Disease, Pain and Sacrifice
Individuality in Pain and Suffering
Although both these books are about pain and suffering and are written by psychologists, they are as unlike as chalk and cheese. Dr. Bakan’s is concerned with the philosophy of pain, and with its biological and existential meaning, while Dr. Petrie’s is concerned with experimental data about pain, with techniques for measuring it and elucidating the ways in which different temperamental and diagnostic groups experience it. Dr. Bakan conceives ideas about pain; Dr. Petrie reports observations on it. Dr. Bakan assumes that his readers are persons of wide and high culture, equally at home in evolutionary theory, psychoanalysis, and theology; Dr. Petrie is writing primarily for research workers and describes in detail her experimental methods and the statistical analyses of her results.
Disease, Pain and Sacrifice consists of three essays, concerned with the biological, psychological, and existential aspects of pain respectively. The blurb asserts that they form a triptych, each essay a single entity, and the whole a unity, but many readers, I suspect, will find that the third, an interpretation of the Book of Job, is based on presuppositions (of which more later) that prevent their retaining the sense of unity of theme.
In his first essay, “Disease as Telic Decentralization,” Dr. Bakan argues that disease can be conceptualized as a manifestation of disruption of the whole, as a failure in communication between the central, higher and peripheral, lower structures of complex organisms, as a result of which the former lose their control over the latter; or, as he himself puts it, “disease is to be conceived of as decentralization of this higher telos of the organism, and its loss of dominance over the lower telê,” This formulation, which applies most aptly to cancer and (though Dr. Bakan does not mention them) congenital disorders, implies that organisms possess an inbuilt drive toward the creation and maintenance of their own inherent form, that they are actuated by “something” which determines their nature. This “something” Bakan calls “telos”—the “tel” is that in teleology not that in telegraph—which he explicitly states to be a concept similar to entelechy, to Bergson’s élan vital, and to McDougall’s hormé.
ALTHOUGH THE DEVELOPMENT of the biological sciences in the nineteenth century was largely based on an explicit rejection of any such notion—in 1842 the physiologists Brücke and du Bois-Reymond “pledged a solemn oath to put into effect this truth: No other forces than the common physical and chemical ones are active in the organism….” Dr. Bakan’s hypothesis is not, I think, nowadays either remarkable or novel; his telos has, for instance, affinities with Koestler’s holon. In one respect, however, the use he makes of it is new.
This is Dr. Bakan’s assumption that the species is itself a telos and that disease may be a manifestation not only of the organism’s individual failure to maintain integration but also of his isolation from the social telos. Disease, he argues, can be the result of “separation-estrangement” and …