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<blockquote>Most of the "pain" we [[experience ]] is of a perceptual [[order]], [[perception ]] either of the urge of [[unsatisfied ]] [[instincts ]] or of something in the [[external ]] [[world ]] which may be painful in itself or may arouse painful anticipations in the [[psychic ]] [[apparatus ]] and is recognized by it as "[[danger]]."<ref>{{BPP}} Ch. 1</ref></blockquote>

<blockquote>Pain-primarily and as a rule-occurs if a stimulus impinging on the periphery breaks through the defenses that oppose stimuli of excessive strength and hence [[acts ]] like a continuous [[instinctual ]] stimulus against which otherwise efficacious muscular [[activity ]] such as serves to remove the stimulated region from the stimulus remains powerless. If the pain does not originate from a point on the skin but from an [[internal ]] [[organ]], this does not alter the [[situation ]] in any way; it is only that a bit of the internal periphery has replaced the external. ... In the [[case ]] of [[physical ]] pain there arises an intense [[cathexis]], which may be termed [[narcissistic]], of the painful region of the [[body ]] - a cathexis which increases progressively and which acts upon the ego in a so to [[speak ]] evacuative manner.<ref>{{PoA}} Ch. 11</ref></blockquote>

<blockquote>It certainly cannot be without signficance that [[language ]] has created the [[concept ]] of inward, of psychic, pain, and has equated the sensations attendant upon [[object ]] [[loss ]] with physical pain.<ref>{{PoA}} Ch. 11</ref></blockquote>

The term "pain" refers to a physical [[sensation ]] or a distress linked to instinctual tension, which the [[psychic apparatus ]] then seeks to [[discharge ]] by [[work ]] according to the [[principle ]] of [[pleasure]]/unpleasure.

Jean-Bertrand Pontalis (1981) noted that the [[outline ]] for an original [[theory ]] of pain can be found in [[Freud]]'s work from "A [[Project ]] for a [[Scientific ]] [[Psychology]]" (1950c [1895]) onward. Taken up again in Inhibitions, [[Symptoms]], and [[Anxiety ]] (1926d [1925]), this theory covers the basic reference points of [[analytic ]] theory: the theory of [[narcissism]], the question of [[trauma]], the definition of primary [[masochism]], and the presentation of the [[death ]] [[instinct]]. Finally, with the concept of [[negative ]] therapeutic reaction in [[place]], Freud, in The Ego and [[the Id ]] (1923b), described how pain [[drives ]] [[resistance ]] to [[analysis]], indeed, how pain is the final refuge from renouncing the [[lost object]], as the resistance implies.

By 1895 Freud had postulated bipolarity as the principle of psychic functioning, and, anticipating his later theory of instinctual [[dualism]], he opposed the experience of pain to the experience of [[satisfaction]]. In qualitative [[terms]], pain is different from [[unpleasure ]] in that pain is situated [[outside ]] the [[economic ]] apparatus of pleasure/unpleasure. In [[dynamic ]] terms, "[p]ain is . . . characterized as an irruption of excessively large Qs [quantities] into N [neurones that don't retain quantities of [[energy]]] and R [neurones that do retain energy and are capable of retaining [[memory]]" (1950c, p. 307). Then the body discharges the accumulated [[excitation]]. Pain can [[cause ]] the [[subject ]] to break out of preestablished paths only because there are boundaries ([[bodily ]] boundaries, ego boundaries); however, its internal discharge has an implosive effect. Like a physical or psychic [[hole ]] (to be distinguished from a possible lacuna or a [[lack]]), the [[excess ]] of excitation caused by pain obstructs all binding activity. Pontalis (1981) has stressed that this theory of pain breaching is a departure from the economic apparatus where the theory of anxiety is more generally situated.

In 1926, in addendum C to Inhibitions, Symptoms and Anxiety, Freud again tried to differentiate pain from anxiety, though not without difficulty or [[contradiction]]. Pain is primarily a reaction to the loss of the object, whereas anxiety is a reaction to the danger that loss entails. Pain is the consequence of a breaching of the protective shield, and by acting as a constant instinctual excitation (some authors have proposed the [[idea ]] of a pseudo-instinct here), it prevents the subject from escaping from it. Nonetheless, pain has a locus: it emanates from the periphery of the body or the organs. If anxiety has already led the subject to [[regard ]] the loss of the object metaphorically, the unmediated [[reality ]] of pain ensures that the subject can survive without the loss of the object or the [[nostalgia ]] of that loss. In a [[third ]] [[stage ]] of his exposition in addendum C, Freud returns to the [[difference ]] between [[mental ]] pain and physical pain, arguing that the former is much more closely related to the [[mechanism ]] of anxiety. "The transition from physical pain to mental pain corresponds to a [[change ]] from narcissistic cathexis to object-cathexis. An object-presentation which is highly cathected by instinctual [[need ]] plays the same [[role ]] as a part of the body which is cathected by an increase of stimulus" (1926d, pp. 171-172).

Freud thus uses the same [[model ]] to describe both physical pain and psychic pain. As Pontalis has made clear, pain is not a case of [[metaphor ]] but rather a case of analogy—a direct [[exchange ]] between one level and [[another]], as if with pain the body mutates into [[psyche ]] and the psyche into body. But while anxiety can be communicated, pain cannot. Despite a scream of pain, the cry does [[nothing ]] to ease it. The experience of pain takes place within a bodily ego. Both physical pain and mental pain partake of the [[content]]-container [[relationship ]] (Enriquez, 1980; McDougall, 1978). The subject in pain finds it [[impossible ]] to recover the object by means of [[representation]]: "Where there is pain, it is the lost, [[absent ]] object that is [[present]]; the [[real]], present object that is absent." The distinctive feature of pain is its blurring of boundaries. Thus, for example, certain types of physical [[suffering ]] serve to alleviate mental pain. [[Recent ]] [[clinical ]] work on somatization and borderline states is often faced with this inchoate [[nature ]] of pain: absolute, naked pain.

Cathexis; [[Dead ]] [[mother ]] [[complex]]; Elisabeth von R. case of; [[Erotogenic ]] masochism; [[Guilt]], [[unconscious ]] [[sense ]] of; Inhibitions, Symptoms, and Anxiety; Masochism; [[Melancholia]]; [[Mourning]]; Physical pain/psychic pain; Pleasure/unpleasure principle; Protective shield, breaking through the; [[Psychosomatic ]] [[limit]]/boundary; "Project for a Scientific Psychology, A"; Quota of [[affect]]; [[Sadism]]; [[Sadomasochism]]; [[Self]]-mutilation in [[children]]; Suffering; Unpleasure.