Vicissitudes of pain and suffering: chronic pain and liminality

This article looks at how the Finnish experience of chronic pain is shaped by socio-cultural practices. Along with the ambiguity that is necessarily present in all chronic illnesses, the invisibility of chronic pain blurs biomedical categorization and confuses diagnostics. This results in a double delegitimation--that of suffering a chronic illness and that of suffering chronic pain--which, obviously, has a serious effect on one's experience of pain as well as on one's self-identity. I draw upon data collected from my interviews (conducted in a pain clinic in Finland) with patients who, for years, have suffered from chronic pain. People who are in pain feel that they have lost something precious, and, as a result, their subjectivity--their sense of who they are--becomes altered. This finding is in keeping with what we have learned from previous studies of chronicity. However, unlike Sue Estroff's (1993) and Jean Jackson's (1994) findings with regard to chronic illness (i.e., that it may be specifically located on a continuum of subjectness), my findings with regard to chronic pain indicate that it is ambiguous, that it involves a continuous back-and-forth movement along a continuum of subjectness. This movement involves reconciling one's self with, as well as distancing one's self from, pain; and it reflects the biomedical construction of chronic pain. In contrast to those narrative studies of chronic illness that represent illness as a "biographical disruption," my interviews with Finnish patients indicate that those living with chronic pain experience continual disruptions--chronic pain being one among many.