The internet encyclopedia of philosophy has a good entry on higher order theories of consciousness. Here 1 they reference a theory of Rosenthals:
- According to Rosenthal’s higher-order thought theory (1986, 1997, 2005), a mental state is conscious when there is a higher-order thought about it. I am conscious of the pain in my knee when I have a thought to the effect that I am in that very pain state.
- ... A third important feature of higher-order thoughts on Rosenthal’s account is that they are assertoric and occurrent. The higher-order thought must assert, rather than hope, fear or speculate that I am in a particular mental state. Moreover, the higher-order thought must occur at roughly the same time as the mental state it represents. The content of the higher-order thought should be, for example: “I am now feeling pain,” not “I might have felt pain yesterday” or “Perhaps I will feel pain in a few minutes.” Rosenthal (1997) has argued that higher-order thoughts must be occurrent in order to distinguish between non-conscious and conscious states. If the mere disposition to produce a higher-order thought were sufficient for a mental state to be conscious, it seems that all one’s mental states would always be conscious.
Of course if someone has a thought about the pain they are experiencing the pain is going to be more conscious. It obviously depends on the situation if the thought makes the pain worse or less. I suppose a thought could make the pain less, but it would also make you more conscious and more aware of this lessened, (but more conscious) pain.
A model is proposed in the below image (B. Timmermans, et all), this is in the abstract of their paper:
- Metacognition is usually construed as a conscious, intentional process whereby people reflect upon their own mental activity. Here, we instead suggest that metacognition is but an instance of a larger class of representational re-description processes that we assume occur unconsciously and automatically. From this perspective, the brain continuously and unconsciously learns to anticipate the consequences of action or activity on itself, on the world and on other people through three predictive loops: an inner loop, a perception–action loop and a self–other (social cognition) loop, which together form a tangled hierarchy.
My interpretation is explained a little differently from their explanation, but is still similar to theirs. The inner loop of the first order network is about the brain learning about the world, first there is stimuli and then brain thinks about the stimuli. When the brain thinks about the stimuli it forms meta-cognitions and has a secondary response from its initial response.
The 'inner loop' or their first-order network, is basically the brain thinking about the stimulus, and part of the meta-cognition (the 'thinking about the thinking') is two other loops, a perception-action loop and a self-other loop (social cognition). This means that the brain thinks more deeply about everything a second time, basically. Two of the things that it thinks more deeply about are perceptions of actions, and general social cognitions about the self and other people.
It makes sense that the mind has different levels of thinking. There is a more simple way of thinking about the world and there is a more complicated way of thinking. When anything is thought about, there is a more simplistic way of thinking about it and a more complicated way of thinking about it. It might be that a human cannot understand the idea or whatever you are thinking about if it is too complicated, in which case the simple level of your mind would be the only level that understands it.
I would say that the lower level of mind which isn't as intelligent or sophisticated as the its higher level is the initial, more animalistic response. What does that mean for sensation versus thought, however? Is there are lower level of feeling pain and a higher level? When someones mind is in the lower mode, how would it think different from its higher mode? It would probably have its higher-level social cognitions shut off. - So it wouldn't be capable of responding intelligently to other people, etc.
Two types of consciousness
So there are two different types of consciousness - one type is awareness of physical sensations, and the other type is high-order or lower-order thought. So the mind could not be thinking clearly and not be responding intelligently to other people, and it could not be aware of the pain, pleasure (other physical sensations, etc) that it is experiencing. In that case it would be in a lower level state.
So it makes sense that pain medication would also make someone think less clearly - that is because they are in a lower physical and mental state (both physical sensations and mental thinking are dulled).