Pain has accompanied me since the onset of a chronic autoimmune disease (SLE) in 2008, and one means of coping is to actively investigate the topic on different levels of theoretical and practical engagement.
As I am a writer, my first approach to research was to read poems, novels, journal entries, and philosophical essays on the subject, leading me to focus on the fictional logic of pain.
'What are you doing at the moment?'
'I'm in pain.'
This is a quote from the book In the land of pain by the French writer Alphonse Daudet, who lived in the second half of the 19th century. Over the final 15 years of his life, he suffered from neurosyphilis, a condition also known as tabes dorsalis: literally, a wasting of the back. Its chief manifestation in his case was locomotor ataxia, a degeneration of the spinal cord that produced violent spasms of the limbs, weakness, and flashes of blinding pain.
Daudet made notes over a period of eight years, documenting his stay in this ‘land of pain’. His notes comprise a record of both the banal and the transformative realities of suffering. ‘Pain is always new to the sufferer, but loses its originality for those around him. Everyone will get used to it except me.''
For Daudet, pain became life determining: ‘Pain, you must be everything for me. Let me find in you all those foreign lands you will not let me visit. You be my philosophy, my science.'
Daudet also noted that he had no general theory about pain. ‘Each patient discovers his own’, he stated, ‘and the nature of pain varies, like a singer's voice, according to the acoustics of the hall.'
This radical subjectivity of pain made Elaine Scarry, a prominent pain researcher, identify an overall incompatibility between pain and the world. Scarry emphasised the disturbed relation between language and pain, writing: ‘Physical pain does not simply resist language but actively destroys it.'
On the other hand, in Scarry’s view of pain lies ‘world-making’: suffering and experiences of pain are, and have been, the inspiration for great works of art, literature, and poetry.
Pains, therefore,should be considered not as mere symptoms, signifying an underlying malfunction or abnormality, but as discrete phenomena of human life, as existential experiences every living — and therefore mortal — being is confronted with during his/her/its lifetime.
In his book The Culture of Pain, David B. Morris argues that ‘pain only emerges at the intersection of bodies, minds and cultures. Pain is never the sole creation of our anatomy and physiology’. Over the course of his book, Morris rejects the myth of the two pains, that dichotomy between physical and mental pain we are usually confronted with.
I too, with this project, wish to participate in that same effort to overcome this dichotomy.
I.I Theoretical starting points
In Roland Borgards' study on the poetics of pain, Goethe's ode ‘Prometheus’ plays a central role as it drafts the image of human life on the basis of autonomy. For Borgards, the poem represents the anthropological re-evaluation of pain in the 18th century: no longer understood as God's punishment or a mere disturbance, the physical signs of pain were free to be studied formeaning in literature and medicine.
Borgards’ study includes a history of pain, with focus on the time around 1800, when significant changes in the understanding of pain began. These changesended the representational logic of pain and began a fictional logic of pain (Fiktionslogik des Schmerzes). It is marked by the physiological experiments of Albrecht von Haller and the cultural theories of Johann Gottfried Herder.
This fictional logic of pain corresponds with a hermeneutics that reads the signs of pain in regard to what eludes them, in regard to the nature of pain. According to Borgards, the fictional logic of pain not only applies to literary texts but also to legal and medical practices.
The language of literature and the observation of scientific experiments clearly show that there is no access to, or grasping of, pain beyond the cultural context in which it is felt, articulated, interpreted, and treated.
I.II Communicating pain
If we want to take care of pain, we have to understand the signs of pain as being part of a particular experience, with a particular meaning and a particular history.
As already mentioned, in The Body in Pain, Elaine Scarry writes that pain not only resists language, but actively destroys it.
Pain is often the reason for visiting a doctor; yet, at the same time, the difficulties of articulating pain means it can become the source of misunderstanding between patient and doctor, influencing the whole process of anamnesis, diagnosis, and therapy.
New categories of pain, described via poetic and pictorial means, may facilitate conversation about pain and help patients to express her/his pain more adequately.
These categories might also extend the perspective of the doctor who is informed with — and therefore limited by — the abstract clinical terminology of her/his medical training, this being a possible cause of her/his separation from the existential dimension of pain.
Over the course of this project, rich, multidimensional, and multimedia pain descriptions are attempted and organised into new categories. The sources for these new categories are to be found in literature (fiction and non-fiction), poetry, and personal experience.
Next section: II. PAIN CATEGORIES – IMAGE TABLEAUS