Reimagining pain as an allostatic imperative: perspectives from contemplative traditions.

Pain is an allostatic imperative that commands an organism to adapt a part of its body. Drawing on empirical studies of pain reprocessing during advanced meditation, allostatic paradigms of biological self-regulation, and the philosophy of pain in the classical Sanskrit Pratyabhijñā Śaivism tradition, this paper theorizes two components of an allostatic response: homeostatic responses, which are error-corrective and aim to return to a previous stable state, and heterostatic responses, which are anticipatory and shift to a new steady state to better prepare for future challenges. Successful adaptation depends on both error-correction and anticipatory change. A broad range of affect properly accompanies pain, and the model may extend to mental pain.

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Abstract

The motivational force of pain is undeniable. But what pain commands us to do, how we might satisfy this command, and if our experience of pain is inherently linked to suffering are far murkier topics. This paper brings together empirical studies of pain reprocessing during advanced meditation, the rise of allostatic paradigms to account for biological self-regulation, and the philosophy of pain in the classical Sanskrit philosophical tradition of Pratyabhijñā Śaivism to argue that pain is an allostatic imperative to adapt a part of one's body. We theorize two components of an allostatic response, heterostatic and homeostatic, that work in tandem to address pain as an allostatic command. Homeostatic responses are error-corrective in that they seek to protect an organism by returning to a previously stable steady state. Heterostatic responses are anticipatory in that they seek to better prepare an organism to meet future challenges by proactively shifting to a new steady state. We note that an organism's successful adaptation to its environment depends not just on error-correction, but also on anticipatory change. We theorize that a broad range of affect properly accompanies pain. We propose potential directions for empirically developing this model. We also note the possibility that this model could be extended to account for mental pain.