All in Your Head: Making Sense of Pediatric Pain

Although pain is a universal human experience, many view the pain of others as private, resistant to language, and, therefore, essentially unknowable. And, yet, despite the obvious limits to comprehending another’s internal state, language is all that we have to translate pain from the solitary and unknowable to a phenomenon richly described in literature, medicine, and everyday life. Without denying the private dimensions of pain, All in Your Head offers an entirely fresh perspective that considers how pain may be configured, managed, explained, and even experienced in deeply relational ways.

Drawing on ethnographic fieldwork in a pediatric pain clinic in California, Mara Buchbinder explores how clinicians, adolescent patients, and their families make sense of puzzling symptoms and work to alleviate pain. Through careful attention to the language of pain―including narratives, conversations, models, and metaphors―and detailed analysis of how young pain sufferers make meaning through interactions with others, her book reveals that however private pain may be, making sense of it is profoundly social.

"Buchbinder’s ethnography not only contributes substantially to our understanding of the social uses of explanations, it also exposes how the cultural meaning of these explanations depends on the language that is used and the social and cultural context in which it is delivered." ― Somatosphere

"All in Your Head comes in the wake of an incredible amount of recent scholarly attention to the topic of pain, yet Mara Buchbinder finds a unique anthropological voice that is subtle and distinctive in her exploration of the treatment of pediatric pain." ― Medical Anthropology Quarterly

"...a thoughtful ethnography on pediatric pain management in the United States." ― Anthropological Quarterly

“All in Your Head deconstructs a pediatric pain clinic through impressive analyses of the clinical language, explanation, and rhetoric used to help adolescent patients get better. Buchbinder tellingly shows how social meanings and social life intersect in creating therapeutic approaches to pain that make it endurable as a clinical reality for patients, families, and clinicians. A serious and useful contribution to medical anthropology, to the field of chronic pain, and to a meaning-centered approach to the art of living.”–Arthur Kleinman, MD, author of The Illness Narratives: Suffering, Healing, and the Human Condition

"Welcome to West Clinic, the subject of Mara Buchbinder's astute study of pediatric/adolescent pain. She perceptively shows how the interpretive work of clinicians, families, and youthful patients themselves far exceeds the medical scaffolding to which all cling. Buchbinder writes that 'pain is polyvalent,' revealing how this rich mystery refuses resolution at the heart of modern biomedicine.”—Rayna Rapp, author of Testing Women, Testing the Fetus

“This book will be illuminating not only for social scientists and health practitioners but also for all who wish to think more deeply about the central role of language in illness experience and healing. Through rich case studies, Buchbinder artfully traces how models and metaphors drawn from neurobiology, psychodynamics, and social-stress theory help clinicians and patients make sense of suffering, pointing the way toward therapeutic change."— Laurence J. Kirmayer, MD, Professor and Director, Division of Social and Transcultural Psychiatry, McGill University

“All in Your Head deconstructs a pediatric pain clinic through impressive analyses of the clinical language, explanation, and rhetoric used to help adolescent patients get better. Buchbinder tellingly shows how social meanings and social life intersect in creating therapeutic approaches to pain that make it endurable as a clinical reality for patients, families, and clinicians. A serious and useful contribution to medical anthropology, to the field of chronic pain, and to a meaning-centered approach to the art of living.”–Arthur Kleinman, MD, author of The Illness Narratives: Suffering, Healing, and the Human Condition

"Welcome to West Clinic, the subject of Mara Buchbinder's astute study of pediatric/adolescent pain. She perceptively shows how the interpretive work of clinicians, families, and youthful patients themselves far exceeds the medical scaffolding to which all cling. Buchbinder writes that 'pain is polyvalent,' revealing how this rich mystery refuses resolution at the heart of modern biomedicine.”—Rayna Rapp, author of Testing Women, Testing the Fetus

“This book will be illuminating not only for social scientists and health practitioners but also for all who wish to think more deeply about the central role of language in illness experience and healing. Through rich case studies, Buchbinder artfully traces how models and metaphors drawn from neurobiology, psychodynamics, and social-stress theory help clinicians and patients make sense of suffering, pointing the way toward therapeutic change."— Laurence J. Kirmayer, MD, Professor and Director, Division of Social and Transcultural Psychiatry, McGill University

Mara Buchbinder is Associate Professor of Social Medicine and Adjunct Associate Professor of Anthropology at UNC – Chapel Hill, as well as core faculty in the UNC Center for Bioethics. She is coauthor of Saving Babies? The Consequences of Newborn Genetic Screening.