain, that experience would not motivate him to escape the totality of danger (ie the battlefield), and instead would make him focus on his painful leg, which would increase his danger in the holistic sense. I go through this scenario in detail in my conference paper – https://www.academia.edu/14971933/Pain_Always_Already_a_Translation

      The point I make (well, actually, that Heidegger makes) is that the notion of self only makes sense in its relationship to the world. Pain thus arises not from a putatively atomistic ego, but from Being-in-the-World, as a unitary concept. The ‘self’ can’t be in danger without a relationship to the world, a relationship which the ‘self’ must interpret (even if this interpretation doesn’t occur in conscious experience). The word “danger,” by its definition, not only describes a current state of affairs, but necessarily the future implications of that current state, for Being-in-the-world.

      In this way, understanding pain as related to the future possibilities for Being-in-the-World means that “time” is not at the “centre” of Butler and Moseley’s statement. The individual’s interpretation of their Being-in-the-World is at the centre, with the further condition that this interpretation relates to a future-orientated understanding of danger and the possibilities available for its negotiation.

      Thanks for the philosophico-psychologico-physio discussion!

      Reply
      • EG Physio

        Thanks Seamus,

        When you use the expression “future-orientated relationship of Being to lifeworld.” That’s one way of defining ‘self’. We’re talking about the same thing. There’s a body, and that body’s mind develops thoughts of “me as an individual, separate from the world”. Egohood or selfhood.

        “The point I make (well, actually, that Heidegger makes) is that the notion of self only makes sense in its relationship to the world”.

        Of course! Because the definition of self contains all this. Self implies ‘other’. ‘Other’ is the rest of the world. Again, we’re talking about the same process – the process of selfing. I find Heidegger’s descritpions a bit awkward to read.

        Your reasoning for the soldier not feeling pain makes sense, but it can’t possibly be correct. We lose all ability for high level, multi-threaded processing in such life-threatening situations. A soldier is just as likely to go into shock and not be able to move to save himself. They’ve done studies on this. Or people who panic, for example, when they are in such a situation. Panic reduces our ability to survive threats. We can’t calculate holistic survival probabilities under duress. Instead we zone out by dissociating or reducing self-referencing. It’s a complete letting go of that which creates pain – self.

        Regards, EG

        Reply
  2. davidboltononoi

    Hi EG,
    For what it’s worth I agree with you that “No self no pain” rather than “No brain no pain” is a more accurate statement …..
    DB
    London 🗿🌁

    Reply
  3. davidbutler0noi

    Thanks Seamus,

    I need to read such articles a few times…..

    If there are any more similar conferences coming up, we would love to know.

    I too found your Heidegger notions intriguing and “fitting” – “pain arising out of an interpretation of the future orientated relationship of Being to life-world

    “and pain already a translation of the projected possibilities”.

    Reminds me of a Pat Wall comment around something like “we hurt in terms of what we can do about it”

    Thanks for a most welcome post

    David

    Reply
    • seamusbarker

      Thanks David, glad to add a piece of fruit to the noijam!

      There are indeed a few interesting conferences coming up. There’s something run by Uni of Glasgow called The Value of Suffering Project – http://www.valueofsuffering.co.uk/
      According to their website, “This project is a three-year investigation by a team of philosophers, psychologists, neuroscientists, and clinicians into the nature and role of suffering and affective experience in general.”

      They’ve run a few things in the UK and Europe, but they’re actually running a 2-day conference at Macquarie Uni in Sydney on Feb 18-19, 2016.

      They have a great list of audio files of all their past presentations too, under their ‘past events’ (although some of them have a very dense Philosophy of Mind focus). One of them is by Ianetti, who I think will be at EP3.
      http://www.valueofsuffering.co.uk/events/

      Reply

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