Changing Pain


Bourke (2014) has a great chapter on metaphors and pain.

Stewart (2014) is also very good, he invokes Susan Sontag’s influential works on illnesses and metaphors.

Changing metaphors is a central tool for David Butler: ‘All pain descriptors are metaphors.’  Butler is very keen on teaching people to change their metaphors as a way of changing their pain experience.

The following quotes and Do’s and Don’ts are from Stewart 2014:

‘Meaningful communication is a key component of pain reconceptualisation.’

‘When expressing her personal account of healthcare delivery for cancer, Sontag (1978) argues that ‘the fight’ against cancer is both unhelpful and misleading. Instead, cancer should be viewed as a process that must be managed and not a battle that must be won. The parallels with the reconceptualisation of pain management are clear to see.’

‘They found a narrative approach to assessment, which embraced metaphoric expression, helped patients and clinicians make sense of pain.’

‘Continual, socratic exploration of the patient’s understanding of pain is an indispensable component of therapeutic pain reconceptualisation through metaphor.’

Metaphor Dos & Don’ts

  • Do Use metaphor sparingly, carefully, and respectfully, Don’t Mix and match your metaphors
  • Do Take metaphor far enough, Don’t Take metaphors too far
  • Do Think about metaphor’s connotations, Don’t Mistake metaphors for marketing language
  • Do Make metaphors culturally appropriate, Don’t Let metaphors stand alone
  • Do Prepare, test, and practice metaphors
  • Do Take metaphors in a given context
  • Do Use authentic metaphors

Distorted Body Maps

‘Illusory hand resizing has recently been found to relieve pain in hand OA.’  Gilpin et al 2014


‘The possibility of generating addiction and the potential for tolerance have made long-term use of opiates controversial.’ Cervelo 2012 p149

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