Pain suffering and the self. An active allostatic inference explanation

Abstract

Distributed processing that gives rise to pain experience is anchored by a multidimensional self-model. I show how the phenomenon of pain asymbolia and other atypical pain-related conditions (Insensitivity to Pain, Chronic Pain, ‘Social’ Pain, Insensitivity to Pain, Chronic Pain, ‘Social’ Pain, empathy for pain and suffering) can be explained by this idea. It also explains the patterns of association and dissociation among neural correlates without importing strong modular assumptions. It treats pain processing as a species of allostatic active inference in which the mind co-ordinates its processing resources to optimize basic bodily functioning at different time scales. The self is inferred to be source and target of regulation in this process. The self-modelling account reconciles conflicting deaffectualization and depersonalization accounts of pain asymbolia by showing how depersonalization and pain asymbolia arise at different levels of hierarchical self modelling.