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Seeking Order Amidst the Chaos: The Role of Metaphor Within Pain Reconceptualisation

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Meanings of Pain

Abstract

Communication is a fundamental component of rehabilitation. Without it, it does not matter what we know. The profoundly complex and idiosyncratic nature of pain experiences often requires the use of metaphoric expressions. Metaphors enable us to link the abstract to what is already known. We use metaphors when conveying experiences that are most resistant to expression. Pain is one such experience. In order to make sense of the distress and confusion that pain often brings, many people turn to metaphors. Healthcare professionals (HCPs) use metaphors to transfer abstract scientific knowledge into meaningful cognitions. However, whilst some metaphors are explicit in their execution, many remain characteristically concealed and many HCPs remain unaware of both the power of language and how best to use metaphors within clinical practice. Through exploring the implicit nature of metaphors clinicians, researchers and people in pain may develop strategies to bridge the communication divide and begin to make sense of their experiences.

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References

  • Ashwin P (2002) Implementing peer learning across organisations: the development of a model. Mentor Tutor 10(3):221–231

    Article  Google Scholar 

  • Banville J (1998) Beauty, charm, and strangeness: science as metaphor. Science 281(5373):40–41

    Article  CAS  Google Scholar 

  • Bennett MR, Hacker P (2003) Philosophical foundations of neuroscience. Blackwell, Oxford

    Google Scholar 

  • Biro D (2010) The language of pain. W.W Norton and Company, New York

    Google Scholar 

  • Bourke J (2014) The story of pain. Oxford University Press, London

    Google Scholar 

  • Bullington J, Nordemar R, Nordemar K (2003) Meaning out of chaos: a way to understand chronic pain. Scand J Caring Sci 12(4):17–21

    Google Scholar 

  • Butler DS, Moseley L (2003) Explain pain. Noigroup Publications, Adelaide

    Google Scholar 

  • Chan Z (2013) Exploring creativity and critical thinking in traditional and innovative problem-based learning groups. J Clin Nurs. doi:10.1111/jocn.12186

    Google Scholar 

  • Clarke A, Anthony G, Gray D, Jones D, Mcnamee P, Schofield P, Smith B, Martin D (2012) “I feel so stupid because I can’t give a proper answer…” How older adults describe chronic pain: a qualitative study. BMC Geriatr 12(1):78–84

    Google Scholar 

  • Clow B (2001) Who’s afraid of Susan Sontag? Or, the myths and metaphors or cancer reconsidered. Soc Hist Med 14(2):293–312

    Article  CAS  PubMed  Google Scholar 

  • Colameco S (2012) Chronic pain: a way out. Createspace Publishing, Charleston

    Google Scholar 

  • Daloz L (1999) Mentor: guiding the journey of adult learners. Jossey-Bass, San Francisco

    Google Scholar 

  • Darlow B, Dowell A, Baxter G, Mathieson F, Perry M, Dean S (2013) The enduring impact of what clinicians say to people with low back pain. Ann Fam Med 11(6):527–534

    Article  PubMed  PubMed Central  Google Scholar 

  • Darlow B, Dean S, Meredith P, Mathieson F, Baxter G, David D, Dowell A (2015) Easy to harm, hard to heal: patient views about the back. Spine 40(11):842–850

    Article  PubMed  Google Scholar 

  • Demertzi A, Liew C, Ledoux D, Bruno M, Sharpe M, Laureys S, Zeaman A (2009) Dualism persists in the science of mind. Ann NY Acad Sci 1157:1–9

    Article  PubMed  Google Scholar 

  • Dewey J (1933) How we think. A restatement of the relation of reflective thinking to the educative process. D. C. Heath, Boston

    Google Scholar 

  • Dow C, Roche P, Ziebland S (2012) Talk of frustration in the narratives of people with chronic pain. Chronic Illn 8(3):134–145

    Article  Google Scholar 

  • Eccleston C, Crombez G (2007) Worry and chronic pain: a misdirected problem solving model. Pain 132(3):233–236

    Article  PubMed  Google Scholar 

  • Edelson JT (1984) Metaphor, medicine and medical education. Pharos 47(2):16–21

    CAS  PubMed  Google Scholar 

  • Foreman J (2014) A nation in pain. Healing our biggest health problem. Oxford University Press, London

    Google Scholar 

  • Gallagher L, McAuley J, Moseley L (2013) A randomized-controlled trial of using a book of metaphors to reconceptualize pain and decrease catastrophizing in people with chronic pain. Clin J Pain 29(1):20–25

    Article  PubMed  Google Scholar 

  • Geary J (2011) I is an other. The secret life of metaphor and how it shapes the way we see the world. Harper Collins, London

    Google Scholar 

  • Gray R, Fergus K, Fitch M (2005) Two black men with prostate cancer: a narrative approach. Br J Health Psychol 10:71–84

    Article  PubMed  Google Scholar 

  • Haigh C, Hardy P (2011) Tell me a story—a conceptual exploration of storytelling in healthcare education. Nurse Educ Today 31(4):408–411

    Article  PubMed  Google Scholar 

  • Harden RM, Crosby J (2000) The good teacher is more than a lecturer: the twelve roles of the teacher. Med Teach 22(4):334–347

    Google Scholar 

  • Hartley T (2012) Cutting edge metaphors. J Assoc Surg GB Irel 37:26–29

    Google Scholar 

  • Hayes S, Strosahl K, Wilson K (2004) Acceptance and commitment therapy. Guilford Press, Cambridge

    Book  Google Scholar 

  • Hejmadi AV, Lyall PJ (1991) Autogenic metaphor resolution. In: Bretto C et al (eds) Leaves before the wind. Bonny Doon. Grinder, DeLozier and Associates, New York

    Google Scholar 

  • Hinchliff S (2004) The practitioner as teacher, 3rd edn. Churchill Livingstone, London

    Google Scholar 

  • Hurwitz B (2003) Looking at pain. In: Padfield D (ed) Perceptions of pain, 1st edn. Dewi Lewis Publishing, Stockport

    Google Scholar 

  • Hussain A, Erdek M (2014) Interventional pain management for failed back surgery syndrome. Pain Pract 14(1):64–78

    Article  PubMed  Google Scholar 

  • Kenny D (2004) Constructions of chronic pain in doctor-patient relationships: bridging the communication chasm. Patient Educ Couns 52:297–305

    Article  PubMed  Google Scholar 

  • Kopp R (1995) Metaphor therapy: using client-generated metaphors in psychotherapy. Brunner, New York

    Google Scholar 

  • Lakoff G, Johnson M (1980) Metaphors we live by. University of Chicago Press, Chicago

    Google Scholar 

  • Laranjeira C (2013) The role of narrative and metaphor in the cancer life story: a theoretical analysis. Med Healthc Philos 16(3):165–172

    Google Scholar 

  • Linton S (2005) Understanding pain for better clinical practice. A psychological perspective. Elsevier, London

    Google Scholar 

  • Loftus S (2011) Pain and its metaphors: a dialogical approach. J Med Hum 32:213–230

    Article  Google Scholar 

  • Mantel H (2013) How much pain is too much pain? IASP Insight Mag 2(1):8–12

    Google Scholar 

  • McMahon L, Murray C, Sanderson J (2012) “Governed by the pain”: narratives of fibromyalgia. Disabil Rehabil 3(16):1358–1366

    Google Scholar 

  • Melzack R (1999) From the gate to the neuromatrix. Pain Suppl 6:121–126

    Article  Google Scholar 

  • Melzack R (2005) Evolution of the neuromatrix theory of pain. Pain Pract 5(2):85–94

    Article  PubMed  Google Scholar 

  • Melzack R, Wall PD (1965) Pain mechanisms: a new theory. Science 150(699):971–979

    Article  CAS  PubMed  Google Scholar 

  • Moseley GL (2003) A pain neuromatrix approach to patients with chronic pain. Man Ther 8(3):130–140

    Article  CAS  PubMed  Google Scholar 

  • Moseley L (2007) Painful Yarns: metaphors and stories to help understand the biology of pain. Dancing Giraffe Press, Canberra

    Google Scholar 

  • Neilson S (2015) Pain as metaphor: metaphor and medicine. Med Hum. doi:10.1136/medhum-2015-010672

    Google Scholar 

  • Nguyen N, Umemoto K (2012) Leading with metaphoric intelligence. J Leadersh Stud 5(4):41–51

    Article  Google Scholar 

  • Padfield D, Janmohamed F, Zakrzewska J, Pither C, Hurwitz B (2010) A slippery surface: can photographic images of pain improve communication in pain consultations? Int J Surg 8(2):144–150

    Article  PubMed  Google Scholar 

  • Paivio A, Walsh M (1993) Psychological processes in metaphor comprehension and memory. In: Ortony A (ed) Metaphor and thought. Cambridge University Press, New York, pp 307–328

    Chapter  Google Scholar 

  • Quintero GA (2014) Medical education and the healthcare system—why does the curriculum need to be reformed? BMC Med 12:213. doi:10.1186/s12916-014-0213-3

    Article  PubMed  PubMed Central  Google Scholar 

  • Rathmell JP (2006) Review of Wall and Melzack’s textbook of pain, 5th edition. Anesth Analg 102:1914–1915

    Article  Google Scholar 

  • Reisfield G, Wilson G (2004) Use of metaphor in the discourse on cancer. J Clin Oncol 22(1):28–39

    Google Scholar 

  • Scarry E (1985) The body in pain: the making and unmaking of the world. Oxford University Press, New York

    Google Scholar 

  • Semino E (2011) The adaptation of metaphors across genres. Rev Cogn Linguist 9(1):130–152

    Article  Google Scholar 

  • Shinebourne P, Smith J (2010) The communicative power of metaphors: an analysis and interpretation of metaphors in accounts of the experience of addiction. Psychol Psychother Theory Res Pract 83:59–73

    Article  Google Scholar 

  • Singer I (2001) Modes of creativity. Philosophical perspectives. MIT Press, Cambridge

    Google Scholar 

  • Solberg H, Nysether G, Steinsbekk A (2012) Patients’ experiences with metaphors in a solution-focused approach to improve self-management skills: a qualitative study. Scand J Public Health 40:398–401

    Article  PubMed  Google Scholar 

  • Sontag S (1978) Illness as metaphor. Oxford University Press, Oxford

    Google Scholar 

  • Southall D (2012) The patient’s use of metaphor within palliative care settings: theory, function and efficacy. A narrative literature review. Palliat Med 27:304–313

    Google Scholar 

  • Stewart M (2014) The road to pain reconceptualisation: do metaphors help or hinder the journey? J Physiother Pain Assoc 36:24–31

    Google Scholar 

  • Stewart M (2015) The hidden influence of metaphor within rehabilitation. In Touch 153:8–13

    Google Scholar 

  • Stones C, Cole F (2014) Breaking the cycle: extending the persistent pain cycle diagram using an affective pictorial metaphor. Health Commun 29(1):32–40

    Google Scholar 

  • Taylor P (1984) Metaphors of educational discourse. In: Taylor W (ed) Metaphors of education. Heineman, London, pp 4–20

    Google Scholar 

  • Thacker MA, Moseley GL (2012) First-person neuroscience and the understanding of pain. Med J Aust 196(6):410–411

    Google Scholar 

  • Tompkins P, Lawley J (2002) The mind, metaphor and health. Posit Health 78:16–19

    Google Scholar 

  • Turner J (2014) Metaphors and therapeutic encounters in mental health nursing. Ment Health Nurs (Online) 34(3):95–99

    Google Scholar 

  • Van Damme S, Crombez G, Van Houdenhove B, Mariman A, Michielsen W (2006) Well-being in patients with chronic fatigue syndrome: the role of acceptance. J Psychosom Res 61:595–599

    Article  PubMed  Google Scholar 

  • Warmington S (2012) Practicing engagement: infusing communication with empathy and compassion in medical students’ clinical encounters. Health 16(3):327–342

    Article  PubMed  Google Scholar 

  • Wiggins NM (2012) Stop using military metaphors for disease. Br Med J 345(7867):31

    Google Scholar 

  • Wilgen C, Keizer D (2012) The sensitization model to explain how chronic pain exists without tissue damage. Pain Manag Nurs 13(1):60–65

    Article  PubMed  Google Scholar 

Download references

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Authors and Affiliations

  1. Faculty of Health and Social Science, School of Health Sciences, University of Brighton, 49 Darley Road, Eastbourne, BN207UR, East Sussex, UK

    Mike Stewart

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  1. Mike Stewart
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Correspondence to Mike Stewart .

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Editors and Affiliations

  1. School of Humanities, Department of Philosophy and Gender Studies, University of Tasmania, Tasmania, Australia

    Simon van Rysewyk

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Stewart, M. (2016). Seeking Order Amidst the Chaos: The Role of Metaphor Within Pain Reconceptualisation. In: van Rysewyk, S. (eds) Meanings of Pain. Springer, Cham. https://doi.org/10.1007/978-3-319-49022-9_20

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