UCL Press

Encountering Pain

Hearing, seeing, speaking

Edited by Deborah Padfield and Joanna M. Zakrzewska

ISBN: 9781787352636

Publication: February 15, 2021

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What is persistent pain? How do we communicate pain, not only in words but in visual images and gesture? How do we respond to the pain of another, and can we do it better? Can explaining how pain works help us handle it? This unique compilation of voices addresses these and bigger questions.

Defined as having lasted over three months, persistent pain changes the brain and nervous system so pain no longer warns of danger: it seems to be a fault in the system. It is a major cause of disability globally, but it remains difficult to communicate, a problem both to those with pain and those who try to help. Language struggles to bridge the gap, and it raises ethical challenges in its management unlike those of other common conditions.

Encountering Pain shares leading research into the potential value of visual images and non-verbal forms of communication as means of improving clinician–patient interaction. It is divided into four sections: hearing, seeing, speaking, and a final series of contributions on the future for persistent pain. The chapters are accompanied by vivid photographs co-created with those who live with pain.

The volume integrates the voices of leading scientists, academics and contemporary artists with poetry and poignant personal testimonies to provide a manual for understanding the meanings of pain, for healthcare professionals, pain patients, students, academics and artists. The voices and experiences of those living with pain are central, providing tools for discussion and future research, shifting register between creative, academic and personal contributions from diverse cultures and weaving them together to offer new understanding, knowledge and hope.

Praise for Encountering Pain

‘This is a majestic volume. Visually striking, intellectually challenging, and experientially transformative, this book promises to change how everyone encounters pain.’ – Rob Boddice, Freie Universität Berlin

‘Deborah Padfield's book, Perceptions of Pain (2003), introduced a ground-breaking strategy through which photography became an effective tool to interpret pain – an aspect of human experience that can, so often, appear inexplicable. The powerful images in this book are further evidence of the collaborative strength of photography and its special ability to give voice to those who are excluded.’ – Dewi Lewis

'A work that brings photographic, figurative and poetic images of chronic pain to the clinic and demonstrates how visual, communicative frameworks can re-voice experiences and diagnoses of pain. This major, deeply reflective collection of papers represents a turning-point in defining the multifaceted importance of painscapes in clinical, therapeutic, and humanistic advocacy work. It firmly situates the arts and humanities, alongside the sciences, in responding to the pressing need for new strategies to alleviate chronic pain.' - Prof Brian Hurwitz, Emeritus Professor of Medicine and the Arts, King's College London

'Pain and its ever-increasing numbers of sufferers inhabit a kind of night world isolated from the “normal” day world. 'A bandage hides the place where each is living', W.H. Auden once wrote, while we, the healthy, 'stand elsewhere’. Encountering Pain is an attempt to narrow this rift by making sure sufferers are heard, seen, and able to speak again – so that they might be better understood. Padfield and Zakrzewska have assembled an impressive team of patients, healthcare providers, artists and academicians, all determined to make pain more visible and communicable. The authors compellingly demonstrate that language -- whether in the form of words, gestures or images – is a necessary first step towards alleviating pain. That it can often be as powerful as medicine. '- Dr David Biro, Associate Clinical Professor of Dermatology at SUNY Health Science Center @ Brooklyn and author of The Language of Pain: Finding Words, Compassion, and Relief.

Deborah Padfield is a visual artist, Senior Lecturer in Arts & Health Humanities at St George's, University of London, and Lecturer (Teaching) at the Slade School of Fine Art, UCL.

Joanna M. Zakrzewska is a consultant oral physician who has both a dental and medical degree, and has specialised in facial pain.

List of figures
List of tables
Notes on contributors
Acknowledgements.
Preface
Rita Charon
Introduction I
Deborah Padfield and Joanna Zakrzewska
Introduction II What is pain? A neurobiological perspective
Maria Fitzgerald
Section I Hearing
1. How to listen for the talk of pain
Rita Charon
2.Testimonies from those living with Pain:
(i) Liz Aldous
(ii) Ann Eastman
(iii) Alison Glenn
3. Approaches to Images: an art therapist’s perspective on photographic images of pain used to communicate the experience of pain in medical consultations
Helen Omand
4. Pleurisy I to V
Rebecca Goss
5. From boardroom to consulting room to jobcentre plus: the bureaucracies of pain
Jens Foell
6. Living with TN: interview from pain under the microscope
Chandrakant Khoda
7. Karuna
Anusha Subramanyam
Section II Seeing
8. The photograph as a mediating space in clinical and creative encounters
Deborah Padfield
9. How Images change nonverbal interaction in chronic pain consultations
Amanda C de C Williams
10. Picturing pain
Suzannah Biernoff
11. Making charcoal for drawing
Onya McCausland
12. The art of pain and inter-subjectivity in Frida Kahlo’s self-portraits
Minae Inahara
13. The thing about pain: the remaking of illness narratives on social media
Elena Gonzalez-Polledo & Jen Tarr
14. Exhibiting pain: the role of online exhibitions in sharing creative expressions of chronic physical pain
Susanne Main
Section III Speaking
15. ‘Me’ AND ‘My Pain’: Neuralgia and a history of the language of suffering
Joanna Bourke
16. Language and images in pain consultations
Elena Semino
17. The tree, spring and well
Sharon Morris
18. Challenges in managing pain in India
Preeti Doshi
19. Disabled lives with an undercurrent of pain
Abba Khetarpal & Satendra Singh
20. Acute pain is sexy and chronic pain is not: language, communication and transformation
Jennifer Patterson
21. Intellectual empathy as conflict resolution in the interdisciplinary team
Tom Chadwick
Section IV The future
22. Visual images: implications for clinical practice
Joanna Zakrzewska
23. What is the pain experience and how can we control it?
Kirsty Bannister & Anthony H. Dickenson
24. Reflecting on encountering pain
Giskin Day
Afterword: Communicating chronic pain
Jonathan Wolff
Delegates’ contributions
Index

'Pain and its ever-increasing numbers of sufferers inhabit a kind of night world isolated from the “normal” day world. 'A bandage hides the place where each is living', W.H. Auden once wrote, while we, the healthy, 'stand elsewhere’. Encountering Pain is an attempt to narrow this rift by making sure sufferers are heard, seen, and able to speak again – so that they might be better understood. Padfield and Zakrzewska have assembled an impressive team of patients, healthcare providers, artists and academicians, all determined to make pain more visible and communicable. The authors compellingly demonstrate that language -- whether in the form of words, gestures or images – is a necessary first step towards alleviating pain. That it can often be as powerful as medicine. ' - Dr David Biro, Associate Clinical Professor of Dermatology at SUNY Health Science Center @ Brooklyn and author of The Language of Pain: Finding Words, Compassion, and Relief