Talking about illness and pain

Communication and health. There is plenty to say on the matter, particularly now with the pandemic and with obesity on the rise. Jana Declercq, whose PhD research focused on health news, has been awarded a Veni grant and is now studying how patients and practitioners in a specialized clinic discuss chronic pain. Last but not least, she is a fervent advocate for the proper and sensible use of metaphors.

^{Text: Eelco Salverda, Communication UG / Photos: Elmer Spaargaren}

Pain from a physical, mental and social perspective

It has been long assumed that body and mind function separately and that illness also only affects one or the other. As such, it has been considered that physical and psychological issues should be treated independently of one another. The prevailing idea is that you have either a physical or a mental problem. But an increasing body of research points to the fact that this division between the two is no longer tenable, explains Declerq: ‘Sadness and stress also cause stomach aches and headaches, and constant pain can make a person sad and irritable. I am conducting my research at a pain clinic at the Gent University Hospital in Belgium. This facility provides care to patients with intense chronic pain, resulting from conditions such as fibromyalgia, neuropathic pain or osteoarthritis. Doctors, a physiotherapist and a psychologist are using a unique approach to pain by looking at it from a physical, mental and social perspective. I am taking an in-depth look at how this affects communication with patients.’

Getting used to a functional approach

At the clinic where Declerq does her research, doctors are taking a highly functional approach to pain and less of a purely physical one, she explains. ‘The main question is, how can we increase quality of life? Medication and other medical treatments are options, but sometimes psychotherapy and physiotherapy which focus primarily on organizing the patient’s day-to-day life need to be considered. This approach sometimes takes some getting used to. Having a less somatic approach by also factoring in mental and social aspects seems to often be challenging for patients.’

In the mind

Declercq became interested in all things medical at an early age – although, as a child, her wish to become a midwife when she grew up was still just part of a game. During her Master’s in Linguistics in Belgium, she focused on how people use language and her focus shifted to Neurolinguistics and language disorders and later onto language use and interaction. Declercq says, ‘People use language – spoken, written, verbal, non-verbal – to share their ideas and how they see the world, sickness and health. I am interested in statements like, ‘it’s all-in the mind’ and why and when we say these things, or how you can look at language and see why people react badly when someone suggests going to see a psychologist.’

Overly simplified health message

In her dissertation about health news, Declerq covers topics such as the interaction between the science community and the media. Medical scientists, dieticians, doctors, the food industry and journalists alike all have an opinion on nutrition and exercise. ‘They tend to imply or explicitly state that we have all the information we need to make our own decisions on how to be or how to become healthy. But that’s a gross oversimplification. We know that health is a highly complex combination of physical, mental, social and environmental factors. It is so much more than simply knowing the nutrients in certain berries or nuts. Not everyone is equally able to gather information, read it critically, and apply it consistently in their daily lives. Particularly in a world that is set up for a sedentary lifestyle, relaxing with a variety of tasty treats, and where certain things become almost impossible to tackle for an individual.

Language of war

In talking about illnesses or the coronavirus for example, metaphors are used constantly. War and battle metaphors are very popular, and not everyone is happy about that. Declerq states, ‘The language of war is definitely used a lot both in a political and medical context. The coronavirus pandemic is at the intersection between the two andso it makes sense that we see a lot of these metaphors in the media. But we also use a lot of metaphors without realising. But this language has an impact. Research among cancer patients has shown that a group of patients feels like a loser when they hear cancer metaphors and so this type of language negatively impacts their wellbeing. At the same time, some patients draw strength from the imagery. What works for one person does not always work for another.’

Impact of language

Declerq’s message is that you should take a moment to consider the possible effects of a metaphor. Metaphors may make a text richer, but there are consequences. ‘Saying for example that corona is hitting us like a tsunami, or is ravaging the planet like a storm, means you are effectively claiming that the pandemic is an external factor and that there is very little we can do to stop it, thereby removing personal responsibility and limiting the possible impact of actions of individuals. In reality there is a lot we can and should do: through social distancing and limiting contact, we can slow the spread of the virus.’

Marathon

Declercq has her own favourite metaphors which take the lead in her metaphorical rankings. Comparing coronavirus measures to a marathon instead of a sprint, for example. ‘On Twitter, there’s a group of British researchers studying these metaphors which often tweet good ones. Recently, they tweeted a metaphor about exponential growth by the Prime Minister of Denmark Mette Frederiksen.’ Whether you are making a good comparison, striking the right chord or talking about pain, communication is an art form, and worthy of more research.