At an inter-disciplinary conference on “pain” several years ago, I struggled to make sense of the first-couple of presentations because the presenters used the words ‘pain’and ‘suffering’ interchangeably. Of course, it’s ordinary linguistic practice to use the word ‘pain’ (and synonyms for pain like ‘hurt’, ‘ache’, and ‘painful’) to refer to suffering. It’s normal to say such things as: “Her back pain’s preventing her from working”; “Losing that job has caused me real pain; “My knee hurts”; “He’s been hurting since she left him”; “This cut’s really painful”; “His death was so painful for me”. But it soon became clear me this wasn’t just a confusing use of terms, it reflected a blurring of the concepts of pain and suffering. In effect, these experts were saying that either some pains are a type of suffering or suffering is a type of pain. This is a mistake. Pain is not synonymous with suffering. The word ‘pain’ has two different meanings (i.e. it’s a homonym); it refers to distinct concepts.
Once experts start making mistakes those mistakes creep insidiously, via the media, into the general population. (This isn’t just an idle concern; in the media some experts and prominent commentators do talk about pain and suffering as though they’re more or less the same thing.) Why does this matter? My worry is that it’s elevating the psychological impact of pain. Someone who thinks that they’ll suffer if they’re in pain is likely to be anxious about both their current pains and the chances of future pain, and anxiety has the capacity (via well established biological mechanisms) to make pain worse.
The distinction between the concepts pain and suffering is marked by the intransitivity of the concept of pain, and the transitivity of the concept of suffering. It’s easier to understand the intransitive/transitive distinction if I explain transitivity first. When I’m suffering I don’t just suffer, I’m suffering something. If I say “I’m suffering”, the natural response is to ask, “What are you suffering?”. As the concept of suffering can’t be abstracted from its cause (i.e. the thing being suffered – a bereavement or chronic back pain, say), suffering is a transitive experience. By contrast, while all pains have a cause, the concept of pain is self-contained; it can be abstracted from cause. When I’m in pain the pain itself is my immediate focus. I might report this by saying “I’m in pain.” Nothing need be added to such a report. Pain is an intransitive concept.
The independence of the concept of pain is also evident in the fact that it’s perfectly consistent for me to talk of the pain I got when I touched something very hot and to deny suffering. However, the reverse claim’s not quite so straightforward because of the dual meanings of the word ‘pain’. Does it make sense to say, “I’m suffering the loss of my job, but I’m not feeling pain”?
The terms ‘physical pain’ and ‘psychological pain’ (or ‘mental pain’) are sometimes used to make sense of the meaning of ‘pain’ in statements like the one above. If I’m suffering the loss of a job, I must be experiencing psychological pain, because suffering something is psychological pain. In which case, my denial that I’m feeling pain refers to physical pain not psychological pain. I am stating that I’m experiencing psychological pain; I’m experiencing psychological, not physical, pain because I’ve lost my job. To add to the terminological complexity, psychological pain (i.e. suffering or transitive pain) can be causally related to physical pain (i.e. pain or intransitive pain). Likewise, physical pain can cause suffering.
You may well be confused by all of this. My view is that ‘physical pain’ and ‘psychological pain’ are unhelpful terms because they makes it seem as though pain and suffering are experiences of the same type. But they’re not experiences of the same type. The pain of touching something hot, of cramp, of a pin-prick doesn’t feel anything like the suffering of bereavement, of divorce, of bankruptcy. So pain is not suffering or even a type of suffering, and suffering is not pain or a type of pain.
Additionally, these terms suggest a misleading dualism. Both pain and suffering are psychological in the sense that they’re experiential mental states. And both are physical in the sense that they can, in principle, be explained in biological terms. (I’ve used an ‘in principle clause‘ because our current biological understanding of experiential consciousness is not developed enough to explain the relationship between mental and biological states.) For these reason, the terms ‘pain’ and ‘suffering’ are better than ‘physical pain’ and ‘psychological pain’, despite the potential confusion.
There’s no solution to this problem. The language of pain is also the language of suffering. My message is simple, don’t be mislead by the dual use of this language or ill-informed commentary in the media. Pain and suffering are distinct experiences, which is why we have distinct concepts of pain and suffering.
The Pain Jam 