Dr. Richard McIlmoyle BSc, DC, PgCPain
Sensation vs Perception Debate
This one has dragged on long enough that we may be able to define it a as a chronic discussion, don’t you think? ;)
What struck me today is that the discussion is arbitrarily creating a false dichotomy.
The IASP definition which I seem to recall, is frequently referenced, states that Pain is a “sensory and emotional experience” Why then are we arguing about whether it is a sensation or perception (I know why… Lorimer Moseley et al have discussed it as such at some point)(1).
When clearly, it is an experience during which we have the embodied perception of a sensory experience.
I have challenged myself to read through what may have been hours of Facebook posts, involving pithy comments by the likes of Ben Cormack, Adam Meakens, as well as posts/blogs by Bronnie Lennox-Thompson, Todd Hargrove (2) and Monika Noy (Noij??).(3)
All the while trying to grasp whether there is any meat on the bone of this discussion (dare I say argument) that I should wrap my head around to help me be a better practitioner?
I had exhausted all avenues and put it to bed until I saw some comments/echoes of the discussion. John Quintner was responding to some comment or another and It struck me, that the reason it had all seemed to be pedantic is that there is a flaw to the argument. It is forcing us to choose between two options that are not independent or present/absent in the experience.
One does not have the experience of pain without perceiving a sensation. There is a conscious awareness that exists when we experience pain that cannot be divorced from sensory experience. Having retained all of my limbs and avoided the experience of a phantom limb, I cannot speak from experience here, however I have spoken with patients with phantom limbs. They have informed me that they do indeed have a perception of sensations in their limbs. The sensory receptors do not exist, yet most of the rest of the hardware (involving the neural activity that represents that limb) does still exist. Albeit, perhaps altered.4,5
So, can't we put this one to bed, by saying pain is an EXPERIENCE, that involves the perception of a sensation???
P L E A S E ! ! ! !
1. Tabor, A., Thacker, M. A., Moseley, G. L., & Kö Rding, K. P. (2017). Pain: A Statistical Account. https://doi.org/10.1371/journal.pcbi.1005142
3. https://www.monicanoy.com/sense-and-sensibility-sensation-pain-perception/?fbclid=IwAR2AvrP0xJ2GInNPZeTD7pyj4AOqBf-jI14L57t1wcpq66IxjMgi9DbGn3Y 4. https://www.facebook.com/todd.hargrove.7/posts/101578354386072002. Condés-Lara, M., Barrios, F. A., Romo, J. R., Rojas, R., Salgado, P., & Sánchez-Cortazar, J. (2000). Brain somatic representation of phantom and intact limb: a fMRI study case report. European Journal of Pain, 4(3), 239–245. https://doi.org/10.1053/eujp.2000.0176
5. Montoya, P., Ritter, K., Huse, E., Larbig, W., Braun, C., Töpfner, S., … Birbaumer, N. (1998). The cortical somatotopic map and phantom phenomena in subjects with congenital limb atrophy and traumatic amputees with phantom limb pain. European Journal of Neuroscience, 10(3), 1095–1102. https://doi.org/10.1046/j.1460-9568.1998.00122.x