Pain and behavior after 25 years

Although I have not followed pain research since the article was published, my general approach to the study of pain, based on teleological behaviorism, would be the same now as it was then. What is that approach as I now see it? First, I would distinguish between everyday use of the word, “pain” and scientific use of that word. In everyday life, the notion that pain is private serves a useful purpose – it mobilizes others to aid the person in pain, to deal with an emergency without first enquiring about cause or consequence. If I say I am in pain, I am indeed in pain and you must help me. However, for scientific purposes, including treatment development, I consider pain to be overt behavior. For example, I believe that, over the long run, the degree of a person’s pain may be better judged by a close observer than by the person himself. A man goes to a physician and, without deliberately lying, claims that his pain is mild. His wife may contradict him. “What are you talking about? It kept you up all night last night,” she may say. Who is right in such a case? The teleological behaviorist says, she is more likely to be right. Following Skinner’s classic dichotomy, like all overt behavior, pain has respondent and operant components. That is, pain may be correlated with antecedent or consequent events. Where pain is correlated with antecedent events, where an external stimulus or a bodily cause (such as a burst appendix) can be found, the pain is defined as respondent. You would treat that pain by removing its stimulus or medically treating its cause. You might administer pain-relieving drugs. But, where a normal cause of pain is removed and pain persists over long periods, and the pain is found to be correlated with some antecedent event such as social attention, relief from work, or access to pain medications, then that pain may be said to have operant components. Just as the respondent components of pain are