The Challenge of Validating the Experience of Chronic Pain: The Importance of Intersubjectivity and Reframing

Abstract

A fundamental tenet of Western biomedicine is the validation of a patient’s predicament by the clinician through demonstration of a disease process underlying illness. For the person experiencing chronic pain, however, the absence of demonstrable pathophysiological evidence of disease is a challenge to the clinician’s ability to discharge that role. What may not have been appreciated is that the reverse situation can also hold true, insofar as the patient cannot validate the clinician as possessing sufficient knowledge and expertise to relieve their pain. In an effort to understand and remediate this impasse, this chapter explores the dynamics of the clinical encounter through the lens of the French sociologist Pierre Bourdieu, and examines the effects on the players when dealing with the aporia of pain. Then, in the novel approach of reframing the field of the clinical encounter through considerations of intersubjectivity, empathy and prospection, ethical possibilities for clinician and patient to achieve mutual validation of their predicaments are canvassed.