Inexpressibility of Pain

Physical pain has existed for as long as living organisms have been around to experience it. Whether it be stubbing your toe, a laceration, or childbirth, pain has always been an experience that all humans can relate to and sympathize with. While this fact of life is unifying and constant, the history of pain and how it is expressed has been evolving since the beginning of mankind. Academics are still studying this age old question: How do human beings communicate and assess pain?

Figure 1. McGill Pain Questionnaire (Barbour & Barbour, 2003)

In her book, The Body in Pain, Elaine Scarry describes the ways in which physical pain is inexpressible and how this affects people in a social and political context. The first point she makes is that physical pain is language resistant. When someone is in pain, their first reaction is not to speak, but to scream or shout, “Ah!” This relatable example proves that immediate pain is not expressible through language. Another important point Scarry makes is that when pain is communicated from the the person that is experiencing it to another person, the original message is often lost in translation. She gives the example of a patient-physician relationship to portray this idea. A patient describing their pain to a physician is not given the same credibility of a medical test proving that there should be a pain (Skelton, 1991). While medical testing is effective and necessary, some pains cannot be tested for. When this is the case, the physician must rely on the patient’s description of their pain. Melzack and Katz establish that the former method of describing pain solely by its intensity (moderate, severe, etc.) was replaced by a more categorical method that examines different facets of pain such as temperature (burning, stinging, etc.), time (throbbing, constant, etc.) and various others (2007). While these categorical methods of describing pain is helpful in diagnosis, reducing the entirety of the felt experience to a word or two in the english language will never communicate the full extent of the pain. Swain claims that language and emotion are not separate from one another (2013). However, pain is an exception to this rule. Another example Scarry gives in her book is a communicating pain in a courtroom setting. When someone is injured in an accident, they must effectively communicate their pain to their lawyer with . Not only this, but the lawyer must then express their perception of the original pain to a jury, who is then responsible for evaluating this already filtered description of the original felt experience. After Scarry establishes that physical pain is difficult to communicate in its entirety, she relates this idea to how pain is often not addressed effectively in society. She shares a phenomenon seen in history and science showing that when two ideas are presented, the idea that is more easily expressed will always be the one that is addressed more effectively and immediately. This phenomenon points us to an unfortunate conclusion: As physical pain is not easily communicated due to the barrier of language, we cannot effectively address and treat it. (Scarry)

Citations:

Barbour, R. S., & Barbour, M. (2003). Evaluating and synthesizing qualitative research: the need to develop a distinctive approach. Journal of evaluation in clinical practice, 9(2), 179-186.

Melzack, R., & Katz, J. (2007). McGill pain questionnaire. In Encyclopedia of pain (pp. 1102-1104). Springer Berlin Heidelberg.

Scarry, E. (1985). The body in pain: The making and unmaking of the world. Oxford University Press, USA.

Skelton, J. A. (1991). Laypersons’ judgments of patient credibility and the study of illness representations. In Mental representation in health and illness(pp. 108-131). Springer US.

Swain, M. (2013). The inseparability of cognition and emotion in second language learning. Language Teaching, 46(02), 195-207.