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Levels of faith and pain intensity
Research studies show significant relationships between strong spiritual well-being, increased pain tolerance and an ability to cope with pain.
A recent study demonstrated that spirituality well-being, and faith particularly, as measured by the Functional Assessment of Chronic Illness Therapy – Spiritual Well-Being-Extended scale (FACIT-Sp-Ex), was significantly related to reduced pain intensity in some study participants over a course of pain treatment. What accounts for this relationship? The authors speculated that:
“It may be that a strong element of “faith” is associated with a greater confidence or trust in health professionals and a greater likelihood of following their advice. It is also possible that those with higher levels of “faith” are more likely to improve because they are more likely to engage with a program that seeks to incorporate a spiritual and existential component. It is also possible that they are more eager to please the program providers and report better outcomes. All of these possibilities would need to be explored further and cannot be answered in the present study.”
The quotation suggests that higher levels of faith might be associated with reduced pain intensity in some people with pain.
Forms of faith and pain intensity: a hypothesis
A hypothesis is that, in addition to levels of faith, particular forms of faith, or combinations of faith forms, could reduce pain intensity.
So, what forms of faith are there? The following forms are commonly distinguished in philosophy of religion (Table 1).
|Faith form||Name in philosophy of religion|
|A feeling of existential confidence||the ‘purely affective’ model|
|Knowledge of specific truths, revealed by God||the ‘special knowledge’ model|
|Belief that God exists||the ‘belief’ model|
|Believing in (‘trusting in’) God||the ‘trust’ model|
|Practical commitment beyond the evidence to one’s belief that God exists||the ‘doxastic venture’ model|
|Hoping the God who saves exists||the ‘hope’ model|
Scientific study could investigate if some forms of faith are significantly related to reduced pain intensity compared to other forms, or combinations of forms, of faith. These same forms of faith could be used prognostically by clinicians to predict improvements in pain intensity in some patients, or in other outcomes, such as quality of life or pain-related disability. Qualitative research could investigate if patient conceptions of faith accurately map onto faith forms, as identified by philosophers.
Faith beyond religion
Can faith exist without commitment to any religion? Tennant wrote that: ‘faith is an outcome of the inborn propensity to self-conservation and self-betterment which is a part of human nature, and is no more a miraculously superadded endowment than is sensation or understanding.’ He thinks that ‘much of the belief which underlies knowledge is the outcome of faith which ventures beyond the apprehension and treatment of data to supposition, imagination and creation of ideal objects, and justifies its audacity and irrationality (in accounting them to be also real) by practical actualization.’
If faith exists beyond religion, then people who commit themselves to a view based on a particular interpretation of reality exclusive of the objective verification of the truth, are people of faith. Faith of this kind may be religious without being theistic, as in Buddhism or Taoism. Or, it may be scientific when people propose that reality is no more than what is discoverable by the natural sciences (e.g. ‘scientific atheists’, ‘naturalists’).
Study of the interaction between faith and pain could investigate relationships between forms of faith and pain intensity, in addition to other psychosocial outcomes. Such forms span broadly across traditional orthodox religious thesim, relgious non-theism, scientific atheism or naturalism. Interaction between forms and levels of faith, and pain outcomes, is a further possibility. Personal faith could be a useful tool in the clinical armamentarium.
 Lysne CJ, Wachholtz AB. Pain, spirituality, and meaning making: What can we learn from the literature? Religions 2010;2(1):1.
 Keefe FJ, Affleck G, Lefebvre J, Underwood L, Caldwell DS, Drew J, et al. Living with rheumatoid arthritis: The role of daily spirituality and daily religious and spiritual coping. J Pain 2001;2(2):101-10.
 McCabe R, Murray R, Austin P, Siddall P. Spiritual and existential factors predict pain relief in a pain management program with a meaning-based component. J Pain Manage 2018:11(2):163-170.
 Bishop J. Faith. In: Stanford Encyclopedia of Philosophy. Available at: https://plato.stanford.edu/entries/faith/
 Tennant FR. 1943/1989. Faith [Tennant, 1943, Chapter 6]. In T. Penelhum (ed.), Faith, London: Collier Macmillan, 99-112.
Another excellent paper in the Pain Medicine special issue I guest edited with Melanie Galbraith, John Quintner and Milton Cohen –
Spiritual Well-Being in People Living with Persistent Non-Cancer and Cancer-Related Pain
Melanie Lovell, Mandy Corbett, Skye Dong, Philip Siddall
Existential and spiritual factors are known to play an important role in how people cope with disability and life-threatening illnesses such as …
As organisms, human beings interact with the world and each other through causal mechanisms that control us and every other physical thing. As persons, we act in the world through our thoughts, emotions, attitudes, or desires.
Accordingly, human beings are describable in two distinct, but complementary ways: in terms of the way the world is, through scientific descriptions of the causal mechanisms and laws that explain physical things, or, in terms of the way the world seems, through descriptions of personal experiences and meanings.
One or the other way of describing human beings comes into focus depending on the questions we ask about ourselves or the world. The features of personal experience—thought, feeling, speech and action—are amenable to standard scientific explanation as specific changes in the body. Traditionally, scientific research has had much to say about the physical nature of pain, but much less about the personal experience or meaning of pain. Indeed, the meaning of pain remains a blind spot in knowledge.
A description of a human being as a person means that there is a way of understanding of human beings in which personal experience and meaning, rather than physical causation alone, is needed to answer the question, “What is happening?”
Human persons can distinguish between how things are in the world and how things seem to me. I can recognise within myself a perspective or point of view on the world and identify it as belonging to me. Every person has such a unique perspective; this is partly what it means to be a person rather than a physical thing. In contrast, a scientific description of the world does not presuppose any personal point of view. Physical science does not use words like “I”, “here,” or “now”. Does this mean that “persons” are unobservable to standard quantitative science?
Possibly. Imagine a complete explanation of pain according to the final neurophysiology of pain—whatever it turns out to be. Such an explanation of pain would, to put it very crudely, accurately map specific neurophysiological changes in physical parts in the living human organism and all their true causal interactions across time. However invaluable such an explanation would be to pain medicine, it could not describe the way pain seems to the person who experiences it, for which of the physical objects described in this explanation is me with pain, here, now? Immediate pain always seems a certain way to persons, and this “seeming” determines the experience of the person with pain. In describing personal pain, human beings use language with other meanings than the language used in neurophysiology. The final neurophysiological explanation of pain therefore could explain only one dimension of pain in human beings—the physical dimension—in language that could not capture the personal experience, burden, or meaning of pain.
A philosophical assumption of neurophysiology is that a person is identical with his or her body. Person and body are one and the same thing. In terms of personal experience, however, the identity between person and body escapes personal understanding. For example, when I feel a pain, there is no information or evidence, or nothing that I could discover about my body subsequent to the experience of pain, that could demonstrate it to be false. When I feel a pain, I simply know that I am in pain.
In person to person interactions, we commonly respond to each other as though we are not identical with the human body, but in a compelling sense operating “through” the body, which seems to be a vehicle of thought, emotion, pain or suffering. We feel that each person we encounter in the world is a unique perspective that is not the body, but the “self”, which peers out through the face. The human face is the social instrument of persons. In seeking to understand you, or adjust how the world or your experience seems to you, I interact with you through your embodied perspective.
In pain experience, it is my loss of personal control over my body, and its dominion over me, that create the compelling sense, for me and for others, of an “incarnate” person. Pain imposes a significant vulnerability on persons: the vulnerability of a free person who is overwhelmed in his or her body by the presence of pain. This can make the person, and the person’s significant others, feel answerable for what he or she experiences.