Pain,suffering and risk

A primary role of medicine is often perceived as treating or alleviating pain, but what actually constitutes pain can be defined in many ways. A major impediment to a more adequate conceptualization of pain is thought to be the manner in which it has been ‘medicalized,’ over the course of the twentieth century resulting in the inevitable Cartesian split between body and mind. Consequently, the dominant conceptualization of pain has focused almost exclusively upon the neurophysiological aspects, both in diagnosis and treatment, with the subsequent inference that it can be rationally and objectively measured. Social science, in particular the sociological literature on chronic illness, offers a framework for understanding the experience of pain by focusing on ‘lived experience,’ including narratives of suffering. Medically, pain is often explained in terms of risk by attempting to measure so-called objective symptoms, whereas accounts of suffering may encompass more easily the notion of total pain (Saunders 1976 Saunders, C. 1976. Care of the dying. Nursing Times, 72: 3–24.  [Google Scholar]), which includes psychological, spiritual, interpersonal and even financial aspects of chronic pain, as well as its physical aspects. This paper proposes that illness narratives and phenomenological accounts have become intrinsic to the understanding and treatment of pain and, using examples from empirical research, considers how pain narratives challenge biomedical approaches to chronic pain, which are inevitably framed in the discourse of risk.     

Health,risk and ‘social suffering’

This editorial provides a summary account of research and writing on ‘social suffering.’ Some of the ways in which this body of work might be approached within the field of health risk research are outlined. Some of the criticisms that might be directed towards the paradigm of risk on the occasions when this is used to account for lived reality of human suffering are reflected upon. In this context, further lines of inquiry into the ways in which social scientist venture to write upon, and ‘bear witness’ to, experiences of pain, misery and distress are initiated. Each of the contributions to the special issue in terms of their distinctive approaches to these concerns is introduced.