Spatial perception of pain (III) How can we feel pain inside the body?

I will first start with a summary of the different propositions I made in the previous post about where it hurts.

- Proposition A (independent channels): there are two independent channels, one that provides pain information (intensity or quality of pain, through pain receptors) and another one that provides spatial information (through tactile receptors or vision). The two channels are bound by co-occurrence.
- Proposition B (sensorimotor): you feel pain at a particular location because specific movements that you make produce that pain.
- Proposition B2 (sensorimotor): you feel pain at a particular location because whenever this particular activation pattern of pain receptors is present, you can manipulate this pattern or the intensity of pain by specific movements or actions.
- Proposition C (learned association): the localization of pain is inferred from the activation pattern of pain receptors (which must be spatially selective), by association with another channel that carries spatial information (e.g. tactile receptors).

Note that in A and C, I have moved the problem of spatial information to another modality, either touch or vision. We may consider that spatial information in touch and vision is constituted by sensorimotor contingencies, but it is not an important assumption here. The puzzle is the following: we can only touch our skin, the surface of our body, and we cannot see inside our body. If touch is central to the spatial perception of pain, then how is it possible that we can feel pain inside the body (say, in the stomach or in the head)?

I have discussed a similar example in spatial perception: when one hears music or speech through headphones, it usually feels like the sound comes from “inside the head”. First of all, there is a simple argument why sounds should feel as coming from your body in this case: when you move the head, the sound is unaffected, which means the source is part of your head – either on the surface (skin) or inside the head. The same argument applies to pain felt inside the body: rigid displacements of the body do not change the pain or any information associated with it. Therefore the pain is in you, not in the external world. However, this remark does not explain why pain feels inside the body and not on the skin.

I mentioned another possibility for sounds, inside as a default hypothesis: if you cannot identify the source as coming from somewhere outside, then the sound feels located inside. The default hypothesis raises a question: why does it feel located inside rather than not located at all? There is also another problem here: pain does not simply feel inside, it feels at a particular place inside the body (e.g. the stomach).

A first answer is proposition B2. Perhaps you feel a headache in the head and not in the stomach because the pain is only affected by movements of the head. In the same way, touching your stomach may alter the intensity of pain but not touching other parts. This explanation is a combination of default hypothesis (it's not on the skin so it's inside) and sensorimotor theory (B2). It is appealing but let's see how it applies to the perception of sounds inside the head. Here again, sounds do not simply feel inside the head, but at a particular place inside the head (say on the left or on the right). But no movement that you make has any impact on the sound, and so proposition B2 only explains why the sound is inside the head, but not where in the head it is.

Let us formalize the problem more precisely. Your stomach hurts. There is a pattern of activation of receptors that is characteristic of this condition, but no movement that you can make generates this pattern. In addition, in the case of auditory perception inside the head, no movement may alter this pattern. The default hypothesis is logical inference: since it is a new pattern, it must be located where I cannot produce it: in my body. But as we saw, this not sufficiently precise. To make some progress, I will start with an experiment of thought.

Imagine that in your life, you have touched only two points on your skin, points A and B. When something touches point A, you feel it located at A because you recognize the activation pattern of the tactile receptors. But what if something touches a point between A and B? One possibility would be that you don't feel it located at all, you just feel that something touches you. But it contradicts the fact that you feel sounds inside the head or pain inside the body. Another possibility is the default hypothesis: since you have never encountered the activation pattern, then you know it is neither A nor B, so you feel the touch somewhere outside of A and B. But this logical inference does not produce anything more precise. It seems to contradict the fact that we can hear sounds in our head on the left or on the right. To feel the touch somewhere between A and B requires some form of interpolation: if the new activation pattern resembles the pattern that is characteristic of A, then the touch was probably located somewhere near A; if it resembles both A and B, then it was probably located between A and B.

More generally, we can only have a finite number of experiences, and so t is unlikely that the exact activation pattern of receptors is encountered twice. Even if physical stimuli were identical, the body changes over time. Thus, it appears that we could not have any perceptual experience at all unless there is some form of interpolation. A natural proposition is then that detailed perception inside our body results from perceptual interpolation. This is not the same as logical inference, as in the case of the default hypothesis, because it necessary involves some arbitrariness: there is no way you can logically know where exactly between A and B your skin was touched if you have never encountered the activation pattern before, so the perceived location is a guess.

Now let us go back to our specific problem. How can pain be located inside our body? The idea of interpolation seems to imply that the pattern of receptor activation induced by such pains should resemble that of pains induced on the skin at opposite locations on the body. For example, pain in a joint, say the knee, should produce activation patterns resembling those of pains induced at the skin all around the knee.

There are two interesting points to note about the interpolation idea:
1) Sounds and pains located inside the body tend be less precisely localized, the location is “vague”. This means that the concept of interpolation as in picking a particular point between two points is incorrect: somehow the process of perceptual interpolation also affects the uncertainty of the location, or perhaps the perceived size.
2) How specifically are perceptual locations interpolated? In other words, what is the topology of spatial perception?

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