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All in Your Head

All in Your Head: Making Sense of Pediatric Pain

Mara Buchbinder
Copyright Date: 2015
Edition: 1
Pages: 256
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  • Book Info
    All in Your Head
    Book Description:

    Although pain is a universal human experience, many view the pain of others as private, resistant to language, and, therefore, essentially unknowable. And, yet, despite the obvious limits to comprehending another's internal state, language is all that we have to translate pain from the solitary and unknowable to a phenomenon richly described in literature, medicine, and everyday life. Without denying the private dimensions of pain,All in Your Headoffers an entirely fresh perspective that considers how pain may be configured, managed, explained, and even experienced in deeply relational ways.Drawing on ethnographic fieldwork in a pediatric pain clinic in California, Mara Buchbinder explores how clinicians, adolescent patients, and their families make sense of puzzling symptoms and work to alleviate pain. Through careful attention to the language of pain-including narratives, conversations, models, and metaphors-and detailed analysis of how young pain sufferers make meaning through interactions with others, her book reveals that however private pain may be, making sense of it is profoundly social.

    eISBN: 978-0-520-96076-3
    Subjects: Anthropology

Table of Contents

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  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-viii)
  3. Acknowledgments
    (pp. ix-xii)
  4. List of Acronyms and Initialisms
    (pp. xiii-xiv)
  5. Transcription Conventions
    (pp. xv-xvi)
  6. Introduction
    (pp. 1-32)

    Marian Grindall wiped a tear from her cheek.¹ “I always feel like I’m just right on the edge of tears,” she said apologetically. Silently, I cursed myself for again forgetting to bring tissues. I was sitting with Marian and her husband, Tom, at their kitchen table on a quiet Sunday morning in February. Abundant sunlight streamed in through French doors, glinting off modern silver appliances and softening their weary faces. I listened intently as they explained to me how their seventeen-year-old daughter, Cassandra, their only child, had come down with a mysterious illness in September that had left her bedridden...

  7. 1 The Bottom of the Funnel
    (pp. 33-55)

    Suppose that a physician had decided that your pain wasall in your head. What, exactly, would that mean? When we label pain as “all in your head,” beyond merely specifying a physical location where pain is thought to reside, we also draw on the head as a prevailing metaphor for psychological phenomena. In the U.S. context, this metaphor is persuasive because it draws on widely held cultural models proposing that illnesses areeithermentalorphysical. Because the mind is the province of the imagination, “all in your head” may also suggest that the pain is made up or...

  8. 2 The Smart Clinic
    (pp. 56-88)

    Zack Morgan had been screaming for days. Hobbling into the West Clinic on crutches, he made his presence known by groaning and crying out in pain every few minutes for the better part of an hour while waiting in an examination room for Dr. Novak to appear. When she finally finished with the previous patient, Dr. Novak invited me to accompany her to meet the family, suggesting that Zack, an eleven-year-old boy who had been diagnosed with CRPS in his right foot, might be a good patient for my research. Recognizing that this would be an interesting case to observe...

  9. 3 Sticky Brains
    (pp. 89-109)

    In the preceding chapters, I have illustrated how pediatric pain clinicians, in conversation with families, employ explanatory frameworks for pain that rely heavily on neurobiological discourses. They do so primarily to legitimize mysterious symptoms and disavow psychosomatic models of pediatric pain, which families might view as dismissive or disbelieving. In spite of this rhetorical strategy, however, there are many cases in which cliniciansdoactually believe that, if not exactly “all in your head,” in the sense of being unreal, persistent pain is caused or complicated by a psychological problem. Consequently, the West Clinic pain team sometimes came to refine...

  10. 4 Treating the Family
    (pp. 110-139)

    One day, a medical student named Cynthia Marantz presented a challenging case to the pain team in the West Clinic’s team meeting. Emilia, a young woman in her early twenties, had been referred to Dr. Novak through a friend of a friend. Her chronic pain had begun after a car accident several years earlier, but a complex psychosocial history seemed to intensify her pain problems and complicate this seemingly straightforward cause. Emilia’s parents had divorced when she was quite young, and she harbored substantial resentment toward her father, while she described her mother as emotionally unavailable. Now she was depressed...

  11. 5 Locating Pain in Societal Stress
    (pp. 140-170)

    The first thing that I learned about eleven-year-old Brittany Rogers was a telling admission that she had printed in thin, wavering letters on the pain clinic’s intake questionnaire: “Middle school stresses me out.” Brittany, a petite ballet dancer and straight-A student with strawcolored hair and very pale skin, had been suff ering from stomachaches and migraines for six months at the time of her first visit to the pain clinic. Brittany indicated that her heavy course load in California’s GATE (Gifted and Talented Education) program at her public middle school was a primary source of stress. She spent four to...

  12. Conclusion
    (pp. 171-186)

    One night in December, several months after I had formally completed my data collection, I drove across town to visit the Harris family. I had left several messages on their answering machine over the preceding few months, and when I finally reached Kay on her cell phone, she apologized profusely for her delay in responding. Things had been especially hectic since the new school year started, because Rob, her husband, had just gone back to school. The next evening, at Kay’s suggestion, I ventured out to their home, hoping that a final meeting would provide a sense of closure for...

  13. Notes
    (pp. 187-208)
  14. References
    (pp. 209-226)
  15. Index
    (pp. 227-233)