Is Pain Unreal?

Abstract

Some pain researchers are unconvinced that self-report of pain is reliable, and have urged its replacement with brain-markers of pain. This suggestion is compatible with a radical philosophy called Eliminative Materialism, which asserts that folk psychological claims and generalizations about the nature and causal powers of pain are false,  and face elimination by a mature, neuroscientific theory of pain. Some eliminativists draw inspiration from our intellectual history, which shows that any theoretical claim  can appear correct or beneficial even when it is false. However, the eliminativist accusation that pain folk psychology is explanatorily stagnant is mistaken, given that folk psychology has motivated important psychological and clinical research programs in pain science that have led to new knowledge and improved outcomes for some pain patients. Pain folk psychology is compatible with advances in pain neuroscience, as evident in successful patient education programs, which replace maladaptive beliefs about pain with adaptive folk beliefs informed by accurate pain neurophysiology. This chapter argues that the philosophy of Eliminative Materialism is one possible theoretical outcome on a continuum comprising  many possibilities. The eliminativist needs to produce independent reasons for thinking that pain neuroscience will replace pain folk psychology in the way eliminativism thinks, which is a difficult task given that a central premise required for the outcome envisaged by the eliminativist is unknown. Facts of scientific history alone cannot inoculate Eliminative Materialism from the unjustifiably promissory nature of its central claims.