{"id":21783,"date":"2026-06-10T13:24:26","date_gmt":"2026-06-10T13:24:26","guid":{"rendered":"https:\/\/www.embryo.nl\/?p=21783"},"modified":"2026-06-13T14:26:57","modified_gmt":"2026-06-13T14:26:57","slug":"pijn-voelen-is-iets-ander-dan-pijn-denken","status":"publish","type":"post","link":"https:\/\/www.embryo.nl\/en\/pijn-voelen-is-iets-ander-dan-pijn-denken\/","title":{"rendered":"FEELING PAIN IS DIFFERENT FROM THINKING ABOUT PAIN"},"content":{"rendered":"

June 4, 2026. Thinking About Pain<\/strong><\/h4>\n

A well-known columnist, Max Pam, wrote a column in a prominent Dutch daily newspaper (De Volkskrant) on May 26, 2026, following an accident at home in which he had hit his head very hard. Complete with swelling and a headache. He bought The Pain Book<\/i> by pain researchers Esmeralda Blaney Davidson and Hans Timmerman.<\/p>\n

The first thing that struck him was the definition of pain. It read: \u201cPain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.\u201d Not without a sense of humor, he writes about this: \u201cThis is the kind of definition that reminds me of the definition of sociology that caused me to lose interest in sociology back then\u201d and \u201cA definition like that hurts your eyes and your ears.\u201d<\/p>\n

JvdW. Potential tissue damage? What is that? Tissue damage that isn\u2019t yet tissue damage and yet is apparently perceived as such? By what or whom, then?<\/em><\/p>\n

It strikes me that nowadays pain and the sensation of pain are almost immediately linked to so-called nociceptors. This definition comes from Wikipedia: Nociceptors (also known as pain receptors) are specialized nerve endings in our body that function as a warning system. They register potential or actual tissue damage and, in case of danger, send an alarm signal via the nervous system to the brain, which we experience as pain. <\/em>And so nociceptors are half-heartedly interpreted by many people as pain receptors. The latter is, by definition, impossible. Pain is not a perception, not a sensory observation. There are no receptors that are activated by a so-called specific pain stimulus. Many people likely have Descartes\u2019 half-baked image in their minds, which suggests that pain is a stimulus that is transmitted from the foot to the brain, where it is \u201cconverted\u201d into the experience of pain. The definition of pain the columnist refers to is clear: there is certainly an association between nociceptors, tissue damage, and pain. But that does not make the two phenomena equal! Consider the following example. It is undeniable that there is a direct association between brain activity and consciousness or thoughts. Nowadays, due to technological developments, these two concepts are coming so close together that, with little effort, the gap between the two realities is overlooked and one is equated with the other. And so many people today are convinced that the brain produces consciousness and thought. It is a classic example of confusing the conditions for a phenomenon (brain activity) with the phenomenon itself (consciousness, thought) .<\/p>\n

The same applies to nociception. These chemoreceptors are said to respond to substances released during ischemia or tissue damage and converted by our brain into the sensation of pain. They are said to respond to three types of harmful stimuli: mechanical (cutting, impact), thermal (extreme heat or cold), and chemical (corrosive or inflammatory substances), according to Wikipedia. These are therefore not \u201cpain stimuli.\u201d Here, two distinct concepts are being conflated. An example. The brain and consciousness are separated (distinguished) from one another by the absolute gulf of the fact that one is a material reality (because it is measurable, quantifiable) and the other is a mental reality (because it can only be experienced individually). After all, no one can experience or perceive the consciousness or thoughts that you have; it is an indivisible reality. The subjective reality of your thoughts is not a reality measurable by another. Neurophysiology and neuropsychology distinguish these two realities as the first-person reality (subjective, consciousness, experienced, lived, participatory reality) and the third-person reality (objective, observable, spectator reality). And there is no neurophysiologist who can explain how a ponderable (material) reality would transition into its opposite, namely an imponderable (mental) reality.<\/p>\n

Our columnist goes further and reads, among other things, about pain thresholds that may malfunction, but also that, according to the book\u2019s authors, pain simply remains an enigmatic phenomenon: \u201cEveryone knows it, no one understands it.\u201d He notes that Ludwig Wittgenstein pointed out that your pain cannot be felt by another person, nor can you feel another person\u2019s pain, which, due to the inadequacy of language, leads to misunderstandings experienced daily by doctors and patients. We cannot speak of our pain, yet nothing is shouted out so loudly.<\/p>\n

There are increasingly more people with pain complaints, pain syndromes, and chronic pain. The explanation for this is often sought in a lowered pain threshold. Such reasoning is again based on the idea that pain is a sensory perception and that there is such a thing as pain receptors. Try applying that to itching, a phenomenon that is perhaps even more misunderstood. Surely you\u2019re not going to claim that there are thousands of itch receptors in your skin just waiting for an itch stimulus? The Dutch philosopher Metz once wrote that pain is the absolute opposite of a (sensory) perception. The senses connect us to the world. The senses with which we see or hear the little bird are, in a certain way, functionally transparent and, in a sense, absent. With an eye that is acting up or inflamed, one can no longer perceive; it demands our attention. Pain does the opposite, making connection with the perceived impossible and throwing us back onto the body. The body in pain separates us from the world and makes us pathologically aware of, for example, a body part.<\/p>\n

The columnist then explains that, like almost every older person, he suffers from chronic lower back pain. To address this, he gets injections at a pain clinic every so often. He recommends this to anyone suffering from pain because the pain begins to subside as soon as he heads home. He says, \u201cDon\u2019t let it get to you, because nagging pain only makes you grumpy and causes you to start avoiding those around you.\u201d Pain does not connect; pain separates. Pain is also not synonymous with nociception, at most associated with it. At the moment, I (JvdW) am suffering from three \u201cforms\u201d of pain. I have muscle pain (which is supposedly a result of the polymyalgia rheumatica I am currently suffering from). I have joint pain (a connective tissue lesion has developed on the inside of my kneecap, perhaps even a small tear). When you experience both types of pain at the same time, it becomes painfully clear that muscle pain is something entirely different from joint pain. On top of all this, I also have neuropathic pain resulting from a herniated disc in my spine that \u201ccauses\u201d radiating pain in my shin and leg. I dare to doubt that all three of these forms of pain have anything to do with nociceptors and tissue damage. But the authors of the definition of pain found a solution for that as well: they distinguish between actual or potential tissue damage.<\/p>\n

It remains difficult with your pain. I sometimes try to understand it as if pain in the body occurs when consciousness arises in a place in the body where it normally isn\u2019t present. A healthy and well-functioning body is transparent. A healthy and well-functioning body fades into the background and serves. When we become aware of that body, it is often disruptive and intrusive. The same goes for pain. The columnist continues: \u201cThe philosopher Bertrand Russell called eternal pain barbaric and the greatest evil for humanity. Yet we cannot do without pain, for there must be something to warn us when our body has taken a blow.\u201d<\/p>\n

A few preliminary conclusions. Pain is not synonymous with nociception. Pain is certainly a sensation but not a perception. Pain receptors do not exist. The first-person reality of pain is in my foot or back; the third-person reality of my pain is an illusion in my brain. For several years, I taught courses to physical therapists on pain, and specifically on the neuroanatomy of pain. We discussed brain centers and connections, spinothalamic nerve pathways, and the like. During the lecture, I would always try to find a student\u2019s foot and, after a warning, step on it. \u201cOuch, that hurts!\u201d \u201cWhere?\u201d \u201cIn my foot, of course.\u201d \u201cWell, it\u2019s not quite that simple. There\u2019s a whole lecture coming up that will make it clear that the pain in your foot is just an illusion produced by the brain.\u201d Surely that can\u2019t be true? Do doctors really assume that your pain is an illusion and that the \u201creal\u201d pain is in your head or hypothalamus? Especially since painkillers often act on the brain. That is unacceptable to a phenomenologist. Pain in my foot is a reality of the first order (reality as I experience, live through, and perceive it\u2014according to philosophers, the Sinneswelt<\/i>); nuclei and pathways are the secondary reality, the reality of the scientific body. One is an absolute prerequisite for the other, certainly. But do we want to go so far as to no longer take the world as we experience it seriously? We already do that with something like a sunset, for example, which is a hard fact in primary reality. But according to the philosopher Staal (1930\u20132012), a sunset is \u201ca scientific myth.\u201d That is correct, because \u201cin reality, the Earth rotates and the sun stands still.\u201d But when Staal then concludes \u201cthat a sunset therefore has no value in reality,\u201d my philosophical world comes crashing down. Wouldn\u2019t we call that \u201cfake news\u201d or \u201cdisinformation\u201d these days? I cannot and will not accept that. The primary reality of the sensory world is the reality in which we have evolved, in which we live, become conscious, and die. To give up that reality for a so-called objective spectator consciousness? No way. The phenomenologist also continues to perceive what is perceived as true and does not reduce his worldview to the objective, observable, measurable, quantifiable reality. But of course, the essential question remains: What does one have to do with the other? Experiencing pain is something entirely different from thinking about pain. And \u201cNever the twain shall meet?\u201d<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

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