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The Story of Pain: From Prayer to Painkillers, by Joanna Bourke, Oxford University Press, RRP£20/$34.95, 396 pages

Pain, says Joanna Bourke, a professor of history at London’s Birkbeck College, is not a private, passively endured event. It is “infinitely shareable”, permeated by cultural beliefs and metaphors, interpreted by doctors and sympathetic outsiders, measured by pain questionnaires. Zigzagging over roughly the 18th to the 21st century in Britain and America, she examines pain’s private/public duality, and how our concept and treatment of it has varied depending on class, race, nationality and gender.

In 1811 a planter could self-interestedly assume that slaves had “less exquisite” bodies, minds and senses than their white masters; in 1739 David Hume declared a day-labourer obviously to have a much cruder physiognomy and mentality than “a man of quality”. All classes, however, were expected to accept pain as divinely designed to test and punish, which may, says Bourke, be one reason for the mystifying delay in inventing forms of pain relief, and the failure to use already-available ones.

But not only is pain differently conceptualised in different times, places and systems, it is also, Bourke contends, differently felt. Dogs in a 1970s experiment couldn’t respond “normally” to painful stimuli in maturity, having never been exposed to these in puppyhood; still more (is the implication) must humans “learn” what it means to be in pain.

Thus, pain, as spoken of by 18th and 19th century Christians welcoming chastisement, must have been a quite different phenomenon to what it is in a secular, pain-killing age; and geographically discrete terms indicate geographically discrete sensations. In India the heat of pain is “imaged” with “parched chickpeas”, its heaviness likened to
“a load of grain”; the Sakhalin Ainu of Japan have “musk deer headaches” and “woodpecker headaches”; westerners complain of “gnawing”, “shooting” and “crushing” pains.

But don’t these metaphors in fact demonstrate the universal constancy of pain experience – piercing, pecking, percussive motion, burning, weight? All that varies are whatever localised objects are invoked to describe it. If military pain metaphors are more detailed and multifarious in the 21st century, surely that is because we have a wider repertoire of weapons to draw upon. A mid-20th century American uses train signals as a simile for the way pain alerts us to bodily damage, but his ancestors might have made the same point via smoke signals.

“Naming can instruct bodies how to respond,” says Bourke, but, in all her examples, the pain experience easily comes apart from the description of it. Do the women she quotes (contemporary ones, it turns out) communicate the quiddity of their labour pains when declaring how proud and heroic they feel, in retrospect, for having just endured them? At most we can guess that their suffering, like that of the cited Christians, was mitigated by the thought of future bliss, but does it even make sense to ask if the quality of their pain was different to what it would have been without these beliefs? By her own remit, Bourke is not entitled to speak of “unspoken meanings”.

Even “the physical body”, apparently, is “not only represented but also created” by culture. A society’s metaphors are “mapped back into the body”, “literally felt and absorbed by the body”. How literally? They “direct the ebb and flow of phlegm, black bile and yellow bile”, and whether blood freezes or circulates. It is a question, says Bourke, whether, prior to the concept of blood’s circulation, blood did indeed circulate. To which her answer is: “Yes, but not as we know or – importantly – experience it.”

As with many constructionist thinkers, Bourke’s claims that it is we ourselves who construct reality range from mild truism to the wildly far-fetched. What does it actually mean to say that pain is a product of culture, metaphor and ideology, or that we “creatively perform our pain”? Motley fascinating facts are portentously brandished but it is unclear what they are meant to prove.

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