What Pain Asymbolia Really Shows

Pain asymbolics feel pain, but act as if they are indifferent to it. Nikola Grahek argues that such patients present a clear counterexample to motivationalism about pain. I argue that Grahek has mischaracterized pain asymbolia. Properly understood, asymbolics have lost a general capacity to care about their bodily integrity. Asymbolics’ indifference to pain thus does not show something about the intrinsic nature of pain; it shows something about the relationship between pains and subjects, and how that relationship might break down. I explore the consequences of such a view for both motivationalism and the categorization of pain asymbolia as a syndrome, arguing for a close link between asymbolia and various forms of depersonalization.