Publication Date

2017-04-17

Availability

Embargoed

Embargo Period

2017-04-17

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PHD)

Department

Sociology (Arts and Sciences)

Date of Defense

2017-04-04

First Committee Member

Linda L. Belgrave

Second Committee Member

Marvin P. Dawkins

Third Committee Member

John W. Murphy

Fourth Committee Member

Guillermo Prado

Fifth Committee Member

Joseph A. Kotarba

Abstract

The main goal of this dissertation project was to understand and explain the meaning of pain for adults who are diagnosed with and treated for cancer. Cancer diagnoses generate different responses and multiple life disturbances in most participants. In this context, the search for meaning of these experiences is fundamental, particularly understanding both physical and emotional pain. In order to comprehend how people diagnosed with and treated for cancer experience their pain, I used a phenomenological approach to interview 15 adults (13 women and 2 men) with a variety of cancer diagnoses. Although I approached these interviews as conversations, I utilized several subquestions to guide my interactions with the participants. Based on this study, the meaning of pain is related to the process of making meaning. This process, although presented in a sequential form, is not strictly associated with the lifeword in this manner. Rather, the process of meaning fluctuates from one stage to another and the boundaries of each stage overlap. The first stage corresponds to The Awakening of Pain. Pain disrupts the participants’ temporality and everyday lives, pushing them to seek meaning within the biomedical field. The trauma and dramatic intensity associated with the initial pain is now related to the shocking news of the diagnosis of the disease. This is quickly followed by the dawning awareness of multiple losses: the loss of function, of daily roles, and of taken-for-granted physical safety; these losses push individuals to retreat from the life they once lived. As the body is transformed due to the medical treatment, participants’ lifeworlds are disrupted. This sudden disruption, for some participants, curtails their involvement in the world, resulting in a shrinking life. Other participants, meanwhile, struggle to keep the world unchanged so as not to be alienated from it. However, in either case, the normal flow of the self is interrupted as participants lose familiarity with the basic process of their identities, their bodies. In the third and final stage, making sense of pain, participants seek to reconcile themselves with their new reality. At this point, communication becomes the main source of meaning. By sharing and communicating their experiences of pain, participants acknowledge the significance of those experiences, and by listening to the communicated painful experiences of others, participants validate their own experiences. The communicated pain is the public essence of the meaning-seeking process, while the search for meaning also has a private realm, explained in the triangle of meaning. This stage extends epistemology into a context of pain awakening, where genuine knowledge of pain is experienced and explained within the boundaries of science, spirituality, and the self. The self is the most important element of this triad, as it regulates and mediates the relationship between the scientific and spiritual meanings of pain. It is through the self that the person in pain becomes both subject and object of his or her experience and meaning, acquiring knowledge about his or her particular experience of pain. In sum, it is through this process of self-reflection and reflection on the pain that each person comes to know what the essence and meaning of his or her experiences are. In some sense, by experiencing pain, participants are experiencing the essence of pain and of themselves. These findings support the claim of many sociologists and phenomenologists (see Kotarba, Charmaz, Zola, Frank, and Leder, among numerous others), physicians (see Biro, Morris), and anthropologists (see Jackson), who all state that pain is more than just a biological response. Pain is a lived experience that encompasses all aspects of a person's life: the body, self, emotions, and culture; therefore, studies should not try to explain the pain outside of these boundaries. The result of this research project has substantial implications for understanding the complexity of how aspects of pain are interconnected and intertwined; each makes the experience meaningful, and none should be taken lightly in future research. The results, hopefully, will help improve the current biomedical understanding of cancer and pain, and promote a change in the way physicians understand and treat their patients, as well as promote a change in the policies of pain.

Keywords

cancer-pain; phenomenology; sociology; emotion; culture; communication; self

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