On Saying It Hurts: Performativity and Politics of Pain

Pain and pleasure affect us all. Knowing this with empathy, and acting upon it, civilises us. Without such empathy, pain can become a means of domination and injustice. Moreover, pain is expressed and responded to in all social contexts, and the word “pain” has diverse meanings, depending on the associated activities. To observe various ways in which we say that it hurts, and the many meanings of pain, I follow ordinary-language philosophy, particularly Ludwig Wittgenstein and John L Austin, and I consider a range of social and historical contexts, from the closest intimacy, everyday chatter, the clinic, and beyond, to the domain of public policy and human rights. This addresses our verbal expressions of pain, their lived contexts and effects, within relationships and among social groups, altering mutual obligations, eliciting actions and reactions, and thence creating moral, legal and political norms. My aim, then, is to consider the social and political implications of ordinary performative pain-talk, in particular regarding the relationship between pain and justice, public policy, human rights and law.Clinical Implications: Clinicians’ roles in disability assessment and pain management are often affected by extrinsic concerns such as financial incentives and the risks of substance abuse. This chapter addresses those complex issues, illustrating how they have arisen in particular historical circumstances, and with political and economic causes and consequences. While unable to provide ready-to-hand clinical solutions, a pragmatic ordinary-language approach to conversations and disagreements about pain helps to chart the grounds on which these matters are debated.