Pain(ful) Experiences as an Archipelago of Knowledge(s)

Dolores Martín-Moruno, University of Geneva

https://doi.org/10.58077/g4gf-xc04

How can we learn from experiences – including those which hurt – to understand them as useful historical knowledge that goes beyond the history of science and medicine? To answer this question – which is at the core of HEX’s agenda – it is essential to consider the potential contribution of the history of experiences to the history of knowledge. The history of experiences provides us with fertile ground for critically examining how – through their everyday practices – ordinary people have crafted multifarious forms of knowledge coloured by their sensations, feelings, memories and thoughts. Historians of experiences can also benefit from establishing a dialogue with philosophers and historians who have placed a polyphonic notion of experience at the centre of their analyses to strengthen their own category of experience.

The idea that experience involves obtaining valuable knowledge gained from practice is an old one which can be traced back to Aristotle. As he explained, ‘in favoured cases perception leads’ to repeated memories of ‘the same item’ which, in turn, results in the configuration of a ‘single experience’. Thus, Aristotle defined experience as the inductive process by which humans acquire a certain understanding of how ‘things come about’ or how ‘things are’. Aristotle distinguished experience from theoretical and practical knowledge, which he referred to as epistêmê and technê, respectively, but he acknowledged that the cognitive powers provided by perception allowed people to discern the general causes which make things happen. However, you cannot gain experience without pain, as this process is like ‘a battle, when a rout has occurred’.[1] Despite further commentators criticising Aristotle’s ‘aristocratic bias for universals’, his notion of empereia remains extremely useful for comprehending how humans shape their memories as ways of feeling and understanding the world through habit rather than contemplation.[2]

Although debates about the role of experience in knowledge production have animated all epochs, the nineteenth century was a turning point for the transformation of science and medicine, through the standardisation of specific methods involving the detailed observation of phenomena to formulate hypotheses which were then tested through experiments. Scientific experiments were designed to reproduce experience under ideal conditions, so as to ensure their replicability. Nonetheless, experiments reified experiences ‘into a world of abstract notions’ by removing ‘the links that tie every process to its surroundings’ and, therefore, creating ‘an impoverished environment’ of reality.[3] The epistemological frontiers between academic experts who performed experiments within the confines of laboratories and ordinary people who experienced – or suffered – the world were reinforced through terms such as scientist, also coined in the nineteenth century. This neologism recognised the social superiority of a professional group who produced knowledge guided by shifting values such as objectivity rather than by looking at ‘the bright, raucous, pulsing world of everyday experience’.[4]

As Michel Foucault reminds us, this knowledge discrimination is the result of a power dynamic that silences the experiences of marginal groups who are at the root of a whole series of ‘subjugated knowledges’ that are disqualified ‘as nonconceptual’ because they are judged to be ‘insufficiently elaborated knowledges’.[5] Foucault’s fascination for investigating limit-experiences – such as those related to madness – would inspire future generations of scholars who were willing to transform their own experiences of oppression into a plethora of liberating knowledges. Thus, feminists denounced the patriarchal roots of scientific objectivity by showing how ‘situated knowledges’ always relied on a partial perspective that was inexorably intertwined with embodied experiences.[6] In turn, Postcolonial scholars decolonised indigenous experiences from Western epistemology so as to understand them as subaltern knowledges.[7] Also echoing Foucault’s call, research conducted in STS explored to what extent patients militated for the social recognition of ‘profane expertise’ inspired by their own experiences of illness, such as those lived by people diagnosed with AIDS.[8]

Although Foucault’s heritage led to people’s experiences being celebrated as truer than the explanations advocated by scientists, paradoxically the very notion of experience would lose all of its emancipatory intensity. Reassessing Foucault, Joan W. Scott said she was tempted to abolish experience as a category of historical enquiry, as it had been taken for granted as evidence to essentialise – rather than deconstruct – social identities. Under Scott’s lenses, experience became a mere illusion provoked by the effects of discourse and, therefore, historians who analysed ‘the reproduction and transmission of knowledge (…) through experience’ were irremediably condemned to failure.[9]

Other historians who engaged with a critical reading of Foucault’s work, such as Roy Porter, revitalised the project of writing a history of experiences in the mid-1980s by placing the figure of the patient at its heart. Deeply inspired by Edward P. Thompson’s work, Porter suggested reconstructing ‘basic mappings of experience’ to understand how doctors and sufferers have reflected ‘upon living and dying’. He also encouraged historians ‘to peer inside the sufferers’, by ‘monitoring how they experienced and expressed pain’, because this was ‘still a virgin field of research’ that could provide valuable knowledge for orienting medical practice.[10] Despite the novelty of Porter’s proposal, he considered that patients’ pain was an experience negotiated with physicians that should be analysed in the light of Thompson’s conception of class; a perspective that made it hard to access sufferers’ experiences without presuming that they were just a construction resulting from the medical gaze.[11]

In this respect, emotions history has opened up productive ways for exploring how pain has become a scientific object, as well as an integral practice in ‘observation, experiment, and theory’, which has also been at the heart of the configuration of the scientific self.[12] Historians of emotions have also made a significant contribution to comprehending pain as an in-the-flesh experience, by examining how suffering can be charted through embodied practices. More recently, scholars who have advocated for reframing emotions history within the new history of experiences have shown that ‘historical pain knowledge is actively useful’ for denaturalising presentist conceptions of suffering by documenting the rich ‘cultural repertoire of pain concepts’ that has provided ‘the framework for expression’ and experience.[13]

Historians of experiences can provide important insights for current medical debates about pain; however, they should also engage in the wider societal discussion about what deserves to be considered as knowledge. As a field that aims to reconstruct the complex networks through which information has been generated and circulated throughout the world,[14] the history of knowledge provides a unique opportunity for understanding how shared experiences have constituted the empirical basis of a variety of knowledge(s) infused with memories, perceptions, feelings and thoughts. To transform the study of the past into a critical tool aimed at enlightening decision-making in our present-day knowledge society, historians of experiences should ‘follow practices wherever they may lead, however remote these may be from anything resembling’ Western science.[15] In mapping historical experiences through practices, historians will be able to discover an archipelago of knowledge(s): a metaphor that enables us to observe knowledge as an entity composed of islands, defined by its plurality. An archipelago perspective allows us, thus, to navigate across ages and cultures in order to connect experiential knowledge(s) around the globe – the most precious heritage of our human diversity.

Notes

[1] Aristotle, Posterior Analytics (Clarendon: Oxford University Press, 2022), 73.

[2] Martin Jay, Songs of Experience: Modern American and European Variations on a Universal Theme (Berkeley: University of California Press, 2005), 27.

[3] Paul Feyerabend, Conquest of Abundance: A Tale of Abstraction versus the Richness of Being (Chicago: Chicago University Press, 2001), 16.

[4] Lorraine Daston and Peter Galison, Objectivity (New York: Zone Books, 2021), 3.

[5] Michel Foucault, Society Must Be Defended. Lectures at the Collège de France, 1975-76 (New York: Picador, 1997), 7.

[6] Donna Haraway. ‘Situated Knowledges: The Science Question in Feminism and the Privilege of Partial Perspective’, Feminist Studies 14:3 (1988): 575-599, at 576.

[7] Gayatri Chakravorty Spivack, ‘Can the Subaltern Speak?’, Marxism and the Interpretation of Culture, eds. Cary Nelson and Lawrence Grossberg, 271-313 (London: Macmillan, 1988).

[8] Steven Epstein, ‘The Construction of Lay Expertise: AIDS Activism and the Forging of Credibility in the Reform of Clinical Trials’, Science, Technology and Human Values: 20:4 (1995): 408-437.

[9] Joan W. Scott, ‘The Evidence of Experience’, Critical Inquiry 17: 4 (1991): 773-797, at 797.

[10] Roy Porter, ‘The Patient’s View: Doing Medical History from Below’, Theory and Society 14:2 (1985): 175-198, at 186.

[11] Florin Condrau, ‘The Patient’s View Meets the Clinical Gaze’, Social History of Medicine 20:3 (2007): 525-540, at 529.

[12] Paul White, ‘Focus: The Emotional Economy of Science’, Isis 100:4 (2009): 792-797, at 793.

[13] Rob Boddice, ‘The politics of pain’, Aeon, 2023.

[14] Peter Burke, What is the History of Knowledge? (London: Polity Press, 2016), 3.

[15] Lorraine Daston, ‘The History of Science and the History of Knowledge’, Know 1:1 (2017): 131-154, at 143.