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Pain Research and Management
Volume 2, Issue 2, Pages 111-117
Symposium Review

Implications of Concepts of Consciousness for Understanding Pain Behaviour and the Definitiion of Pain

Kenneth D Craig

Faculty of Graduate Studies, University of British Columbia, Vancouver, British Columbia, Canada

Received 23 May 1997; Accepted 30 June 1997

Copyright © 1997 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Judgements of the nature and severity of pain others may be experiencing are heavily influenced by an observer's preconceptions about the nature of the experience. Our personal sense of conscious experience dictates a search for consciousness characterized by the state of awareness found in competent adults, including constructive memories and thoughts, images and feelings. People incapable of verbally articulating experiences akin to those reported by competent older children and adults are at risk of having other evidence of pain denied, minimized or ignored. Despite substantial behavioural evidence for pain in the neonate and infant, and findings indicating destructive immediate and long term consequences if pain is not controlled, pain in infants and children often continues to be discounted. An alternative perspective on infant consciousness of pain focusing upon sensory and emotional components is presented. The current prominent definition of pain supports the prejudice favouring adult conceptions of consciousness by emphasizing the importance of self-report in assessing pain. Explanatory notes accompanying this definition also perpetrate the misguided belief that the experience of pain emerges as a product of early life experiences. The case for using nonverbal as well as verbal expression in the process of inferring states of pain is presented. As well, the proposition is supported that there should be explicit recognition that the experience of pain is an inherent quality of life present in all viable newborns, with the nature of the experience and its expression changing in the course of maturation and as a result of exposure to life experiences related to tissue injury.