Sean Mackey, M.D., Ph.D.

There's the formal definition of pain, which is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage. It's a mouthful. If you think of it as it's an unpleasant sensory and emotional experience, it's usually tied to something physically happening, but may not be.

There's the formal definition of pain, which is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage. It's a mouthful. If you think of it as it's an unpleasant sensory and emotional experience, it's usually tied to something physically happening, but may not be.

I think sometimes what's missing in that definition, one of the things I wish they had put in but never did, is that pain is the great motivator. Pain is one of the most primitive experiences going back to, if you will, single-cell organisms. It's either pain or reward. You're either being driven towards oxygen, food, sex, or you're trying to get away from danger.

I think sometimes what's missing in that definition, one of the things I wish they had put in but never did, is that pain is the great motivator. Pain is one of the most primitive experiences going back to, if you will, single-cell organisms. It's either pain or reward. You're either being driven towards oxygen, food, sex, or you're trying to get away from danger.

Pain is so wonderful because it's so terrible. It keeps us alive. Without pain, when we have these genetic issues of congenital insensitivity to pain, we would have never lived as a species. So pain is an unpleasant sensory and emotional experience. To understand pain, whether you're a Martian or you're a human now, I think you have to look back in history.

Pain is so wonderful because it's so terrible. It keeps us alive. Without pain, when we have these genetic issues of congenital insensitivity to pain, we would have never lived as a species. So pain is an unpleasant sensory and emotional experience. To understand pain, whether you're a Martian or you're a human now, I think you have to look back in history.

And so I'm going to evoke Rene Descartes, 17th century French philosopher, thought to be the father of modern philosophy. Incredible contributions brought Cartesian geometry to us, which led to calculus. And he had this dualistic model of pain. that he put forward.

And so I'm going to evoke Rene Descartes, 17th century French philosopher, thought to be the father of modern philosophy. Incredible contributions brought Cartesian geometry to us, which led to calculus. And he had this dualistic model of pain. that he put forward.

To his credit, it was the first mechanistic foundation for pain because beforehand, pain was thought to be something mystical or religious. It was punishment of the gods. So he put this framework together that's often illustrated this famous picture of a little boy with his foot in the fire. And there's a little string from his foot going up into his brain.

To his credit, it was the first mechanistic foundation for pain because beforehand, pain was thought to be something mystical or religious. It was punishment of the gods. So he put this framework together that's often illustrated this famous picture of a little boy with his foot in the fire. And there's a little string from his foot going up into his brain.

And it ends up in the pineal gland, which was thought to be uniquely a human area. And the idea is the fire pulls on the little string, opens up pores in the pineal gland, rings a bell, and the boy withdraws his foot. The idea is in this dualistic model, there is a complete separation between body and mind. The body is where pain is generated. The mind is where it's perceived.

And it ends up in the pineal gland, which was thought to be uniquely a human area. And the idea is the fire pulls on the little string, opens up pores in the pineal gland, rings a bell, and the boy withdraws his foot. The idea is in this dualistic model, there is a complete separation between body and mind. The body is where pain is generated. The mind is where it's perceived.

But the mind is simply a passive receptacle receiving these signals. That model put forward in the 17th century stuck with us for hundreds and hundreds of years and I would argue is with us today. And it has influenced medical care. It has influenced policy. It's influenced everything in our society about the way we think about pain. And it's utterly, completely wrong.

But the mind is simply a passive receptacle receiving these signals. That model put forward in the 17th century stuck with us for hundreds and hundreds of years and I would argue is with us today. And it has influenced medical care. It has influenced policy. It's influenced everything in our society about the way we think about pain. And it's utterly, completely wrong.

So, yes, he got Cartesian geometry right. But he really, complete bollocks, screwed it up when it came to pain. This biomedical model, this dualistic model, was with us for hundreds and hundreds and hundreds of years. And it's only been in the last number of decades that we've appreciated the nuance of what pain really is.

So, yes, he got Cartesian geometry right. But he really, complete bollocks, screwed it up when it came to pain. This biomedical model, this dualistic model, was with us for hundreds and hundreds and hundreds of years. And it's only been in the last number of decades that we've appreciated the nuance of what pain really is.

And instead of it being under this guise of this separate mind and body, we now appreciate it is this integrated biopsychosocial phenomenon. Meaning that, and I think this is one of the most important things that I'd like to drive across.

And instead of it being under this guise of this separate mind and body, we now appreciate it is this integrated biopsychosocial phenomenon. Meaning that, and I think this is one of the most important things that I'd like to drive across.

I'm going to introduce a term, we're going to get to a term called nociception, which are electrochemical injury signals that occur in the periphery, that what goes on in the body is And what goes on in the brain, the experience of pain, they may have nothing to do with each other or very little linkages. And we're going to hopefully unpack that.

I'm going to introduce a term, we're going to get to a term called nociception, which are electrochemical injury signals that occur in the periphery, that what goes on in the body is And what goes on in the brain, the experience of pain, they may have nothing to do with each other or very little linkages. And we're going to hopefully unpack that.