Let's talk about pain

“I feel your pain,” Bill Clinton told an AIDS activist in the 1992 presidential campaign. Well, he probably didn’t. Pain is notoriously subjective and hard to measure. Some patients take the dentist’s drill without an anaesthetic; most of us would rather die.

In the 19th and early 20th Centuries doctors speculated why some groups were more sensitive. Their answers reflected the cultural and racial prejudices of the era. One popular theory was that less civilised groups were both less sensitive to pain and more expressive when they experienced it. Doctors contrasted stalwart, stoic Britons with degenerate, weeping dark-skinned people.

A contrasting theory was that civilisation was making people soft. The father of modern neurology, Silas Weir Mitchell, wrote in 1892 that “in our process of being civilized we have won, I suspect, intensified capacity to suffer. The savage does not feel pain as we do: nor as we examine the descending scale of life do animals seem to have the acuteness of pain-sense at which we have arrived.”

Today the opioid epidemic makes the study of differential rates of pain more urgent than it ever was. Current research seems to indicate that Americans in lower socio-economic groups experience more pain.

“If you’re looking at all pain – mild, moderate and severe combined – you do see a difference across socioeconomic groups. And other studies have shown that,” says University at Buffalo medical sociologist Hanna Grol-Prokopczyk. “But if you look at the most severe pain, which happens to be the pain most associated with disability and death, then the socioeconomically disadvantaged are much, much more likely to experience it.”

It’s also relevant in the debate over assisted suicide. Remember Brittany Maynard, the 29-year-old woman whose assisted suicide in Oregon sent a powerful message to Californians to legalise assisted suicide? Shortly before dying, she said, "I don't want to die. But I am dying. Death with dignity is the phrase I'm comfortable using. I am choosing to go in a way that is with less suffering and less pain." Pain, or even the prospect of pain, is often regarded as sufficient reason to ask a doctor’s help in committing suicide.

From the point of view of a utilitarian, an increasingly popular philosophy, any pain might be enough to justify suicide. Indeed, the pessimistic South African philosopher David Benatar argues that “a life filled with good and containing only the most minute amounts of bad – a life of utter bliss adulterated only by the pain of a single pin-prick – is worse than no life at all” (Better Never to Have Been: The Harm of Coming into Existence, 2008).

Coming at pain from a different perspective, linguistics expert David Johnson, of Kennesaw State University, in Georgia, has opened up another line of research. In an article in the Interdisciplinary Journal of Research on Religion he charted the frequency of the words “pain” and “hurt” since the year 1800 in four linguistic databases: Google Books Corpus, Corpus of Contemporary American English, Corpus of Historical American English, and Time Magazine Corpus. What he found was a sharp increase in “pain language” in American English since the 1960s. And over the same period words like “religion” and “God” and related concepts like “mortification”, “patience”, “dread”, and “sin” declined steeply.

Why? It is impossible to propose a definitive answer based on word usage, but Johnson’s investigation points at some intriguing lines of inquiry. His theory is that “this growth parallels the era when language related to the divine was in sharp decline”. In other words, a much greater willingness to talk about pain is correlated to a decrease in religious motivation for enduring pain.

... increasing American secularism plays a significant role. After all, the dilemma of the co- existence of pain and a good God is an eternal problem. To suffer in silence is lauded as the appropriate Christian response to pain. And there is a long Christian tradition of promoting suffering in silence ... 

But with the increasing secularization in 20th and 21st century American society, notions of Christian stoic piety evaporated; thus, people discuss their pain more. And why not? If suffering in silence is not meritorious nor does it assist in religious redemption, then, like [the Greek mythological figure] Philoctetes, sufferers should complain all they want. If for no other reason, it might make them feel better. Interestingly, the data presented above does show an increase in pain, particularly since the 1960s in American English, which coincides with the same era when language related to the divine was in sharp decline.

This is hardly a watertight proof that secularism is responsible for our increasing sensitivity to suffering, but it sems like a plausible explanation. The central symbol of Christianity is the Cross, two crossed beams of wood with a man who claimed to be God nailed to them. It is, in other words, a religion which purports to explain the mystery of suffering by asking us to contemplate the example of God himself. Secularism’s answer to inescapable pain is “stuff happens” or “life’s a bitch and then you die”.

The ancient wisdom of mankind –Christian, Muslim, Buddhist or Hindu -- is that we can bear any suffering if we find meaning in it. But without meaning, all we can do is talk about it. Endlessly. As Johnson points out, if “proscriptions against complaining or even discussing pain are removed, the modern American sees little reason to withhold discussion of pain.”

Michael Cook is editor of MercatorNet.

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