The Representation of Pain and Illness Narratives

The experience of pain is one of the most important symptoms of illness. It is, therefore, not surprising that from a medical perspective numerous taxonomies of pain representations are available which have resulted in detailed pain questionnaires. It is astonishing, however, that from a linguistic / discourse-analytic point of view hardly any investigations are to be found, al-though doctor-patient communication has been a central focus of discourse- analytic research for decades. In order to mitigate past research deficits three primary aspects are to be exam-ined in this project: First, the project will develop an empirically founded systematic description of the procedures which German- speaking humans actually use in order to describe pain of different kinds and quality. Both, lexicon, metaphors, metonymy as well as the use of paraphrases, reformulations, and presentation strategies are of interest in this connection. Secondly, the issue will be addressed, whether the forms of women`s pain descriptions differ from those by men. Gender-specific differences might have effects on the diagnosis, as the results of a discourse-analytic pilot project (Menz et al. 2002) indicate. Thirdly, a matter of special relevance is the question how the pain representations of the pa-tients are transferred into the institutional context. Which forms of the pain representation do experience which transformations and categorisations? This aspect is particularly important, since the idio-syncratic pain perception of individual patients has to be communicated here and must be transformed to a specific form of medical treatment. The study will be carried out within the framework of the Vienna school of critical discourse analysis and a medical-semiotic framework. It will be based on the following data sources: - Pain descriptions by female and male patients of an internal ward (tape-recorded and transcribed for the most part already) - Tape-recordings in two different outpatient pain clinics of the AKH (headache outpatient clinic of the University Clinic of Neurology; outpatient clinic of the Dept. of Physical Medicine and Rehabilitation) - Tape-recordings in two neurological wards of the University Clinic of Neurology - interviews with selected patients and doctors in attendance Apart from the examination of the research questions a primary goal of the planned study is to reach a better fitting between authentic, oral talk-in-interaction of the descriptions of pain with existing medical taxonomies and classifications.

The experience of pain is one of the most important symptoms of illness. It is, therefore, not surprising that from a medical perspective numerous taxonomies of pain representations are available which have resulted in detailed pain questionnaires. It is astonishing, however, that from a linguistic / discourse-analytic point of view hardly any investigations are to be found, al-though doctor-patient communication has been a central focus of discourse- analytic research for decades. In order to mitigate past research deficits three primary aspects are to be examined in this project: First, the project will develop an empirically founded systematic description of the procedures which German- speaking humans actually use in order to describe pain of different kinds and quality. Both, lexicon, metaphors, metonymy as well as the use of paraphrases, reformulations, and presentation strategies are of interest in this connection. Secondly, the issue will be addressed, whether the forms of women`s pain descriptions differ from those by men. Gender-specific differences might have effects on the diagnosis, as the results of a discourse- analytic pilot project (Menz et al. 2002) indicate. Thirdly, a matter of special relevance is the question how the pain representations of the patients are transferred into the institutional context. Which forms of the pain representation do experience which transformations and categorizations? This aspect is particularly important, since the idiosyncratic pain perception of individual patients has to be communicated here and must be transformed to a specific form of medical treatment. The study will be carried out within the framework of the Vienna school of critical discourse analysis and a medical-semiotic framework. It will be based on the following data sources: Pain descriptions by female and male patients of an internal ward (tape-recorded and transcribed for the most part already) Tape-recordings in two different outpatient pain clinics of the AKH (headache outpatient clinic of the University Clinic of Neurology; outpatient clinic of the Dept. of Physical Medicine and Rehabilitation) Tape-recordings in two neurological wards of the University Clinic of Neurology Interviews with selected patients and doctors in attendance Apart from the examination of the research questions a primary goal of the planned study is to reach a better fitting between authentic, oral talk-in- interaction of the descriptions of pain with existing medical taxonomies and classifications.