Enactive pain and its sociocultural embeddedness

This paper disputes the theoretical assumptions of mainstream approaches in philosophy of pain, representationalism and imperativism, and advances an enactive approach as an alternative. It begins by identifying three shared assumptions in the mainstream approaches: the internalist assumption, the brain-body assumption, and the semantic assumption. It then articulates an alternative, enactive approach that considers pain as an embodied response to the situation. This approach entails the hypothesis of the sociocultural embeddedness of pain, which states against the brain-body assumption that the intentional character of pain depends on the agent’s sociocultural background. The paper then proceeds to consider two objections. The first questions the empirical basis of this hypothesis. It is argued based on neuroscientific evidence, however, that there is no empirical reason to suppose that the first-order experience of pain is immune to sociocultural influences. The second objection argues that the mainstream approaches can account for sociocultural influences on pain by drawing on the conceptual distinction between narrow and wide content. In response, the semantic conception of pain underpinning the proposal is challenged. Pain experience can occur in pre-reflective, affectively reflective, or cognitively reflective forms, but the semantic conception at most only applies to the last form. The paper concludes that the enactive approach offers a promising alternative framework in philosophy of pain.