Psy-Knowledge and the Problem of ‘Pain Without Lesion’
Date
2022-12-16
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Abstract
This thesis examines the two most significant responses to the problem of pain without lesion by the Western psy-complex in the last 150 years. Through a close reading of disciplinary discourses, it specifically examines the differential techniques and vocabularies deployed by expert practitioners of psychoanalytic psychiatry (1895 – 1961) and cognitive psychology (1963 – 1995) in their efforts to render pain without lesion, a definitionally intangible and subjective phenomenon, into an identifiable, knowable, and workable entity. In doing so, I examine the way that the mind was brought into the question of pain by influential psychiatrists and psychologists: Freud, H.S. Sullivan, and Szasz in psychiatry, and Ellis, Beck, and M.J. Sullivan in cognitive psychology. In psychoanalytic psychiatry, pain without lesion was understood as a symptom of hysteria, which was caused by the unconscious conversion of emotional suffering into physical pain. The goal of psychoanalytic treatment was to increase patients’ self-knowledge and help them experience a broader range of emotions. Addressing chronic pain, cognitive psychology focussed instead on “pain cognitions,” peoples’ mental and emotive reactions to pain. The goal of their treatment was to teach patients how to monitor their thoughts so that they could identify and change cognitions that made pain worse. In this thesis, I consider the implication of these discourses in shaping the range of possible experience for those in pain, the assumptions they reveal about human nature and responsibility, and the degree to which they do and do not consider those in pain as socially positioned. I argue that the cognitive approach to pain without lesion is less equipped to consider aspects of the patient’s lifeworld that were once important in psychoanalytic considerations of pain, and that revisiting psychoanalytic ideas regarding the relationships between mind, pain, and the lifeworld may benefit contemporary pain researchers.
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Sociology of medicine, Sociology of knowledge, Chronic pain, Pain without lesion, Pain catastrophizing, Psy-complex
Citation
Knox, E. (2022). Psy-knowledge and the problem of ‘pain without lesion’ (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.