Painfully conscious

I’ve just finished reading Melanie Thernstrom’s 2011 book The Pain Chronicles, a journalist’s inquiry into the concepts that “define” pain and the medical discoveries concerning chronic pain, in addition to a bit of memoir as a narrative device. Although I have experience with chronic pain myself, the part of the text that most interested me comes in her concluding chapters, in which she gathers the variously-disciplined evidence of her enterprise to suggest that pain is the ultimate test of the mind-body problem (thank you, René Descartes). The experts Thernstrom interviews disagree on how much we do know or can know about the human brain and how it processes anything, let alone such a complicated psycho-physiological event as pain. Some of them believe human beings will make enormous technological discoveries to unlock our brains’ workings, but the majority seem to have learned from research that each “a-ha!” leads only to further complications. Discussing the outlook for future fMRI scanning in brain research, Dr. John Keltner tells the author:

[N]obody has come up with a rich and complicated enough model to analyze the complexity of the distributed patterns of neural  networks and deduce anything like underlying rules…We’re literally grappling with the fundamental aspects of human beings. We naively believed that pain is simple–it hurts or it doesn’t hurt–so there should be a single brain state we could see every time someone is in pain. But what we’ve stumbled into is the discovery that there’s a relative universe of hurt–that hurting is an immense, rich, and varied human experience associated with an unknown number of possible brain states.

I find some of these analogies, and some of this language, appealing–I can think of poems that express “a universe of hurt.” I embrace the idea that hurting is immense, rich, varied, and human–we are aware (conscious) that we hurt, that others hurt, that hurt can be painful even when it is not caused by a toothache but through loss of a friend or lover…the beloved other, the pain in ourselves. Isn’t compassion born of this awareness? Does art have a place here, too? I wonder.

Thernstrom concludes with the agreement of several expert researchers: “pain and suffering are properties of the mind” [my italics]. That means pain is, at least in part, a property of that elusive thing we generally call consciousness. Scott Fishman of UC Davis explains that “[t]he mind is like a virtual organ–it doesn’t  have a physical address that we know of.” Consciousness, these researchers imply, is not merely the sum of firing neurons, a process that can be considered on some level mechanical. Thernstrom asks, “Do we need to understand consciousness itself in order to understand pain?”

If so, that is a tall order, one the author posits is analogous to understanding aesthetics (what is beauty?). But though the task appears daunting, the discoveries en route make the trek valuable.

Even if we never understand the answer.

neural matrix fiber topography, Johns Hopkins University

neural matrix fiber topography, Johns Hopkins University


2 comments on “Painfully conscious

  1. KM Huber says:

    “the majority seem to have learned from research that each “a-ha!” leads only to further complications.” And when I read this, all I could think was, “ain’t it the truth?” Of course, the later phrase “universe of hurt” seems to say it all, at least for me. And it does make sense that to understand pain we must first understand consciousness but as you say even if we find the answer would we understand it? Indeed, would we even recognize the answer? Really enjoyed the post, Ann. Thank you.

    P. S. I’m a bit late in my reading and in my responses but it is always a joy to spend time here.



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