Do we primarily design for PAINS?

It was suggested to me by a designer that while PLEASURES motivate some users, PAINS motivate all users.

Furthermore, Cooper et. al. suggest that we should align our designs to users GOALS (which could encompass both pleasures and pains.)

And many like to talk about NEEDS, and we all know developers love to talk about USE CASES (which sounds like low-level TASKS to me…)

So as designers who seek to solve problems, what are the motivators to focus on? All of the above, or is there a higher level principle?