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and experienced in three time frames (past, present, and future). 3
Consider some examples: guilt and shame are varieties of disgust
in differing social contexts. When disgust is directed outward, it
may take the form of disdain; when combined with anger, it
may turn to recrimination and vengeance. The experience of primary
emotions is modified by the virtually infinite variety of
states of mind, particularly considering that the associations of
long-term memory are unique representations of objects and
events. One potential criticism of this taxonomy is that it is
reductive or deterministic. I refute such criticism by calculating 4
the unlimited variety of the precursors of suffering, values, and
behavior. The present discussion is about suffering; but I cannot
ignore the fact that creativity cannot be predicted by a reduction
to finite elements. Our appetites for curiosity and mastery will
sometimes motivate us to think and do outrageous and wonderful
things. When considering the variety of experiences that
result in suffering, most observers recall the opening of Tolstoy’s
Anna Karenina: “All happy families resemble one another; every
unhappy family is unhappy in its own fashion.”
PREMISE 2
When pain evokes fear and grief, the effect on the
maps in the brain’s body-sensing regions is the
same as for fear and grief alone.
I PROPOSE THAT CHRONIC PAIN, OR SEVERE ACUTE PAIN,
evokes fear and grief and that the pain-evoked fear and grief
have the same effect on the maps in the body-sensing regions of
the brain as do fear and grief alone. When pain evokes fear or
grief by threatening the existential domains of the individual, as
in Cassell’s formulation, the suffering that results is qualitatively
no different from any other form of suffering. The differences
in the varieties of the experience of suffering, I propose, arise
from its context—what Cassell referred to as “the meaning” of
suffering. The current technology of neuroscience does not have
the resolution to address, no less to validate, this theoretical
postulate. I have no doubt that it will.
PREMISE 3
Suffering is not an emotion, but is an “emotionally
competent stimulus” capable of evoking emotions.
FEAR AND GRIEF, THE PROPOSED ANTECEDENTS OF SUFFERING,
ARE EMOTIONS. I propose that suffering is not. Emotions evoke
action, somatic and visceral motor activity, and aversive behavior
in the face of fear and disgust. I propose that if fear and
grief do not evoke suffering, they do motivate corrective or
aversive action in the face of danger or loss. 5
I am persuaded to think that suffering does not evoke aversive
or corrective behavior by itself. Suffering is involutional,
resulting in withdrawal, stasis, and inaction. Suffering is interior
and isolating. Suffering is experienced as distress, misery, agony,
anguish, torment, wretchedness, despair, hopelessness, excruciation,
and woe. When we are lonely, we seek companionship.
When we “suffer” the death of a loved one, we shut ourselves
off and rely on the cultural rituals of the funeral, wake, or
receiving of friends and family to provide resilience and connection
to others. We recognize and admire the resilience of those
who console others around them, even though everyone has
experienced the same loss or, in the case of danger, the same
jeopardy and fear.
I have portrayed suffering as leading to inaction and stasis.
I propose that with the evolution of suffering, the emotions of
disgust and anger took on the role of decreasing the intensity of
suffering by motivating action. Such actions often appear to be
maladaptive when they are resentful or hostile. The ancient role
of disgust was to protect against injury from contamination by
waste, decay, and contagion. To experience disgust at the perception
of an abstract stimulus or of a benign object is a recent
response. Rage once served for aggressive display and dominance
in reproductive and survival conflicts. Now, exploitation
and dominance, as expressed in revenge, are more common. 6
Although Elisabeth Kubler-Ross’s work has been criticized after
her death, her well-known monograph on loss and grief
demonstrates how suffering evokes disgust and rage (11).
3 Time frames include the “past” from long-term memory, both declarative
and non-declarative; the “present” from short-term memory (the answer to
Emily Webb’s question [from Thornton Wilder’s Our Town] is: no, we do
not experience life as we live it, we experience it after it happens); and the
“future” as representations of anticipated objects and events (5).
4 The calculation of possible states of mind multiplies six primary emotions,
10 drive states, three time frames, and an arbitrary ordinal scale of intensity
for the contribution of each of the other three dimensions. Even if many of
the cells of such a matrix are empty, the product is a number beyond
comprehension.
5 For example, if I am afraid of a bull moose, I wait until he leaves and do
not cross the valley to fish where he is feeding. But I do not suffer for it,
unless he is feeding at the edge of the best pool in the river.
6 We easily intuit the ancient survival value of fear, surprise, disgust, and anger;
however, we might consider the role of disgust and anger in meliorating suffering
when we recall the media frenzy that accompanies any human tragedy.
Accusation, scapegoating, recrimination, and revenge follow hard upon fear
and grief. A good example is the Sago Mine explosion in January 2006. After
days of intense rescue efforts, a rumor spread that 1 miner was dead and that
12 survived. The opposite was true and the truth was not transmitted to the
community for 3 hours. The disgust and rage that followed were severe,
arguably out of proportion to the offence. For many, rage and disgust were
easily turned against the media for exploiting the suffering of the lost miners’
families. Perhaps we cleave to the suffering of others to validate our own
resilience, but our reactions only reveal our vulnerability.
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