‘Barbed wire wrapped around my feet’: Metaphor use in chronic pain

Abstract

Objectives. As there is no objective test for pain, sufferers rely on language to communicate their pain experience. Pain description frequently takes the form of metaphor; however, there has been limited research in this area. This study thus sought to extend previous findings on metaphor use in specific pain subgroups to a larger, heterogeneous chronic pain sample, utilizing a systematic method of metaphor analysis. Design. Conceptual metaphor theory was utilized to explore the metaphors used by those with chronic pain via qualitative methodology. Methods. An anonymous online survey was conducted which asked for the descriptions and metaphors people use to describe their pain. Systematic metaphor analysis was used to classify and analyse the metaphors used into specific metaphor source domains. Results. Participants who reported chronic pain completed the survey (N = 247, age 19-78, M = 43.69). Seven overarching metaphor source domains were found. These were coded as Causes of Physical Damage, Common Pain Experiences, Electricity, Insects, Rigidity, Bodily Misperception, and Death and Mortality. Conclusions. Participants utilized a wide variety of metaphors to describe their pain. The most common descriptions couched chronic pain in terms of physical damage. A better understanding of pain metaphors may have implications for improved health care communication and provide targets for clinical interventions. Statement of contribution What is already known on this subject? There is no objective test for the existence or nature of pain. Chronic pain sufferers regularly use metaphor to describe their pain. Metaphor use in chronic pain has not been comprehensively examined. What does this study add? A systematic analysis of pain metaphors in a heterogeneous chronic pain sample. A taxonomy of pain metaphors, which has the potential to enhance communication in health settings. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Understanding Youth’s Lived Experience of Anxiety through Metaphors: A Qualitative, Arts-Based Study

“…In this way, metaphorical language stabilizes chaos and instils a sense of control by capturing what is impossible to describe literally [ 42 , 43 ]. Across illness experiences, metaphors have proven to be essential to the way patients make sense and communicate about their illness, including its physical, emotional, and psychological implications [ 42 , 44 , 45 , 46 , 47 , 48 , 49 ].…”

Parallel worlds and personified pain: A mixed‐methods analysis of pain metaphor use by women with endometriosis

“…Pain was frequently discussed in terms of a malevolent external attacker ( pain as external animate agent metaphor), a description that may reflect a conceptualization of pain as distinct from the self. This is reflected in a study conducted by Munday, Newton‐John, and Kneebone (2020), in which a large corpus of self‐reported descriptions of pain by 247 people with chronic pain (not endometriosis‐specific) was reviewed for common overarching source domains. This work indicated that the domain of an external attacker was the most frequent metaphorical reference to pain and demonstrates the shared experience of such conceptualizations across people with endometriosis pain and non‐endometriosis pain, with personification of pain potentially creating a separation from a healthy, pain‐free self (Munday et al ., 2020).…”

“…Further, this perception could represent the belief in pain as punishment and that they are passive ‘victims’ (Graham, Horne, & Brown, 2019), which may pose a threat to the well‐being of those who perceive their endometriosis in this way and may even cause women to delay seeking medical assistance thereby prolonging diagnosis even further. Indeed, references to being in so much pain ‘you’d think you were dying’ may reflect a perception of pain being so intense that it could only be communication through death itself (Munday et al ., 2020). Such negative personification of pain is a demonstrated predictor of pain‐related distress, depression, and illness intrusiveness (Schattner & Shahar, 2011) and could indicate catastrophic thinking and concerns that warrant additional attention, therefore highlighting targets for future work to examine.…”

“…Sensitivity to the role of language in clinical and social encounters is vital in ensuring that women with endometriosis feel heard. Making health professionals aware of the valuable insights presented in this study may help to enhance doctor–patient communication, with health professionals being less likely to dismiss, minimize, or misunderstand pain when it is expressed through metaphor (Munday et al ., 2020). The integration of metaphor in endometriosis pain education and assessment tools could provide benefits in understanding and communicating pain to others, by going beyond single word descriptors (e.g., the MPQ) and providing a richer range of metaphors to choose from, as reflected in Semino’s (2014) work with the ‘metaphor menu’ for pain communication in cancer patients.…”

Metaphoric Perceptions of Covid-19 Patients Related to the Disease

“…The questionnaire was prepared by the researchers following a thorough search of the literature and included five demographic characteristics, age, gender, education, and living place (Chung et al, 2020;Munday et al, 2020;Rajkumar, 2020). To determine the metaphorical sense, participants were asked to fill in the blanks in the statements below:…”