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Face2face: Sharing the Photograph Within Medical Pain Encounters—A Means of Democratisation

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Painscapes

Abstract

Pain is common and difficult to communicate or reduce into the verbal or numerical scales commonly used in clinical practice. This chapter 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. The chapter 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, we report early research findings suggesting that the verbal language is enriched and the non-verbal interaction impacted on.

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Notes

  1. 1.

    Hjermstad, M. J., P. M. Fayers, D. F. Haugen, et al. “Studies Comparing Numerical Rating Scales, Verbal Rating Scales, and Visual Analogue Scales for Assessment of Pain Intensity in Adults: A Systematic Literature Review”. Journal of Pain and Symptom Management 41 (2011): 1073–1093.

  2. 2.

    Morse, J. M. “Using Qualitative Methods to Access the Pain Experience”. British Journal of Pain 9 (2015): 26–31.

  3. 3.

    Deignan, A, J. Littlemore, and E. Semino, eds. Figurative Language, Genre and Register (Cambridge: Cambridge University Press, 2013), 267–304.

  4. 4.

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

  5. 5.

    Charon, R . “A Narrative Medicine for Pain”. In Narrative Pain and Suffering: Progress in Pain Research and Management, edited by D. Carr, J. Loeser, and D. Morris , vol. 34 (Seattle: IASP Press, 2005).

  6. 6.

    Biro, D . The Language of Pain. Finding Words, Compassion and Relief (New York: WW Norton & Co, 2010).

  7. 7.

    Bourke, J. Pain and the Politics of Sympathy, Historical Reflections, 1760s to 1960s (Utrecht: Universiteit Utrecht, 2011), 10. Back to Context.

  8. 8.

    Padfield, D. “Mask: Mirror: Membrane”. Pain News 10, no. 2 (2012): 104–109.

  9. 9.

    Padfield, D. Unpublished PhD dissertation, University College London, 2013.

  10. 10.

    Padfield, D., J. M. Zakrzewska, and A. C. de C. Williams. “Do Photographic Images of Pain Improve Communication During Pain Consultations?” Pain Research & Management 20, no. 3 (2015): 123–128.

  11. 11.

    Padfield, D. Perceptions of Pain. 1st ed. (Stockport: Dewi Lewis Publishing, 2003).

  12. 12.

    Padfield, D, F. Janmohamed, and J. M. Zakrzewska, et al. “A Slippery Surface, Can Photographic Images of Pain Improve Communication in Pain Consultations?” International Journal of Surgery 8, no. 2 (2010): 144–150.

  13. 13.

    Bleakley, A. Association of Medical Humanities Conference Programme, 2015: 3.

  14. 14.

    Biro, D. “Psychological Pain: Metaphor or Reality?” In Pain and Emotion in Modern History, edited by R. Boddice (Basingstoke: Palgrave Macmillan, 2014), 53–65.

  15. 15.

    Biro (6): 104. Craig and Williams have also recently proposed expanding the IASP definition of pain to include a distressing experience associated with actual or potential tissue damage with sensory, emotional, cognitive and social components (A. C. de. C. Williams and K. D. Craig. Updating the Definition of Pain: Pain 157 (2016): 2420–2423.

  16. 16.

    Bourke, J . The Story of Pain: From Prayer to Painkillers (Oxford: Oxford University Press, 2014).

  17. 17.

    Good, B. J. Medicine, Rationality, and Experience: An Anthropological Perspective (Cambridge: Cambridge University Press, 1994).

  18. 18.

    Boddice, R., ed. Pain and Emotion in Modern History (Basingstoke: Palgrave Macmillan, 2014).

  19. 19.

    Kleinman, A. The Illness Narratives, Suffering, Healing & the Human Condition (USA: Basic Books, 1988).

  20. 20.

    Kleinman , A. “Catastrophe and Caregiving: The Failure of Medicine as an Art”. Lancet 371 (2008): 22–23.

  21. 21.

    Kleinman , A. “Care: In Search of a Health Agenda”. Lancet 386 (2015): 240–241.

  22. 22.

    Green, C. R. “Being Present: The Role of Narrative Medicine in Reducing the Unequal Burden of Pain”. Pain 152 (2011): 965–966.

  23. 23.

    Charon (5): 29.

  24. 24.

    Charon (5): 30.

  25. 25.

    Harrison, B. “Seeing Health and Illness Worlds—Using Visual Methodologies in a Sociology of Health and Illness: A Methodological Review”. Sociology of Health & Illness 24, no. 6 (2002): 856.

  26. 26.

    Spence , J. Putting Myself in the Picture (London: Camden Press, 1986).

  27. 27.

    Martin, R., and J. Spence . “New Portraits for Old: The Use of Camera in Therapy”. In Looking on: Images of Femininity in the Visual Arts and Media, edited by R. Betterton (London: Pandora, 1987), 267–279.

  28. 28.

    Dennett, T., “Jo Spence’s Auto-therapeutic Survival Strategies”. In Bell, S., and A. Radley , eds. “Representations of Illness and Disease”. Health 15, no. 3 (2011): 223–239.

  29. 29.

    Radley , A., and D. Taylor. “Images of Recovery: A Photoelicitation Study on the Hospital Ward”. Qualitative Health Research 13 (2003): 77–99.

  30. 30.

    Radley , A., D. Hodgetts, and A. Cullen. “Visualising Homelessness: A Study of Photography and Estrangement”. Journal of Community and Applied Social Psychology 15 (2005): 273–295.

  31. 31.

    Radley , A. Works of Illness: Narrative, Picturing and the Social Response to Serious Disease (Ashby–de-la-Zouch, UK: InkerMen Press, 2009).

  32. 32.

    Radley, A. “What People Do with Pictures”. Visual Studies 25, no. 3 (2010): 268–279.

  33. 33.

    Henriksen, N., T. Tjornhoj-Thomsen, H. Ploug Hansen. “Illness, Everyday Life and Narrative Montage: The Visual Aesthetics of Cancer in Sara Bro’s Diary”. In Bell, S., and A. Radley , eds. “Representations of Illness and Disease”. Health 15, no. 3 (2011): 277–297.

  34. 34.

    Willenfelt, J. “Documenting Bodies: Pain Surfaces”. In Pain and Emotion in Modern History, edited by R. Boddice (Basingstoke; New York: Palgrave Macmillan, 2014), 260–276 (or do I use Boddice (18) here?).

  35. 35.

    Collen, M. “Life of Pain, Life of Pleasure: Pain from the Patients’ Perspective – The Evolution of the PAIN Exhibit”. Journal of Pain & Palliative Care Pharmacotherapy 19, no. 4 (2005): 45–52.

  36. 36.

    Collen, M. PAIN. http://painexhibit.org/ accessed 5th August 2014.

  37. 37.

    Main, S. “Picturing Pain: Using Creative Methods to Communicate the Experience of Chronic Pain”. Pain News no. 1 (2012): 32–35. http://www.britishpainsociety.org/bps_nl_vol12_issue1.pdf

  38. 38.

    Gonzalez-Polledo, E., and J. Tarr. “The Thing About Pain: The Remaking of Illness Narratives in Chronic Pain Expression on Social Media”. Newmedia & Society (2014): 1–18.

  39. 39.

    Davis, F. D. “The Problem of Pain”. In Maldynia, Multidisciplinary Perspectives on the Illness of Chronic Pain, edited by J. Giordano (New York: Taylor & Francis, 2011), 243–255.

  40. 40.

    Wilkinson, M., and D. Robinson. “Migraine Art”. Cephalalgia 5, no. 3 (1985): 151–157.

  41. 41.

    Broadbent, E., K. Niederhoffer, and T. Hague, et al. “Headache Sufferers’ Drawings Reflect Distress, Disability and Illness Perceptions”. Journal of Psychosomatic Research 66 (2009): 465–470.

  42. 42.

    Maclean, S. “Exploring the Use of Drawings for Patients Communicating Chronic Pain to Healthcare Professionals”. Pain News Winter (2009): 34–37. http://www.britishpainsociety.org/bps_nl_winter_2009.pdf

  43. 43.

    Geller, B. “The PainT project”. Pain News Winter (2011): 42–43. http://www.britishpainsociety.org/bps_nl_winter_2011.pdf

  44. 44.

    McMahon, E., L. Wilson-Pauwels, J. Henry, et al. “The Iconic Pain Assessment Tool: Facilitating the Translation of Pain Sensations and Improving Patient-Physician Dialogue”. Journal of Bio-Communication 34, no. 2 (2008): E20–E24.

  45. 45.

    Lalloo, C., and J. L. Henry. “Evaluation of the Iconic Pain Assessment Tool by a Heterogeneous Group of People in Pain”. Pain Research and Management 16, no. 1 (2011): 13–18.

  46. 46.

    Stones, C. “Positively Picturing Pain? Using Patient-Generated Pictures to Establish Affective Visual Design Qualities”. International Journal of Design 7, no. 1 (2013): 85–97.

  47. 47.

    Closs, S. J., P. Knapp, S. Morely, et al. “Can Pictorial Images Communicate the Quality of Pain Successfully?” British Journal of Pain (2015): 1–8.

  48. 48.

    Dannequin, L. Hardy Animal. AMH Conference 2015.

  49. 49.

    Eisenberger, N. I., M. D. Lieberman, and K. D. Williams. “Does Rejection Hurt? An FMRI Study of Social Exclusion”. Science 302, no. 5643 (2003): 290–292.

  50. 50.

    Tracey, I. “Objectifying Pain Through Brain Imaging”. In Narrative Pain and Suffering: Progress in Pain Research and Management, edited by D. Carr, J. Loeser, and D. Morris , vol. 34 (Seattle, USA: IASP Press, 2005), 137.

  51. 51.

    Carr, D., J. Loeser, and D. Morris , eds. Narrative Pain and Suffering: Progress in Pain Research and Management. Vol. 34 (Seattle, USA: IASP Press, 2015).

  52. 52.

    Tracey, I., and P. Mantyh. “The Cerebral Signature for Pain Perception and Its Modulation”. Neuron 55(Aug. 2, 2007): 377–391.

  53. 53.

    Wiech, K., and I. Tracey. “The Influence of Negative Emotions on Pain: Behavioral Effects and Neural Mechanisms”. NeuroImage 47 (2009): 987–994.

  54. 54.

    McMahon, S. B., and M. Koltzenburg. Textbook of Pain. 5th ed. (London: Elsevier, 2006).

  55. 55.

    Jones, D. “Portraits of Pain”. Lancet 378, no. 9789 (July 30, 2011): 391.

  56. 56.

    Elkins, J. Pictures of the Body: Pain and Metamorphosis (Stanford: Stanford University Press,1999): 1.

  57. 57.

    Padfield, D., and J. M. Zakrzewska. “Encountering Pain”. Lancet 2017: 389 (in press).

  58. 58.

    Semino, E., J. M. Zakrzewska, and A. Williams. “Images and the Dynamic of Pain Consultations”. Lancet 389 (2017): 1186–1187.

  59. 59.

    Padfield, D., T. Chadwick, and H. Omand. “The Body as Image: Image as Body” 2017: 389 (in press).

  60. 60.

    Radley (44): 270.

  61. 61.

    Radley (44): 270.

  62. 62.

    Tagg, J. “Power and Photography: Part One, A Means of Surveillance: The Photograph as Evidence in Law”. Screen Education 36 (autumn 1980): 17–55.

  63. 63.

    Tagg, J. The Disciplinary Frame: Photographic Truths and the Capture of Meaning (Minneapolis: University of Minnesota Press, 2009), 1.

  64. 64.

    Padfield, D. “Representing the ‘Pain of Others’”. In Bell, S., and A. Radley , eds. “Another Way of Knowing; Art, Disease and Illness”. Health 15, no. 3 (2011): 241–258.

  65. 65.

    Gell, A. Art and Agency, An Anthropological Theory (New York; Oxford: Clarendon Press, 1998).

  66. 66.

    Carlin, N., and T. Cole. “Maldynia as Muse: A Recent Experiment in the Visual Arts and Medical Humanities. In Maldynia, Multidisciplinary Perspectives on the Illness of Chronic Pain, ed. J. Giordano (New York: Taylor & Francis, 2011), 105. 67.

  67. 67.

    Pither, C. “Pain Clinic is Not a Place for Diagnosis”. Pain News (Winter 2011): 21.

  68. 68.

    Gilbert, M. Saving Faces. Exhibition of portraits by Mark Gilbert. National Portrait Gallery, London, 2002.

  69. 69.

    Sontag , S. On Photography (London: Penguin, 1978).

  70. 70.

    Carlin & Cole (20): 105.

  71. 71.

    Kosloff, M. “Real Faces”. In Lone Visions, Crowded Frames: Essays on Photography (Albuquerque: University of New Mexico Press, 1994), 76–78.

  72. 72.

    Fletcher, J. “Sweet Liberties: Narratives of Resistance and Desire”. In Masquerade: Women’s Contemporary Portrait Photography, edited by K. Newton and C. Rolph (Cardiff: Ffotogallery Publishing, 2003), 51.

  73. 73.

    Stahl , D. “Living into the Imagined Body: How the Diagnostic Image Confronts the Lived Body”. Medical Humanities 39 (2013): 5358.

  74. 74.

    Stahl (84): 53–54.

  75. 75.

    Bleakley (13): 11.

Acknowledgments

This work was completed as part of Deborah Padfield’s PhD thesis under the primary supervision of Prof Sharon Morris, Slade Deputy Director, Slade School of Fine Art. Her PhD was funded by the Arts and Humanities Research Council, UK. We are grateful to all the patients and clinicians who participated in the study and to Prof Alan Radley and Dr Deborah Kirklin for their valuable comments on earlier drafts.

Competing Interests

Neither of the authors has any conflict of interest to disclose.

Funding

Arts & Humanities Research Council (AHRC) and Arts Council England (ACE). Deborah Padfield was supported by the AHRC and by a Centre for Humanities Interdisciplinary Research Fellowship (CHIRP) from University College London (UCL), and Joanna Zakrzewska was supported by the National Institute for Health Research University College London Hospitals (UCLH) Biomedical Research Centre while carrying out this research.

The multidisciplinary analyses were supported by the Friends UCH and by Grand Challenges, UCL.

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Padfield, D., Zakrzewska, J.M. (2018). Face2face: Sharing the Photograph Within Medical Pain Encounters—A Means of Democratisation. In: Gonzalez-Polledo, E., Tarr, J. (eds) Painscapes. Palgrave Macmillan, London. https://doi.org/10.1057/978-1-349-95272-4_10

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  • DOI: https://doi.org/10.1057/978-1-349-95272-4_10

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