MIND THE PAIN GAP

The Problem of Women and Pain in Science and Art

Image by Hailey Kean

“Beauty will be convulsive or it will not be” declares André Breton in his novel, Nadja. Representation is a tricky business; it largely helps shape the dialogue around its subject. Who we choose to represent and how we choose to represent them matters in the common imagination. Some, like Breton, find beauty in the unsettling: representations of women in pain have been dominated for centuries by the trope of the “hysterical” woman. But how has this stereotype become so rooted in our artistic and scientific tradition? And why does it hinder our understanding of women’s pain so detrimentally?

Literary representations of female pain have largely been accredited to the body. The word “hysteria” itself comes from hystera, the Greek word for “uterus”. In the Christian faith, God punishes Eve (the first woman) for disobeying him by making childbirth painful.

"...throughout history, the simplest way to rationalise and understand female pain was often through the lens of male experience."

One of the first gendered theories of disease hails back to ancient Greece, with Hyppocrates’ “wandering uterus”; the role of women in society was to act as vessels for life. If women weren’t bearing children, the uterus was thought to dislodge itself from their abdomen and wander around their body, causing illness and pain.

Yet it seems as though, throughout history, the simplest way to rationalise and understand female pain was often through the lens of male experience. As Leclerc de Buffon wrote in 1807, “Women are but men turned inside out”. The pain of women has also been turned inside out through its conflation with theatrics. A study from 1949 serves testament to this: it investigates whether pain was indeed a part of the child-bearing process, or simply an act. The investigation concluded that women did indeed feel pain during labour, but only after using pain measurements on male patients. 

Photographique de La Salpêtrière (1876-1880)

With the nineteenth-century advent of psychoanalysis, the cliché of the “hysterical” woman was redefined with a psychological slant, which the art of the time signposts extensively. André Brouillet’s Une leçon Clinique à la Salpêtrière (1887) illustrates a voyeuristic scene from a female institutional facility. Brouillet’s Photographique de La Salpêtrière (1876-1880) (a series of risqué photos of young ladies in the throes of hysteria), examines male sensation toward the female experience of pain. Female “hysteria” was romanticised and glorified into something beautiful, explosive and sexually-charged, primarily by surrealist artists such as Salvador Dalì. His works feature many faceless, contorted female bodies in hallucinatory settings, reminiscent of the subjects in the Salpêtrière photographs.

"...the medical establishment is still rife with “invisible” and highly problematic practices which affect women."

André Brouillet’s 1887 painting, Une leçon Clinique à la Salpêtrière (A Clinical Lesson at the Salpêtrière)

Salvador Dalìs Soft Construction with Boiled Beans (Premonition of Civil War), 1936 (Oil on Canvas)

Although we have come a long way since Dali’s time, the medical establishment is still rife with “invisible” and highly problematic practices which affect women. 80% of chronic pain research is conducted on men and male mice only, despite being a condition that primarily affects women.

One study found that women wait longer than men in the ER (65 minutes compared to men’s 49 minutes) and are more likely to be diagnosed with psychological ailments despite exhibiting physical symptoms. Women also wait longer to be prescribed painkillers (and receive less of them). Scientists have suggested that this could potentially be attributed to their levels of oestrogen (the female sex hormone), which affects their pain perception and the efficacy of painkillers. 

"...validation is derived from believing that women can be trusted to provide an honest account of their lived experience."

It becomes evident, then, that there is still a so-called“credibility deficit” (a term coined by philosopher Miranda Fricker): women are seen as unreliable sources of information. This is problematic as it threatens their credibility as epistemic agents (how they form their beliefs and affects the beliefs of others), knowers and as conveyors of information. 

The very act of invalidating a woman’s perception of her own pain serves to further highlight shortcomings in our emotional intelligence. In order to empathise with another person's pain, we must recognise its existence. This cannot be done if we deny its plausibility - instead, validation is derived from believing that women can be trusted to provide an honest account of their lived experience. Perhaps we are still waiting for the punchline to a (bad) joke when learning that our knowledge of twentieth century atomic physics preceded our understanding of women’s medicine.

Indeed, it would be erroneous to look at yesterday’s history with today’s eyes. Though half of the world’s population is affected by cultural and societal perceptions, very little has been understood of women and pain in scientific and literary contexts. With so many confounding factors, it is hard to pin this on gender bias or genuine belief in the fact that sex makes no difference in how pain is perceived. Regardless, recognising that women feel and perceive pain differently on the account of being female will undoubtedly change the face of medical research. 

After centuries of serving as a reservoir of inspiration for artists and scientists alike, hysteria ceased to be classified as a mental disorder in 1980. Yet what we choose to do with hysteria’s legacy is up to us. Our agency and awareness of that legacy’s “side effects” ensures that its fate is in our hands. In short, it is through engaging with our ideological inheritance that will determine whether it leads us to a world of good, or a world of hurt.

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