+TOMKINS ON PAIN

PAIN

“Affect – Imagery – Consciousness” volume 1:  The Positive Affects and volume 2:  The Negative Affects

by Silvan S. Tomkins (Professor of Psychology, Princeton U)

Springer Publishing Company, inc

NY 1962

3/8/2007

++++

I must note, I skimmed over all this pain info the first time around – avoiding it rather than accepting that it was very important, if not central information to my research – so I had to come back and get it!  I am finding that more often now with the less “technical” information – I call it dissociating from this information.  Like walking down a hallway and passing right by the doors I know I need to open…

++++

“Finally, we will consider the primary drive of pain.  This drive is quite different from other drives.

First, compared with hunger, it is purely negative – there is no pleasure in its cessation.

Second, the organism can live a lifetime despite continuous pain – it is not necessary for the organism’s survival that he reduce his pain.  In this respect it differs radically from hunger.

Third, it is not necessary that it ever be instigated in the lifetime of the organism so long as he avoids noxious stimulation.  Again it differs from hunger and the need for air and water in this respect.  It is midway in characteristics between most drives and most affects.  It has generality of time but not of space.  If the receptor site is stimulated, there is a high probability of pain awareness, but whether the individual never experiences pain in his lifetime, (Tomkins/dai/57) is continual pain, or only experiences pain from time to time depends upon the somewhat accidental stimulation of the appropriate receptors.  In contrast to air, food and water, there is no necessary requirement, in terms of the body’s needs for the transport of materials into and out of the body, that the stimulation of the pain receptors be periodic.  (Tomkins/dai/58)”

++++

“Although deep pain may be referred to the wrong site or may be very diffuse with respect to localization, the pain receptors on the surface of the skin provide reasonably accurate information as to their address.  This site specificity of pain information is supported by withdrawal reflexes, but to the extent to which escape and avoidance depend upon consciously directed responses, the precise site information is as necessary a condition for the consummatory escape response as is the precise site information in the case of air, hunger, thirst and sex.  (Tomkins/dai/58)”

“Like other drives, its urgency, though great and insistent – one of the chief persuaders – has nonetheless been exaggerated.  Indeed, the widespread concurrent responses to the stimulation of the pain receptors have complicated the measurement of pain thresholds.  There is, from the birth cry onward, [from the pain of birth?  The pain of being born?] an immediate concurrent cry of distress instigated by pain stimulation.  Freud mistakenly interpreted this initial distress cry as the prototype of the anxiety response.  It is clear that pain, and particularly the threat of pain, may later instigate the fear response, but in infancy it appears to activate the general cry of distress rather than the fear response.  (Tomkins/dai/58)”

“Whether the adult responds with distress or fear or both, either affect provides massive amplification of the pain drive.  Just how much of what appeared to be pain was in fact fear or distress was not appreciated even in anaesthesiology [sic]until the Second World War.  Beecher reported that not only were some wounds disregarded during fighting due to inattention, [in other words, if our attention is not focused on an injury at a given moment then it doesn’t hurt?] but that the removal from the danger of the battlefield to the relative safety of the military hospital also produced in some a euphoria and a consequent disregard for wounds.  Inattention on the one hand and positive affect on the other [to me this is still inattention – the attention is focused on the safety and relief] are capable of blocking and masking the pain impulses.  (Tomkins/dai/58)” [change in attention = a distraction]

“The critical role of affect in the tolerability of pain is evident in the common technique of mastering inflicted pain by concurrently inflicting a more severe pain on one’s self, e.g., by digging the nails into the skin or biting the skin of one’s hand. In such cases the pain one inflicts on oneself must be more intense if it is to mask the pain one is suffering passively. [Wouldn’t this be describing a parallel process to self mutilation aspects?] What is the gain, then, in substituting a more severe for a less severe pain?  It is that the lesser pain is accompanied by the distress and fear of helplessness and passivity whereas the more severe pain is attenuated by the more tolerable affects of excitement and, for some, even delight, in overcoming the distress and fear and the status of helplessness in the face of pain and assault[How does this relate to hurting someone else instead of additionally hurting one’s self?  How does the physical pain interrelate with psychological pain?  Don’t both pains share the same neuronal brain circuits?] In other words, a more intense pain combined with less negative affect is preferable to a less intense pain with more intense negative affect.  (Tomkins/dai/59)”

“Nor does pain necessarily instigate only negative affect.  The sexual pleasures and excitements of the masochist are instances of pain as a necessary condition, along with sexual pleasure, of intense positive excitement and joy.  Indeed the pleasure of sexual experience is insufficient to excite the masochist.  He requires the spice of pain and sometimes the perception of helplessness before he can respond with either the affect of excitement or joy.  The over-all combination of pleasure, excitement, joy and pain is not only acceptable, but eagerly sought by such individuals.  (Tomkins/dai/59)”

What are the psychological counterparts of this process as not related to sex?  Is this an “alternative” coupling between pleasure and pain? It makes me think of curiosity – there must be pleasure in the “search” coupled with “pain” of fear or anxiety that “something bad might happen.”  Is this related to this area of the topic?  How about the pain of sports, either as in football, or when the training itself hurts?  People challenge themselves past this type of pain.

“Not only may inattention block pain, but either intense positive or negative affect, if perceived as connected to something other than pain, will attenuate affective response to pain.  Nowhere is this more clear than in schizophrenia.  (Tomkins/dai/59)”

“The imbeddedness of pain in the larger matrix of thought and feeling was studied by Goldfarb in a group of institutionalized schizophrenic children.  All children showed a reaction to pain.  Experimentally each child was given a sudden pin prick.  This non-penetrating and superficial stimulus produced some sign of pain among all schizophrenic children.  Despite the evidence that all schizophrenic children show a pain reaction, many show little or no indication of personal distress.  For example:  “Carol has a lifelong history of insensitivity to physical pain, which at times was and is a medical hazard.  Her parents re- (Tomkins/dai/59) ported on one occasion that no one was aware of her having a serious middle ear infection (normally very painful) until her eardrum burst to permit the exudation of pus.  Similarly, at the Center, she developed a severely abscessed tooth, with swollen face and fever, but gave no evidence of distress to the presumed pain….  The dentist reports his amazement at her insensitivity when he drills her teeth.  [was he not using novocain?] .  (Tomkins/dai/60)”

Such unresponsiveness to pain is not because of lack of affect, but rather because of competing affect which is concerned with something other than pain[When this response happens, might it run the risk of being identified as dissociation?  What are the physiological components or manifestations in the body while this is happening?] Goldfarb notes that the simultaneous occurrence of minimal pain reaction with exaggerated panic states in the same schizophrenic child is of a degree and quality never seen among normal children.  When panic dominates, the experience of pain can be blocked or masked from awareness[In other words, I think other forms of distress can become overwhelming.] Competing affects such as aggression may also minimize the importance of pain for the schizophrenic child.  [Or, like in my mother’s case, aggression against me diverted her own pain away from herself onto me – along with the externalized projections of her own sense of her own evilness.  This was, for my mother, an impulsive process she seemed to have no control over.] This is seen in the case of a child who is occupied continuously with external methods for controlling his impulsivity.  He asks the adults to lock the doors to keep him from running away.  Similarly, he announces the fact when he anticipates that he will be destructive or assaultive.  These announcements are always taken seriously and suitable adult controls are supplied to him.  [Isn’t he diverging here a little bit from his topic with these last points?] Frequently, when in a frustrated rage, he bites his hand till he bleeds, and with no apparent awareness of pain.  Here the affect of rage appears to either block the awareness of normal distress [and I think this can be also done on the psychological level, as with my mother] or what is more likely, to prevent the emission of distress or fear response by competing successfully against these responses using the same autonomic apparatus.  (Tomkins/dai/60)”

Interesting – so he is saying that these “avoidance” or “defensive” actions and reactions are connected to “autonomic apparatus?”

“In another case cited by Goldfarb it was not aggression but fear and distress about the absence of her mother which blocked affective responsiveness to pain.  [This must be related to some sort of “prioritizing” of what is meaningful, valuable, important – what the focus is, what should be paid attention to first.] This schizophrenic girl kept (Tomkins/dai/60) asking for her mommy in an anxious, distressed way all day.  She was found sitting on a hot radiator with no apparent awareness of the heat.  The teacher found the radiator so hot that she could not keep her own hand on it.  (Tomkins/dai/61)”

“It is also possible for schizophrenic children to become distressed about pain when the possibility of interpersonal communication and the evocation of sympathy and nurture arises.  Thus one schizophrenic child was found listless and febrile one day.  He could not walk because he could not put any weight on his right leg.  Examination by the doctor revealed a hot, swollen knee diagnosed as an infectious arthritis.  When his mother visited him, however, he began to cry and complain loudly of the pain and tenderness in his knee.  (Tomkins/dai/61)”

“Hardy has reported a similar phenomenon in adults.  Some patients, although ostensibly tranquil before being asked about their pain, overreacted with a show of grimacing and fears when their attention was focused upon it by a direct question concerning its quality and its intensity.  (Tomkins/dai/61)”

[This reminded me of when I was in high school and faked a limp, thinking tht as I walked down the hallway this way somebody might notice – and I guess I thought some “invisible” compassion would be sent my way – but at least I might be noticed and receive some “attention” which evidently mattered to me, even if it might come from total strangers noticing me from some remote distance.

“The affective component of the total response to pain has generated difficult measurement problems in anaesthesiology.  [sic]  According to Beecher both experimentally induced pain in the laboratory setting and pain of pathological origin [meaning what?] have a sensory and an affective component, but with the second dominant in pathological pain and the first in experimental pain.  Beecher reports uniformity of response to analgesic agents of pathological pains of widely differing origin in man.  He has shown that there is quantitative reproducibility of results between different research groups dealing with the analgesic properties of morphine when tested against pathological pain.  But in the case of experimental pain there appears to be a different situation.  Fifteen groups of investigators have failed to demonstrate that the experimental pain threshold varies dependably even with large doses of morphine or other analgesic agents, whereas small doses of morphine will relieve the pain of a great wound or extensive disease.  (Tomkins/dai/61)”

“There are apparently two ways in which the pain threshold can be made more reliable and sensitive as a measure of the potency of analgesics.  One is to increase the fear component in the experimental technique.  Thus, Beecher reports that with (Tomkins/dai/61) experimental pain in man produced by tourniquet, where pain intensity grows slowly, as contrasted with the sudden stab of pain produced by most experimental methods, there appears to be a better measure of the effect of analgesics.  Hill, Kornestsky, Flanary and Wikler also report that intensities of pain are overestimated when tested under conditions which promote fear of pain and that morphine reduces this effect, and that with little fear there is little overestimation of pain, and finally, that morphine does not affect the ability to judge pain when fear is dissipated.  Morphine is an analgesic only when anxiety is present. (Tomkins/dai/62)”  [Does he mean this is so only in the experimental pain situation?]

“If increased arousal of affect improves the reliability and sensitivity of the method of experimentally  induced pain, so does the elimination of those subjects who respond to such methods with anxiety.  Benjamin, following up an investigation in which Hardy’s thermal radiation method produced no difference between the effect of ten grains of aspirin on the pain threshold and that of a placebo, was able to demonstrate that the difference between aspirin and placebo becomes more pronounced with the greater ability of the subject to evaluate pain objectively.  (Tomkins/dai/62)”

“Apparently the admixtures of affective responses to pain experimentally induced in the laboratory vary from subject to subject sufficiently to obscure the action of analgesics.  Heightening or reducing this component produces better measures of pain response.  The same variability is probably also occurring with pathological pain, but the extensity, intensity and duration of pain and the perception of seriousness of consequences from pathological pain combine to produce at least a minimum of affective arousal which is probably absent in some subjects tested with the experimental method under laboratory conditions.  (Tomkins/dai/62)”

I am having a hard time understanding or comprehending what he is saying here!  Why?

“If the affective response constitutes a substantial component of the pain response, [so they are separate] then it should be possible to reduce the discomfort by non-analgesic methods, e.g., by techniques which reduce the cognitive determinants of the affective responses. [Is this part of what they do with the marijuana pain alternative?] It does not follow that operating on these alone should necessarily entirely reduce discomfort since pain itself is a highly potent activator of the affect of distress.  It is rather that distress can be amplified by the perceived consequences of pain or by its estimated duration, or by the apparent concern of those taking care of the one in pain.  Placebos therefore ought to reduce that much (Tomkins/dai/62) of the distress response which is mediated by cognitive factors.  Lasagna, Mosteler, Von Felsinger and Beecher reported that about 35 per cent of their patients received satisfactory relief from postoperative pain from a placebo.  This represents about a 50 per cent reduction compared with the analgesic action of morphine.  Morphine afforded the same degree of relief for 70 per cent of the same group of patients.  (Tomkins/dai/63)”

I am finding myself wondering here about mother and the twilight sleep….

“Another investigator, Jellinek, reported that 60 per cent of one hundred ninety-nine patients received relief from a placebo on one or more occasions.  Other investigators have also found evidence for a massive placebo effect.  (Tomkins/dai/63)”

“Another partially successful technique of reducing the discomfort of pain is the frontal lobotomy and lobectomy.  Whether this interferes with cognition or affective responsiveness or both, in those cases in which it alleviated pain it did not necessary raise the pain threshold.  Freeman and Watts, among others, reported that it changes the attitude of the individual toward his pain not the perception of pain.  There appears to be a rather generalized reduction in affective responsiveness, an apathy towards his pain, but usually towards much more than his pain.  Hardy, Wolff and Goodell report that patients who are partially or totally relieved with respect to their pain exhibited a flattened affect.  When incontinent of feces, for example, they were as indifferent to this as to their pain.  These investigators and others have also noted that when such patients are asked to report on their pain they almost always report pain and show discomfort.  To some extent, then, the frontal operation is influencing the mechanisms underlying attention in general.  The condition following frontal lobotomy is remarkably similar to cases of congenital insensitivity to pain.  [Wouldn’t this be like autism?] Critchley, among others, has commented on the great discrepancy between the feeling of pain as a discriminative quality of sensation which is present and the lack of the response of distress.  (Tomkins/dai/63)”

“Another partially successful technique of attenuating the distress and some of the autonomic responses to pain is the hypnotic technique.  Major surgery continues to be reported under the influence of hypnosis, with the patient showing no signs of pain or distress with pulse and blood pressure with normal limits of variation.  Experimental studies of hypnotically induced analgesia also generally show a reduction of the usual (Tomkins/dai/63) cardiac and respiratory responses to pain stimulation.  It is also clear that not all hypnotic subjects are capable of such hypnotically induced analgesia.  Barber reported that all of his somnambulistic subjects had been able since childhood to go to sleep easily and quickly at any time and to concentrate on their work or studies by blocking out irrelevant stimuli.  In my experience with hypnotic subjects who are capable of induced analgesia I have found the same abilities.  Further, whenever I have been able to relieve pain by hypnotic suggestion, it has also been possible to transfer to the subject the ability to hypnotize the self and to induce analgesia by self-instruction.  (Tomkins/dai/64)”  [Maybe this ability is closely related with the positive thinking that JW practices.]

“Quite apart from hypnosis, Pavlov demonstrated similar phenomena in his experimental dogs.  (Tomkins/dai/64)”

Competing affect, inattention and hypnosis are not the only ways in which one can block the affective response to pain.  The satisfaction of another drive plus the positive affect accompanying such satisfaction are capable of blocking the cardiac and motor responses to pain.  (Tomkins/dai/64)”

“Pavlov showed that even strong electric shocks could be used as conditioned stimuli for the salivary response, if their intensity were increased gradually, and the animal fed for a few seconds after each stimulation.  Although before conditioning, these shocks had produced large perturbations in breathing and pulse and attempts to escape, after conditioning there was no evidence of changes in breathing or pulse or flinching.  (Tomkins/dai/64)”

IMPORTANT

“We have presented the preceding evidence to show that, as is the case for the drive system in general, pain is not as painful a signal as it has been supposed.  Much of its urgency is a function of the massive affects which are concurrently instigated in its support.  Further, without such amplification, there is the possibility that it will not be transmuted into a report.  Pain which is unattended is entirely unpainful.  Pain may be attenuated or amplified or not attended to in a variety of ways.  It may be unattended, i.e., not transmuted into a report, because the channel is full with competing information.  It may be attended to as a signal of anticipated drive satisfaction with positive rather than negative affect, as in the case of Pavlov’s [conditioned] dogs.  It may be attended to, but in an over-all positive context of sexual pleasure and excitement rather than distress, as in the case of masochism.  (Tomkins/dai/64)  It may be attenuated by being combined with positive affect as in the case of self-inflicted pain to mask pain inflicted by another which has created anxiety and the feeling of helplessness.  It may be attenuated through change in the beliefs about what is happening, as in the placebo effect, and frontal lobotomy and hypnosis.  It may be attenuated by massive competing affect, whether negative or positive, which is conceptually unrelated to the pain, as with schizophrenic children in panic states, or in states of rage when pain is inflicted on the self to give expression to the hostility at the cost of self-inflicted pain which seems not to distress these children.  It is important to note here that overwhelming fear need not amplify pain if the fear is not perceived as fear of pain.  (Tomkins/dai/65)”

So fear of my mother could have been strong enough to lessen the physical pain of beatings – nothing to do with dissociation per se.

He still isn’t discussing the connections and crossovers between psychological and physical pain – and reactions to the former.

“Pain may be amplified by affect as in the case of schizophrenic children who begin to show and communicate distress only when visited by the mother.  When attention is called to pain by inquiry it may suddenly become distressing, as reported in the cases of frontal lobotomy.  If the subjects in experimentally induced pain are frightened, we have seen, the pain intensities are overestimated compared with more neutral conditions.  (Tomkins/dai/65)”

“We should distinguish between blocking the pain response proper, or blocking the affective response from consciousness and interfering with the affective response itself.  It seems very probable that two affects, one positive and one negative, or both negative but different, for example, fear and rage, may utilize the same organs of expression and therefore block each other by antagonistic autonomic innervations.  We must also distinguish the negative affective response in support of pain from the same response in competition with pain.  Panic which is panic about pain has very different conscious and behavioral sequels than panic about the loss of control of impulses by the schizophrenic child who does not even notice the pain stimulation to his body.  (Tomkins/dai/65)”

++++++++++++++++++++++++++++++++++++++

primary drive of pain

different from other drives.

it is purely negative – there is no pleasure in its cessation.

the organism can live a lifetime despite continuous pain

it is not necessary that it ever be instigated in the lifetime of the organism so long as he avoids noxious stimulation.

It is midway in characteristics between most drives and most affects.

It has generality of time but not of space

++++

This site specificity of pain information is supported by withdrawal reflexes, but to the extent to which escape and avoidance depend upon consciously directed responses, the precise site information is as necessary a condition for the consummatory escape response as is the precise site information in the case of air, hunger, thirst and sex.  (Tomkins/dai/58)”

“Like other drives, its urgency, though great and insistent – one of the chief persuaders – has nonetheless been exaggerated.

Freud mistakenly interpreted this initial distress cry as the prototype of the anxiety response.  It is clear that pain, and particularly the threat of pain, may later instigate the fear response, but in infancy it appears to activate the general cry of distress rather than the fear response.  (Tomkins/dai/58)”

“Whether the adult responds with distress or fear or both, either affect provides massive amplification of the pain drive.

Inattention on the one hand and positive affect on the other [to me this is still inattention – the attention is focused on the safety and relief] are capable of blocking and masking the pain impulses.  (Tomkins/dai/58)” [change in attention = a distraction]

“The critical role of affect in the tolerability of pain is evident in the common technique of mastering inflicted pain by concurrently inflicting a more severe pain on one’s self,

a more intense pain combined with less negative affect is preferable to a less intense pain with more intense negative affect.  (Tomkins/dai/59)”

“Not only may inattention block pain, but either intense positive or negative affect, if perceived as connected to something other than pain, will attenuate affective response to pain.

imbeddedness of pain in the larger matrix of thought and feeling

Such unresponsiveness to pain is not because of lack of affect, but rather because of competing affect which is concerned with something other than pain.

When panic dominates, the experience of pain can be blocked or masked from awareness

Competing affects such as aggression may also minimize the importance of pain for the schizophrenic child. 

to prevent the emission of distress or fear response by competing successfully against these responses using the same autonomic apparatus.  (Tomkins/dai/60)”

both experimentally induced pain in the laboratory setting and pain of pathological origin [meaning what?] have a sensory and an affective component, but with the second dominant in pathological pain and the first in experimental pain.

failed to demonstrate that the experimental pain threshold varies dependably even with large doses of morphine or other analgesic agents, whereas small doses of morphine will relieve the pain of a great wound or extensive disease.  (Tomkins/dai/61)”

“There are apparently two ways in which the pain threshold can be made more reliable and sensitive as a measure of the potency of analgesics.  One is to increase the fear component in the experimental technique.

Morphine is an analgesic only when anxiety is present. (Tomkins/dai/62)” 

the difference between aspirin and placebo becomes more pronounced with the greater ability of the subject to evaluate pain objectively.  (Tomkins/dai/62)”

Heightening or reducing this component produces better measures of pain response.

affective response constitutes a substantial component of the pain response

pain itself is a highly potent activator of the affect of distress.  It is rather that distress can be amplified by the perceived consequences of pain or by its estimated duration, or by the apparent concern of those taking care of the one in pain

a massive placebo effect.  (Tomkins/dai/63)”

frontal lobotomy and lobectomy.

changes the attitude of the individual toward his pain not the perception of pain.

To some extent, then, the frontal operation is influencing the mechanisms underlying attention in general.

great discrepancy between the feeling of pain as a discriminative quality of sensation which is present and the lack of the response of distress.  (Tomkins/dai/63)”

some of the autonomic responses to pain is the hypnotic technique.

hypnotically induced analgesia

able since childhood to go to sleep easily and quickly at any time and to concentrate on their work or studies by blocking out irrelevant stimuli.

whenever I have been able to relieve pain by hypnotic suggestion, it has also been possible to transfer to the subject the ability to hypnotize the self and to induce analgesia by self-instruction.  (Tomkins/dai/64)” 

Competing affect, inattention and hypnosis are not the only ways in which one can block the affective response to pain.  The satisfaction of another drive plus the positive affect accompanying such satisfaction are capable of blocking the cardiac and motor responses to pain.  (Tomkins/dai/64)”

“Pavlov showed that even strong electric shocks could be used as conditioned stimuli for the salivary response, if their intensity were increased gradually, and the animal fed for a few seconds after each stimulation.  Although before conditioning, these shocks had produced large perturbations in breathing and pulse and attempts to escape, after conditioning there was no evidence of changes in breathing or pulse or flinching.  (Tomkins/dai/64)”

IMPORTANT

pain is not as painful a signal as it has been supposed.  Much of its urgency is a function of the massive affects which are concurrently instigated in its support.  Further, without such amplification, there is the possibility that it will not be transmuted into a report.  Pain which is unattended is entirely unpainful.  Pain may be attenuated or amplified or not attended to in a variety of ways.  It may be unattended, i.e., not transmuted into a report, because the channel is full with competing information.  It may be attended to as a signal of anticipated drive satisfaction with positive rather than negative affect, as in the case of Pavlov’s [conditioned] dogs.  It may be attended to, but in an over-all positive context of sexual pleasure and excitement rather than distress, as in the case of masochism.  (Tomkins/dai/64)  It may be attenuated by being combined with positive affect as in the case of self-inflicted pain to mask pain inflicted by another which has created anxiety and the feeling of helplessness.  It may be attenuated through change in the beliefs about what is happening, as in the placebo effect, and frontal lobotomy and hypnosis.  It may be attenuated by massive competing affect, whether negative or positive, which is conceptually unrelated to the pain, as with schizophrenic children in panic states, or in states of rage when pain is inflicted on the self to give expression to the hostility at the cost of self-inflicted pain which seems not to distress these children.  It is important to note here that overwhelming fear need not amplify pain if the fear is not perceived as fear of pain.  (Tomkins/dai/65)”

“We should distinguish between blocking the pain response proper, or blocking the affective response from consciousness and interfering with the affective response itself.

It seems very probable that two affects, one positive and one negative, or both negative but different, for example, fear and rage, may utilize the same organs of expression and therefore block each other by antagonistic autonomic innervations.  We must also distinguish the negative affective response in support of pain from the same response in competition with pain.  Panic which is panic about pain has very different conscious and behavioral sequels than panic about the loss of control of impulses by the schizophrenic child who does not even notice the pain stimulation to his body.  (Tomkins/dai/65)”

++++

“The pain receptors form an intermediate system sharing half of the characteristics of the drive system and half of the critical characteristics of the affect system.  The pain receptors are like drives in their site specificity.  If one stimulates a pain receptor on the hand, it is the hand which “hurts.”  It is rarely referred to the foot.  Like the drive signal, it not only motivates but informs the sufferer where something needs to be done.  Unlike the drive system but like the affect system, it has the characteristic of freedom of time.  One needs to be in pain only so long as something stimulates the pain receptors.  Theoretically one could live a life entirely free of pain, or only occasionally experience pain or live in constant pain.  These contingencies depend entirely (Tomkins/aic/124) on how often and how continuously the individual’s pain receptors are stimulated.  There is here no essential rhythm as there is with respect to the drive system.  In contrast with the drive system there is no upper limit to the frequency or continuity of pain stimulation.  Although man cannot eat continuously except at the risk of death, he can tolerate intractable intense pain.  Although such a condition is extremely distressing, it nonetheless does not constitute a threat to the life of the individual.  Whereas a variety of materials must be regularly transported in and out of the body and thus drive signals wax and wane, ther4e uncertainties of noxious encounters with the environment call for a device which combines the site specificity of the drive system with the time freedom of the affect system.  (Tomkins/aic/125)”

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