van Rysewyk Simon
Department of Philosophy and Gender Studies, School of Humanities, University of Tasmania, Hobart, TAS, Australia.
Front Pain Res (Lausanne). 2023 Aug 2;4:1251676. doi: 10.3389/fpain.2023.1251676. eCollection 2023.
This article contributes a perspective on pain motivated by the philosopher Ludwig Wittgenstein. According to Wittgenstein, the child learns from others that the occasions on which it manifests certain reactions-the reactions that human beings manifest when injured-make it appropriate to self-ascribe "pain". When the child can signal correctly that she is in the requisite bodily state, then she has a conception of pain. Using the concept to symbolise an experience also makes it possible to tell other people what is going on and to solicit their help in managing the pain. In pain discourse, we can say "Sam can tell that Jason is with pain", or "She could tell you that Jason is with pain if she wanted to". These uses are linked to social milieu where rules are learnt for the application of concepts, such as the concept . In many rural communities, adults tell other adults about pain when it interrupts work or social activities. Otherwise, it is normative to "carry on". The rural stoic who tells another about pain only if he wants to can complicate clinical pain management, which can undermine the patient's special authority. In contrast, convergence in pain definitions and judgements between the patient and health professional can protect the authority of the patient and improve the clinical interaction. Pain is not simply a quale that is privately perceived; it must be capable of being expressed. Thus, pain has a social role, which is learnt. The study of linguistic rules in pain discourse could help explain the learning and application of the concept .
本文呈现了一种受哲学家路德维希·维特根斯坦启发的关于疼痛的观点。按照维特根斯坦的说法，儿童从他人那里了解到，当它表现出某些反应——人类受伤时所表现出的反应——时，就适合将“疼痛”归于自身。当儿童能够正确地表明她处于所需的身体状态时，那么她就有了疼痛的概念。使用这个概念来象征一种体验，也能够告诉他人正在发生什么，并在应对疼痛时寻求他们的帮助。在关于疼痛的话语中，我们可以说“萨姆能看出杰森很疼”，或者“如果她愿意，她可以告诉你杰森很疼”。这些用法与社会环境相关联，在这个环境中人们学习概念（如疼痛这个概念）的应用规则。在许多农村社区，成年人在疼痛妨碍工作或社交活动时会告诉其他成年人自己的疼痛情况。否则，“坚持下去”是常态。那种只有在愿意时才会告诉别人自己疼痛的农村坚忍者，可能会使临床疼痛管理变得复杂，进而损害患者的特殊权威。相比之下，患者与医疗专业人员在疼痛定义和判断上的趋同能够维护患者的权威并改善临床互动。疼痛并非仅仅是一种私下感知到的感觉特性；它必须能够被表达出来。因此，疼痛具有一种社会角色，这种角色是后天习得的。对疼痛话语中语言规则的研究有助于解释疼痛概念的学习和应用。
