Where Does Your Pain End and the World Begin?

The missing social layer of chronic pain

Pain can often feel like the most private thing imaginable — it's an experience that lives in your body that no one else will ever feel. At least not in the exact same way.

And yet. Our experience of pain is in large part shaped from the outside in. The world around us determines how we make sense of, mitigate, and relate to our embodied sensations of discomfort. Cultural stories around pain, weakness, and bodies; the confines of the medical system; societal expectations around work and productivity — all of these contour the experience from the outside. As much as pain is internal and private, the structures of our society and the dynamics of our relationships play a large role in shaping it.

This is the part of my work that's hardest to explain without sounding like I'm about to assign you a reading list. Prior to that, I spent years practicing as a clinical bodyworker. I wrote a dissertation on this — medical sociology, the structural conditions that make certain kinds of pain visible or invisible, credible or dismissed. What those two things together taught me is that the question "what's actually mine here?" is one of the more useful ones a person in pain can ask. Not because it lets you off the hook, but because it puts the hook in the right place.

I think about this a lot in the Monday pain group, and it's a big part of what I find myself doing with people in individual sessions — trying to sort out: what's yours, what's the system's, and where do you actually have room to create change? I'm going to have more to say about that second part soon.