For many of us living with chronic illness, pain is an unwelcome fact of life. Perhaps it ebbs and flows; perhaps it remains constant—but the experience of pain changes people. Elaine Scarry talks about pain as an “annihilating negation” of self and of the world. She writes about the “unsharability” of pain due to its resistance to language. That is, it’s difficult—if not impossible—to describe to another the experience of pain.

Why might this be? For one thing, pain overwhelms our capacity for thought and language. When we are experiencing acute pain, we often communicate in cries and grunts. Another facet of the difficulty in communicating pain—the focus of this post—is the difficulty of being believed, of being taken seriously. Scarry speaks to this when she writes: “To have great pain is to have certainty; to hear that another person has pain is to have doubt.”

Think about whether Scarry’s perspective rings true for you. When we are in pain, we know it. It is an overwhelming sensation that evades description. When we try to make sense of someone else’s pain, it’s an entirely different processing experience. We use logic and language to categorize it, to shrink it down to a manageable size. There’s nothing wrong with this; in fact, it’s often necessary to procure treatment. (For example, in assessing pain, medical providers ask us to rate our pain on a pain scale.) However, something of the experience of pain gets lost in a bystander's attempt to catalog it. It’s this piece that gets lost—the chaos, terror, and annihilation—that leaves people in pain feeling alone, doubted, and invalidated.

Many people who deal with pain—especially those who live with chronic pain—experience a sense of being disbelieved (Nicola et al., 2019). Especially when there’s no physical sign of disease, pain often is doubted or minimized. “It can’t possibly be that bad,” an exasperated family member might say. “I am not finding any medical reason why you should be in pain,” a physician might shrug. “You were OK yesterday; why are you in pain today?” a co-worker might ask skeptically.

This disbelief leads to a lack of compassion regarding the pain. People around the individual living with chronic pain grouse about what a burden the individual is—as if the pain is a choice the individual is making. Lack of compassion is also exacerbated by a lack of understanding about pain. Pain is the result of a complicated interplay between mind and body. It’s simply not true that pain that cannot be documented by tests and scans is imaginary or “all in a person’s head.”

Sadly, people living with pain often internalize these invalidating messages and question their own experience and worth. “Perhaps I am a malingerer,” they may wonder, feeling shame and doubt about their pain. This disconnect between what they experience and what others believe they experience leads to isolation and loneliness. This profound part of their identity—the pain with which they live—is not understood by anybody else.

In contrast to pain invalidation, validation is an acknowledgment of another’s pain (Nicola et al., 2022). It encompasses belief in the existence of pain, desire to understand the experience of pain, and recognition that the pain experience is worthy of attention. I equate pain validation with “witnessing,” which is a skill that can be practiced and built.

When we witness someone’s pain, we come toward the experience from a place of “not knowing.” We are aware that the person is experiencing something to which we don’t have immediate access. Perhaps we feel ourselves pull back internally, as pain is an experience we instinctively avoid. When we choose to proceed, we leave ourselves open to the raw feelings that may arise: helplessness, confusion, sorrow, and anger. Witnessing is a brave act.

When we witness someone's pain, we let ourselves sit in feelings that may not have words. We remind ourselves that witnessing is not about knowing, naming, or solving. It is about being with and traveling alongside; it is about authentic presence.

Pain swallows up identity, connection, and order. Witnessing is its antidote, communicating to the person in pain: “I see you. I am not leaving you emotionally alone in this experience. I am a constant in the chaos.”

When people have the experience of their pain being validated, they feel relief, safety, and social connectedness (Nicola et al., 2022; Nicola et al., 2019). Stress decreases and trust increases, both beneficial components in pain reduction (Nicola et al., 2022).

To validate someone’s pain:

References

Nicola M., Correia H., Ditchburn G., & Drummond P.D. (2022). Defining pain-validation: The importance of validation in reducing the stresses of chronic pain. Frontiers in Pain Research. 2022; 3884335

Nicola M., Correia H., Ditchburn G., & Drummond P. (2019) Invalidation of chronic pain: a thematic analysis of pain narratives. Disability and Rehabilitation. 2019; 43: 1–9

Scarry Elaine (1985) The Body in Pain: The Making and Unmaking of the World. Oxford: Oxford University Press.

QOSHE - Validation and Pain: Why Witnessing Matters - Katie Willard Virant Msw
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Validation and Pain: Why Witnessing Matters

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16.04.2024

For many of us living with chronic illness, pain is an unwelcome fact of life. Perhaps it ebbs and flows; perhaps it remains constant—but the experience of pain changes people. Elaine Scarry talks about pain as an “annihilating negation” of self and of the world. She writes about the “unsharability” of pain due to its resistance to language. That is, it’s difficult—if not impossible—to describe to another the experience of pain.

Why might this be? For one thing, pain overwhelms our capacity for thought and language. When we are experiencing acute pain, we often communicate in cries and grunts. Another facet of the difficulty in communicating pain—the focus of this post—is the difficulty of being believed, of being taken seriously. Scarry speaks to this when she writes: “To have great pain is to have certainty; to hear that another person has pain is to have doubt.”

Think about whether Scarry’s perspective rings true for you. When we are in pain, we know it. It is an overwhelming sensation that evades description. When we try to make sense of someone else’s pain, it’s an entirely different processing experience. We use logic and language to categorize it, to shrink it down to a manageable size. There’s nothing wrong with this; in fact, it’s often necessary to........

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