The Phenomenology of Pain. Saulius Geniusas

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      CHAPTER 2

      PAIN AND INTENTIONALITY

      A STRATIFIED CONCEPTION OF PAIN EXPERIENCE

      Having clarified the fundamental methodological commitments that must underlie phenomenologically oriented pain research, we are now ready to turn to our second task. We are ready to raise the fundamental question: What is pain? According to the definition proposed by the International Association for the Study of Pain (IASP), “Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” (Merskey and Bogduk 1994, 209). This established definition, however, cannot be accepted at face value in phenomenology. We know one reason for this from the introduction. Although this definition admits that pain is an experience, it does not clarify the nature of pain as experience. It is not enough to qualify pain experience as sensory, emotional, and unpleasant since many other experiences, such as nausea, bodily exhaustion, various kinds of bodily illness, and psychological suffering could also be qualified the same way. The IASP definition does not give us an account of the explanandum, which could then be provided with further explanans.

      One can single out additional reasons why this definition cannot be relied upon in phenomenology. With the performance of the phenomenological epoché, one can no longer clarify the nature of pain experience on the basis of associations with actual or potential tissue damage. The claim that pain experience is associated with actual or potential tissue damage relies on the assumption that the body that experiences pain is composed of tissues—body cells that are organized in accordance with a specific structure and function—and that the experience of pain either is, or derives from, damage that affects these tissues. Such a conception of pain is grounded in pain biology. Yet, as we know from the methodological investigations offered in chapter 1, pain phenomenology cannot rely on pain biology. There are, thus, not only thematic but also methodological reasons why the IASP definition of pain cannot be relied upon in phenomenological research.

      What, then, is pain, when conceived in accordance with the fundamental phenomenological principles? The answer that I wish to offer runs as follows: pain is an aversive bodily feeling with a distinct experiential quality, which can be given only in original firsthand experience, either as a nonintentional feeling-sensation or as an intentional feeling. The legitimacy of such an answer must be established on the basis of phenomenological descriptions, which would rely on the methodological principles outlined in chapter 1. To offer such descriptions and thereby justify the phenomenological legitimacy of the proposed conception of pain, one must proceed by asking seven questions, which I will list here in the order in which I will pursue them in this study. What does it mean to claim (1) that pain is a nonintentional feeling-sensation; (2) that it is an intentional feeling; (3) that it can be given only in firsthand experience; (4) that this feeling is fundamentally aversive; (5) that it has a unique experiential quality; (6) that it is an original experience; and (7) that it is localized in the body? This chapter will be concerned with the first three questions. Chapter 3 will turn to the fourth and fifth questions, and chapter 4 will offer an analysis of the sixth one, while in chapter 5 we will complete the analysis by turning to the seventh question. At the end of chapter 5, we will have justified the phenomenological conception of pain proposed here.

PAIN AND INTENTIONALITY

      Few other questions are as germane to the phenomenology of pain as the question concerning the intentional structure of pain experience. Should pain be qualified as an intentional feeling, namely, as a “consciousness of something,” or should it be characterized as a nonintentional feeling-sensation, a mere “experiential content,” or a pure “affective state,” which does not intend anything? This is the oldest question in the phenomenology of pain. We come across this question in a controversy between two of Edmund Husserl’s teachers: Franz Brentano and Carl Stumpf.¹ While Brentano was committed to the view that pain is an intentional feeling, Stumpf argued that pain is a nonintentional sensation, which he called a “feeling-sensation” (Gefühlsempfindung). As Stumpf (1924) was subsequently to observe, although in virtually all other regards he considered himself Brentano’s follower, the question concerning the intentional status of such feelings as pain marked an uncompromising disagreement between him and Brentano.

      This unresolved controversy had far-reaching repercussions for the subsequent development of the phenomenological analyses of pain. Three sets of illustrations should suffice as a clear confirmation that the oldest question in the phenomenology of pain never reached a clear resolution. First, consider Max Scheler’s reflections on pain. In his Formalism in Ethics and Non-Formal Ethics of Values, Scheler (1973, esp. 328–44) sides with Stumpf when he argues that pain is a nonintentional feeling state. However, in his later works, most notably in “The Meaning of Suffering,” Scheler (1992) conceptualizes pain as a particular form of suffering, conceived of as an intentional experience. In “The Meaning of Suffering,” Scheler takes over the Brentanian point of view and interprets pain through the prism of intentionality. Second, consider Frederik J. J. Buytendijk’s (1962) and Michel Henry’s (1973) reflections on pain. Much like the later Scheler, Buytendijk also follows Brentano when he argues that pain cannot be conceived of as a nonintentional feeling-sensation, which, allegedly, affects only the body-self. According to Buytendijk, to clarify pain’s personal significance, one must address the meaning that pain has for the sufferer. To do so, one must address pain in various intentional frameworks that bind the sufferer to his or her body, to others, and to the sociocultural world at large. By contrast, Michel Henry radicalizes Stumpf’s position and argues that pain is the paradigm of worldless self-affection, conceived of as a purely immanent feeling that living beings have of the concrete modes of their lives. No other experience exemplifies auto-affection as purely as the experience of pain.² Third, consider Elaine Scarry’s (1985) and Abraham Olivier’s (2007) studies of pain. On the one hand, Scarry provides one of the strongest defenses of Stumpf’s view. As she puts it in her classical study, The Body in Pain, “Desire is desire of x, fear is fear of y, hunger is hunger for z; but pain is not ‘of’ or ‘for’ anything—it is itself alone” (Scarry 1985, 161–62). On the other hand, in direct contrast to Scarry, Olivier presents us with a concept of pain as a “disturbed bodily perception bound to hurt, affliction or agony” (2007, 198). Conceiving of pain as a form of perception, Olivier defends the Brentanian line and argues that pain is an intentional experience.

      Thus, in the phenomenological literature on pain, the question concerning the intentional status of pain experience remains to this day unresolved. One might be tempted to interpret this seemingly endless controversy as a failure on the part of СКАЧАТЬ