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Pain and consciousness: A constructivist approach. Functional brain imaging studies reveal the complexity of brain activity during pain. If pain is a dynamic product of a self-organizing brain, then pain research needs a theoretical framework to address the observations that functional brain imaging yields.
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It is in fact the only thing in the universe whose ultimate intrinsic nature we can claim to know. It is utterly unmysterious. The nature of physical stuff, by contrast, is deeply mysterious, and physics grows stranger by the hour.
Pain and consciousness.
Or rather, more carefully: The nature of physical stuff is mysterious except insofar as consciousness is itself a form of physical stuff. I think Russell is right: Human conscious experience is wholly a matter of physical goings-on in the body and in particular the brain.
A model is described, progressing from unconscious sensori-motor and limbic processing of spinothalamic and spino-parabrachial input, to an immediate sense of awareness supported by coordinated activity in sensorimotor and fronto-parieto-insular networks, and leading to full declarative consciousness through integration with autobiographical memories and self-awareness, involving posterior cingulate and medial temporal areas.
This complete sequence is only present during full vigilance states. We contend, however, that even in unconscious subjects, repeated limbic and vegetative activation by painful stimuli via spino-amygdalar pathways can generate implicit memory traces and stimulus-response abnormal sequences, possibly contributing to long-standing anxiety or hyperalgesic syndromes in patients surviving coma.