ArticlePDF AvailableLiterature Review


Might science need philosophy for a precise and complete understanding of pain?
MJA 196 (6) · 2 April 2012410
The Medical Journal of Australia ISSN: 0025-
729X 2 April 2012 196 6 410-411
©The Medical Journal of Australia 2012
Reflections — feature
e were invited to reflect upon brain–mind–
pain interactions and to opine on whether
modern neuroscience adequately considers
pain phenomena and experience. One might suggest that
adequacy is not a particularly lofty goal in this respect.
However, if we were to consider whether modern
neuroscience thoroughly, or precisely, considers pain
phenomena and experience, we would have to conclude
in the negative.
Classically, clinicians have been taught to ask patients a
series of questions to extract the information required to
establish a diagnosis. Although this is standard practice,
it may mean that the individual patient’s experiences are
not heard. This is not always seen to be a bad thing —
removing the patient’s perspective might be considered
to make the interview more objective. Contrast this view,
however, with the common complaint from patients with
longstanding pain that they feel they have never had a
chance to fully explain what is going on with them, that
no one has ever fully understood what is wrong and,
moreover, that no one is listening. Dissatisfaction and
disempowerment are not the only risks here — scientists
show us that such feelings are likely to be associated with
up-regulation of our protective systems, most notably
the nociceptive pain system.1 Aside from that, the folly
of eliminating a patient’s report from his or her pain
assessment has been highlighted for decades. Patrick
Wall, perhaps the forefather of modern pain science,
repeatedly stated that pain research was a waste of time
unless it directly answered questions that are of interest
to patients as well as clinicians.2
Brain neuroscience as it relates to our understanding of
pain really only arrived a century ago. It was pioneered by
such Cartesian dualists as Charles Sherrington and John
Eccles, who separated the concept of the mind from the
brain, and whose data paved the way for an alternative
perspective — that the mind could be directly attributed
to the brain. Quickly, aspects of the mind were attributed
to specific areas of the brain, and the brain was
considered to directly possess experiences. The brain
was seen as able to reason, to perceive and to construct
schemata. These abilities were, more and more,
considered properties of specific anatomical centres
within the brain.
Philosophy offers a different viewpoint, classifying
such conclusions as mereological fallacies — or the
misattribution of a property of the whole being to a single
part of that being.3 The problem arises because the
terminology of these “fallacies” fits with common
language and syntax and represents a logical argument
for the way things “are”. While the linguistic aspects of
such fallacies are easy to appreciate, the philosophical
perspective suggests that the “logic” is seriously flawed.
For example, taking time to consider commonly used
statements such as “the brain thinks” or “the brain
produces pain” leaves fundamental questions over their
plausibility. Could we really enact Roald Dahl’s fantastic
story of William,4 who is kept alive and conscious by an
eccentric neuroscientist as only a brain and an eye,
floating for eternity in a tub of fluid with a heart–lung
machine pushing blood in and out? Could we seriously
expect the brain formerly belonging to William to be
capable of thinking or of producing pain? A philosopher
might disagree with William’s neuroscientist friend, and
suggest that it is instead the whole person who
experiences, reasons, perceives and constructs schemata.
If so, it is also clearly the whole person who is in pain.
The study of pain has historically been closely linked to
dualism and therefore to similar mereological fallacies,
that raise their head in both the clinical and research
settings. Increasingly, patients are being told that their
pain is in their brain. We have no doubt that such
messages are delivered by well intentioned clinicians,
who are rightly dissatisfied with outdated concepts of the
biology of pain. Such dissatisfaction certainly lends itself
to ready acceptance of new paradigms, however
implausible they may be — fancy proposing that one’s
pain is in one’s head when it is clearly in one’s back! It is
a fine line, though, between embracing the critical role
of brain-held mechanisms in producing pain and
presuming that it is in these mechanisms where the
pain itself resides.
Our perspective is that pain is emergent. Emergent
properties are those that are possessed by entire systems.
A system comprises several distinct parts, and these parts
interact with one another to give the system its emergent
properties. There are two ruling criteria of emergence:
that the one system, comprising the same components,
can produce a range of emergent properties; and that
none of the individual units comprising the system are
capable in themselves of producing any of the emergent
properties. The temptation is to simplify things a little
and state that pain is an emergent property of the brain.
First-person neuroscience and the understanding
of pain
Michael A Thacker
Lectur er1
G Lorimer Moseley
BAppSc(Phty)(Hons), PhD,
Professor of Clinical
Neurosciences and Chair in
Physi other apy,2 and Senior
Research Fellow3
1 Centre of Hu man and
Aerospace Ph ysiological
Sciences, and Pain Research
Section, Department of
Neuroimaging, I nstitute
of Psychiatr y,
King’s College London,
London, UK.
2 Sansom Institute for
Health Research, University
of South Australia,
Adelaide, SA.
3 Neuroscience Research
Australia, Sydney, NSW.
doi: 10.5694/mja12.10468
Might science need philosophy for a
precise and complete understanding
of pain?
411MJA 196 (6) · 2 April 2012
Indeed, either or both of us have fallen into this
oversimplification in our writing at some stage. However,
on what grounds do we confine the system to the brain?
A more accurate position is that pain is an emergent
property of the person who is suffering it. There is a
compelling body of research that clearly challenges a
“neurocentric” view of pain and, in so doing, allows the
propagation of new conceptual models with which to
investigate conditions such as complex regional pain
Does this Gestalt-like view have any relevance for
the attempts of modern neuroscience to elucidate pain?
A cynical view might suggest that neuroscientists are
bothered by data that deviate from the expected results (a
problem confined to neither neuroscientists nor modern
times7). In such instances, outliers might be omitted until
the data fit the expected and “acceptable” level, or the
composite images from functional imaging studies may
be “cleaned up” to look more like the predicted pain
matrix. Furthermore, the concept of emergent properties
requires clinicians and scientists to understand pain
across several domains: to have contextual knowledge of
neuroscience, immunology, endocrinology, psychology,
sociology and philosophy. Most of us have been trained
as specialists in one area and are reluctant to dip even a
toe into other specialties, especially, perhaps, philosophy,
which is notoriously challenging due to its strange and
difficult terminology.
Yet pain is well within the scope of philosophers —
Brentano, Husserl, Heidegger, Sartre and Merleau-Ponty
all discussed pain as a phenomenological entity.
Phenomenology refers to the study and understanding of
human experience and the way in which things are
perceived, as they appear in the structure and processes
of consciousness, and therefore directly deals with the
subjective aspects of pain. As biomedically trained clinical
scientists, we have a growing interest in how this
philosophical field may influence both the scientific and
clinical understanding of pain. Phenomenology takes a
first-person perspective — it is based on what the person
experiences. This contrasts with empirical science and
clinical observations, which have an observational,
objective, third-person perspective. The dialectical
challenge here is patently obvious: there seems to be
a very large gap between the two perspectives that
requires considerable confidence to leap.
What might be needed to help us make this leap?
Several groups have proposed methods with which to
bring the first- and third-person perspectives together8-10
— collectively forming a new field of “first-person
neuroscience”, or the study of a “first-brain
perspective”.9 First-person neuroscience attempts to
combine the subjective experience of an individual with
physiological data obtained in the third-person domain.
The first-person perspective is dependent on both
introspection and phenomenological analysis, and its
proponents claim that they are elucidating the “science of
experience”. This is where the whispering in our minds
becomes distracting — “How can we control for
confounders?”; “Look at all the bias-related threats to
validity!”. Yet ground is surely being made — a small
community of first-person neuroscientists has formed
the vanguard in this area, with elegant studies of
psychopathological abnormalities, mental illness and
neurological disease.9 Work has been done in the pain
field,10 but, perhaps not surprisingly, it has received little
attention from the wider pain community.
Might the clinical community more readily embrace
first-person neuroscience in their pain practice? We
suspect that there are already a select few who go beyond
the routine medical history to extract the feelings and
experiences of the individual patient, together with the
meaning for the person and its impact on his or her life.
Psychologists are charged with first-person assessment,
although few schools of psychology pay attention to
phenomenological aspects. Most other specialties apply
third-person analysis to evaluate a series of answers in
the hope of identifying the source structure or
dysfunction that is causing the pain. Clearly, the
conceptual gap between pain as an injury, a dysfunction
or even a disease and pain as a state that emerges from
the whole person is vast. If we are to bridge this gap,
we need conceptual frameworks that provide a way of
integrating first- and third-person perspectives into our
thinking about pain. Long have we all lamented the
barriers that seem to stand between clinicians and
scientists as they search for better treatments for people
in pain. But the ante may well have been upped, for it is
time to also bring the philosophers to the table.
Competing interests: Lorimer Moseley has received consultancy fees from Grünenthal
and spea ker’s fees or t ravel expenses for meetings organised by NOIGroup Au stralia,
Boehringer Ingelheim Europe, Grünenthal Europe and Sandoz.
Provena nce: Commissioned; not externally peer reviewed.
1Butler DS, Moseley GL. Explain pain. Adelaide: NOIGroup Publications, 2003.
2Wall P. Pain: the science of suffering. London: Orion Books, 1999.
3Bennett MR, Hacker PMS. Phi losophical found ations of neuros cience. Oxford:
Blackwell Publishing, 2003.
4Dahl R. Willi am and Mary. In: Kiss kiss. Harmo ndsworth: Penguin, 1960.
5Marinus J, Moseley GL, Birklein F, et al. Clinical features and pathophysiology of
complex regional pa in syndrome. Lanc et Ne urol 2011; 10: 637-6 48.
6Mose ley GL , Galla ce A, Spence C. Bod ily il lusion s in h ealth a nd di sease:
physiological and clinical perspectives and the concept of a cortical ‘body
matrix’. Neurosci B iobehav Rev 2012; 36: 34-46.
7James W. The principles of psychology. New York: Henry Holt, 1890.
8Gallagher S . Phenomeno logy and experi mental design : toward a
phenomenologically enlightened experimental science. J Conscious Stud 2003;
10: 85-9 9.
9Northoff G, Qin P, Feinberg TE. Brain imaging o f the self — conceptual,
anatomical and methodological issues. Conscious Cogn 2011; 20: 52-63.
10 Price DD, Barrell JJ, Rainville P. Integrating experiential-phenomenological
methods a nd neuroscience to s tudy neural mech anisms of pai n and
consciousness. Co nscious Cogn 2002 ; 11: 593-608.
the conceptual
gap between
pain as an injury,
a dysfunction or
even a disease
and pain as a
state that
emerges from
the whole
person is vast
... Effective pain treatment requires health professionals to adopt a holistic understanding of pain across several domains, including neuroscience (Louw et al., 2020), immunology, endocrinology, sociology, psychology, and philosophy (Thacker & Moseley, 2012). ...
Full-text available
Objectives: To explore how Australian exercise physiologists (EPs) utilise pain neuroscience education (PNE) in their management of patients with knee osteoarthritis. Methods: A semi-structured interview concerning a knee osteoarthritis vignette was designed to understand each participant's beliefs about physical activity, pain, injury and coping strategies and quantify their use of pain neuroscience concepts. Themes were derived from pre-determined pain target concepts as well as others that emerged from thematic analysis. Results: Thirty EPs (57% male, mean clinical experience 7 years (SD 7.1) participated in the semi-structured interviews. 13 themes emerged. EPs primarily focussed on: (1) active treatment strategies are better than passive, (2) pain and tissue damage rarely relate, and (3) learning about pain can help individuals and society. Other themes included the use of biomedical-based education, pain during exercise and delivery of PNE. Underutilised themes included the role of the brain in pain, validation that pain is real and personal, the concept of danger sensors as opposed to pain sensors, and pain depends on the balance between safety and danger. Conclusion: EPs primarily advised on active treatment approaches (e.g. exercise and self-management). Quality of care is likely to improve through increasing focus on the systemic benefits of exercise in overcoming psychological barriers (e.g. fear avoidance and pain catastrophising) that may prevent exercise treatment engagement. Broadening PNE to reconceptualise knee osteoarthritis pain as a sign of an overprotective nervous system, rather than structural damage, may facilitate greater patient engagement in exercise therapies, thus improving patient outcomes.
... While some of the PNE statements we used contain metaphors, their logical propositional structure is that of "truth claims" that presume to convey an "objective" scientific truth (Klement, 2004). The act of suggesting a so-called "objective" scientific truth to explain a first person's (subjective) lived experience has been identified as a possible source for tension between clinicians and patients (Bennett et al., 2003;Playle, 1995;Quintner et al., 2008;Thacker and Moseley, 2012). In effect, we claim that the many suggested "truths" of PNE are nothing but mere opinions and philosophical stances (i.e., dualism, constructivism, neuroessentialism, and homuncular views) that do not genuinely reflect an "objective" agreed-upon consensus in pain science and medicine. ...
Full-text available
Background Pain neuroscience education(PNE) programs have become popular among clinicians and are widely promoted through social and mainstream media. Purpose To test the hypothesis that people with persistent pain are likely to express negative attitudes to PNE statements and compare their responses to other social media user groups. Methods A total of 1319 respondents completed an online survey and were directed into four groups: persistent pain, healthcare professionals with persistent pain, pain-free healthcare professionals, and pain-free controls. The survey included ten statements of popular PNE concepts. Feedback was invited by offering seven attitudinal response categories(three positives, three negatives, and one neutral). A two-step hierarchical regression model was used to assess the likelihood of reporting negatively. Results Compared to controls, respondents from the persistent pain group were more likely to report negatively towards all statements(OR 1.6–2.16), except for two statements(#3 and #5). Healthcare professionals were less likely to report negative attitudes for 4 out of 10 statement(OR 0.35–0.58). Health care professionals living with persistent responded to most statements like the pain-free controls(besides statement #2, OR 0.59). Conclusion People living with persistent pain are more likely to express negative attitudes to PNE statements on social media, unlike healthcare professionals who were less likely to express negativity. Healthcare professionals living with persistent pain responded to most PNE statements like the pain-free control group. The study's main weaknesses include the lack of psychometric information of the questionnaire used, selection bias, small samples of the healthcare professionals and the overrepresentation of young social media users.
... We will conclude on this basis that the EPP theory satisfies the constraint on an adequate explanation of pain that it make intelligible in the terms of the science of pain, how pain as it is described in phenomenology could be neurobiologically constituted (cf. Northoff 2014Northoff , 2018Thacker & Moseley 2012). ...
Full-text available
This paper aims to provide a theoretical framework for explaining the subjective character of pain experience in terms of what we will call ‘embodied predictive processing’. The predictive processing (PP) theory is a family of views that take perception, action, emotion and cognition to all work together in the service of prediction error minimisation. In this paper we propose an embodied perspective on the PP theory we call the ‘embodied predictive processing (EPP) theory. The EPP theory proposes to explain pain in terms of processes distributed across the whole body. The prediction error minimising system that generates pain experience comprises the immune system, the endocrine system, and the autonomic system in continuous causal interaction with pathways spread across the whole neural axis. We will argue that these systems function in a coordinated and coherent manner as a single complex adaptive system to maintain homeostasis. This system, which we refer to as the neural-endocrine-immune (NEI) system, maintains homeostasis through the process of prediction error minimisation. We go on to propose a view of the NEI ensemble as a multiscale nesting of Markov blankets that integrates the smallest scale of the cell to the largest scale of the embodied person in pain. We set out to show how the EPP theory can make sense of how pain experience could be neurobiologically constituted. We take it to be a constraint on the adequacy of a scientific explanation of subjectivity of pain experience that it makes it intelligible how pain can simultaneously be a local sensing of the body, and, at the same time, a more global, all-encompassing attitude towards the environment. Our aim in what follows is to show how the EPP theory can meet this constraint.
... For example, acute damage to the structures of the spine inevitably involves the nociceptive system, conveying signals from the periphery to the central nervous system. But there is more to it than just nociceptive signaling [71]. As with other pain conditions, people of all ages who experience spinal pain try to make sense of their pain by drawing on previous experiences, and social and cultural contexts. ...
Full-text available
Spinal pain in adults is a significant burden, from an individual and societal perspective. According to epidemiologic data, spinal pain is commonly found in children and adolescents, where evidence emerging over the past decade has demonstrated that spinal pain in adults can, in many cases, be traced back to childhood or adolescence. Nevertheless, very little focus has been on how to best manage spinal pain in younger age groups. The purpose of this article is to put the focus on spinal pain in children and adolescents and highlight how and where these problems emerge and how they are commonly dealt with. We will draw on findings from the relevant literature from adults to highlight potential common pathways that can be used in the management of spinal pain in children and adolescents. The overall focus is on how healthcare professionals can best support children and adolescents and their caregivers in making sense of spinal pain (when present) and support them in the self-management of the condition.
... 29 Modern understanding of pain is that it is multifactorial and not solely dependent on "input" from tissues. 3,45 Notably, there is an ambiguous link between nociception and pain and a disparity between reported pain and disability. 2 The multifactorial nature of pain is unlikely to be captured solely by a pain provocation test or by basing diag- ...
Full-text available
Objective: To assess the diagnostic test accuracy of pain provocation tests for the sacroiliac joint. Design: Systematic review of diagnostic test accuracy. Literature search: Eight electronic databases and reference lists of included studies and previous reviews. Study selection criteria: Studies investigating the diagnostic accuracy of clusters of clinical tests for sacroiliac joint pain. Data synthesis: Bivariate random effects meta-analysis was employed. Risk of bias and applicability concerns were assessed using the QUADAS-2 tool and the GRADE tool to judge credibility of evidence. Results: From 2195 records identified in the search, five studies were included that assessed clusters of pain provocation tests for the sacroiliac joint. The estimated likelihood ratios (LLR) and diagnostic odds ratio (DOR) were positive LLR (2.13, 95%CI: 1.2, 3.9), negative LLR (0.33, 95% CI: 0.11, 0.72) and DOR (9.01, 95% CI: 1.72, 28.4). GRADE ratings for the outcomes were of very low certainty. Assuming a point prevalence of sacroiliac joint pain of 20%, we calculated positive posterior probability of 35% (95%CI: 32%, 46 37%) and negative posterior probability of 8% (95%CI: 6%, 10%). Conclusions: A positive result on a sacroiliac joint pain provocation test cluster gives the clinician 35% certainty of having correctly identified sacroiliac joint pain. Clusters of pain provocation tests for the sacroiliac joint do not provide sufficient diagnostic accuracy for ruling in the sacroiliac joint as the source of pain. Clinicians can rule out the sacroiliac joint as the source of pain with more confidence-the negative post-test probability indicates the clinician can conclude with 92% certainty that a negative test result is correct. J Orthop Sports Phys Ther, Epub 1 Jul 2021. doi:10.2519/jospt.2021.10469.
... Although some have discussed the combination of first-and third-person approaches and potential methods in the context of pain (Thacker & Moseley, 2012), in general, the four domains (physiological, experiential, sociocultural, and existential) are still all too often entertained partly or independently in pain research and clinical practices. Research methods in the physiological domain are typically quantitative, such as in vivo and in vitro electrophysiological studies, neuroimaging, or behavioral testing. ...
Full-text available
In recent years, the societal and personal impacts of pain, and the fact that we still lack an effective method of treatment, has motivated researchers from diverse disciplines to try to think in new ways about pain and its management. In this paper, we aim to develop an enactive approach to pain and the transition to chronicity. Two aspects are central to this project. First, the paper conceptualizes differences between acute and chronic pain, as well as the dynamic process of pain chronification, in terms of changes in the field of affordances. This is, in terms of the possibilities for action perceived by subjects in pain. As such, we aim to do justice to the lived experience of patients as well as the dynamic role of behavioral learning, neural reorganization, and socio-cultural practices in the generation and maintenance of pain. Second, we aim to show in which manners such an enactive approach may contribute to a comprehensive understanding of pain that avoids conceptual and methodological issues of reductionist and fragmented approaches. It proves particularly beneficial as a heuristic in pain therapy addressing the heterogenous yet dynamically intertwined aspects that may contribute to pain and its chronification.
... Resting state functional magnetic resonance imaging (rs-fMRI) is a useful tool for investigating brain networks underlying pain processing in healthy participants and perturbations in these networks in chronic pain patients. Pain is an emergent property; a multi-system response to perceived threats to the body, comprising peripheral and central, autonomic, endocrine and immune components (Thacker & Moseley, 2012). Changes in functional connectivity (FC) from "task negative" to "task positive" networks (e.g. the "default mode" and "salience" networks -DMN/SN respectively) have been reported in various chronic painful conditions (Baliki, Mansour, Baria, & Apkarian, 2014;Schwedt et al., 2013;Seminowicz & Davis, 2007a). ...
Full-text available
Background Functional connectivity (FC) perturbations have been reported in multiple chronic pain phenotypes, but the nature of reported changes varies between cohorts and may relate to the consequences of living with chronic‐pain related comorbidities, such as anxiety, and depression. Healthy volunteer studies provide opportunities to study the effects of tonic noxious stimulation independently of these sequelae. Connectivity changes in task negative and positive networks, for example, the default mode and salience networks (DMN/SN), respectively, have been described, but how these and other connectivity networks, for example, those governing descending pain control are affected by the presence of tonic, noxious stimulation in healthy, pain‐free individuals remains unknown. Method In 20 healthy volunteers, we assessed FC prior to, during, and following tonic cold painful stimulation in the ventromedial prefrontal cortex (vmPFC), rostral anterior insula (rAI), subgenual anterior cingulate cortex (ACC) and periaqueductal grey (PAG). We also recorded subjectively reported pain using a computerised visual analogue scale. Results: We saw DMN FC changes during painful stimulation and that inter‐network connectivity between the rAI with the vmPFC increased during pain, whereas PAG‐precuneus FC decreased. Pain‐induced FC alterations persisted following noxious stimulation. FC changes related to the magnitude of individuals’ subjectively reported pain. Conclusions We demonstrate FC changes during and following tonic cold‐pain in healthy participants. Similarities between our findings and reports of patients with chronic pain suggest that some FC changes observed in these patients may relate to the presence of an ongoing afferent nociceptive drive.
Introduction Chronic pain is a widespread problem and predicted to rise, yet remains poorly understood. Acupuncture is a frequently used intervention for pain. Acupuncture can be understood as a complex intervention involving ‘specific’ and ‘non-specific’ effects. Given the complexity of acupuncture therapy, and the inherently subjective and multidimensional nature of pain, acupuncture might therefore interact with pain at a multidimensional level, with implications for the therapeutic encounter and how this influences experiences of pain. The aim of this research was to re-examine and thus enhance understandings of how lived experiences of being-in-pain encounters acupuncture therapy. Methods Research design and analysis was carried out using Interpretative Phenomenological Analysis (IPA). Phenomenology has been widely applied in pain research, yet there is a relative paucity of acupuncture phenomenological studies. An opportunity thus exists to re-examine the complexity of the therapeutic encounter from this perspective. In depth, semi-structured interviews were carried out with a purposive sample of three participants recruited from a private acupuncture clinic. Results Three superordinate themes explicated the encounter: (1) A journey of becoming a person-in-pain and arriving at acupuncture, (2) The embodied encounter with acupuncture, and (3) Acupuncture as an intersubjective encounter of evolving meanings. Conclusion Applying a phenomenological perspective revealed self-identity, temporally and socially-constituted meanings, and relationship dynamics as integral to the encounter. Deqi (therapeutic needling) was a complex, temporal, meaningful construct that went beyond established sensory descriptors. Pain alleviation was important but validation and the alleviation of personal suffering often took priority.
It is the psychological dimension that brings life to the lived experience, much like colour and textures enliven a painting. Contemporary understanding of the lived experience via the study of phenomenology, enactivism and embodied cognition informs us that ‘what it is like’ is not separate to the physical body or the circumstances within which the experience arises. One can consider thoughts and emotions, which emerge together, and bodily sensations to be embodied and embedded within a context. This context is modern society.
When acute pain persists beyond the expected healing time following an injury, important neurological changes occur that allow pain to transition from adaptive to maladaptive. Spine pain has become an important global problem, with significant increases in prevalence, disability, and subsequent healthcare costs over the past several decades. Low back pain is now the number one cause of disability in the world. Because of the magnitude of the effect of low back pain, and especially chronic low back pain, it has become imperative that we embrace the best available evidence and clinical sensibilities as we work with patients to find appropriate solutions. Intrinsic to the successful care of persons with spine pain is the acknowledgment that the experience of pain is a biopsychosocial one. There is no universal experience of pain and thus our solutions must accommodate variation in the meanings of pain. Experiential (qualitative, subjective) knowledge of spinal pain can be integrated with our understanding of spinal pain neurobiology (quantitative, objective) in rehabilitation contexts to improve health outcomes. Ultimately, the rehabilitation of persons with spine pain exists at the intersection of the objective and subjective goals of care.
Full-text available
I review three answers to the question: How can phenomenology contribute to the experimental cognitive neurosciences? The first approach, neurophenomenology, employs phenomenological method and training, and uses first-person reports not just as more data for analysis, but to generate descriptive categories that are intersubjectively and scientifically validated, and are then used to interpret results that correlate with objective measurements of behaviour and brain activity. A second approach, indirect phenomenology, is shown to be problematic in a number of ways. Indirect phenomenology is generally put to work after the experiment, in critical or creative interpretations of the scientific evidence. Ultimately, however, proposals for the indirect use of phenomenology lead back to methodological questions about the direct use of phenomenology in experimental design. The third approach, 'front-loaded' phenomenology, suggests that the results of phenomenological investigations can be used in the design of empirical ones. Concepts or clarifications that have been worked out phenomenologically may operate as a partial framework for experimentation.
Full-text available
A complex regional pain syndrome (CRPS)--multiple system dysfunction, severe and often chronic pain, and disability--can be triggered by a minor injury, a fact that has fascinated scientists and perplexed clinicians for decades. However, substantial advances across several medical disciplines have recently improved our understanding of CRPS. Compelling evidence implicates biological pathways that underlie aberrant inflammation, vasomotor dysfunction, and maladaptive neuroplasticity in the clinical features of CRPS. Collectively, the evidence points to CRPS being a multifactorial disorder that is associated with an aberrant host response to tissue injury. Variation in susceptibility to perturbed regulation of any of the underlying biological pathways probably accounts for the clinical heterogeneity of CRPS.
Review of the book Philosophical foundations of neuroscience by M. R. Bennett and P. M. S. Hacker. Those who take up the task of reading the 450 pages of this book can accept or reject one or more of the ideas and conclusions of the authors--but they will be unable to go back to "science as usual," passively accepting the dogmas so strongly shaken by the current authors. This means that the book is mandatory reading material. The book has several important merits. First, the tandem of prominent authors--a neurophysiologist and a philosopher--are fully devoted to the search for truth and clarity, not to impress the public with a new bestseller. Second, it is written in excellent English, with a brilliant sense of humor. Third, it is extremely comprehensive and in this respect, reminds one of James's Psychology. The authors consecutively analyze all forms of mental activity: sensation, pain, perception, imagination, memory, thinking, knowledge and beliefs, emotions, volition, and different kinds and subdivisions of consciousness. In addition to this, the authors briefly review the history of philosophical ideas as manifested in the classics of neuroscience from Willis and Bell to Adrian, Eccles, and Penfield. They discuss methodological issues in the study of the mind-body problem and formulate a clear, though not uncontroversial, view on what is possible and impossible for neuroscience, as well as what is possible and impossible for philosophy. They close with an analysis of the several most influential approaches in the modern philosophy of mind, as represented in the recent books of the Churchlands, Dennett, and Searle. Thus, the authors do not leave out any of the important problems of interest for cognitive and behavioral neuroscience. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
In this paper we consider two major issues: conceptual-experimental approaches to the self, and the neuroanatomical substrate of the self. We distinguish content- and processed-based concepts of the self that entail different experimental strategies, and anatomically, we investigate the concept of midline structures in further detail and present a novel view on the anatomy of an integrated subcortical-cortical midline system. Presenting meta-analytic evidence, we show that the anterior paralimbic, e.g. midline, regions do indeed seem to be specific for self-specific stimuli. We conclude that future investigation of the self need to develop novel concepts that are more empirically plausible than those currently in use. Different concepts of self will require novel experimental designs that include, for example, the brain's resting state activity as an independent variable. Modifications of both conceptual and anatomical dimensions will allow an empirically more plausible account of the relationship between brain and self.
Understanding the nature of pain at least partly depends on recognizing its inherent first person epistemology and on using a first person experiential and third person experimental approach to study it. This approach may help to understand some of the neural mechanisms of pain and consciousness by integrating experiential-phenomenological methods with those of neuroscience. Examples that approximate this strategy include studies of second pain summation and its relationship to neural activities and brain imaging-psychophysical studies wherein sensory and affective qualities of pain are correlated with cerebral cortical activity. The experiential paradigm of offers the possibility of improved designs and methods for investigating neural mechanisms underlying pain and consciousness.