“He can’t see my pain. He doesn’t know what it’s like when I’m lying in bed” she started.
“It’s difficult for people who are not in pain” I explain “Like you say you go home with your pain but he doesn’t he just gets 10 minutes with you”.
If you work with people in pain (and have sufficient time to talk/listen) this will probably resonate. They might be talking about a health professional, a colleague, a family member, a friend, a lover. It becomes a sensitive issue.
Sensitivity is a concept we encounter in both professional but also personal domains. It’s worth delving into some of its construct. For a start it seems a gendered construct. It is commonly used to describe either the qualities or flaws of a female. You are much more likely to be thought of as sensitive if you are female, and more likely to accept the label too. Being sensitive is associated with positive qualities such as consideration, care, thoughtfulness, diplomacy, tact, delicacy, subtlety, finesse, understanding, empathy, intuition, responsiveness, perception, discernment, insight, savoir faire (‘to know’ (how) ‘to do’). Not many men light up at being described as sensitive, positive or negative. It’s just not very masculine.
I mentioned in my previous blog that:
For me becoming a man was about playing sports (football, rugby not hockey, gymnastics) and winning, being strong, being competitive, not being concerned with detail or appearance, not trying (or at least not being seen to try), ignoring girls, becoming emotionally distant. Looking back a lot of this was to distinguish myself from female forms. These forms became less valued to me. (I will detail more of my journey with this in my next blog!)
My story here gains me no street cred or ‘man’ points (a strange concept). As a child I was nicknamed the squirrel due to my timidity. A sensitive child. I would hide behind my mum at toddler group waiting for an opportune moment to run and for a toy before retreating to safety. As a boy I would sit on my own and write poems. Sometimes to help process things, other times because I enjoyed their sound. My teenage years was spent pushing this out of me in search of a more masculine me. Through football I learned to be assertive and gregarious (I would continue to be socially awkward in mixed gender groups). My sensitivity however remained although I learned to combat this through detachment and disengagement. A tactic I use to this day because big boys don’t cry.
Sexism does not just affect genders other than male. Suicide is an issue heavily steeped in the culture of masculinity. It perpetuates myths creating difficulty when facing obstacles such as relationship breakdown, bereavement, loss of work. Such emotional illiteracy can contribute to alcoholism, poor access to psychological services and powerlessness that is oft reported with suicide. The danger with rejecting female forms to distinguish as male seemingly comes at a cost. The stigma of mental health and needing to be seen as strong is also strong in sport settings.
It requires more than intellect to rehabilitate the person in pain. Indeed inherent danger lies with intellectualisation of experience. Intelligence becomes the crucial factor. Someone experiences pain? Ask someone educated not someone in pain. Oppression? Sexism? Racism? Mental health? The answers are assumed with the educated not the experienced.
Can those who have never experienced oppression define the lived experience of those oppressed. Accessing the lived experience of pain is essential in the rehabilitation of people in pain. We cannot experience this from a textbook. As clinicians we cannot enter lived experience as we have not lived the pain they live. Not all lived experiences are equal here. It is context dependent. Here the lived experience of the person of pain is Queen. The person without pain cannot tell with authenticity what the person with pain is experiencing.
For too long as a therapist I gave out my view of how to fix things. After all when I had pain I didn’t worry about it, it just got better. When I felt down I just did something I enjoyed or in time it would pass. When I had been oppressed……. oh does being ginger count? Let’s call these my ‘Black Swans’. I had only ever experienced ‘Black Swans’ and so when people came to my clinic describing ‘White Swans’ it was suspicious, alien and lacking in reality. It’s easy to assume “oh they must be talking about black swans” and plough on regardless. This is how non responders can easily be labelled as malingerers. I was unknowingly part of the world stacked up against them.
This should not diminish the role of the healthcare clinician. Or education for that matter. Intelligence after all is surely context dependent. There is a real danger that the patient absolutises or objectifies their experience. The process of projecting their experience as the whole of reality.
Our sensitivity to others lived experience is essential to our practice as healthcare clinicians. Our main strength here is multiplicity. We have seen, listened to and touched many lived experiences. We can access a wider world in this respect. The person we seek to help can only access a few. Synthesising the many lived experiences we encounter and linking this to medical related knowledge is a skill requiring education, intelligence but most importantly sensitivity to others stories. We can help them to see with new eyes.
Isms control by stacking up. A power gradient. Otherwise it isn’t an ism. When life is stacked against you sensitivity is bound to appear. It is easy to shrug things off. Not get offended. Woman up. Get over it (‘I get over things all the time’). If life is stacked for you. We could get self righteous about it. Things are a lot more difficult on the reverse. Continually in my clinic it is the people with hard lives, low socio-economic status, from ethnic communities, those struggling to care for others; these are the groups who struggle to enact change.
Anyway back to my case. Naturally I told her to “Woman Up”. Just like I tell people with depression to cheer up and people with anxiety to not worry. Sensitivity is often a sign of something deeper. An emotional reaction. Just like when you fly off the handle at your partner, sibling, parent, kids! Maybe some thoughtfulness would help here. Maybe not saying grow some bollocks?! Perhaps to be sensitive could be masculine too.
Be more human. Be less robot.
Thanks for reading this far. (Again a short musical performance can be found below to adjunct the blog.)
Soft sounds vibrate all around
You won’t hear them making all that sound
Your voice it wakes me, I don’t see what you see.
But can I blame you, when you shout so loud.
When you feel pain, you are never the same.
A black swan showed me something bigger than me.
Orchestrate big sounds, illuminate the symphony.
A kaleidoscope changes view, suddenly I see something new.
Can you feel me, from your books and TV?
Because I can’t see you, come…… and share my view.