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Gwen Bradford: Pain’s Badness

There is surprisingly little discussion about pain’s badness in the philosophical literature. One might think that it falls naturally out of any of the various theories of well-being, but this is not so straightforward (as Shelly Kagan argues).[1] In recent work, I look at some ways pain’s badness can be explained. This post summarizes some of my arguments.

At first, the explanation for pain’s badness seems simple: it hurts! Ideally, an account of pain’s badness will appeal to pain’s feel in the explanation. It would be nice if that were all there were to it – pain is bad straightforwardly in virtue of the negative feeling tone. Call such a view dolorism. Straightforward dolorism is, however, too straightforward. It fails to allow for cases where pain is not intuitively bad. I will discuss one type of case. (Another, which I explain elsewhere, is a condition called pain asymbolia, in which patients report to experience pain but don’t find it bothersome.)

There are some instances where pain is enjoyed directly, just for the way it feels, such as the pain of exertion in intense exercise. Some people enjoy this feeling not as a sign of the good work they are doing, but intrinsically, i.e., for the sake of the feeling itself. I call these kinds of experiences “hurts so good” (HSG) experiences. They are surprisingly commonplace. Many people enjoy the painful zing of very spicy food, the pain of a deep tissue massage, jumping in a freezing cold lake, or sitting in a very hot sauna. There are also psychological HSG experiences, such as the fear induced in watching a horror movie or riding a roller coaster, or feelings of deep sorrow from listening to very stirring music or watching a tragic play. All of these experiences have negative feeling tone, and so according to dolorism, they would be intrinsically bad for us. But this seems inaccurate. It does not seem irrational to pursue these feelings simple for the way they feel. But if they were intrinsically bad for us, then it would be. Dolorism cannot explain this.

One may think to say that dolorism can very easily account for these experiences. It’s simply a matter of the right hedono-doloric balance – the pain of these experiences is worth some small number, X, dolors, but also some larger Y number of hedons, and on balance is positive. A dolorist will insist that this is true. But things are not this simple. The hedono-doloric calculus requires that the pleasure outweigh the pain. But this simply does not seem to be necessary in some cases. Suppose S is currently enjoying a very intense deep tissue massage. Suppose the masseuse increases the pressure even more intensely. It is now very painful! S’s enjoyment stays the same. S enjoys the increased pain just as much and no more as the less intense pain. I take it the natural intuition is that her level of well-being stays the same. But the dolorist cannot say this. They are committed to saying that either it decreases when the pain increases. This is counterintuitive.

Moreover, consider the reasons that S has to get the massage. S enjoys painful massages, so she has reason to get one. But according to dolorism, the pain gives her some reason not to get one, because it is bad for her. But the painful experience is the very thing that gives her the reason to get one – this is just what she wants. Dolorism is too straightforward to capture this.

Cases such as these lead others to endorse a conditionalist account of pain’s badness: an experience is bad for S iff S desires not to experience it. Most of the time we don’t want to feel pain.

While conditionalism captures the intuitions about HSG experiences, it fails, however, to capture the most basic intuition about pain, namely, the theoretical intuition that pain’s badness is explained by how it feels. The quality of pain’s feel is irrelevant for the conditionalist explanation of its badness. But the way pain feels seems centrally relevant for why it is bad. It justifies our dislike of it. The conditionalist account has the direction of explanation going the wrong way.

Yet attitudes do seem relevant to the value of pain experiences. After all, the painful massage seems to be good for S at least in part because she wants it, just for the way it feels. Consequently the best approach would be a hybrid view that captures that pain’s feel is relevant for its badness and that attitudes can shape its value.

I propose such a view. Dolorism is correct insofar as pain is bad in virtue of the way it feels. But the badness of pain can be defeated by the presence of a pro-attitude. In a nutshell:

S’s experience E is bad for S (at t) if E has negative feeling tone, unless S has a relevant pro-attitude intrinsically toward E at t.

I call this reverse conditionalism. This view retains the dolorist thesis that pain is bad in virtue of feeling tone, and adds a defeating “unless” clause. Thus reverse conditionalism captures the relevance of pain’s badness in the explanation – indeed, pain’s feel is all there is to the explanation of its badness – and yet also explain why HSG experiences and other such cases are not bad (and may even be good).

This view follows a pattern of the defeat of value that can be seen in other cases. Desert is a classic example. Says Chisholm, “[i]f A is a wicked deed and if B is the suffering involved in the sinner’s remorse or in his retribution, then the two evils, A and B, may be preferable to A without B”.[1] The two bads in this case are defeated by being part of a larger whole in which the presence of the other part defeats the badness of the overall whole. This is not to say that the sinner’s pain is not bad for the sinner; rather, the point is to illustrate that there are plausible cases in which this pattern of value appears, namely, where the badness of one thing is defeated, either entirely or partially, as a result of a relation to something else.

This, then, is what I propose for pain and the defeat of its badness: the badness of pain can be defeated by an attitude of the welfare subject toward his pain intrinsically.

The next question to ask is about the relative badness of pains – i.e., how bad any two pains might be in relation to one another. Plausibly, pain’s badness (absent any pro-attitude) is a function of its intensity and duration, i.e., a very intense pain is worse than a less intense pain for the same duration. Pro-attitudes too vary in intensity.

But could even a very weak pro-attitude defeat the badness of horrible, unrelenting, agonizing pain? Could even the slightest welcoming of some slight feature of the sensation neutralize the badness of unrelenting agony? This seems implausible.

But just as in other cases of the defeat of value, reverse conditionalism can allow that the badness of the pain may be defeated only partially, depending on the badness of the pain absent the pro-attitude, and the intensity of the pro-attitude itself. If a very intense pain is met with an only weak pro-attitude, the badness of the pain is defeated only partially – it may still be bad for the subject, albeit (perhaps just slightly) less bad than it would be absent the pro-attitude. (This is not to be confused with the (likely true) claim that the experience of a pain may change depending on the attitude – a pain that one looks forward to is likely to hurt less than a pain that one is not expecting at all or even dreading. This is a matter of the feel of the pain experience itself, whereas its value is a function of this experience and the attitude toward it.)

There is much more to be said, and what I have written here is a short version of a full paper. I look forward to hearing what you think.

[1] Brentano and Intrinsic Value (CUP, 1986), p. 72. See also R. M. Chisholm, “The Defeat of Good and Evil,” Proceedings and Addresses of the American Philosophical Association, Vol. 42 (1968-1969), pp. 21-38.

[1] See Shelly Kagan, “An Introduction to Ill-Being,” in Mark Timmons, ed., Oxford Studies in Normative Ethics, Vol. 4 (OUP, 2014).

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Gwen Bradford is an associate professor of Philosophy at Rice University with a research focus in value theory and normative ethics.

6 Responses to Gwen Bradford: Pain’s Badness

  1. Liz G says:

    From my experience … A painful massage is endured for the predicted benefits. Also, each painful stroke is balanced by the relief of the release. But, chronic pain erodes one’s will to thrive, strive and, eventually, just survive.

  2. Avi Appel says:

    Thank you for the interesting post.

    I agree with Liz that the analysis of the massage example is missing something. The exercise one too, for that matter. The pain of a massage or of exercise is desired because we believe (implicitly or explicitly) that effectiveness covaries with unpleasantness. It’s the same attitude we take towards toothpaste (which has no intrinsic reason to taste as it does, but customers don’t believe that non-stinging toothpaste is effective) and energy drinks (same story). But I’m not sure that any of this matters to your arguments. You can grant that the etiology or subconscious explanation for a preference for particular kinds of pain is due to the pain’s instrumentality. But, like rats that have been fed sugar every time they receive a small shock, non-instrumental desires can spring from instrumental roots.

    Could you explain how your view deals with the condition you mention at the beginning of your post (pain asymbolia). It seems like you would have to say that pain is bad for a person who does not find pain bothersome. That seems counterintuitive to me.

  3. Eric Wiland says:

    We might want to distinguish two claims, each of which, if true, merit some explanation:

    1. Pain is bad.
    2. Pain is bad for you (the one who is pained).

    It looks like you move back and forth between the two claims, but I think that only the second is true. (Someone saying the first claim says something true only if they simply mean the second claim.)

    I’m probably the only person worried about this, so feel free to move on!

  4. Thank you for your comments!

    First, Liz and Avi – indeed, often – perhaps even most of the time – a painful massage or the pain of exertion while exercising are only indirectly, or extrinsically, enjoyed. Often, if we seek out a painful experience, it is not strictly for the way it feels, but for some other reason or benefit. Sam might not really enjoy the painful burn of the extra-spicy chicken wings, but he enjoys attention and feeling macho, for example.

    My claim is not that there are painful experiences that are ALWAYS enjoyed. My argument does not need that claim. I am simply claiming that there are SOME CASES in which painful experiences are enjoyed intrinsically, that is to say, directly, just for the way they feel, and those cases do not seem to be bad. Perhaps even the contrary. There do indeed seem to be at least some cases sometimes in which this happens. So the challenge is for an account to explain why these cases are not bad.

    About pain asymbolia, there are several things to be said. People with pain experience reporting feeling pain sensations, but don’t find them bothersome or react to them with the typical affective and motivational responses. Intuitively, the pain is not bad for the person with asymbolia, but, assuming it has a negative feeling tone, reverse conditionalism appears to say that it is bad for them.

    One possibility is that people with pain asymbolia have a defeating attitude toward their pain – their attitude toward the pain is one of equanimity or of being “unbothered.”

    But there is reason to resist this response since it’s not clear that equanimity should be properly considered a PRO attitude, and if the view accepts that some attitudes that are weakly pro can defeat pain’s badness it opens the view to potential counterexamples.

    A second, more appealing possibility is that asymbolic’s pain sensations do not, in fact, have a negative feeling tone. The lesson to be learned from asymbolia is that (physical) pain has two components: a physical sensation and an affective response to that sensation. (This position is represented widely in the pain literature in philosophy of mind (e.g. Grahek 2001). In that case, reverse conditionalism would not entail that the asymbolic’s pain is bad (dolorism would not entail this pain is bad either, but dolorism would still need to content with HSG experiences, giving reverse conditionalism the upper hand overall).

    A drawback of this approach, however, is that it means there is something that is recognizably a “pain sensation” yet has no hurting feeling whatsoever. It’s difficult to conceive of such a sensation. Supposing that the pain sensation does, then, have negative feeling tone, reverse conditionalism would be committed to saying that it is indeed bad for the asymbolics, in spite of the appearance. It has been suggested that there is a malfunction in the cognitive capacity to react appropriately to their pain (e.g., Klein 2007) so a third approach is that the pain is indeed bad for them, even though they don’t mind it, and people with asymbolia simply lack the capacity to react in the usual way.

    So there are at least these three approaches. I’m somewhat inclined to think the second of these is the strongest, even though it requires some imagination.

  5. Eric – I’m sure you are not the only person to worry about this. Here, I ONLY mean 2. Here, when I say “pain is bad” it is short for “pain is bad for [the one who is pained].” Thank you for pointing this out so that I could clarify.

  6. Alex Dietz says:

    (1) A clarificatory question: “Pain” is often taken to be synonymous with “the opposite of pleasure,” but some people point out that there are unpleasant experiences that we wouldn’t ordinarily call pains (I think nausea is the standard example). But your psychological examples make me suspect that you do want to use “pain” to refer to unpleasant experiences in general. Is that right?

    (2) Your hybrid view seems really interesting and plausible. For what it’s worth, I’m skeptical that there is a feeling tone that painful or unpleasant experiences have in common (I’m inclined to accept an attitude-based theory of what makes experiences pleasant or unpleasant). But maybe there’s a version of your view that people like me could agree with: that certain conscious experiences could be intrinsically bad for us, unless defeated by a positive attitude.

    (3) I’m curious whether you would want to say something parallel about the goodness of pleasure, or whether you think we should resist the temptation to see pleasure and pain/the unpleasant as parallel.

    (4) Finally, I’m wondering how to think about the massage case that you use against dolorism in light of the view you end up with. You write that when the massage becomes more painful but the person’s enjoyment stays the same, then the dolorist has to say that the level of well-being goes down, but the natural intuition is that the level of well-being stays the same.

    But ultimately, you suggest that the badness of pain is a function of both the intensity of the pain and the intensity of any pro-attitude you might have toward it. The simplest way of cashing this out would be: badness = intensity of pain minus intensity of pro-attitude. But if the person’s enjoyment stays the same, I take it that we can assume that the intensity of their pro-attitude remains the same. And in that case, since the intensity of pain increases but the intensity of the pro-attitude remains the same, it seems like you would also have to say that the level of well-being does go down. So maybe you would want to say that the function is more sophisticated than that?

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