Saying your are in pain is part of being in pain. It is an alternative to crying or exclaiming "Ouch!" It is not a report of pain in the sense that you observe yourself and discover that there is a pain inside of you. You have simply learned to leverage the language of reporting to talk about pain. Since such talk often brings relief, it doesn't matter if it is not technically correct to a pedant like me. The ultimate purpose was not to report but to bring relief.

You mentioned patients who report they “have separated into an 'observed' and an 'observing' self. “ The statement is clinically valid. People who go to a doctor and make statements like that require treatment, and the statement may dictate a specific therapy. I don't think we, however, are justified in concluding that there are literally two selves in the person, just like we don't conclude there are demons inside people who say they feel that they are possessed by the devil.