“Pain unites.”, states Arne Johan Vetlesen in his “A Philosophy of Pain” — and it therefore ought not surprise how much he is out to cover in this 167-page book. Torture and illness, anxiety and depression, evil and culture, computer games, anorexia and neo-liberalism are among the topics that Vetlesen sees united by pain. Vetlesen’s approach is rooted in cultural criticism and phenomenology. Therefore, the book has two main points: The meaning of pain for the individual and for society.

Using torture, prolonged illness and existentialism as starting points, Vetlesen rightly diagnoses pain as an inherently subjective and individual experience: I can feel and know only my own pain. Inherently, pain attracts one’s attention — the stronger, the more we care, until everything is entrenched with pain. Pain is also the experience of passivity, as pain is something happening to me. Does pain mean something? Does it refer to something like the thought of my leg refers to my actual leg? According to Vetlesen, pain is strongly individualizing in virtue of its privacy and its passive element, both of which point towards its meaning for the individual: I am a vulnerable body, alone in my vulnerability. Loneliness and vulnerability connect physical pain with psychic pains like anxiety, depression and mourning. However, physical pain emphasises that I am a body and thereby alive. Psychic pain on the other hand can lead to being imprisoned inside the mind.

Vetlesen takes this analysis from first-person experience and constructs a specific tension raised by pain: „Pain is in existence as that which absolutely cannot be doubted [from a first-person stance toward my own pain] and that absolutely can be doubted [from the stance of an outsider].” It is this tension we face in scientific research, and it enables us to inhumane acts like torture. Vetlesen claims that our own psychodynamics in dealing with pain tend towards the transportation of pain: we inflict pain in others to get rid of our own pain. This is contrary to sharing pain where I keep my pain. The quantum leap available through culture is the transformation of pain: the symbols offered by culture allow me to deal with my pain without inflicting it onto others. Great works of art dealing with pain, like Munch’s paintings, allow the pain to be experienced without needing to go through the actual experience, thereby providing a coping and learning mechanism for society’s members.

Culture’s role in pain expression and coping is used by Vetlesen’s for his criticism of such cultural phenomena like self-mutilation, anorexia and the growing violence in youth culture or media coverage. Here, the book becomes in parts too simplistic, e.g. when eating disorder, sadomasochistic sex and piercings are all lumped together as manifestations of shame. His diagnosis: after realising our own vulnerability and the impossibility of overcoming it, we seek to control at least the level of pain we can endure. All this leads to a call for higher moral standards in our ways of dealing with pain. Not more transportation and depiction of pain, but more transformation ought to be our goal.

Given the huge area Vetlesen sets out to cover, it is remarkable what he leaves out. Whoever is searching for insights from empirical pain science will not find it here, but instead lots of psychoanalysis. Neither does Vetlesen mention the rich debate on pain in analytic philosophy over the last thirty years; his approach is strictly bound to old-school  phenomenology and cultural theory. Nor does he mention specific medical case studies or neurophenomenological approaches like Nikola Grahek’s outstanding Feeling Pain and Being in Pain. Some conceptual clarity combined with a better knowledge of the empirical literature might have enriched Vetlesen’s analysis of pain. Without this, Vetlesen produces inspirational passages side by side with misleading ones. For an audience of academics in the field of cultural criticism or friends of the feuilleton, this book might provide some gems. Those in search of a better understanding of the phenomenon of pain (instead of its impact) by science, nursing, reports of sufferers themselves, or analytic arguments might better seek for different sources.

© 2010 Sascha Benjamin Fink

Sascha Benjamin Fink is a PhD student at Osnabrück’s Institute for Cognitive Science and a member of the MINDGroup at the Frankfurt Institute for Advanced Studies. His main research is in philosophy of mind, where he specialises in the philosophy of consciousness research and the incorporation of first-person reports in the sciences, as well as philosophy and science of pain and suffering and the implications of science on animal ethics.