Pain and Its Transformations. The Interface of Biology and Culture


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Coakley, Sarah and Shelemay, Kay Kaufman (Eds) (2008) Cambridge: Harvard University Press. ISBN: 978-0-674-02456-4. xii + 439 pp. $49.95.This volume is the consequence of a conference culminating a 2 year seminar series led by psychiatrist-anthropologist, Arthur Kleinman (to whom, along with his wife, Joan Kleinman, the book is dedicated) and Coakley, a professor of divinity. Coeditor Shelemay is a professor of music and of African and African American studies. The entire project was sponsored by the Harvard “Mind/Brain/Behavior Initiative” with significant support from the John Templeton Foundation which has a major interest in research on moral and spiritual issues. The tone and content of the volume reflects these factors, as well as Kleinman's long-standing concerns expressed mainly in 3 books (The Illness Narratives: Suffering, Healing and the Human Condition; What Really Matters: Living a Moral Life amid Uncertainty and Danger; and Social Suffering).Two major presentations, early in the volume, deal with the somatic and neural mechanisms of pain. However, the bulk of the chapters are, as Coakley notes in her introduction, “about the meanings of pain that different cultures, ethnicities and religions ascribe to pain, thereby mediating—often through meditative, musical, and ritual enactment—a narrative that transcends the individual sufferer and so gives public expression to private agony (p. 1)”. In his opening remarks Kleinman underlines the centrality of “experience”: “the biomedical researcher's vision of pain as a universal, prelinguistic, neurological condition and the clinician and anthropologist's understanding that pain is felt, lived and dealt with in the intimate context of a person's life and local world can be together accommodated as different sides of experience (p. 17)”.The book is written largely in the language of cultural anthropology with due attention to that of major religious traditions. It is not the stuff of the practitioner's every day experience, and does not confront issues related to analgesic and antidepressant treatment. However, it could add considerably to the richness of the clinician reader's perceptions.

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