Thresholds of pain: photography and pain communication

Pain is common and difficult to communicate or reduce into the verbal or numerical scales commonly used in clinical practice. Some academics have argued that pain resists description in language while others have argued conversely that it generates language. This chapter identifies the limitations of verbal language and current standardized scores for assessing pain, highlighting the social and economic (as well as individual) costs of pain’s incommunicability, so often resulting in inadequate treatment and increased suffering. It explores the specificities of the photographic medium demonstrating that visual images (in particular photographs) can be alternative vehicles for eliciting language and narrative capable of expanding and improving communication and clinician-patient interaction within medical pain consultations. Against the backdrop of other work exploring the value of arts and humanities to pain medicine, it focuses on a fine art/medical collaborative project, face2face, at a leading London teaching Hospital, which co-created images of pain with pain sufferers and piloted a selection of these in the clinics of ten experts. Giving examples of images from the project as patients progressed through their management, it also reports early research findings suggesting that the verbal language is enriched and the non-verbal interaction impacted on. It concludes that further investigation is necessary from multidisciplinary perspectives but that images and image-making processes should be considered valuable tools for enhancing and democratizing medical pain encounters