Article Text
Abstract
The challenge for those treating or witnessing pain is to find a way of crossing the chasm of meaning between them and the person living with pain. This paper proposes that images can strengthen agency in the person with pain, particularly but not only in the clinical setting, and can create a shared space within which to negotiate meaning. It draws on multidisciplinary analyses of unique material resulting from two fine art/medical collaborations in London, UK, in which the invisible experience of pain was made visible in the form of co-created photographic images, which were then made available to other patients as a resource to use in specialist consultations. In parallel with the pain encounters it describes, the paper weaves together the insights of specialists from a range of disciplines whose methodologies and priorities sometimes conflict and sometimes intersect to make sense of each other’s findings. A short section of video footage where images were used in a pain consultation is examined in fine detail from the perspective of each discipline. The analysis shows how the images function as ‘transactional objects’ and how their use coincides with an increase in the amount of talk and emotional disclosure on the part of the patient and greater non-verbal affiliative behaviour on the part of the doctor. These findings are interpreted from the different disciplinary perspectives, to build a complex picture of the multifaceted, contradictory and paradoxical nature of pain experience, the drive to communicate it and the potential role of visual images in clinical settings.
- pain management
- art and medicine
- fine art
- arts therapist
- metaphor
This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/
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Footnotes
Contributors DP co-created all the images with people with pain and originated the project. JZ recruited patients and staff. DP and JZ developed the project with input from all of the authors in relation to the research. All the authors analysed the interviews from their disciplinary perspectives. DP wrote the first draft combining these analyses and all authors contributed fully to the writing and editing.
Funding The original project generating the material analysed in this article was funded by the Arts and Humanities Research Council (AHRC) and Arts Council England (ACE). The subsequent multidisciplinary research analyses were supported by additional funding from the Friends of University College Hospitals Trust and Grand Challenges, University College London (UCL). DP was supported by the AHRC and by a Centre for Humanities Interdisciplinary Research Projects (CHIRP) Interdisciplinary Fellowship from UCL. ES was supported by funding from the Economic and Social Research Council (ESRC), grant numbers: ES/K002155/1, ES/R008906/1. This work was undertaken at UCL/UCLH, where JMZ received a proportion of funding from the Department of Health’s National Institute for Health Research (NIHR) Biomedical Research Centre.
Competing interests None declared.
Patient consent Not required.
Ethics approval Royal Marsden Research Ethics Committee, and NRES Committee London, Chelsea.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement The full set of postconsultation questionnaires, the transcripts and the video recordings of the baseline and study consultations are available on encrypted drives to all of the researchers involved. These data are not available for sharing with others in raw form for confidentiality reasons.