An image with the power to heal?’ – a contribution to our special edition collection of pain in the medical humanities, by Leigh Rooney.

Image credit: G. Cruikshank fect, Wellcome Trust Images. A man suffering from headache in the form of devils.

Image credit: G. Cruikshank fect, Wellcome Trust Images. A man suffering from headache in the form of devils.

The representation of pain is interesting not only from a theoretical, semiotic perspective, but also in how representation, and the issues involved in representing, come to constitute the experience of pain. The Wellcome Library image collection contains a number of historic images where pain is represented as some malevolent entity inflicting an attack upon a sufferer. And it is not just a historical occurrence, with it also finding contemporary expression. Pain can also sometimes be represented as a personified entity in and of itself. Yet expressing pain in these ways may seem a curious oddity that stands out to the reader (both contemporary and historic) because of its imaginative removal from the ‘reality’ of what we ‘really’ think pain is. It may also stand out because of an unnerving invocation of an alternative reality where we as lone individuals are powerless against spiteful monsters we are hardly aware of (much like the ‘incubus’ demon of sleep paralysis). A peculiarity of representation usually confined to the realm of art and poetic literature, or as a scientific metaphor at best, it is nevertheless an extension of a more fundamental principle guiding our conceptions of pain: that pain is an object, an entity, a ‘thing’. As Joanna Bourke wrote in her recent work ‘The Story of Pain’ (2014), ‘the most dominant “doing” of pain is to objectify it as an entity’ (P. 8).

In the hugely influential work ‘The Body in Pain’, Elaine Scarry (1985) argued that pain and its objectification go hand-in-hand. In this regard, she suggests that the ‘first’ and ‘most essential’ aspect of pain is that it is against:

‘Pain is a pure physical experience of negation, an immediate sensory rendering of “against,” of something being against one, and of something one must be against. Even though it occurs within oneself, it is at once identified as “not oneself,” “not me,” as something so alien that it must right now be gotten rid of (1985:52).’

In being against in the first instance, pain instantaneously positions itself as an object separate from (and against) the self. The first moment of the objectifying process is being against: it is here where the notion of pain-as-object is born. In another similarly influential work, The Absent Body, Drew Leder (1990) echoes Scarry’s sentiments. Leder famously considered that pain exerts a ‘telic demand upon us’ (P. 77), something consisting of a ‘hermeneutical’ moment where the suffering of pain ‘gives rise to a search for interpretation and understanding’ (P. 78). In this search ‘the body becomes the object of an ongoing interpretative quest’ (P. 78). The objectification of pain is here framed as fundamental to its nature.

Yet despite being so fundamental, this aspect of its nature does not fade into the background as some almost-forgotten but firmly cemented ontology. Foundational it may be, but strikingly visible it remains. As Peter Mere Latham, a physician writing on pain in the 19th Century noted (with some evident degree of puzzlement):

‘I have known many a philosopher [. . .] take to rating and chiding his Pain, as if it were an entity or quiddity of itself’ (quoted in Bourke, 2014:4, emphasis in original).

It seems probable that its visibility remains prominent because it is tied up with another (apparently contradictory) aspect of pain’s fundamental nature: that pain is actually objectless. Thus, Scarry considered that pain ‘is an intentional state without an intentional object’ (1985:164). In this understanding pain is the absence of objects. Indeed, where the objects (material or conceptual) constituting our world become destroyed, where our world is unmade, we are left with pure pain: the ‘mute facts of sentience’ (Scarry, 1985:256).

It is from this seemingly discordant ontological foundation that representations of pain emerge, representations where the struggle plays out between these two intimately familiar but interminably conflictual shades of pain’s nature.

In returning to the malevolent demons with which this piece started, Byron Good (1992) gives an example of this struggle within the context of chronic pain which, for one particular sufferer he interviewed, he likened to being possessed by a spirit entity. Here a ‘series of names are called out, and the diviner and sufferer alike wait for the power to announce itself’, but ‘the response is often unintelligible, the power refuses to reveal itself, or the clinicians cannot agree upon the name of the power’ (P. 43). The sufferer is caught within a moment where pain’s present indefinability presses against the telic demand of objectification, against some explanation that can allow the sufferer to understand the enemy and how to defeat it, against the sufferer’s desperate attempt to ‘find an image with the power to heal’ (P. 47). More than simply an epistemological issue, the conflictual nature inherent in the representation of pain constructs the essential nature of its experience.

This guest contribution was written by Leigh Rooney, a PhD candidate in the School of Applied Social Sciences, Durham University. His PhD explores methodological issues relating to the representation of pain with persons experiencing chronic pain.

Correspondence to Leigh Rooney.


Works cited

Bourke, J. (2014). The Story of Pain: From Prayer to Painkillers. Oxford: Oxford          University Press.

Good, B.J. (1992). A body in pain – the making of a world of chronic pain. In M.         DelVecchio Good, P.E. Brodwin, B.J. Good and A. Kleinman (Eds). Pain as    Human Experience: An Anthropological Perspective. Berkley: University of California Press.

Leder, D. (1990). The Absent Body. Chicago: The University of Chicago Press.

Scarry, E. (1985). The Body in Pain: the Making and Unmaking of the World. New       York: Oxford University Press.


Categories: CMH Publications


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