On the first page, Morris summarizes his project in this book: to "describe how the experience of pain is decisively shaped or modified by individual human minds and by specific human cultures. It explores what we might call the historical, cultural, and psychosocial construction of pain." Contemporary Western culture tries to convince us that pain is nothing but an aspect of disease and, therefore, a medical problem. But pain only exists in human experience; nerve impulses are not pain.

In calling our attention to the social and cultural meanings of pain, Morris begins with Tolstoy's short novel, The Death of Ivan Ilyich (see this database). He then presents various images of human suffering: gender-based pain, as in Charlotte Perkins Gilman's, The Yellow Wallpaper (see this database: annotated by Felice Aull, also annotated by Jack Coulehan); religious views, as in the stories of Job and the Christian martyrs; the aesthetic ideal, as manifested in the romantic idea of the sublime as painful; social uses, as in satire and torture (see Kafka's In the Penal Colony, annotated in this database); the relationship between pain and sex, as in the work of Marquis de Sade; and tragic pain, as evidenced in Sophocles' Philoctetes.

Throughout the book, Morris refers to the "invisible epidemic" of chronic pain that exists in the United States today. This epidemic of chronic pain can be adequately understood and treated only by approaching it with a cultural model, rather than a disease model.


Morris develops his thesis through a series of fascinating historical, literary, and cultural examples. The book's title can be understood in at least two ways: the cultural dimension of pain in general, or the particular "painfulness" of American culture. The latter meaning suggests an important concept that Morris develops in his final chapter; i.e. the attempt to make pain meaningless (except in purely neurochemical terms) has generated in our society an epidemic of "painfulness" that is poorly addressed by the biomedical model.

This book resonates well with Elaine Scarry's The Body in Pain and David Bakan's Disease, Pain, & Sacrifice (see entries in this bibliography), both of which deal on a more philosophical level with the meaning of pain. Likewise, see Arthur Kleinman, The Illness Narratives: Suffering, Healing & the Human Condition (Basic Books, New York, 1988) for a consideration of the same cultural issues, but based on individual patient narratives. Finally, Eric Cassell's The Nature of Suffering and the Goals of Medicine (see this database) presents a medical understanding of pain and suffering that acknowledges the need to approach human suffering on a symbolic level.


Univ. of California Press

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