In this chapter, I begin by exploring the status of the claim that shame is pain. What would we be doing in making that claim? Would we be invoking identity or category membership, such that shame is a particular type of pain? Or are we speaking figuratively, invoking "pain" metaphorically? If we are tempted to the latter characterization of 'shame is pain", then what is the status of the metaphor? Is it a conceptual or cognitive metaphor, and thereby deeply embedded in our modes of thought? Or is it a literary metaphor, intentionally employed so as to illustrate and draw attention to certain aspects of shame experiences? These questions then serve to frame the discussion that follows. In that discussion, I want to put into question what I see as prejudice in favour of propositionality. I pursue this task with reference to a widely discussed "dilemma of adequate explanation" in the philosophy and psychology of emotions and recent attempts to explain the placebo response, in the work of Daniel Moerman, and that of Fabrizio Benedetti. I offer an alternative to propositionality, which respects the data on the placebo response and helps us avoid otherwise seemingly intractable problems—chiefly the dilemma of adequate explanation—in the philosophy and psychology of emotions. Having done so, I return to my question before concluding with some reflections on the questions these considerations raise regarding debates in medical epistemology.