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HORIZON 10 (1) 2021 : II. Book Reviews : V. Lekhtsier : 328-341
ФЕНОМЕНОЛОГИЧЕСКИЕ ИССЛЕДОВАНИЯ • STUDIES IN PHENOMENOLOGY • STUDIEN ZUR PHÄNOMENOLOGIE • ÉTUDES PHÉNOMÉNOLOGIQUES
https://doi.org/10.21638/2226-5260-2021-10-1-328-341
DIALOGIC PHENOMENOLOGY OF PAIN EXPERIENCE
SAULIUS GENIUSAS
THE PHENOMENOLOGY OF PAIN
Athens, Ohio: Ohio University Press, 2020. ISBN 978-0-8214-2403-2 VITALIY LEKHTSIER
DSc in Philosophy, Professor.
Samara National Research University named after S. P. Korolev. 443086 Samara, Russia. E-mail: lekhtsiervitaly@mail.ru
The review focuses on Saulius Geniusas' book, The Phenomenology of Pain. In this study, Geniusas develops his own systematic phenomenology of the experience of pain, based primarily on the conceptual resources of Edmund Husserl's phenomenology. In doing so, the philosopher formulates and successfully implements original methodological principles of "dialogical phenomenology." Such a phenomenology consists of, on the one hand, strict phenomenological analysis of pain based on the methods of epoche, phenomenological reduction and eidetic variation, and on the other hand, of actual and partly polemical inclusion of phenomenological point of view in the ongoing discussion of pain in the social and biological sciences. The author manages to do this by supplementing his eidetic analysis of the essence of pain experience with the method of "factual variations" and by appealing to the analytical optics of Husserl's late genetic phenomenology. This way the book reflects—on strictly phenomenological grounds—numerous findings from the sociology and biology of pain. The book relies on the tradition of phenomenological research, offers a conceptual reconstruction of the key dispute about pain that took place in this tradition (between Franz Brentano and Carl Stump) and, in its turn, grounds the positive sciences of pain in the direct evidence of experience itself.
Keywords: phenomenology, eidetics, pain, intentionality, stratified experience, sensation, feeling.
© VITALIY LEKHTSIER, 2021 328
ДИАЛОГИЧЕСКАЯ ФЕНОМЕНОЛОГИЯ ОПЫТА БОЛИ
РЕЦЕНЗИЯ НА КНИГУ САУЛЮСА ГЕНИУСАСА THE PHENOMENOLOGY OF PAIN
Athens, Ohio: Ohio University Press, 2020. ISBN 978-0-8214-2403-2 ВИТАЛИЙ ЛЕХЦИЕР
Доктор философских наук, профессор.
Самарский национальный исследовательский университет им. академика С. П. Королева. 443086 Самара, Россия. E-mail: lekhtsiervitaly@mail.ru
Обзор посвящен монографическому исследованию Саулюса Гениусаса «Феноменоменология боли». В монографии Гениусас разрабатывает собственную систематическую феноменологию опыта боли, основываясь, прежде всего, на концептуальных ресурсах феноменологии Эдмунда Гуссерля. При этом философ формулирует и успешно реализует оригинальные методологические принципы «диалогической феноменологии», то есть с одной стороны, строгого феноменологического анализа боли, основанного на методах эпохе, феноменологической редукции и эйдетической вариации, с другой стороны, актуального и отчасти полемического включения феноменологической точки зрения в ту продолжающуюся дискуссию о боли, которая идет в социальных и биологических науках. Автору удается это сделать благодаря тому, что он дополняет свой эйдетический анализ сущности болевого опыта методом «фактической вариации», а также апеллирует к аналитической оптике поздней генетической феноменологии Гуссерля. Таким образом, в книге осмысляются — строго на феноменологических принципах — многочисленные результаты социологии и биологии боли. Книга фундирована в традиции феноменологического исследования боли, предлагает концептуальную реконструкцию того ключевого спора о боли, который в ней состоялся (между Карлом Штумпфом и Францем Брентано) и сама, в свою очередь, предлагает позитивным наукам о боли фундаментальную опору в виде непосредственных свидетельств самого опыта.
Ключевые слова: феноменология, эйдетика, боль, интенциональность, стратифицированный опыт, ощущение, чувство.
Substituting the notion of time with the notion of pain in the celebrated saying of Augustine, Saulius Geniusas begins his investigation1, and the Augustinian struggle to express the seemingly inexpressible is both difficult and crucial. It is necessary for theoretical and empirical reasons. Geniusas focuses mainly on the theoretical ones, although occasionally his book also deals with the therapeutic implications that follow
1 Saulius Geniusas' book "The Phenomenology of Pain" is based on his articles published in the 2010s dealing with various aspects of the phenomenology of pain experience, articles reworked into a monograph, such as: (Geniusas, 2012, 2014, 2016, 2017a, 2017b).
from his theoretical considerations. Pain, and especially chronic pain, is still a curse of our time, an embarrassing dilemma for medical professionals and a stigma in everyday communication (Craig, 2009). Due to the joint efforts of various pain studies over the last fifty years it has been acknowledged that pain is much more than a biomedical problem, that biomedicine has no monopoly over pain analysis, that we need to open a dialogue between all the sciences that are in one way or another concerned with pain investigations (Morris, 1993; Khaidarova, 2013).
Yet despite this acknowledgement, which we come across in philosophy as well as social and human sciences, Simon van Rysewyk, the editor of a rather recent anthology, Meanings of Pain, remarks that "preference for neurobiology continues to overshadow research and clinical attention to psychosocial factors of pain such as meaning" (Rysewyk, 2016, 2). The conventional definition of pain that was offered by the International Association for the Study of Pain (IASP) in 1979 and that is to this day approved by World Health Organization is criticized from time to time in philosophy and interdisciplinary studies2. According to this definition, pain is an "unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage" (as cited in Rysewyk, 2016, 1).
Geniusas also criticizes this definition, but his critique relies on phenomenological reasons: because this definition mixes apples and oranges by unjustifiably combining physicalist discourse with appeal to experience and especially because this definition does not clarify the specific character of pain experience. According to Geniusas, the nature of pain as experience has not been defined successfully either in the sciences or in philosophy, despite the repeated attempts to do this. The dominant methodological paradigms in pain studies—naturalism and social constructionism—dwell only on mechanisms leading to pain and forming it (the neurological and cultural mechanisms accordingly), but say nothing about pain itself (Geniusas, 2020, 145-151). These approaches uncritically and unjustifiably assume that we already know what pain is. Sociology and biology of pain must be founded in the analysis of pain as experience, and this grounding analysis must be undertaken by phenomenology, which traditionally legitimizes itself though the task of founding other analytic approaches, which neglect reliance on immediate data.
Methodologically, Geniusas offers an investigation that is based on classical Husserlian phenomenology and considers his own investigation a supplement to those rather sporadic phenomenology-oriented studies of pain that were published during
The history of this definition, its criticism and the alternative pain definition suggestion see here: (Cohen, Quintner & Rysewyk, 2018).
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the last two decades and were based on Martin Heidegger's existential analytics and Maurice Merleau-Ponty's phenomenology of the body (Gruny, 2004; Olivier, 2007). Yet Geniusas is the first to have developed a systematic phenomenology of pain, which has never existed before the publication of this book as far as its conceptual scale and empirical base are concerned. His systematic approach is grounded in the resources of Husserl's conceptual-analytical framework. On the one hand, this framework allows us to escape naturalistic objectivations. On the other hand, it equips us with a method for direct phenomenological description, directed at the phenomenon's essence in the eidetic variation, as it manifests itself in embodied experience. It also enables us—due to the notion of the Lebenswelt—to clarify in what ways pain is rooted in cultural worlds. On the whole Geniusas' book is characterized by continuous detailed argumentation and clarification of the methodological steps taken in analysis: the choice of Husserlian methodology, the reasons why it is most relevant for the subject of his research, his own definition of pain, the solution to the Carl Stumpf—Franz Brentano long-standing debate over the nature of pain, etc.
I would like to point out that that author's reference to the Husserlian tradition has not prevented him from developing his own methodological position, which is in a good sense ambivalent, or "oxymoronic". His methodological approach is both fair to phenomenology and in some ways even too rigorously subscribes to the "die-hard" phenomenological research identity, yet it also takes into account various theoretical results that reach us from other sciences, which do not deal with the epoche and the phenomenological reduction. "Phenomenology need not be victim of its own purity: it must be open to the developments in other sciences—natural, social, and human..." (Geniusas, 2020, 12). Geniusas calls such phenomenology "dialogical" (Geniusas, 2020, 12).
I want to dwell upon these theses in detail, since the author makes systematic clarification of phenomenological pain analysis one of the main objectives of his book, which is definitely an advantage. What is meant by "dialogical phenomenology" here? Both words matter, of course. On the one hand, it is strictly a "pure" phenomenological study of pain. I mean that firstly, in light of its adherence to the epoche, the study stays clear of references to the biology and sociology of pain, to "tissue damage", neurological explanations, or pain interpretation as a natural thing. Secondly, due to its adherence to the phenomenological reduction, the study treats pain within the immanent "field of pure experience" (Geniusas, 2020, 16), and thirdly, due to the eidetic variation—the study is concerned with the discovery of the essential and invariant structures of the Heraclitean stream of experience, without which the phenomenon would lose its identity. Adherence to these three principles in their unity prevents
phenomenology from "misappropriations," for example from a common pain talk in the first-person perspective, from the paradigm of introspective psychologism, or from various idiosyncratic singular descriptions. This adherence also lets us access intersubjective and verified knowledge about the essence of pain experience, even if this essence cannot be "accurate" and cannot be defined comprehensively.
As we know, "morphological" or non-ideal, "non-geometrical" essences, i.e., essences implying sensuous embodiment, cannot, according to Husserl, be strictly shaped in eidetic mind and are "essentially and non-randomly ambiguous" (Husserl, 1999, 155). Thus, Geniusas dispels some stereotypes connected with phenomenology, including phenomenology of medicine, with its common criticism: as immersion into subjective pain experience, which allegedly cannot be corroborated intersubjectively, for instance in a doctor-patient relationship (Gergel, 2012). Nevertheless, while criticizing phenomenology of medicine in one regard, Geniusas agrees with it in another— that phenomenology must not become "sectarian polemic" (Gergel, 2012, 1103), that it must not be methodologically and thematically isolated, which would result in negative consequences for phenomenology itself. On the contrary, phenomenology must become dialogical, and this is the other side of the coin. If phenomenology is practiced in an isolated way, it can result in psychologization and dependence on the phenome-nologist's cognitive abilities, which would limit the possibilities of eidetic variation and provide the false assurance that experiential essences have already been understood. For example, if we want to include in our imaginative variation of the essence of sound or color synesthesia, which is mentioned in empirical science and which does not exist in our subjective experience, this would mean that we, phenomenologists, need a methodological permission for this action. Geniusas calls this permission principle a "factual variation," and he maintains that it must supplement the eidetic one.
Actually, Husserl does not exclude factual variations from phenomenological analysis. On the contrary, in Ideas I, for instance, Husserl discusses the use of "objects of art, especially poetry" for the phenomenological understanding of essences, as far as this understanding concerns the practice of "conjuring up representative details" of an object, its free variation in mind, and here, according to Husserl, nothing can compare with poetry (Husserl, 1999, 146). For Geniusas this combination of eidetic with factual variations has the status of a pure opportunity and it opens the way to cross-disciplinary and cross-cultural dialogue with positive sciences, the arts and other research fields. More specifically, it deals with pain experience, which is so complex and varied, as it refers to a variety of experiences, which are not always tangible subjectively—from pain dissociation syndromes (congenital insensitivity to pain, asym-bolia for pain, etc.) to masochism.
Geniusas finishes his explication and description of the methodological principles required for the phenomenology of pain with a thesis, which states that static, constitutive eidetics of pain should be combined with genetic eidetics. Such a supplementation enables one to incorporate intuitions that rely on pre-conceptual understanding of pain. "Genetic considerations arise from the need to supplement the analyses of being with reflections on becoming" (Geniusas, 2020, 33). Eidetics is open to diachrony, if we mean both ways of genetic optics, suggested by Husserl, and including epoche and in this case transcendental reduction: the psychological way leading to the temporally structured contents of transcendental experience, to the sphere of the formation of apperceptions, and the ontological way through the appeal to Lebenswelt as an intentional correlate of transcendental intersubjectivity (Geniusas, 2020, 35). Genetic eidetics enables us to open a dialogue between phenomenology of pain and cultural anthropology of pain, psychopathology and other disciplines.
Geniusas offers the following definition of pain: "pain is an aversive bodily feeling with a distinct experiential quality, which can be given only in original firsthand experience, either as a nonintentional feeling-sensation or as an intentional feeling" (Geniusas, 2020, 42). The author substantiates each element of this definition in the course of analytical descriptions and historical-philosophical reconstructions, in particular commenting on the historic debate about the nature of pain between Husserl's teachers Franz Brentano and Carl Stumpf3. The question behind this debate concerned whether it was possible to consider pain to be an intentional experience or whether it was a plain empirical/material aspect of experience, which did not refer to anything. Brentano in his theory of emotions and affects maintained that pain was an intentional feeling (Brentano, 1996), whereas Stumpf, who is known to have been a follower of Brentano in many other regards, considered pain to be a non-intentional feeling-sensation (Gefühlsempfindung) (Stumpf, 1916, 1928). This debate within the phenomenological tradition did not reach any consensus: many phenomenological or phenomenology-oriented studies dealing with the nature of pain were in favor of either Brentano's (Olivier, 2007; Buytendijk, 1962) or Stumpf's position (Scarry, 1985). We can also see a personal "from...to" evolution as far as this problem is concerned, for example, in Max Scheler's studies, who considered pain in his early works in ethics to be a non-intentional feeling, and in his later works to be a modality of suffering, understood as an intentional experience.
For the history and twists and turns of this long-lasting indirect debate between Stumpf and Brentano, the debate where the positions were specified, see here: (Fizette et. al., 2017)
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The phenomenological style of Geniusas' analysis is characterized by regular systematic argumentation. The reader is offered detailed explications of conceptually incompatible and equally descriptively convincing arguments for both standpoints. For Stumpf, the interruption of intentional attitude in pain, distancing from objects, pre-reflective ambiguity of act and its object in pain experience, metaphoric reifica-tion/objectification of pain in language etc; for Brentano, pain as a way to get to know your body and as a form of attitude to other objects, pain not only as noesis, but also as noema, etc.
The book presents the thesis of the intentional nature of pain, including the consideration of its development after Brentano, in its full complexity. According to Geniusas, the intentionality of pain can be conceptualized in three ways: pain as an intentional feeling correlating with the body; pain as an intentional object (a body experiencing pain); and pain as a special atmosphere "coloring" all the intentional objects, which can be illustrated, for example, with the words of the Russian poet Vladislav Khodasevich: "And every sound is hard to hear, / And every ray for me is torture...." In my opinion, the third "variant" of pain intentionality can be understood as a modification of the first one. If we demystify the vague notion of "atmosphere" of its seemingly ontological status, which can be understood non-intentionally (Schmitz, 2009, 23-27), then it can be said to concern pain as a sensual act, yet it will correlate not with the body where the pain is localized, but with any object being in the focus of "violated" attention (Olivier, 2007).
On the whole, the Brentanian and Stumpfian positions being equally persuasive, Geniusas decides not to follow either of them but to provide reasons that underlie his proposed compromise solution: "pain is a stratified experience. This claim means that the experience of pain is composed of two fundamental strata: while its founding stratum is non-intentional, the founded stratum is marked by intentionality" (Geniusas, 2020, 44). Geniusas finds the theoretical resource for giving grounds to this reconciling solution in Husserl's and Sartre's works. In §15 of Husserl's Fifth Logical Investigation, Husserl focuses on intentional and non-intentional feelings. Here Husserl mentions Gefuhlsempfindungen and states that pain is not a feeling as act, that it "should not equal belief, guess, willingness etc., but such aspects of feelings as being rough and smooth [.] at best they represent the content or even the objects of intentions, but they are not intentions themselves" (Husserl, 2001, 367-368). Itself not being an act, pain and other similar "content of feelings" "undergo object 'interpretation' or 'grasping.' So, they are not acting themselves, but acts are constituted through them." (Husserl, 2001, 367)
This position, which is usually mentioned in philosophical studies to support Stumpf's views, underlies Geniusas' view that there is a specific conceptual pros-
pect—an opportunity to understand pain as an ontologically two-edged phenomenon, i.e., both as a pure feeling and an intentional object (constituted in inner perception, with the help of localization, for example). In the first case we deal with pain as a simple phenomenon, in the second case (i.e., after its intentional transformation), as a complex, stratified phenomenon. However, these types of pain experience correlate not according to the principle of juxtaposition but according to founding relations. If pain is experienced intentionally (and according to Husserl it can also be experienced non-intentionally), this non-intentionality does not have to be represented (as Brentano thought) but can be based on feelings which function as "representing content."
In addition, the simplicity of the pain phenomenon (pain as Gefuhlsempfindung) gives ground to the issue (mentioned above in the definition of pain as "the original first-hand experience") that pain can be given only directly, as a personal immanent and indubitable embodied sensation, comprised in the actual content of experience. Therefore, this experience can be non-thematic, pre-reflexive, passive, if we mean the experience of pain in the background, i.e., weak and short pain, which one puts up with and which one might not notice. Pain becomes thematic when there is an intentional transformation, through which it acquires noetic and noematic characteristics; it happens, in particular, when pain becomes strong, excruciating and long-lasting: "The more obtrusive the pain, the more it has the tendency to change its character and transform itself into an intentional experience" (Geniusas, 2020, 60). The reflexive objectifying modification of the basic pain experience happens in the mind forcefully and unintentionally.
Sartre undertook an analytical description of pain as a complex, hierarchical experience in the third part of Being and Nothingness, in the chapter Body, where he considered the reference to the phenomenon of "physical" pain (douleur) a paradigmatic example for the phenomenology of the body, or the embodied subject. Sartre also uses the notion of "levels" while describing pain experience. At the first, basic, level, pain is given in the "unanimity of 'experience' and 'living'," it is lived as a feeling in "your body", as a "pure affective quality" (Sartre, 2002, 334, 349, 350) At this level of "nonthetical self-consciousness" "pain is completely free from intentionality", it is the embodied subjectivity itself and in plain experiencing causes suffering, but it is elusive (Sartre, 2002, 349, 351). At the second level, reflection renders pain a psychic phenomenon (mal), which has its manifestation and which begins to live its own life. Like a living being, it comes and goes, forming a "tune" of suffering. Noematically, at this level we experience the so called "animism of pain" (Sartre, 2002, 355). Finally, the third level is introduced by the alienating "for another" structure, which brings about the knowledge of our body, as it is given to others. We thereby acquire "our disease":
"we transfer pain to Disease, another person is responsible for my disease" (Sartre, 2002, 374). At this level the experience of pain includes the mechanisms of the alienating body-for-another, i.e., mechanisms of feeling "acquisition" and mechanisms of "anticipation": "a suffering body is a basis, material for alienating meanings which anticipate it." (Sartre, 2002, 373).
Despite the fact that Sartre reconstructs intentional levels of pain experience in a way which is rather different from Geniusas', Sartre's pattern serves a ground in promoting the thesis of pain as a complex and stratified phenomenon. Meanwhile, such spacious metaphors as levels, strata, layers can certainly set up naturalizing traps during analysis. However, bearing this in mind, it must be admitted that it is hard to think of better working notions to describe the constitutive processes which organize pain experience.
The conceptual idea of pain experience as stratified and aversive and at the same time different from other unpleasant experiences (i.e., possessing a "special empiric quality") is tested by the author when he turns to various data of factual variation, first of all those coming from cognitive science of pain, describing, in particular, dissociation pain syndromes—congenital insensitivity to pain, lobotomized, cingulotomized, and morphinized patients, and threat hypersymbolia. Geniusas argues, for example, that the first of the above-mentioned symptoms proves that pain experience cannot be replaced with pain behavior, that "sensory dimension is fundamental to pain experience," that "there must be something about pain sensations themselves that motivates consciousness to apperceive them as painful" and to combine different pain sensations (fulgurant, lancinating, pounding, severe, throbbing pain etc.) into "whole pain experience" (Geniusas, 2020, 73, 74, 79) with a distinctive characteristic. In other cases, pathological block of "transition" from pain as a sensation to pain as an intentional object shows the structural presence of such transition in stratified experience.
However, it seems that analyzing the data of this factual variation the author does not consider them as milestones to the eidetic definition of pain which is still to be acquired, but evaluates them from the position of the already given definition. For this reason, some conclusions in the discussion with cognitivists are not absolutely flawless.
For example, the phenomenon of threat hypersymbolia (when pain is experienced without noxious stimulation and painful sensations), might invert the notion of founding relations in pain experience if they had not been defined already. In the next chapters, while considering the issue of the subject of pain experience, the author introduces the notion of the lived-body (Leib), which clarifies the notion of sensation from the phenomenological point of view. This clarification complicates the picture
of founding in pain experience. Besides, I find it very important that Geniusas takes such a risk, does not discard awkward facts, but on the contrary, deals with the issue that can question his own conception of the essence of pain experience. He actually introduces the phenomenological point of view into the broad discussion that we come across in various sciences, thereby suggesting that we recognize not only the biological but also the phenomenological meaning in these phenomena.
Meanwhile, it is most likely that the author needs these supplements and the dialogue with specific sciences not only for the phenomenological founding of these sciences but also for the correction or at least problematization of the already existing traditional phenomenological concepts. For instance, while discussing the phenomenon of somatizing (description of psychic distress "in the language" of somatic complaints) and psychologizing (manifestation of physical pain in the idiom of psychic complaints) and outlining the prospect of their interpretation in Husserl's theory of the life-world, Geniusas problematizes Husserl's idea of Heimwelt. There must be some reasons that explain how somatic phenomena can transfigure themselves into psychic phenomena, and vice versa (this happens with somatization and psychologization, and these transformations are typical not only for the period of chronic diseases). Cultural anthropology suggests that a "sufferer misrepresents the nature" of their experience, that through somatizing and psychologizing (Geniusas, 2020, 168) processes, the sufferer reinterprets and disguises their experience, that is, the sufferer legitimizing some forms of expression and delegitimizing others, in conformity with what is acceptable in this or that society. In his turn the phenomenologist relies on such notions as the lived-body and embodied personhood, which let him explain the connection of pain as a somatic sensation and pain as an intentional feeling. He also has the genetic notion of intersubjective life-world, within which such disguising "pre-reflective modes of expression" can be explained (Geniusas, 2020, 180). However, what shall we do, asks Geniusas, with Husserl's concept of Heimwelt as a homogeneous world of concordant experiences (einstimmige Erfahrungen)? Husserl understands the "homeworld" not only as a cognitive construction, as a combination of what is accustomed and familiar, "the area of the closest familiarity" (Landgrebe, 2018, 277), but also as "the feeling of homeness," family connection, i.e., emotional intimacy, togetherness, which is intuitively projected at the togetherness of family, tribe or nation. Common cases of somatization and psychologization indicate that our accustomed and familiar home worlds can include discord, stigmatization, the delegitimizing of specific forms of experiential expression, therefore its living can include, according to Geniusas, the "feeling of homelessness" penetrating "personal worlds." Even if we take into account the Husserlian notion of Heimwelt as a pure transcendental-constitutive intersubjec-
tivity model, where such conflicts do not take place, we will still have to agree with Geniusas that this model of verification and traditionally understood eidetics of the "home world" becomes problematic and require further elucidation.
Geniusas' phenomenological style is not only marked by aspiration to maximum argumentation, but also by an amazing combination of a strict systematic and taxonomic writing, on the one hand, and regular polemics, on the other hand. Everywhere the book offers us classifications and typologies of concepts, possible solutions to this or that problem, and one of them is always phenomenological. Every chapter outlines its polemical targets. For instance, bringing the topic of possible reconciliation of two motives—the feeling of pain absolutism (its "inner" presence) and at the same time its experiencing as something localized (its "outer" presence), Geniusas at once introduces and describes six available theoretical solutions to this paradox. Here we will repeat neither these ways, nor their criticisms, but the important thing is that in this book, the phenomenological solution is always grounded (and this is logical) as the most adequate solution since it is grounded in the evidence of experience.
To conceptualize this evidence Geniusas refers to Husserl's phenomenology of the lived-body (Leib), as described first of all in Ideas II, i.e., to the understanding of the lived-body (or the embodied consciousness) as the field of sensings, to the notion of Empfindnis, which refers to special sensations experienced as localized "inside" the lived-body, and to those consequences, which result from Husserl phenomenology of the lived-body as a twofold constitutive unity: pain as "inner protest against its constitutive appropriation" (Geniusas, 2020, 121). The issue how pain can be simultaneously absolute and unattended (lived in the background) brings the author to the topic of different forms of pain temporality, of immanent memories and their pre-percep-tual influence on its intensity. This directly refers to the phenomenon of chronic pain and to its treatment in medical institutions. Phenomenology of pain thereby acquires therapeutic significance.
The author also relies on some of Husserl's theses from Ideas II in his analysis of the subject of pain. This subject is not just a lived-body or embodied consciousness, it is rather the person, who undergoes the processes of depersonalization and re-personalization while experiencing chronic pain. Depersonalization is a disturbance of accustomed self-understanding, a relation to one's body, to the outer world and other people. However, persons can reorganize their personality anew with their unavoidable reaction to chronic pain (the reaction being cognitive, emotional and corporeal).
Actually, this consideration of chronic pain, its phenomenological description, its demarcation from other types of pain (transient and acute) is a great achievement of the book. Chronic pain is an "invisible epidemic" of our life, as David Morris has
rightly pointed out (Morris, 1993, 57). Chronic pain, which remains after it has performed its alarm function, the pain which has become a pathology (Leriche, 1961) and is the most typical disease of our time, this chronic pain still "challenges" us—it challenges both our understanding and medical institutions and practices (Good et. al., 1994). Geniusas is absolutely right to say that chronic pain brings into question the opposition between psychogenic and physical understanding of pain mechanisms, or as a lot of other researchers state, demonstrates the pain monism. However, Geniusas believes in his usual polemical mode that chronic pain also brings into question other distinctions at work in the phenomenology of medicine nowadays—the distinctions between illness and disease, healing and curing. He writes that "these distinctions, introduced 'to provide the phenomenology of medicine with its raison d'etre', have outlived their function and that, presently, they leave phenomenology with an artificially confined domain that it sooner or later must transgress" (Geniusas, 2020, 155-156).
This is a bold statement which needs further discussion. I would just like to say that the principal differentiation between "illness" and "disease," i.e., a health problem as a subjective experience and a health problem as a nosological category, is unlikely to have become out-of-date. It was grounded, first of all, by Leon Eisenberg and Arthur Kleinman (Eisenberg, 1977; Kleinman, 1988, 14) for medical practice itself, in order to deal with the conflict of interpretations between the medical semiotics of a health problem and the meanings given to the patient during patient-doctor interactions. This differentiation is especially important in "the remission society" (Frank, 1997, 8), for which the most important problem of pain experience is connected with the issue of what happens to chronic patients outside the doctor's offices. It does not mean that phenomenology should not deal with such a phenomenon as disease. What is more, the diagnosis establishment is an issue which is relevant for phenomenology, especially social phenomenology. Nevertheless, the phenomenological study of illness and chronic pain as illness is to be continued. It is no accident that Geniusas also mentions narrative medicine and even traces together with it the "phenomenology of listening," and the grounding for narrative medicine. Its ethical and therapeutic meaning is impossible without the differentiation between "illness" and "disease" (Lekhtsier, 2018).
Geniusas' book, The Phenomenology of Pain, is extremely informative. The author has studied a great number of works in phenomenology, anthropology, neurology, cultural studies, medical psychology and other sciences. All the results of biology and sociology of pain that are referred to in this book are incorporated into the phenomenological eidetics of pain while relying on all the necessary methodological procedures, based on immediate evidence of experience. From my point of view, the book
clarifies many principal issues connected with the phenomenology of pain. It is also its great merit that it outlines new prospects for a dialogue between phenomenology and the positivistic sciences of pain. The latter do not always refer to phenomenology as a methodological resource, of course, as it is done, for example, by an American anthropologist Byron Good, who introduces the notion of the "world of chronic pain" in his studies (Good, 1994, 123)4. Let us agree with Geniusas that phenomenology should always follow its mission of philosophically grounding the sciences in experience.
REFERENCES
Becker, G. (2004). Phenomenology of Health and Illness. In Ember, C. R. & Ember, M. (Eds.). Encyclopedia of Medical Anthropology. Health and Illness in the World's Cultures Topics, Vol. 1; Cultures, Vol. 2 (125-136), New York: Kluwer Academic/Plenum Publishers.
Brentano, F. (1996). Selected Works. Rus. Ed. Moscow: Dom intellektual'noi knigi, Russkoe fenomeno-logicheskoe obshchestvo Publ. (In Russian)
Buytendijk, F. J. J. (1962). Pain: Its Modes and Functions (Eda O'Shiel, Trans.). Chicago: University of Chicago Press.
Craig, K. D. (2009). The Social Communication Model of Pain. Canadian Psychology, 50, 22-32. https:// doi.org/10.1037/a0014772
Cohen, M., Quintner, O, & Rysewyk S. van (2018). Reconsidering the International Association for the Study of Pain definition of pain. PAIN Reports, 3 (2), 1-7. https://doi.org/10.1097/ PR9.0000000000000634
Eisenberg, L. (1977). Disease and Illness: Distinctions Between Professional and Popular Ideas of Sickness. Culture, Medicine and Psychiatry, 1, 9-23.
Frank, A. W. (1997). Wounded Storyteller: Body, Illness, and Ethics. Chicago: University of Chicago Press.
Fizette, D., Koniaev, S., & Sultanova, M. (2017). Love and Hate: Brentano and Stumpf on Emotions and Sense-Feeling. Filosofskaia antropologiia, 2, 161-178. https://doi.org/10.21146/2414-3715-2017-3-2-161-178 (In Russian)
Geniusas, S. (2014). The Origins of the Phenomenology of Pain: Brentano, Stumpf and Husserl. Continental Philosophy Review, 47 (1), 1-17.
Geniusas, S. (2016). Max Scheler's Phenomenology of Pain. Frontiers of Philosophy in China, 11 (3), 358-76.
Geniusas, S. (2017a). Phenomenology of Chronic Pain: De-Personalization and Re-Personalization. In Rysewyk, S. Van (Ed.), Meanings of Pain (147-64). Dordrecht: Springer.
Geniusas, S. (2017b). Pain and Intentionality. In Walton, R., Taguchi S. & Rubio R. (Eds.), Perception, Affectivity, and Volition in Husserls Phenomenology (113-36). Dordrecht: Springer.
Geniusas, S. (2020). Beyond Naturalism and Social Constructionism: The Function of Phenomenology in Pain Research. Topos, 1, 137-157.
For more information on phenomenology founding social studies of health and illness since the last quarter of the XX century see, for example, the article by Gay Becker Phenomenology of Health and Illness published in Encyclopedia of Medical Anthropology (Becker, 2004, 125-136).
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Gergel, T. L. (2012). Medicine and the Individual: Is Phenomenology the Answer? Journal of Evaluation in Clinical Practice, 18 (5), 1102-1109.
Good, B. J. (1994). Medicine, Rationality, and Experience. An Anthropological Perspective. New York: Cambridge University Press.
Good, M. J. Del V., Brodwin P., Good, B. J., & Kleinman, A. (Eds.). (1994). Pain as Human Experience: An Anthropological Perspective. Berkeley: University of California Press.
Grüny, C. (2004). Zerstörte Erfahrung: Eine Phänomenologie des Schmerzes. Würzburg: Königshausen & Neumann.
Husserl, E. (1999). Ideas Pertaining to a Pure Phenomenology and to a Phenomenological Philosophy: First Book: General Introduction to a Pure Phenomenology. Rus. Ed. Moscow: Dom intellek-tual'noi knigi Pul. (In Russian)
Husserl, E. (2001). Collected Works. Т. 3 (1). Logical Investigations, vol. II (1). Rus. Ed. Moscow: Dom intellektual'noi knigi Publ. (In Russian)
Khaidarova, G. R. (2013). The Phenomenon of Pain in Culture. Sankt-Peterburg: Russkoi khristianskoi gumanitarnoi akademii Publ. (In Russian)
Kleinman, A. (1988). The Illness Narratives. Suffering, Healing, and the Human Condition. New York: Basic Books.
Landgrebe, L. (2018). The Phenomenology of Edmund Husserl. Rus. Ed. St. Petersburg: Russkii Mir Publ. (In Russian)
Leriche, R. (1961). Basics of Physiological Surgery. Rus. Ed. Leningrad: Medgiz Publ. (In Russian)
Lekhtsier, V. L. (2018). Illness: Experience, Narrative, Hope. Essay on Social and Humanitarian Research in Medicine. Vil'nius: Logvino literatures namai Publ. (In Russian)
Morris, D. B. (1993). The Culture of Pain. Berkeley and Los Angeles; London: University of California Press.
Olivier, A. (2007). Being in Pain. Frankfurt am Main: Lang.
Scarry, E. (1985). The Body in Pain: The Making and Unmaking of the World. New York: Oxford University Press.
Rysewyk, S. van. (Ed.). (2016). Meanings of Pain: A Call for Study on the Meanings of Pain. Dordrecht: Springer.
Sartre, J.-P. (2002). Being and Nothingness: An Essay on Phenomenological Ontology. Rus. Ed. Moscow: TERRA Publ. (In Russian)
Stumpf, C. (1916). Apologie der Gefühlsemfindungen. Zeitschrift für Psychologie und Physiologie der Sinnesorgane, 75, 330-350.
Stumpf, C. (1928). Gefühl und Gefühlsempfindung. Leipzig: J. A. Barth.
