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Last updated: Tue, Oct 29, 2024
Pain is "subjective," a term that in medical parlance means it can't be observed by the doctor. Scientists and medical practitioners are skeptical of things subjective. They always prefer something that they can see and measure for themselves. The patient or subject may be mistaken, may be untruthful, may not understand what is being asked. It doesn't make a solid foundation for scientific or medical inference.
The question "How much?" is often important in pain treatment and research. Although we can easily ask someone to estimate their "pain intensity" from zero to "the worst pain imaginable," it is impossible ever to know whether two people have the same sense of the magnitude of common pains, much less the unusual pains that chronic sufferers are subject to. Although we know that we can communicate some understanding about our pains, the noise in these communications is high. On top of this, pain sensations are often complex and shifting.
There is much reason to be concerned about the "subjectivity" of pain. Much hand-wringing goes on about this among researchers and practitioners.
My own view, which I believe is well-supported by my research, is that both researchers and medical people are also often skeptical of subjects' motives. More about this is found in Secondary Gain and Psychiatric Co-morbidities of Pain. And, as you may have seen in the section Folk or Cultural Understandings, this skepticism is shared by many politicians, benefit administrators, and people whose shoulders rub against yours in daily life.
In the 1920s, Pavlov taught his dogs to salivate in response to a dinner bell. He did this by pairing the bell with dinner. The dogs learned to associate the bell with food, and hence they salivated when the bell rang.
Taking this a step farther, Pavlov paired dinner with an electric shock delivered to one of the paws. He reported that dogs trained in this way no longer showed external signs of pain when shocked. They salivated, wagged their tails, turned toward their food dishes, and in fact acted as though they weren't experiencing pain but were anticipating their dinners. This only happened when the trained paw was shocked. If a different paw were shocked the dog's response would be the typical pain response.1
If we take Dr. Pavlov's reports, the results indicate that the “pain” messages delivered to the trained paw were intercepted and reclassified as “food” messages before they could be interpreted as pain. This suggests an obvious and simple solution for pain problems. We must eat something (perhaps M&Ms) immediately whenever we feel a twinge. In this way we can train ourselves out of any pain we find disagreeable. Surely there is no reason why chronic pain should continue to exist.
While this result is certainly intriguing, the following questions/qualifications come to mind:
Pavlov conducted his research early in the history of the USSR. The pliability of human nature (or doggy nature) was an important article of political faith, used to explain both the existence of capitalism and the prospects for communism.2