Talking about pain

There are two major factors that will impact on how your talking about pain is understood. One of these is who you are considered to be, and the other is whether you fit into expectations of pain communication. This happens in medical settings and also in any other context where talking about pain might be a thing.

Women have a much harder time of it than men getting pain taken seriously. Black women have an appalling hard time of it getting pain taken seriously. If you are perceived as drug seeking, attention seeking or fuss making you won’t get your pain taken seriously – this can often affect people with mental illness and neurodivergence, or anyone else who might be stigmatised. Sexism and racism inform how people interpret expressions of pain. Anyone who experiences prejudice is likely to find that prejudice shows up when they express pain and results in minimising, dismissal and a lack of help.

How you express pain and how that fits with expectations has a big impact on whether you get taken seriously. There are two particular groups I’m aware of that suffer around this. Neurodivergent people don’t express themselves in the same way as neurotypical people. A monotone speaking voice, or not using your vocal chords in the expected way can go against you. People with chronic illness have similar issues – when you live with pain all the time you don’t go around crying and screaming over the things that would make normally pain-free people cry and scream. So you aren’t believed.

I’ve had plenty of first hand experience of saying ‘my whole body hurts’ and being met with disbelief. I can say that calmly, because mostly I communicate calmly. It happened to me while I was giving birth. I expressed my distress in a calm voice and no one took me seriously. I got most of the way to being ready to push with no support or pain relief as a consequence.

If someone is expressing that they are in more pain than they can bear, then how they express that should not be the most important thing. Pain relief is widely available in many forms. There’s nothing weak or immoral about wanting it. The only consideration should be safe dosage. And yet, all too often for too many people, pain is dismissed or ignored. Why on earth would it even make sense to judge a person’s pain on how it compares to pain some imaginary other person might experience? Why should how normal or credible we find someone’s pain expression to be – which is so subjective – be a measure of what help they deserve?

Oh, but some people make a fuss about nothing.

Why does that external judgement carry so much weight against reported suffering? Why does it even matter? Pain relief isn’t a rare thing, it’s not massively expensive. Kindness isn’t a finite commodity. It’s much more important to ask why some people are taken more seriously than others, how privilege informs this, and how we ignore the presence of our own prejudices and assumptions when we downplay someone else saying they are in unbearable pain.