I appreciate your joining in here but find your reply rather confusing. You put the word involuntary in quotes as if I said this. Would you please point out where I did so? I'm sure I've used the word in the past but having a context would be quite helpful.

Ideomotor activity is best described as instinctive rather than reflexive in that the latter implies great difficulty in our ability to suppress its expression. Consider the poker player who successfully bluffs for instance. This is an effective suppresion of ideomotor activity. You might also consider the fact that many people with a 20 minute sitting tolerance before experiencing pain remain in their seat long beyond this in a variety of situations wher standing is considered "improper." Both of these nonmovements represent a successful suppression of instinctive expression, and this is the very definition of domestication.

You say, "Surely pain is conscious and then withdrawal from pain is conscious." By this do you mean that we plan and willfully move with volition in this manner when stimulated painfully? Not according to Patrick Wall, who includes withdrawal as the first of three hard wired responses to painful sensation (the second being protection and the third resolution). Ideomotor movement (that which we use to achieve the third stage) is fairly easy to suppress if our "higher centers" deem it inappropriate, and I think they do so regularly.

The second paragraph doesn't quite make sense to me either. I don't know how you separate mechanical deformation of the sensory organ from mechanical deformation of, well, something else. What else but the former would be relevant to the painful experience? What is "the essence of pain"? Is pain a "thing" that has parts to you? The loss of sensory ability in a deformed limb presents us with well known problems and they are solved with procedures of care developed over many years. It is the deformation that produces pain in the normally sensitive tissue that concerns me. When the instinctive response to such a situation is suppressed therapists should come to understand how that is possible, what it looks and sounds like and how to handle patients in a way that changes the situation for the better.