When pain overwhelms the self: A phenomenological study of a new mode of suffering, based on adults' recollections of their worst pain episodes.
Peter Stilwell, Mael Gagnon-Mailhot, Anne Hudon, Virginia McIntyre, Keith Meldrum, M Gabrielle Pagé, Shaun Gallagher, Timothy H Wideman
Journal of Pain May 2, 2025 DOI: 10.1016/j.jpain.2025.105413 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Qualitative phenomenological study Peer reviewed |
|---|---|
| Sample size | 12 |
| Population | Adults across Canada living with various pain conditions |
| Topics | Philosophy of mind |
| Keywords | Chronic pain Qualitative methods Suffering Thematic analysis Dissociation Self-identity |
| Citations | 8 |
| Key findings | Pain can cause suffering through an immediate, disruptive impact on one's sense of self that does not require self-reflection. |
Abstract
Suffering is a foundational yet understudied construct within the field of pain. There is general agreement that pain-related suffering involves disruption to one's sense of self. The selfhood literature characterizes two inter-related modes of self-experience. One mode entails in-the-moment experiences that shape one's stream of consciousness; another involves self-reflective thoughts about the past or expected future, related to self-narratives and identity. The field's current conceptualization of pain-related suffering is exclusively anchored to the latter, self-reflective mode of experience. Our past work argues that this framing fails to account for pain's immediate, disruptive impact and denies the potential for suffering among individuals without self-reflective capacities (e.g. infants). The purpose of this theoretically-informed, phenomenological study was to explore a new potential way by which people living with pain can suffer. We conducted in-depth, qualitative interviews with 12 adults across Canada living with various pain conditions. Interviews focused on understanding the moment-to-moment experiences of their worst episodes of pain. Results revealed important accounts of pain that overwhelmed thoughts and self-reflective capacities and disrupted foundational aspects of self-experience, including senses of agency, bodily ownership and time. Participants reported that these experiences were incapacitating, dehumanizing and dissociating. The findings are remarkably similar to first-hand accounts of torture and support a new mode of pain-related suffering that does not require self-reflection and is characterized by an immediate, disruptive impact on one's sense of self. Findings will inform the development of the first theoretically-informed and evidence-based definition of pain-related suffering and help advance pain theory and practice. PERSPECTIVE: This qualitative phenomenological study characterizes how pain can radically transform one's in-the-moment sense of self. Results reveal a new mode of pain-related suffering that does not require self-reflection. This supports the expansion of traditional understandings of suffering, exclusively anchored to self-reflection, to now include two inter-related modes of pain-related suffering.
Comparable studies
Other qualitative studies on philosophy of mind, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Qualitative thematic analysis of the phenomenology of near-death experiences Cardiac arrest survivors | 2018 | Qualitative study | n = 34 |
| Phenomenology and Sequelae of 3,4-Methylenedioxymethamphetamine Use Psychiatrists who had taken MDMA | 1992 | Qualitative study | n = 20 |
| A phenomenology of meditation-induced light experiences: traditional buddhist and neurobiological perspectives American Buddhist practitioners | 2014 | Qualitative study | |
| Evoking the ineffable: The phenomenology of extreme sports. Extreme sports participants across three continents, including BASE jumping, big wave... | 2017 | Qualitative study | n = 15 |
| Phenomenology and content of the inhaled N, N-dimethyltryptamine (N, N-DMT) experience. Naturalistic inhaled N,N-DMT experiences posted to the r/DMT Reddit community | 2022 | Qualitative analysis | n = 3,778 |
Citations in the library
Cited by 2
Cites 14
- Embodied and Enactive Approaches to Cognition Cambridge University Press eBooks October 31, 2023
- The crisis of minimal self-awareness in schizophrenia: a meta-analytic review. Schizophrenia Research 2014
- Investigating modes of being in the world: an introduction to Phenomenologically grounded qualitative research Phenomenology and the Cognitive Sciences February 16, 2021
- Dynamical Relations in the Self-Pattern Frontiers in Psychology May 11, 2018
- Disordered Selfhood in Schizophrenia and the Examination of Anomalous Self-Experience: Accumulated Evidence and Experience. Psychopathology 2021
and 9 more in the library