Encountering Pain: hearing, seeing, speaking


Past Projects


Dr Deborah Padfield
Slade School of Fine Art, UCL

Prof Joanna Zakrzewska
University College London Hospitals, NHS Foundation Trust (UCLH)

Pain is difficult to communicate and constrict into the verbal or numerical scales commonly used. The face2face project at UCLH explored how photographic images can expand pain dialogue in the consulting room to include aspects of experience frequently omitted using traditional measures, such as rate your pain on a scale of one to ten.

It was a collaboration between facial pain specialist, Professor Joanna Zakrzewska and clinicians and patients from University College London Hospitals and artist, Deborah Padfield. 

The project had many strands: art workshops for clinicians and patients to attend together; the co-creation of photographs with facial pain patients reflecting their experience at different points in their treatment journey; the creation of an image resource developed as an innovative communication tool for clinical use (examples of which are on display) and an artist's film, duet for pain, focusing on doctor-patient dialogue and the role of narrative. 

The project aimed to evidence ways in which photographs of pain placed between patient and clinician can trigger more negotiated dialogue in the consulting room.  It presents the co-creation of 'pain portraits' with pain sufferers as part of a Fine Art practice, extending the boundaries of what is considered Fine Art by shifting the power-dynamics inherent within the act of portraiture. Through shared control of the lens and a negotiated aesthetic, pain sufferers retain control of how their pain is visualised, instead of being on the passive receiving end of a medical/photographic gaze.  In this way it attempts to validate and make visible the invisible subjective experience of pain, addressing its incommunicable nature. It also aims to demonstrate that not only is medicine capable of providing new material for the gallery space, but art is capable of bringing new knowledge into the consulting space.

Through funding provided by CHIRP, UCL, we have been able to develop the project further as a new research collaboration able to analyse the material generated through multi-disciplinary lenses. Details of the new project: Pain: speaking the threshold which gave rise to this conference are below.

Pain: speaking the threshold

Prof Sharon Morris
Slade School of Fine Art, UCL

Dr Deborah Padfield
Slade School of Fine Art, UCL

Prof Joanna M. Zakrzewska
University College London Hospitals, NHS Foundation Trust (UCLH)

Pain: Speaking the Threshold is a three-year interdisciplinary project to further research the value of visual images in the diagnosis and management of chronic pain. Funding comes from the Centre for Humanities Interdisciplinary Research Projects (CHIRP) Scheme.

It brings together art and medicine in the tradition of the founding professors of the Slade who were also surgeons, addressing the public understanding of pain through both science and the humanities. The project builds on the face2face project at University College London Hospitals (UCLH) and the doctoral research of Deborah Padfield, co-supervised by Dr. Sharon Morris (Slade School of Fine Art, UCL) and Prof. Joanna M. 
Zakrzewska (UCLH).

Accessing Prof. Zakrzewska's clinics, Padfield co-created with patients over 1,000 photographic images that reflected and symbolised their pain. From this material Padfield made a pilot pack of 54 pain cards, which were trialed as a communication tool in clinical consultations at UCLH. Video recording were made of 20 base-line consultations, without images, and 20 study consultations with images.

Taking unique data (video recordings and transcripts of pain consultations and co-created photographic images of pain) a new expanded interdisciplinary team will produce an in-depth analysis of the effects of using visual imagery in the clinical setting, using theories of narrative, metaphor and translation drawn from Linguistics; methodologies in Medical Anthropology and History of Medicine; theories of empathy and transference from Health Psychology and Psychoanalysis. The project hopes to evidence ways in which photographs of pain placed between clinician and patient can increase rapport and improve the quality of medical dialogue.

Interdisciplinary team

Prof Joanna Bourke: History: Birkbeck College
Dr Sahra Gibbon: Medical Anthropology: UCL
Helen Omand: Art Psychotherapy: The Studio Upstairs
Prof Elena Semino: Linguistics and English Language: Lancaster University
Dr Amanda C de C Williams: Psychology: UCL & UCLH

Research Assistants

Judy Addai-Davis
Research Department of Clinical, Educational & Health Psychology, UCL
Tom Chadwick
MSc, Social Research Methods, LSE

Project Assistant

Mariana Gomes Goncalves
MFA, Fine Art, Slade School of Fine Art

For further information please contact: d.padfield@ucl.ac.uk

See also: