Narrative and Pain: Towards an Integrative Model

Abstract

Doctors and health-care professionals have recently developed a vigorous new interest in narrative. The new medical interest (obvious in the titles and subtitles of research studies) follows the success of a so-called narrative turn in psychology, education, social sciences, political thought, policy analysis, law, theology, and cognitive science (The travelling concept of narrative, 2006, pp 20–41). A narrative turn has even supplied the framework for an entire rethinking of medical education and practice, as described in an important JAMA article on “narrative medicine” (Journal of the American Medical Association 286: 1897–1902, 2001). This new medical attention to narrative is international and cross-cultural. The British Medical Journal published a series of articles on “narrative-based medicine,” subsequently collected as a book (Narrative based medicine: Dialogue and discourse in clinical practice, 1998). It is now accurate, as awareness deepens, to speak of narrative-based medicines, plural, indigenous as well as postindustrial (The Permanente Journal 12: 88–96, 2008). Pain medicine too has begun to explore narrative. In 2005, the International Association for the Study of Pain published Narrative, Pain and Suffering (Narrative, pain, and suffering, 2005), and medical journals regularly include studies that employ narrative as an instrument for understanding pain and pain-related states. The traditional medical landscape—where narrative was barely tolerated as a sign of high culture—has changed forever.