Reflections on Representing Pain: Narrative and Fragments

Chronic pain is in a state of representational crisis. That was how Sara Wasson opened the symposium, ‘Representing Pain: Narrative & Fragments’ at Lancaster University in August. Part of Wasson’s AHRC-funded network, Translating Chronic Pain, the day brought together academics, many of whom are also pain sufferers, from various disciplines to discuss narrative practices and products depicting pain and illness. I had initially been drawn to the event because much of Wasson’s work on different kinds of narrative possibility speaks to my own research on multiple forms of life writing about mental illness. That and, when you have already cited 7 of the 9 speakers billed for the day in your thesis, you do anything to be in that room and be part of the discussion!

by @Paula_JKnight see more at Paula Knight’s website

The critical medical humanities has recently fostered an increased engagement with narrative and the limits of its ability to communicate and represent illness. A previous disproportionate focus on templates of illness experience flattened the knotty work that narrative, and scholarship on it, can undertake. Certain stories of illness, those which demonstrate cohesion, progression, linearity, and recovery, have been valorised, both in and outside of the academy. But what does this mean for people whose experiences of illness and pain do not, and cannot, adhere to such narrow confines? Focus on such stories excludes those who live with chronic and terminal conditions, for whom a grand redemptive narrative is inaccessible and inappropriate. Chronic pain demands different forms of representation.

This is why Wasson wrote a creative manifesto calling for ‘flash’ pieces of short- form creative work that express moments or fragments of experiences of persistent pain, either from the person experiencing the pain, or from the perspective of a witness. The resulting online Anthology of Moments has created a chorus of voices that express the vivid, contradictory, and diverse realities of living with pain. Wasson’s emphasis on captured glimpses lessens the teleological burden on the individual to explain their pain, or to garner any sense of meaning from it. Instead these fragments, and the multiple ways in which they can be navigated in the anthology, foreground incompleteness, ambiguity, and a sense of pausing in the present moment.

In light of this, the symposium was dedicated to ways of breaking open narrative representation of pain. Angela Woods, spoke on the ways in which scripted recovery narratives have held particular prominence in a psychiatric context. Whilst there have been critiques of recovery as a policy maker, Woods argued, there has been relatively little interaction with the difficulties and risks of the recovery story and its “finished product factor.” Drawing on the Recovery in the Bin movement, she emphasised the need to be open to listening to stories that are unrecovered, whilst ensuring that our critical call for complexity does not undermine the attainments of any individuals.

Stella Bolaki  shared some of her work on the Artists’ Books and the Medical Humanities project. Artists’ books, Bolaki asserted occupy a middle ground between embodied process and narrative structure, and can depict pain before it has solidified into story. Focusing on the work of Martha A. Hall, Bolaki analysed how stitches, cuts, rips, staples, and erasures present in artists’ books disrupt any shape of narrative as improvement. Instead of looking for patterns and conclusions, these books are shaped by pulses, repetitions, and pauses; their materiality and the physical processes that go into making and reading them enforce a willingness to dwell in the embodied now, however troubling and painful.

Engaging with yet more forms, Ann Jurecic and Megan Crowley-Matoka gave talks on the essay and ethnography respectively. Thinking about genre as a technology, Jurecic reflected on the history of the essay form: given that it literally means “to attempt,” the essay encourages an exploration of the unknown and is both an intellectual endeavour and literary challenge. She then applied this to a discussion of gender and pain in Elua Biss’ “The Pain Scale” and Leslie Jamison’s “A Grand Unified Theory of Female Pain” in The Empathy Exams. A practising ethnographer, Crowley-Matoka gave a fascinating talk about her experiences observing how clinicians encounter pain. As well as sharing complex moments, for example, how she had observed the difference between clinicians’ attitudes to donors’ and recipients’ pain post organ transplantation, Crowley-Matoka reflected on ethnography’s status as a fragmentary form of knowledge making that is dependent on moments of attention, and consequently has to negotiate its own inherent incompleteness.

Taking different lines of approach James Berger, Alan Bleakley, and Javier Moscoso spoke on problems posed by pain in society. Berger talked about the idea of a shared, “social pain” in the current political landscape as the combination of a cultural despair and economic anxiety, and followed onto consider the possibility of its opposite: “social happiness,” as utopian project and political imperative. Bleakley argued that medicine itself is sick and in pain, and currently unable to treat itself. He drew attention to medicine’s structural burdens and the resulting iatrogenic sickness levels, as well as highlighting the unhealthy and unsustainable working environment caused by the institution’s lingering paternalism and authoritarianism. Moscoso shared some of his work from his acclaimed Pain: A Cultural History, talking about historical accounts of pain suffering, as well as the scopic pain of those bearing witness, and showed us a video clip from some of his current work on Fibromyalgia.

Finally, Brendan Stone gave an experimental presentation/performance of the fragment. Weaving together a series of moments of personal and collective pain, poetry by Rivka Miriam, and extracts from psalms, Stone’s talk was generous and beautiful. It is easy to wrap up discussions of the importance of fragments in academic discourse that, in its very nature, strives for coherence, linearity, and progression, and consequently excludes many. Stone’s paper, however, demonstrated the lyrical power of fragmentation in its bringing together of form and content, and led us wonderfully into the concluding round table.

From left to right: Stella Bolaki, Sara Wasson, Ann Jurecic, and Angela Woods leading the roundtable

I found myself overwhelmed at the end of the day by the sheer amount of work, across different disciplines, and with different outputs, on the subjects of illness, pain, and representation. As a PhD candidate entering the final stages of my thesis, I found it inspiring (and inspiring not in a saccharine clichéd way, but in an unexpectedly emotional way) to listen to these critical and creative possibilities that are so deeply rooted in embodied experiences. The work of Translating Chronic Pain is ongoing and is still accepting submissions to its online anthology, if you haven’t yet looked up the project, I urge you to do so.


Katrina Longhurst is an Associate Editor of The Polyphony and a PhD candidate in The School of English at The University of Leeds. She is on Twitter @K_A_Longhurst

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