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Home , Eliminative materialism, Georges Rey, Neurophilosophy, Pain (philosophy), Paul Churchland

Baetu TM. Eliminativism. J Ment Health Clin Psychol (2020) 4(3): 22-25 JOURNAL OF MENTAL HEALTH AND CLINICAL

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Mini Review Article Open Access

Pain Eliminativism Tudor M. Baetu* Department of and Arts, University of Quebec at Trois-Rivieres, Canada

Article Info Abstract

Article Notes The philosophical thesis of pain eliminativism can be understood in several Received: June 24, 2020 ways. As a claim about the inadequacy and replacement of folk explanatory pain Accepted: July 17, 2020 constructs and , it is congruent with scientific findings. Eliminativism is *Correspondence: controversial in as much as it demands a more or less radical recharacterization Dr. Tudor M. Baetu, Università du Québec à Trois-Rivières, of the phenomenon of pain in order to ensure compatibility with Département de philosophie et des arts, 3351, boul. des and an model of reductive explanation. In this respect, eliminativism Forges, Trois-Rivières (Québec) G8Z 4M3, Canada; Telephone is at odds with experimental and explanatory at work in biomedical No: 819 376-5011; Email: [email protected]. research. The latter is concerned with reproducible phenomena, controlled experiments generating evidence for causation and causal-mechanistic © 2020 Baetu TM. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License. explanations. Since nothing here supports conclusive about the identity or non-identity of pain, or aspects of it, with biological activity, it is not clear what, if anything at all needs to be eliminated.

In philosophy of , eliminative is the thesis according to which folk psychological explanations of the sort ‘I removed my hand from the stove because I felt pain’ should be replaced by explanations in terms of neural mechanisms.

incomplete, approximately correct, or a special case–in which caseA replacement it could be isreduced justified to a when more an complete, explanation accurate is not or general merely explanation–, but is false or systematically uncorroborated1. Replaced are abandoned, which usually entails that explanatory constructs postulated by these theories are eliminated. Historically, constructs such as ‘phlogiston’ and ‘gravitational

were abandoned. By analogy, it may be argued that pain doesn’t play theforces’ explanatory were eliminated role folk once psychological the explanations explanations in which attribute they figureit. For instance, the explanation posting that a conscious pain causally mediates the transition from the hot stove stimulus to hand 2.

thatwithdrawal the elimination is false, since doesn’t this nociceptive concern response the phenomenological is largely reflex In this case, eliminativism is justified, although it must be emphasized or as reported by those experiencing it, but rather the causal roleexperience attributed of painto this as perceivedexperience from by folk a first-person explanations. perspective Thus, an eliminativist can deny that an explanatory of pain refers to a causal structure existing in the world, without denying that people pain. This is a position (1978)3, Patricia and (1981; 1986)4,5 seem to adopt. Alternatively, Daniel Dennett (1978)3 and Valerie Hardcastle (1999)6 argue that pain is an incongruous encompassing both subjective and a set of common about what it means to be in pain, such as the beliefs that one cannot

Page 22 of 25 Baetu TM. Pain Eliminativism. J Ment Health Clin Psychol (2020) 4(3): 22-25 Journal of Mental Health & Clinical Psychology be mistaken about in pain and that being in pain misrepresentation or false of . Larry Hardin (1988)11 and (1997)12 argue that some aspects a problem for folk psychological explanations, since a of subjective experience must be a sort of error, since they subjectis sufficient may forsimultaneously having an awful hold experience. contradictory This mental raises represent physical objects as having phenomenological properties which they don’t really have. For instance, we feel that pain is in the burned hand, but the hand states, such as experiencing a non-awful pain under the itself does not have the property of being in pain. This is influence of an analgesic while25 remainingseems to convincedsuffer from that a particularly obvious in the case of phantom limb . being in pain is sufficient for having an awful experience. The apparent of phenomenological properties Theunpleasant IASP definitionexperience of while pain at the same time endorsing that seem to be located ‘out there,’ in the external world, reportingsimilar incongruity. as a valid, The reliable definition and tells accurate us that method pain is foran is a misrepresentation of reality and should be eliminated. measuring pain. Yet patients with frontal lobotomies and Following a similar line of argumentation, Paul Churchland cingulotomies sometimes report feeling similarly intense, (2007)13 targets for elimination the apparent but not distressing pain in response to noxious stimulation. of some conscious experiences. He suggests that we commonly think of and report some experiences as being inconsistent, they should be eliminated. subjective, and therefore distinct from objective physical Since such pain concepts and definitions are logically This variety of eliminativism too is uncontentious. The proposed elimination does not concern the perceived experiences represent, and ultimately refer to objective reality, simply because we failed to realize that these intensity of pain experiences or their negative valence, states of physical reality. but the necessary and universal association between Daniel Dennett adopts a more mitigating approach, pain intensity, unpleasantness and certain cognitive appraisals. This is just another way of saying that the model of reality. This model remains instrumentally useful forrelegating predicting talk behaviour, of pain experiences but has no place to a scientifically in modern . naïve At the ‘personal level’ of phenomenological experience, evaluative–canthree dimensions be dissociated along which7,8. Some pain authors varies–sensory- take this discriminative, motivational-affective, and cognitive- blocking any further investigation of mechanisms. We may that the necessary and universal association targeted for pain is unanalyzable into any kinds of components, thus variety of eliminativism to be superfluous, since they doubt elimination is part of most people’s conception of pain in the mechanisms, but then we change the subject matter from 9,10 painswitch experience to the ‘sub-personal to “the motions level’ of ofhuman neurophysiological bodies or the may be argued that it is not what philosophers understand first place . As for the so-called IASP definition of pain, it pains and not bringing them along to identify with some for something to count as pain–, but rather the physicalorganization event” of (1996, the nervous 94)14 system […] abandoning the by a definition–namely, necessary and sufficient conditions Dennett does not deny the and usefulness of in the general human population. This is consistent with phenomenological reports. Notwithstanding,. It must be emphasized such reports that of a statistically significant phenomenon documented the that the studies to which Dennett and Hardcastle are effectively eliminated from science. allude describe natural or controlled experiments in which certain interventions (strokes, cingulotomy, analgesics, Despite its physicalist motivations, this last variety hypnotic suggestion) result in atypical pain experiences. of eliminativism clashes with current experimental and explanatory paradigms. The life comprise Since concepts and constructs are revised in light of primarily experimental disciplines relying on statistical

correlations and on controlled experiments for discovering empirical findings, these varieties of eliminativism are causalmethods structures of data analysis linking forcorrelated characterizing variables. reproducible Roughly compatible with scientific practice. Moreover, they are at targets pain as a phenomenon to be explained. Elimination speaking, the former constitutes phenomena in need of an least in part justified. Problems arise when elimination is viewed as necessary because, according to an identity explanation, while the latter are the main building blocks model of reductive explanation, aspects of subjective of mechanistic explanations. For instance, the object of experience and psychological phenomena that cannot study in pain research is not the subjective experience of pain simpliciter, but an experimental model of pain. mechanisms constitute an unexplainable, irreducible It could be an experimental setup consisting of human andbe identifiedimmaterial with phenomenological biophysical entities, surplus. processes To restore or subjects reporting their experiences of pain in response physicalism and the explanatory closure of science, any to noxious stimulation. The phenomenon replicated in this surplus should be eliminated. model amounts to the fact that subjects are not randomly Some eliminativists treat this potential outputting pain values, but reliably report certain values phenomenological surplus as an artefact created by a when presented with certain stimuli and information, in

Page 23 of 25 Baetu TM. Pain Eliminativism. J Ment Health Clin Psychol (2020) 4(3): 22-25 Journal of Mental Health & Clinical Psychology conjunction with certain behaviours, when administered The net result is an abundance of causal explanations and a lack of evidence for psychoneural identities. The consists of an extended network of correlations between gap between the explanatory project in and analgesics, etc. More generally, the phenomenon of pain pain as reported by other subjects, medical conditions, abandon altogether and explicitly embrace a descriptivestimuli, pain termsas experienced appearing in self-experimentationin verbal reports of setups, pain, thoroughlythe mind- causal identity metaphysical assumption picture led of some reality authors in which to biological, psychological and social variables, etc. physical and mental states are distinct and equally real causes and effects23. In its most familiar form, this amounts Can certain aspects of a phenomenon be eliminated? For instance, can the correlation between chest pain and it refers to an exclusively causal model that precludes to about mental states. More generally, sensation of pain cannot possibly be in the chest? Should relationships () between biological and reduced blood flow to the heart be ignored given that a mentalany form states. of reductive physicalism postulating non-causal the variable ‘pain location’ with something else? I think Still, controlled experiments do not prove that thiswe recharacterizekind of elimination the phenomenon is unwarranted. of angina If ‘pain or location’ replace psychological states are not identical with some biological can be reliably measured and, moreover, it systematically activity either. Absence of evidence is not evidence for correlates with other measured variables, then pain absence. It is mere lack of information, which can only location is part and parcel of empirical reality. justify agnosticism. Given that many psychological variables Explanation too, diverges from the identity model lack a clear physical interpretation (we don’t know assumed by eliminativists. Some of the most ambitious what exactly we are measuring when we measure these experiments in neuroscience rely on interventions targeting biological factors. If such interventions result in differences variables, one psychological and one biological, refer to in psychological outcomes, as contrasted with comparable thevariables), same biological it is possible activity–as that reductionists two operationally have it–, defined even controls, it may be inferred that biological factors are though controlled experiments show that one variable is causally relevant to these psychological outcomes15,16. causally relevant to the other. It is therefore possible that Nothing here demonstrates that psychological states as a physical interpretation of psychological variables are identical with (or, more generally, supervene on) emerges, an extended causal structure involving biological biological states. If anything, according to standard causal and psychological variables, such as those postulated by 24 , controlled experiments can only demonstrate biopsychosocial models of pain , eventually collapse what psychological states are not identical with, namely into a set of strictly biological mechanisms. the biological factors shown to causally impact on these Interestingly enough, in this scenario, nothing needs states17. to be eliminated. The starting point is that of agnosticism about the physical interpretation of certain psychological The argument extends to mechanisms as well. variables. This entails that the phenomenon of pain about various causal determinants16,18,19. For interpretation that needs to be subsequently eliminated. example,Mechanisms the are gate hypothesized control neural or reconstructed circuitry explains by compiling why Asdoes for not variables, come with correlations, a built-in and physical phenomena, or metaphysical they are pain intensity subsides when we rub a smack, while the all still there. A psychological and a biological variable of action of ibuprofen explains its analgesic may ultimately refer to the same biological factor, but this effects. Both explanations are unambiguously causal. The does not mean that the variables themselves are identical. They are still measured by different techniques, such that of and thermomechanical sensors blocks the distinct observable outputs with distinct characteristics first mechanism posits that the simultaneous20 activation transmission of noxious signals to the brain ; the second, (different units, values, scales, etc.) are produced in that ibuprofen inhibits the production of prostaglandins, of the distinct inner workings of the techniques in question. 21. Likewise, one may argue that the recently discovered Acknowledgments patternwhich are of knownneural activity to sensitize predicting spinal whether neurons toa subject pain will report a heat stimulus as being painful or not22 refers to a putative mechanism of pain, not pain itself. It reveals Canada).This work was supported by a start-up research budget which structures and patterns of brain activity should be from the Université du Québec à Trois-Rivières (Québec, monitored to measure pain or targeted by interventions in References order to alter pain experience, but it doesn’t demonstrate 1. ’s Field Guide.” Seminars in the . 1990; the identity of pain with a biological activity. Churchland PM, Churchland PS. “: A

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