Objective: This study examines patients' pictorial representations of their chronic pain, alongside their accounts of those images, in order to help our understanding of their lived experience of the condition.
Method:The sample comprises seven women in middle adulthood from southern England. They began by drawing what their pain felt like and were then interviewed about their portrayals. The interviews were analyzed with interpretative phenomenological analysis.
Results:The participants produce strong, vivid, abstract pictures. In many of the pictures, the pain is objectified as punitive and sinister. This is enhanced through the use of stark colours of red and black. Paintings also often have a temporal element, showing either the movement from self before pain to self since the pain had started, or pointing to aspirations for the possible relief of pain in the future. The analysis of the images is grounded in the participants' accounts of them.
Conclusion:The images and accounts provide a powerful insight into the internal world of the pain sufferer and the subjective experience of chronic pain. We link this work to other attempts to represent patients' pain and point to the particular contribution our work makes. We make some suggestions for subsequent research following on from what is presented here and we also argue that the methodology outlined in the paper offers considerable potential for research on other health conditions. We know of no previously published IPA work on pain which elicits artwork from participants but it was done as part of an IPA study on addiction (Shinebourne & Smith, 2011). The aim of this study is to examine how patients represent their pain pictorially, how they describe those pictures and how they then use them as a springboard for further reflection on their pain experience.
MethodThe first author is a health/counselling psychologist, with five years' post qualification experience delivering pain management programmes. The second author is an academic psychologist with extensive experience of qualitative research, including work on living with chronic pain. The third author is an art therapist in the National Health Service.
ParticipantsIPA works with small purposive homogeneous samples. This allows for the microanalysis of psychological convergence and divergence in what is a relatively homogeneous group, in terms of obvious demographic and other variables. Our sample comprised seven White-British women in middle adulthood (aged 36-52) recently referred to a community PICTORIAL REPRESENTATIONS OF CHRONIC PAIN 6 pain management service in southern England. Almost all participants presented with complex cases and had multiple sources of pain. On average they had had pain for 12 years, and all had had it for at least 6 years. Most had a history of unsuccessful medical investigations. Only one, Fran, had prior exposure to any 'pain self-management' approaches before attending this pain management clinic. See Table 1 for participant details.
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