Most people with persistent pain have trained themselves to prepare for a doctor’s appointment.
They decide how much to say. They pre-select what pain scale number they’ll report. Pick a number high enough to be taken seriously, but low enough to avoid seeming dramatic. They worry they’ll be categorized as drug-seeking.They pick their clothes to appear functional, but not too functional. They rehearse their script, knowing their time with their doctor will be too brief.
This work becomes automatic, and it becomes exhausting.
This is a real component of pain, and it rarely gets acknowledged. I talk about this work with my clients all the time, and sometimes I’m lucky enough to help them prepare for upcoming appointments so that they can go in with a feeling of agency and clarity. I'm a medical sociologist by training, and my academic research was about how explanations of pain get produced and what happens to people when those explanations change. What I found, again and again, is that a great deal of the work of being in pain is social management. We manage other people's beliefs about whether our pain is real.
Nobody is born knowing how to do any of this - it’s a learned behavior. Somewhere along the way, we learn what counts as an acceptable amount of pain to have and how to mask it from the world.
This is most of what we talk about on Monday evenings in my drop-in Pain Group.
Each week, I pick a topic that's sociological in nature, give a short overview of what the literature says, and then we get into it, together. Nobody on that call needs the details of your backstory, they’re just there to listen and make space for the shared experience of being in a body that sometimes hurts.
