Abstract: How People with Chronic Pain (Do Not) Talk about Pain-Related Uncertainty

◆ Manuel D. Pulido, University of Illinois at Urbana-Champaign

People with chronic pain face chronic uncertainties they must manage through communication. This study investigates uncertainties people with chronic pain (do not) express during conversations with important others. The guiding research question is: How do people with chronic pain talk about their pain-related uncertainties with others? Data will include conversation transcripts and analytic memos based on semi-structured interviews with a projected 40 individuals currently experiencing chronic pain. Participants are currently being recruited via Amazon’s Mechanical Turk service and compensated $10US. Data are actively being analyzed using Tracy’s (2013) iterative analysis techniques throughout the collection process, guided by sensitizing concepts from Brashers’ (2001) uncertainty management theory.
Preliminary results from six initial interviews reveal two emerging themes that highlight how people question if and how they should talk about their pain. The first theme is how social uncertainty frames, and often inhibits, talk about pain: How will my partner respond to my pain? Will my pain burden my partner and our relationship? For example, Dan reports asking himself if his wife is tired of hearing about his pain, and if she is even listening to him. Grinny explains how he hid his pain from his wife for years because he did not want her to “suffer with him.” Claire similarly hid her pain for years to protect her sons, but now discusses her pain with her adult son because he lives with her and witnesses her pain. Even so, Claire is hesitant to talk about her pain because she does not want to worry her son. Sam avoids revealing increased pain to his wife if he knows he exacerbated his pain by doing an activity he shouldn’t, such as lifting something heavy. When he does reveal increased pain, he expresses uncertainty to frame the conversation (e.g., “It was heavier than it looked”) so his wife will be more sympathetic and less critical.
The second developing trend is: when people explicitly talk about pain-related uncertainties, these conversations tend to focus on managing medical uncertainties. They question: What are my treatment options? Will those options even work? For example, Dan, Grinny, and Cory worry about surgeries for their foot, knee, and back, respectively, because doctors have told them surgery could either alleviate or worsen their pain. Claire says her son “hate[s] it when [Claire] goes to the doctors and they give [her] more medicine.” Ana’s mother recommends holistic therapies like “myofascial release” for her fibromyalgia pain, which Ana admits work, but exchange intense short-term pain for long-term relief. Interestingly, participants appear split between allopathic and alternative medicine for managing medical uncertainty, with multifaceted appraisals of how effective these strategies will be.
These preliminary results point to dual opportunities to encourage open discussion of social uncertainties as they relate to pain, and intervene in discussions about medical uncertainties that produce anxiety for both partners. Final results will extend these practical implications for encouraging open conversations about pain and pain-related uncertainties that facilitate effective coping with chronic pain.