I appreciate the use of a specific scenario to outline one aspect of suffering-focused thinking—the range of examples (mental, physical) was especially helpful.
However, my intuition is that the things people consider to be their own least pleasant experiences are often not the moments of greatest pain/suffering in their lives. I’ve been punched in the face, I’ve run wind sprints until I dry-heaved, and I’ve been dragged along a rocky ocean floor by a strong wave...
...but those barely even register on my list of “things I wish hadn’t happened”, compared both to major negative life events but also to something like “the time I wrote someone an embarrassing love letter”, which still bothers me to this day.
How many “hell-seconds” might someone experience from a sense that they never lived up to their potential, or from their parents’ acrimonious divorce, or from a friend’s instantaneous but untimely death?
Of course, your metric isn’t meant to be universal, but as far as metrics of well-being go, I see extreme pain as relatively narrow—I’m curious whether there are any systems that go beyond DALY and “hell-seconds” in capturing lingering low-valence negative emotions, even if they don’t amount to “depression”.
(1) We are trying to arrive at a metric like you describe at QRI. See: Quantifying bliss and a future for neuroscience for the big-picture idea. I think the suffering you describe is very relevant for instrumental reasons, but perhaps not very large in terms of absolute values (still sucks, obviously!).
(2) I think that another important update that people should make in EA is that hell-seconds are not only much, much, much worse than garden-variety pain and suffering. But also that they are *far more prevalent* than we realize. About 20% of people in the US live with chronic pain, of which 8% is “high-impact” (i.e. severe enough to interfere with life on many fronts). Kidney stones happen to 10% of people, migraines are equally as common, and about 2-3% of people who get fractures develop complex regional pain syndrome, which tops the scale (and worse of all, it is chronic and persistent pain rather than episodic like cluster headaches).
I suspect most people will be horrified when we get an accurate estimate of a country’s Hell-Index. Perhaps you don’t dip your toes into those realms often, but chances are that your neighbor or two houses down the line someone very close to you does.
I looked up CRPS and kidney stones, and it looks like both of them have relatively mild symptoms in most cases. Are you sure that this isn’t a case of conflating the pain of the most extreme cases and the prevalence of all cases?
You’re right about the 8% figure for chronic severe pain, though.
CRPS sufferer here. There are cases that are mild or that resolve quickly. But when it becomes chronic by some metrics it is the most painful condition in existence, with a persistent pain worse than having a finger cut off without anesthetic or childbirth without anesthetic.
Let’s say “the typical pain of the top 5% most painful of the cases of a given condition”.
My sense is that the pain scale is exponential. Let’s say that kidney stones rank on average at a 7⁄10 level with a standard deviation of 1. In that case, about 2% of the kidney stone cases are a 9⁄10, which might be hundreds of times more painful than the 7⁄10 typical case. In other words, you can’t really judge how many hell-seconds a given condition contributes by observing a *median* case… you need either the average or to look at the more painful side of it.
It’s just that your first comment sounded a bit like you’re implying that 10% of the population suffers from excruciating kidney stones. With your estimated numbers (10% of population affected at some point in their lives, 2% of cases at 9⁄10 on the pain scale), it would be more like 0.2%.
That’s probably still a lot if you multiply by the world population and total pain episode lengths. I don’t know how long such a case typically lasts with modern medical care, but plenty of people don’t have access to it.
Of course, this all depends on whether the 2% number is a reasonable estimate, and whether the pain scale is exponential.
But my guess is that a better strategy will probe better medical prevention and treatment of underlying causes in most cases. After all, flooding the USA with powerful painkillers hasn’t exactly been a boon to the nation (see opioids).
While unpleasant, I don’t think being punched in the face is comparable to having kidney stones (a pain so excruciating that often morphine can’t touch it). It seems totally believable to me that such an experience might rank as among the worst in one’s life.
There are probably also two systems at play here: the experience itself and the lingering memory of it. It’s conceivable you might not remember some extremely painful experience as ‘bad’ (through post-hoc rationalisation, or the peak-end effect or similar); I’m not sure how to weight that against the actual raw badness of the experience itself.
I wonder if we sufficiently understand the psychological dynamics of chronic or extreme pain. The existence of the bullet ant glove ritual makes me wonder to what extent the cultural context of pain influences our remembered perception of its quality, intensity, and meaning.
It seems helpful to distinguish between meaningless, “I would’t wish this on my worst enemy” pain, which probably accounts for the vast majority of extreme pains, “a little pain is necessary to toughen you up” pain, and “this is a sacred extreme-pain ritual.”
What are some resources you’d recommend on understanding the psychological dynamics you mentioned? I’d be especially interested in sources that push against the common (and perhaps very wrongheaded?) idea that people can adjust to almost anything, and that we become somewhat more “numb” even to extreme pain over time.
I’ll give that some thought, but I’m no expert on this. Just pulling together some memories of things I’ve read and experiences I’ve had. But my impression is that chronic extreme pain is something that we never adapt to.
I appreciate the use of a specific scenario to outline one aspect of suffering-focused thinking—the range of examples (mental, physical) was especially helpful.
However, my intuition is that the things people consider to be their own least pleasant experiences are often not the moments of greatest pain/suffering in their lives. I’ve been punched in the face, I’ve run wind sprints until I dry-heaved, and I’ve been dragged along a rocky ocean floor by a strong wave...
...but those barely even register on my list of “things I wish hadn’t happened”, compared both to major negative life events but also to something like “the time I wrote someone an embarrassing love letter”, which still bothers me to this day.
How many “hell-seconds” might someone experience from a sense that they never lived up to their potential, or from their parents’ acrimonious divorce, or from a friend’s instantaneous but untimely death?
Of course, your metric isn’t meant to be universal, but as far as metrics of well-being go, I see extreme pain as relatively narrow—I’m curious whether there are any systems that go beyond DALY and “hell-seconds” in capturing lingering low-valence negative emotions, even if they don’t amount to “depression”.
Thank you.
Two things:
(1) We are trying to arrive at a metric like you describe at QRI. See: Quantifying bliss and a future for neuroscience for the big-picture idea. I think the suffering you describe is very relevant for instrumental reasons, but perhaps not very large in terms of absolute values (still sucks, obviously!).
(2) I think that another important update that people should make in EA is that hell-seconds are not only much, much, much worse than garden-variety pain and suffering. But also that they are *far more prevalent* than we realize. About 20% of people in the US live with chronic pain, of which 8% is “high-impact” (i.e. severe enough to interfere with life on many fronts). Kidney stones happen to 10% of people, migraines are equally as common, and about 2-3% of people who get fractures develop complex regional pain syndrome, which tops the scale (and worse of all, it is chronic and persistent pain rather than episodic like cluster headaches).
I suspect most people will be horrified when we get an accurate estimate of a country’s Hell-Index. Perhaps you don’t dip your toes into those realms often, but chances are that your neighbor or two houses down the line someone very close to you does.
I looked up CRPS and kidney stones, and it looks like both of them have relatively mild symptoms in most cases. Are you sure that this isn’t a case of conflating the pain of the most extreme cases and the prevalence of all cases?
You’re right about the 8% figure for chronic severe pain, though.
https://www.acsh.org/news/2018/09/14/who-hurting-prevalence-chronic-pain-america-13407
CRPS sufferer here. There are cases that are mild or that resolve quickly. But when it becomes chronic by some metrics it is the most painful condition in existence, with a persistent pain worse than having a finger cut off without anesthetic or childbirth without anesthetic.
https://www.burningnightscrps.org/sufferers/pain-scale/
Let’s say “the typical pain of the top 5% most painful of the cases of a given condition”.
My sense is that the pain scale is exponential. Let’s say that kidney stones rank on average at a 7⁄10 level with a standard deviation of 1. In that case, about 2% of the kidney stone cases are a 9⁄10, which might be hundreds of times more painful than the 7⁄10 typical case. In other words, you can’t really judge how many hell-seconds a given condition contributes by observing a *median* case… you need either the average or to look at the more painful side of it.
It’s just that your first comment sounded a bit like you’re implying that 10% of the population suffers from excruciating kidney stones. With your estimated numbers (10% of population affected at some point in their lives, 2% of cases at 9⁄10 on the pain scale), it would be more like 0.2%.
That’s probably still a lot if you multiply by the world population and total pain episode lengths. I don’t know how long such a case typically lasts with modern medical care, but plenty of people don’t have access to it.
Of course, this all depends on whether the 2% number is a reasonable estimate, and whether the pain scale is exponential.
But my guess is that a better strategy will probe better medical prevention and treatment of underlying causes in most cases. After all, flooding the USA with powerful painkillers hasn’t exactly been a boon to the nation (see opioids).
While unpleasant, I don’t think being punched in the face is comparable to having kidney stones (a pain so excruciating that often morphine can’t touch it). It seems totally believable to me that such an experience might rank as among the worst in one’s life.
There are probably also two systems at play here: the experience itself and the lingering memory of it. It’s conceivable you might not remember some extremely painful experience as ‘bad’ (through post-hoc rationalisation, or the peak-end effect or similar); I’m not sure how to weight that against the actual raw badness of the experience itself.
I wonder if we sufficiently understand the psychological dynamics of chronic or extreme pain. The existence of the bullet ant glove ritual makes me wonder to what extent the cultural context of pain influences our remembered perception of its quality, intensity, and meaning.
It seems helpful to distinguish between meaningless, “I would’t wish this on my worst enemy” pain, which probably accounts for the vast majority of extreme pains, “a little pain is necessary to toughen you up” pain, and “this is a sacred extreme-pain ritual.”
What are some resources you’d recommend on understanding the psychological dynamics you mentioned? I’d be especially interested in sources that push against the common (and perhaps very wrongheaded?) idea that people can adjust to almost anything, and that we become somewhat more “numb” even to extreme pain over time.
I’ll give that some thought, but I’m no expert on this. Just pulling together some memories of things I’ve read and experiences I’ve had. But my impression is that chronic extreme pain is something that we never adapt to.