Our friend Seamus Barker sent us this post on his recent presentation at an international conference:
Translating Pain: Translating Between Science and the Humanities
Last week I had the pleasure of presenting at a conference at Monash University in Australia, convened in partnership with Warwick University in the UK, entitled Translating Pain: an International Forum on Text, Language and Suffering.
One of the central questions asked by the conference was whether pain, suffering and trauma can be represented as such – in the historical record, linguistically, or by other means of expression, or whether rather these experiences cannot be adequately later rendered into a communicable form. This question has been widely addressed, and so this conference framed it afresh by using the theme of “translation” to further complexify the issue of pain and its representation (for the fascinating range of papers that responded to these questions, see the conference’s program).
My paper, entitled Pain: Always Already a Translation sought to perform its own act of translation – between the discourses of Clinical Neuroscience and Hermeneutical Phenomenology (which comes out of European, or “Continental,” Philosophy).
Clinical Neuroscientist and Physiotherapist (and one of my PhD supervisors) Lorimer Moseley, and David Butler state that the conditions necessary and sufficient for pain are such that:
“We will experience pain when our credible evidence of danger related to our body is greater than our credible evidence of safety related to our body”.
Moseley points out that in making this appraisal, the brain draws on all available information to hand, including somatosensory data, but also thoughts, past experiences, and beliefs. This gestalt is further coloured by emotions. As we know, this all occurs instantaneously, preconsciously, and without direct volition. According to Moseley and Butler, it seems it is this level of appraised danger to the body that precedes and determines the immanent experience of pain.
Already a Translation
From this starting point, I put forward the idea that “pain is always already a translation”. Ever since the “linguistic turn” in 20th Century Philosophy, most philosophers have accepted the idea that our access to reality is structured by language. When I see a tree, a chair, or a table, I cannot help but recognize the tree as a tree, the chair as a chair, the table as a table, even when no words enter my mind. I cannot help but see the world as divided up into units, units which, even when they are very practical, still require some underlying concept. We perceive the world always already as divided into different things, a differentiating effect which emerges through the structuring properties of language.
For Moseley and Butler, it seems that before the individual feels pain, they must interpret what counts as “credible”, what counts as “evidence”, and what counts as “danger”, even if none of this occurs in conscious awareness. At the conference I suggested that such an appraisal of danger to the body must be grounded, at least partially, in complex conceptual categories that emerge through language. But, this implicit, preconscious interpretation of being-in-danger is not pain. Pain is the translation of this prior moment of (pre-conscious, non-volitional and instantaneous) interpretation.
The question then remains as to whether pain can be translated back into its “original” – into the interpretation of being-in-danger. Butler and Moseley’s DiMs and SiMs can be understood as attempting this backwards translation, but it seems possible that there will always be an excess of meaning, an irreducible gap in the translation, as some part of our mind remains divided from us – not fully knowable or controllable – even as this part of our mind interprets our Being-in-danger. This was the point that interested the linguists, historians, literary scholars and philosophers in the room, although for those of us who have worked in pain and been exposed the ideas of Explain Pain, it’s not a big stretch.
Heidegger, potentiality and projections
Another idea that I found even more interesting emerged from my grappling with Heidegger’s notion of “projection”. For Heidegger, we are defined by our potentiality – by the fact that, in each instant, multiple potentialities for future Being-in-the-World present themselves, always as a background, implicit Understanding (Verstehen). For Heidegger, it is a problem that we frequently fail to recognise the true and the false potentialities available to us, as well as the true and false circumscriptions to those potentialities. Heidegger calls this future-orientated sense of multiple potentialities “projection”, and for him it is “projection” that is constitutive of our Being.
I would suggest that pain, when defined as resulting from the appraisal of danger, arises out of the interpretation of the future-orientated relationship of Being to lifeworld. Which is to say, pain can be understood, philosophically, to arise out of “projection” (in the Heideggerian, not psychoanalytic, sense). “Danger” does not describe tissue damage, or even the perception of tissue damage, but rather – by its definition – always something that relates to the future. And if we think of Butler and Moseley’s oft-quoted examples of badly injured soldiers who feel no pain while they are concentrating on escaping the battlefield alive, or of boxers who feel no pain while they believe they will win the bout, it seems that we interpret in a very complex and holistic (but preconscious) way what our potentialities for Being are, and that pain always reflects this understanding of our possible futures. You could say (and I did) that pain is always already the translation of our projected possibilities, in their opening, and in their closing.
I hope my conference paper helped translate some of the exciting work coming from the clinical and scientific worlds into a language meaningful to scholars from the Arts and Humanities. Equally, I hope that such conversations continue to develop, as abstract philosophical and linguistic approaches also show how they can usefully impact on scientific and clinical thinking.
– Seamus Barker
Seamus Barker is completing a PhD in Medical Humanities at the University of Sydney, in the Centre for Values, Ethics and the Law in Medicine (VELiM), under Dr Claire Hooker, and is also supervised by Professor Lorimer Moseley at the University of South Australia. He is investigating what is at stake – ethically, philosophically, and pragmatically – in the discrepancies between the different narratives that account for pain, coming from science, medicine, and from personal accounts. He has worked as a Physiotherapist for over ten years in various pain clinics in Australia and the UK. Please contact at firstname.lastname@example.org or tweet to @sbpainphysio