Please use the form below to submit comments. Also provide an e-mail address and name. Your e-mail address and/or name will be used only to communicate with you about this or future comments you may submit. I am particularly keen to receive references to published material that contradicts the assertions and arguments I have made.
By submitting the above comment, I grant to Ross Alan Hangartner the right to incorporate the comment in full or in part, literally, paraphrased, or conceptually, as he sees fit, into State of Pain or other writings that he may create in the future. However, I don't grant permission to include my name or e-mail address, or to use them in any other way than to contact me for follow-up. I understand that by submitting the comment I acquire no right of any kind in State of Pain or other writings of Ross Alan Hangartner.
Last updated: Sat, Aug 24, 2024
In a prior section, Pain Science 1: Basics, I painted a rough picture of what pain is from several perspectives. Later sections elaborate these perspectives. Different intellectual disciplines look at different aspects of pain, and they 'see' using different techniques. If all is well, they should provide different but complementary views of pain phenomena. Ideally the different perspectives should supplement rather than contradict each other.
In this section I try to convey something different and perhaps more difficult, what an anthropologist might call a "folk" or "cultural" view of pain. The idea that there is a cultural view of pain is of course an abstraction. In fact everyone has their own view of pain, or more accurately, everyone has views of pain that may differ over time or in different contexts, and that are not necessarily consistent. Nevertheless, cultural anthropologists have found the idea of cultural or folk beliefs useful even if abstract.
In this section I use the idea of cultural beliefs in a loose way, to mean beliefs that seem to occur commonly in society at large or within some subset of society. So it would make sense, for example, to talk about "cultural beliefs within the medical community." Cultural beliefs are distinguished from scientific beliefs in that they aren't necessarily consistent with scientific evidence. They may instead be based on personal experience, on things heard, things inferred, or things taught, and may either coincide with or conflict with current scientific understandings.
I have relied largely on two sources for the ideas that I present here as "cultural." The first is "Pain: a political history," by Keith Wailoo, Johns Hopkins University Press, 2014. As the title suggests, his book chronicles pain as an American political issue, primarily over the past sixty or seventy years. The second source I've used consists of statements and ideas that I've come across during my research into the science and medicine of pain. I haven't tried to prove that these ideas are the cultural beliefs about pain because my underlying points don't depend upon that. Contradictory ideas can exist within one person. I hope that the sourcing information that I provide will allow you to make your own judgments about the prevalence of the beliefs, and I suspect that you will recognize many of them from your own experience.
The significance of these cultural beliefs is of course that people tend to act in accord with their beliefs. If pain is a large aspect of your identity (either as you see it or as others see you), their beliefs about pain are beliefs about you.
Scientific ideas are very different from cultural beliefs in at least a couple of important ways. I don't mean different in their degree of truth or falseness. The degree of truth in a statement (as I see it) is independent of its source but is inherent in the statement itself. A cultural belief can certainly be more true than a scientific belief, although the odds favor good science in the long run.
Truly scientific beliefs first are more bounded than are the beliefs that I've termed "cultural." Each of the terms in an ideally scientific assertion is clearly and unambiguously defined (see Scientific Understanding). The scope of a truly scientific assertion is well-defined. That is, it is clear whether the statement applies to a particular situation. Like good journalism, the who, what, when and where are clear. In this view, a statement or idea can be more or less scientific and more or less valid. The science of pain, particularly pain psychology and pain medicine, is rife with assertions that are not strictly scientific. When this is the case, the boundaries of truth and proof become blurred and any distinction between scientific and cultural beliefs becomes blurred.
Scientific and cultural beliefs also differ in the degree of heat (emotion) they carry. Scientific agendas certainly are arrived at socially, and scientific research is ultimately intended to solve real problems. Scientific findings then carry some of the heat of the problem area that has motivated them. New scientific findings are often controversial, among other reasons because of the implications they are believed to have in their releated problem areas. After a finding has been properly vetted (by the "scientific process"), however, it gradually becomes part of that which is, a background fact and a tool that can be used to solve problems.
Cultural beliefs tend to carry more heat than scientific beliefs for a cluster of reasons. Perhaps first, strong cultural beliefs exist because they are beliefs about things that are important to us. The fuzzy nature of cultural beliefs can promote the heat: A general and open-ended belief can be at the same time easier to agree with and easier to dispute than a buttoned-down and antiseptic scientific hypothesis. At the same time there is a tendency to expand the boundaries of any idea that we find attractive. The rules of cultural discourse do not promote clear statements and clear definitions in the same way that the rules of scientific process do. On top of this, findings from linguistics suggest that we must think in terms of metaphors and generalizations.
We are prone to think normatively (in "oughts" and "oughtn'ts") when we think about important cultural issues, which include issues of responsibility and entitlement. Our moral sense can be quite strong (Core Intuitions and Core Behaviors), and can justify the withholding of compassion or even justify aggression when our beliefs are sufficiently strong.
Given the impacts of chronic pain on public finances and its challenge to politico-religious ideologies, narratives about chronic pain are common. They include the intentional malingerer and the sad victim of his own spirit who unknowingly wills his own incapacity. These narratives can arise from or be wrapped within psycho-theory. Not surprisingly, invidious theories of class and racial differences have been intertwined with theories about pain. The nature of man, his capacity for self-control and responsibility, are challenged by scientific understandings of pain, and hence laypersons of various backgrounds take positions about those scientific understandings. Public concerns around pain extend to public opinions about pain treatments, most prominently the use of narcotics in pain treatment.
Within this section...
Pain Intersects with Community and Economics (Last updated: Sat, Aug 24, 2024)
Understandings of Chronic Pain in the Culture (Last updated: Fri, Sep 13, 2024)
Some Political History of Pain in the USA (Last updated: Sat, Aug 24, 2024)
Envy Up, Scorn Down (This page is incomplete.)
There, But For the Grace of God, Go I (Last updated: Fri, Sep 13, 2024)
Themes in Social Understandings of Pain (Last updated: Fri, Sep 13, 2024)
Common-sense Prescriptions (Last updated: Wed, Jul 3, 2024)
Or skip to...
How We Misunderstand (Last updated: Wed, Aug 28, 2024)