[The pain-emotion: Advocating pain as an emotion]

Encephale. 2017 Dec;43(6):603-606. doi: 10.1016/j.encep.2017.02.002. Epub 2017 Mar 25.
[Article in French]

Abstract

Objectives: Pain is a common experience, both physical and emotional. However we often feel powerless with our patients suffering pain. This paper aims to give a new heuristic and psychological understanding of pain.

Methodology: According to new theories, recent researches as well as different points of view, we form an analogy between pain and emotion. Throughout historical considerations pain has always been perceived through theories and beliefs, changing its definition. This is also the case for emotion. Could they be two ways of expressing a single phenomenon?

Results: First, we must clarify the definition of emotion. In past, emotion was considered as a multiple-conditioned notion. To be considered as an emotion the pain had to fill numerous features, which differ according to the scientific opinions. The emotion may be considered as a physical expression or perceived only as the consequences of a real emotion, i.e., the subjective feeling. We propose as a way of thinking that emotion brings together these two concepts. We support a flexible vision of emotion. To investigate the field of the emotion different mental steps may be thought of: we should conceive of the emotion as a stimulus, as an emotional evaluation and as a tendency to action, which becomes an emotional response. These steps are colored by subjective feelings. It can be summarized in three levels: the situation decoding (1), the response organization (2) and the effectiveness of the response (3). Second pain can be considered as a complex notion involving personal and subjective feelings. We can use multidimensional patterns and consider emotion with its multiple features: the generating mechanisms, the pain perception, the pain behavior and the environment. Each stage can be divided in different ways. Hence pain treatment could be approached as an emotional treatment. Indeed, we can make a link between generating mechanisms and emotion situation decoding, between pain perception and emotion situation decoding and response organization, between pain behavior and environment and emotion response effectiveness and consequences. A heuristic analogy can be formed enriching therapeutic possibilities. First, emotion and pain could be considered as a unique phenomenon that can be expressed in different ways. We can let aside the opposition between psychological and physiological: these are two different levels of a same phenomenon. This point of view can be helpful to treat pain disorders because the skills to manage emotion disorders are well known.

Keywords: Cognition incarnée; Douleur; Embodied cognition; Emotion; Modèles multidimensionnels; Multidimensional patterns; Pain; Psychotherapy; Psychothérapie; Émotion.

MeSH terms

  • Cognition
  • Emotions*
  • Humans
  • Pain / psychology*
  • Pain Management
  • Pain Perception