Direct and indirect perceptual theories of Pain

The perceptual view of pain as presented so far is a view even an indirect realist can subscribe to, although, as a matter of historical fact, very few indirect realists have done so (Perkins 1983, 2006; Maund 2003, 2006). A sense-datum theorist is someone who thinks that all perception of extramental reality is indirect, mediated by a direct perception of sense-data that stand in certain systematic relations to extramental objects in the world in virtue of which sense-data contingently come to represent them. So it is entirely possible, in fact reasonable, to hold that pain sense-data are also representational. In other worlds, direct awareness of pain sense-data could constitute the indirect perception of tissue damage in bodily regions which typically and systematically cause these sense-data.

The reason why this line was not pursued by indirect realists has probably something to do with the intuitive resistance against any perceptual view of pain already embedded in our ordinary conception that we discussed above.^[10] Indirect realists like sense-datum theorists, as we have already seen, have the theoretical resources to accommodate the intuitive understanding of pain without forcing it into a perceptualist mold. Without any qualms, they can say that we are directly and immediately aware of pain qua a mental object or quality, whether or not this signals tissue damage. This is to say that they already have a locus of concept application in their theory for the concept of pain: PAIN directly applies to the experience or to its internal direct object, i.e., to either a sense-datum or to its direct awareness. This seems to accommodate all the intuitions embedded in common sense; why go further? Furthermore, if one is not a perceptualist, one doesn’t have an obligation to deal with what we’ll call below the problem of focus, the problem of explaining why there is an asymmetry in conceptual focus between pain and standard exteroception if both are genuinely perceptual.

In practice, almost all defenders of perceptual view of pains are direct realists. If one wants to run a direct realist version of the perceptual theory, however, one immediately runs into the difficulty of finding an appropriate locus for direct perceptual awareness, and for that matter, a locus for immediate concept application; that is, one runs into the difficulty of finding an object, state, or event to which we spontaneously apply PAIN, ITCH, TICKLE, etc., when we are introspectively aware of our pains, itches, tickles, etc., and report them on this basis. This difficulty arises because the mark of any (early) direct realism in the theory of perception is the repudiation of consciously available perceptual intermediaries that mediate standard exteroception: when I see a red apple on the table, there is no object or quality distinct from the apple and its redness such that I see the apple in virtue of seeing it (or more generally, in virtue of directly perceiving or being aware of it). On this view, when I see an apple, I directly perceive, or am directly acquainted with, the apple and its qualities such as its redness. This view works well in veridical perception: the locus of concept application is always the public object of perception, like the apple and its properties. It also explains why the spontaneous concept application is the way it is even when one hallucinates or have illusions: even when one hallucinates a red apple, one is naturally disposed to apply the concept RED APPLE to what one either takes or is tempted to take to be the public object of one’s epistemic efforts and its publicly available features, and rarely to what one believes to be a private mental object or quality.

But how is the repudiation of consciously available perceptual intermediaries to be reconciled with the admission that the concept of pain is the concept of a subjective sensation/experience of a certain sort? Recall that most perceptual theorists admit that introspective reports of pain in body regions are reports of experiences that represent physical disorder of some sort in those regions. This is just to say that when one is in pain one is directly aware of a sensation or experience, i.e., pain. This in turn means that the concepts we are spontaneously prompted to apply in having pains and other intransitive bodily sensations directly apply to the prompting sensations/experiences in the first place — appearances to the contrary. So how to understand the direct realist’s talk of conscious sensations or experiences?