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History of Pain

The Ancients Those two giants of Ancient Greece, Plato and his student Aristotle, both considered pain to not be a sensory experience, but an emotional one. And while pain was experienced by the human heart, it was something that originated external to it, something that descended upon it. Pain was an independent being that invades […]

The Ancients

Those two giants of Ancient Greece, Plato and his student Aristotle, both considered pain to not be a sensory experience, but an emotional one. And while pain was experienced by the human heart, it was something that originated external to it, something that descended upon it. Pain was an independent being that invades a subject to take it over. Aristotle described it as like a spirit that enters through an injury. This tradition of pain as an external force has been a persistent one, with pain often seen as the act of gods (or God) as a kind of punishment, or a test of faith. The word pain itself derives from the Latin poena, meaning ‘penalty.’

The Renaissance

During the Renaissance, René Descartes refuted the idea that pain came from the outside by proposing that pain was actually an internal mechanical process. For Descartes the body was a machine, and pain was a disturbance within the “machine” that passed through nerves to the brain. This preceded the specificity theory of pain (that persisted into the 20th century), which considered pain to be a specific sensation distinct from the other senses. Long after Descartes (in 1975 to be exact), the International Association of the Study of Pain put forth a definition that re-united Descartes’ mind-body split. They described pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” This considers how emotional reaction to pain can affect its physical intensity.

Evolution

In evolutionary theory, pain is simply a way that the body defends itself by forcing a reaction away from the thing causing us pain. And the intensity of pain works to remind us to avoid that thing in the future. In fact, the intensity of pain should be about proportional to the risk the stimulus creates for us (or more correctly, created for ancient humans). However, natural selection is rarely perfect, and so some things may be disproportionately more painful than the risk they pose. Like paper cuts!

Language

And yet, for all that we’ve said about pain…what can we really say about pain? For Elaine Scarry, a professor of literature at Harvard University, pain is, in the end, inexpressible. In her hugely influential work on the subject, The Body in Pain, she argues that the concept of pain is something that resists language. As she quotes from Virginia Woolf: “…let a sufferer try to describe the pain in his head to a doctor and language at once runs dry.” Not only is pain very difficult to express in language — for Scarry it also actively destroys it. Pain reduces human speech to just a few moans and grunts and cries.

Cultural Approaches to Pain

India: But, contra Scarry, plenty of cultures have tried to actively explain indescribable pain, with their descriptions shaping their very idea of it. Judy F. Pugh researched the descriptions of pain in India, and unsurprisingly, found they are developed from images familiar to every day life. She wrote, “home field, workshop, and weaponry [are used] to describe pain’s sensory qualities.” She found, for example, that joint and muscle pains are described as the “cracking of earthenware” or the “bursting of a seed-husk.” In terms of pain relief, powerful pain killers like opium have been used as part of traditional medicine and religious ceremonies for centuries. But following the passing of the stringent Narcotic Drugs and Psychotropic Substances Act in 1985, opium use has become more stigmatized. Today, the use of raw opium is more common in rural areas, especially in the northwest.

Uganda: In Uganda, the expected tolerance of pain is deeply divided along gender lines. In most cultural groups, women are seen as subordinate to men. Their capacity for enduring pain while ensuring that their husbands and other clan members are comfortable is seen as an essential part of their duty. They are also often expected to deal with physical abuse with stoicism. However, when men, and when women, fall ill in Uganda, they will seek treatment from traditional healers who provide spiritual and medial care through rituals and natural remedies. It’s estimated 57 per cent of the population will never see a health worker trained in Western medicine.

Ukraine: In Ukraine, a strong stoic attitude towards pain has long been valued, and has taken on many forms throughout the years. During the Second World War, stoicism was an integral aspect of national heroism in resistance to the Nazis. Anecdotal evidence also suggests that for many Christians in Ukraine, suffering is seen as a requirement to enter heaven. It is an essential punishment for one’s sins, or the sins of those close to a person. The punishment of pain can be seen as a sacrifice for heavenly reward. This may leave some people unwilling to push for better access to pain medication.

Copyright © 2012 University of British Columbia Graduate School of Journalism. All rights reserved.
Generous support provided by the Mindset Social Innovation Foundation and the MITACS Accelerate Project.