The Phenomenology of Pain - Saulius Geniusas Series in Continental Thought

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method, we can investigate the temporal nature of pain experience not only in terms of its formal structures, but also in light of its development, paying close attention to the significance of retention and protention, as well as memory and anticipation. Moreover, following the genetic method, we can also investigate how the experience of pain is incorporated into various apperceptions—both conceptual and affective—and how these apperceptions codetermine the nature of pain experience. The analysis of these themes will require that we understand pain not only as a depersonalizing, but also as a repersonalizing experience: not only as an experience that robs us of our selfhood, but also as an experience that invites us to reconstitute ourselves anew. Last but not least, the genetic method also invites us to examine the significance of the person’s immersion in the life-world. In this regard, a genetically oriented phenomenology of pain can demonstrate to what extent the processes of somatization and psychologization codetermine the nature of pain experience.

      As my references to such processes as depersonalization and repersonalization, as well as somatization and psychologization, suggest, genetically oriented phenomenology of pain must be pursued in dialogue with other disciplines—such as cultural anthropology, cultural psychopathology, and psychoanalysis—which study the same processes on the basis of other methodological principles. In this regard, genetic phenomenology, much like the method of factual variation, liberates phenomenology from insularity by opening exchanges with other fields of research.

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      Let us sum up these methodological considerations. I presented the methods of the epoché, the phenomenological reduction, and eidetic variation as the three fundamental methodological principles that make up the basic core of phenomenologically oriented investigations. I further argued that these three principles are necessary, although not sufficient. In virtue of inherent limitations, they need to be supplemented with further methodological considerations. As we saw, even though the method of eidetic variation is meant to provide the researcher with access to the essence of the phenomenon, it cannot guarantee that the investigator will not confuse this essence with a generalized factual description. Such being the case, the method of eidetic variation needs to be supplemented with the possibilities opened up by factual variation. Such a supplementation significantly enriches the phenomenological field of analysis, even though, admittedly, it does not close off the open possibility that the phenomenological insights might still fail to reach the essence of the phenomenon. Such a methodological supplementation, which reconceptualizes factual variation as a necessary ingredient of eidetic variation, imparts upon phenomenology a much-needed dialogical orientation. Phenomenology need not be disadvantaged by its own purity. Insofar as it is willing to supplement imaginative variations with factual variations, it can build on the basis of accomplishments derived from other sciences by transforming these accomplishments into pure possibilities. Insofar as phenomenology is willing to take on such a methodological orientation, it loses its insularity and becomes dialogical.

      Such a dialogical approach is especially called for in pain research. As Gallagher has it, “Phenomena that pertain to biological and specifically human behavior and experience are so complex, that we cannot always grasp the imaginative possibilities in a unified intentional act” (2012, 55). Pain is such a phenomenon. Thus, even though I will begin my analysis in chapter 2 by building phenomenological descriptions in line with the first three fundamental phenomenological methods, it will soon become apparent that a dialogue between phenomenology and a number of other disciplines—such as cognitive science, cultural anthropology, and psychoanalysis—is of great importance for phenomenologically oriented pain research. In addition to supplementing eidetic descriptions with resources obtained from other disciplines, it will also prove necessary to supplement static analyses with genetic investigations. In phenomenology, it does not suffice to clarify the nature of pain experience in terms of its fundamental structures. This is a great task in itself, and it can be achieved by following the methodological guidelines of static phenomenology. Nonetheless, the phenomenological determination of the nature of pain experience remains formal in the absence of genetic investigations, and it therefore needs to be supplemented with an inquiry into the origins and development of pain experience. Such a genetic inquiry supplements the static account by demonstrating the astonishing degree to which pain experience is nested in apperceptions and rooted in the life-world. Genetic phenomenology provides us with the methods needed to study these apperceptions in terms of the fundamental laws that guide their development.

      In the introduction, I suggested that the science of pain is in need of phenomenology for two central and interrelated reasons: first, it does not have a reliable method to study the nature of pain experience; and second, it is not in the position to inquire into the compatibility of the findings obtained by means of the first-person and third-person methodologies. The methodological considerations offered in this chapter provide the science of pain with the methodological foundation that it can rely upon as it strives to accomplish both tasks.

      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,

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