Black, Sarah Grace

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Oxford University Research Archive

259Essay 6. Anthropological approaches to pain demonstrate how the body uses creativity,imagination and language to reformulate the sense of self and to create social connections.Sarah Grace BlackEssay prompt, same as for essay 5: ‘What insights about the body can be gained throughanthropological approaches to pain?’In Western biomedicine, pain classification is often arbitrary. Sub-acute or ongoing pain iscommonly reclassified as chronic after six months. Often, this does not correlate with tissuedamage (Morris 1991). Despite advances in imaging techniques and chemical testing, mostefforts to source the site of chronic pain are fruitless. Moreover, almost all surgical attemptsto alter neurological pain pathways are undone by the body's efficient generation of alternateroutes which reinstate the suffering (Good 1992: 39). Chronic pain is genuine and takes overthe sufferer’s entire world, even though it might not be flagged up by biomedical markers.Such a powerful human experience enlightens much about the body. Many ethnographic casestudies, linguistic interpretations and alternative narratives within anthropology have steppedin to provide insights about the body where biology and medicine fall short.By reflecting on selected anthropological studies by Elaine Scarry (1985), ByronGood (1992) and Jason Throop (2008), this essay will demonstrate how the body usesimagination as a tool to formulate the sense of self and maintain social connections. Each ofthese works, influenced by the Harvard school of phenomenology,7 come to divergentconclusions and employ different research methodologies, yet each link pain to imaginationand creativity. The connection between body, mind and pain is obvious, but the link betweenimagination, pain and sociability is less so. The body transforms suffering from a preverbal,physically bounded and isolating experience into one in which the human capacity forconnection and belonging gives it language, physiological metaphors and oftentransformational frameworks with a moral component.In The Body in Pain (1985), a literary discussion of the nature of pain and torture,Scarry argues that the experience of pain resists language. The sufferer feels pain through‘presymbolic shrieks’. Intense pain is ‘worlds destroying’ because it cannot be encompassedwith language. She locates pain as a universal experience which is resistant to cultural7 All these studies are heavily influenced by the earlier work of Alfred Schütz. In The Phenomenology of theSocial World (1967). His themes of intersubjectivity and social time are clear within the selected works andprovide the framework within which to understand the interaction between the body, sociality, creativity andpain.260interpretation because so primitively experienced. A few years later, Byron Good (1992)challenged Scarry’s conclusions in his ethnography A Body in Pain: The Making of a Worldin Chronic Pain. He argued that pain may initially come out in shrieks, ‘but suchdeconstruction is countered by a human response to find meaning…’ (ibid.: 29). Goodreviews the aetiology of a chronic TMJ patient named Brian to conclude that pain is veryverbal (ibid.: 35). Patients use language to manage and ground the ‘de-objectifying’experience of pain.Both Good and Scarry show that pain is traumatic because it isolates the sufferer fromtheir experiences and the connected social world. Humans are social creatures, and the humanbody is a social instrument. In C. Jason Throop’s (2008) From Pain to Virtue: DysphoricSensations and Moral Sensibilities in Yap (Waqab), Federated States of Micronesia, hedemonstrates how the body can accommodate both states. In his ethnographic analysis ofYapalese back pain, he argues that, when people experience a functional transformation ofsuffering to the more socially valuable ‘suffering for’, the entire experience is renderedbearable.These studies are essentially facets of the same anthropological piece. Each explorehow creativity is used to frame pain and construct meaningful social connections. Scarryexamines the individual and wider political and societal impacts of pain through aphilosophic lens. Good uses a more intimate perspective within the narrative arc of the casestudy of Brian. Throop explores a larger cultural context with his ethnographic examinationof Yapalese back pain. They all explore how emotional suffering adds to physical distress aspain isolates the sufferer socially from ‘normal’ shared experiences. Each emphasizes the‘worlds’ encompassing the effect of pain; how the body in pain’s experience shifts in theperception of time, language and even self. However, these authors only touch on concepts ofcreativity and pain, rather than using it as their central argument. This essay creates anarrative progression between their themes to explore the use of creativity and imaginationby the body in pain. The essay ends by presenting the hypothesis that the body uses creativityto form bridges and fulfil its social needs.Scarry’s The Body in Pain: The Making and Unmaking of the World (1985)establishes the conceptual framework which Good (1992) and Throop (2008) later populate.She says: ‘[Pain and imagination] are each other's missing intentional counterpart, and …they together provide a framing identity of man.’ (Scarry 1985: 169) She explores theindividual and cultural frameworks of pain, considering the effect pain has on the individual,as well as expanding her reasoning to macro, philosophical and cultural constructs. Scarry261repeatedly asserts that pain defies language and serves as a destructive force which‘unmakes’ an individual. Importantly for the argument, she also posits the need for factorswhich drive a ‘remaking’ of the world to produce language and culture.After exploring the socially destructive powers of pain, Scarry discusses the actionsthat re-‘make’ the world, namely creativity and imagination. She sees physical pain andimagination as opposing forces, however closely linked. This objectlessness (of pain), thecomplete absence of referential content, almost prevents it from being rendered in language:objectless, it cannot easily be objectified in any form, material or verbal. This objectlessnessmay give rise to 'imagining ' or to a creative linking of interior states with companion objectsin the outside world (Scarry 1985: 162).She proposes that pain has neither object nor creativity nor imagination, but requiressymbols and objects to express it. Creativity is needed, argues Scarry, because pain disruptsthe connection of the body’s internal state to the external world. She identifies the humanurge to ‘bind’ its internal psyche to objects in the outside world (1985:162). By groundingwith shared experiences, images and objects, humans can share experiences. Pain isdetrimental because it disrupts this process. Imagination acts as a ‘ground of last resort’ for abody in pain to ground itself in the physical, relatable social world (ibid.: 166).Imagination further transforms a body’s experience of pain because it alters theframing:In isolation, pain intends nothing, it is wholly passive, it is suffered rather than willed ordirected. Pain only becomes an intentional state once it is brought into relation with theobjectifying power of the imagination. Pain is transformed from a wholly passive and helplessoccurrence into a self modifying one. (ibid.: 164)She asserts that ‘Pain and imagining are ‘framing events’ within whose boundaries all otherperceptual, somatic, and emotional events occur; ‘thus between the two extremes can bemapped the whole terrain of the human psyche’ (ibid.: 165).Although Scarry highlights the crucial connections between imagination, pain andbodily framing experiences, she polarises the constructs of pain and imagination, choosing todefine them as opposites. By doing so, she misses the chance to explore a more organicrelationship between these and the ways in which the individual may use their connections tointeract with others. In the next selected work, Byron Good develops the body’s use ofimagination as a tool to remake social connections and self-framing.262Good mines Scarry’s model to new purposes in his ‘A Body in Pain’ (1992). ForGood, creativity serves as the only way a body in pain can bridge internal experiences toform social connections. A body in pain uses language to explain pain creatively, make socialconnections and create meaning. To demonstrate this, Good uses an ethnography of a chronicpain patient to argue that creativity in both language and art can be used to connect to others.He interprets a four-hour conversation with a young man, ‘Brian’, with chronic pain causedby TMJ. Unlike Scarry, he argues that pain is highly verbal. Pain shaped Brian’s world (Good1992: 36), so there is none of Scarry’s 'shattering of language through pain'. Good observed:‘For many patients, language is anything but shattered in this literal sense. Brian waswonderfully and frighteningly articulate’ (Good 1992: 35). By using creative idioms andlanguage, Brain is able to connect socially with the world around him.Brian uses multiple narratives and symbolism to frame the pain conceptually, or asScarry puts it, to ‘objectify’ it. At the start of the interview Brian gave a specific diagnosis forhis chronic pain (TMJ), but the description of his pain and its history ‘quickly eluded orderedcharacterisation, spilling out into his own life’ (Good 1992: 162). Imagination allows Brian toexplore the connection between his emotional state, his psyche and his body. This isdemonstrated through the cyclical framing of the question ‘Is it my body? Is it my thinkingprocess that activates physical stresses?...Or is it the other way around?’ (ibid.: 35) Brian usescreative narratives to understand his own pain. Objectifying the pain created some relief forBrian: ‘...I actually had some clear image ... I knew what it was. I wasn't groping in the dark.It wasn't ambiguous anymore. It wasn't a whole lot of things’ (ibid.: 34). However, Brianoften failed in his attempts to objectify the pain. He created many possible alternatives, whichranged from dizzy spells to depression, nausea, anxiety attacks, heart palpitations andsensations of weakness. This uncertainty ‘threatened the objective structure of the everydayworld in which Brian participates’ (ibid.: 36). Similarly, Good identifies this search in manychronic pain sufferers. ‘Chronic pain sufferers ... constantly seek a name for their suffering,an image that will name its source and allow it to be set off from the self, an image that willprovide the symbolic structure for the remaking of the world’ (ibid.: 43). He goes on to ask,‘Is the pain an essential part of the self, or merely a part of the body?’ (ibid.: 45).As well as finding a way to frame the pain creatively for himself, Brian uses creativelanguage and imagery to describe the pain to others and to form social connections. Thisshows how the body is social and uses imagination to share the experience of pain. In theinterview, Brian uses creative language and images in an attempt to explain the slipperyworld of pain to Good. Brian used imagery: ‘...it would seem as though there, there, there's a,263ah, ama, a demon, a monster, something horrible lurking around banging the insides of mybody, ripping it apart’ (Good 1992: 36). He noted: ‘pain streaks throughout the body likelightening’ (ibid.: 38).Brian is an artist who uses painting as a form of creativity to express andcommunicate his pain. However, he is hesitant to share his works for fear of social rejection.This supports the body’s social need: ‘yeah...I have to know if they will be accepted...if Ireveal something about myself...it will be likely to be met with scepticism or mockery. I can’tshow ordinary people…’ (Good 1992: 47). Brian’s creativity is a way to mediate interactionsbetween his experience of pain and others who cannot feel it. Brian uses his imagination toprovide a small point of access to a world of pain which cannot be measured throughbiological markers or lesions.Throop’s (2008) From Pain to Virtue: Dysphoric Sensations and Moral Sensibilitiesin Yap offers the platform whereby Good’s connection of creativity, pain and sociality isexpanded into a cultural context. By objectifying pain through the imagination, the Yapeseare able to form meaningful socio-cultural connections from pain. For Throop, the body issocial and craves individual, intrapersonal and cultural connections. Pain is creatively viewedas culturally embodied experience influenced by the sufferer’s moral framework. Thus pain istransformed from an isolating experience, as described by Scarry and Good, into a sociallyintegrating one.Throop, who conducted an ethnographic analysis of the people of the Micronesianisland of Yap, was able to demonstrate that pain is influenced by creative moral and culturalframing. Many people suffer from a local illness categorized as maath’keenil’ (‘SeveredSpine’). This covers a broad range of illnesses and symptoms, linked to hard physical labour.Individuals refer to their pain with the personified phrase, ‘pain came to me’. The pain isobjectified, made tangible, separable, from the self who suffers. Yapese social theory andethics are interconnected models of ethical subjectivity and virtuous comportment which alterthe meaning of pain (Throop 2008: 264). The personal experience of pain cannot be separatedfrom Yapese cultural logics and moral sensibilities. When asked where his pain came from, a64-year-old man suffering from maath’keenil’ attributed his pain to ‘...hard work I put in longago when I was a child.’ Through this social framing of pain, the Yapese turn pain from asign of dysfunction or disability into a sign of merit earned by working hard for familymembers and the wider group. Pain is transformed from suffering to a symbol of dedicationand love.264DiscussionUnlike easily identified sources of pain, like a severed arm or a sore tooth, not all forms ofpain necessarily have an identifiable internal or external tissue marker. Biology does notprovide all the answers to the questions surrounding the body; anthropology weaves avaluable conceptual web and provides creative insights to the inner workings of the body.Chronic pain is bounded by sensation, resistant to documentation by biomedicine, whichmakes its study by anthropologists valuable because their examination can capture itssensations, affect and social effects. This essay has used anthropological approaches to painto demonstrate that the body is social. The body in pain uses imagination and creativity toframe the psyche, form social connections and make meaning. It further shows that the bodycan create meaning that transforms pain from being an isolating experience, laden withshame, depression and fear, into a source of pride. Thus pain is transformed from affliction topurpose.ReferencesGood, B. (1992). A Body in Pain: The Making of a World of Chronic Pain. In M.DelVechhio et al. (eds.), Pain as Human Experience: An Anthropological Perspective.Berkeley: University of California Press, pp. 100-137.Morris, D. (1991). Pain is Always in Your Head: The Culture of Pain. Berkeley: Universityof California Press, pp. 152-160.Scarry E. (1985). The Body in Pain: The Making and Unmaking of the World. New York andOxford: Oxford University Press, pp. 161-190.Schutz, Alfred (1967). The Phenomenology of the Social World, Evanston: NorthwesternUniversity Press.Throop, C.J. (2008). From Pain to Virtue: Dysphoric Sensations and Moral Sensibilities inYap (Waqab), Federated States of Micronesia. Journal of Transcultural Psychiatry45(2): 253-286.

Essay 6. Anthropological approaches to pain demonstrate how the body uses creativity, imagination and language to reformulate the sense of self and to create social connections

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Essay 6. Anthropological approaches to pain demonstrate how the body uses creativity, imagination and language to reformulate the sense of self and to create social connections

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