Padfield Deborah, Omand Helen, Semino Elena, Williams Amanda C de C, Zakrzewska Joanna M
Slade School of Fine Art, University College London, London, UK.
Institute of Medical and Biomedical Education, St George's, University of London, London, UK.
Med Humanit. 2018 Jun;44(2):74-81. doi: 10.1136/medhum-2017-011415. Epub 2018 Jun 12.
The challenge for those treating or witnessing pain is to find a way of crossing the chasm of meaning between them and the person living with pain. This paper proposes that images can strengthen agency in the person with pain, particularly but not only in the clinical setting, and can create a shared space within which to negotiate meaning. It draws on multidisciplinary analyses of unique material resulting from two fine art/medical collaborations in London, UK, in which the invisible experience of pain was made visible in the form of co-created photographic images, which were then made available to other patients as a resource to use in specialist consultations. In parallel with the pain encounters it describes, the paper weaves together the insights of specialists from a range of disciplines whose methodologies and priorities sometimes conflict and sometimes intersect to make sense of each other's findings. A short section of video footage where images were used in a pain consultation is examined in fine detail from the perspective of each discipline. The analysis shows how the images function as 'transactional objects' and how their use coincides with an increase in the amount of talk and emotional disclosure on the part of the patient and greater non-verbal affiliative behaviour on the part of the doctor. These findings are interpreted from the different disciplinary perspectives, to build a complex picture of the multifaceted, contradictory and paradoxical nature of pain experience, the drive to communicate it and the potential role of visual images in clinical settings.
对于那些治疗疼痛或见证疼痛的人来说，挑战在于找到一种方法，跨越他们与疼痛患者之间意义的鸿沟。本文提出，图像可以增强疼痛患者的能动性，尤其是在临床环境中，但不仅限于此，并且可以创造一个共享空间，在其中协商意义。它借鉴了对英国伦敦两个美术/医学合作项目所产生的独特材料的多学科分析，在这些项目中，疼痛的无形体验以共同创作的摄影图像的形式变得可见，这些图像随后作为一种资源提供给其他患者，供他们在专科会诊中使用。与它所描述的疼痛遭遇并行，本文将一系列学科专家的见解编织在一起，这些学科的方法和重点有时相互冲突，有时相互交叉，以便理解彼此的发现。从每个学科的角度对一段在疼痛会诊中使用图像的短视频片段进行了详细审视。分析表明图像如何作为“交易对象”发挥作用，以及它们的使用如何与患者谈话量和情感披露的增加以及医生更多的非语言亲和行为相吻合。从不同的学科视角对这些发现进行了解读，以构建一幅关于疼痛体验的多面、矛盾和悖论性质、传达疼痛体验的动力以及视觉图像在临床环境中潜在作用的复杂图景。
