Why has the 'Pain Revolution' not occurred? An analysis of the competition between material semiotic translations of pain in a neoliberal age.

Abstract

This thesis investigates the competition between different material-semiotic translations of pain in the period of neoliberalism. Moseley and Butler (2017) published a novel pain theory, which understands pain as emergent from a complex system, in which biological, psychological, and social elements interact. The "Pain Revolution" is a practical implementation of the theory, but this thesis uses the phrase to refer to a wider paradigm shift that is unrealised. This thesis synthesises actor-network theory, Bourdieusian field sociology and narrative theory, and describes a competition between different material-semiotic translations of pain. It demonstrates that Moseley and Butler’s theory has not become imbricated in the networks of major institutions and their translations of pain, nor become predominant in the pain field. To understand why, this thesis traces the coevolution, from the mid 19th century to 2020, of an “economy of responsibility” and a competition between different translations of pain. I establish that this economy of responsibility has been constituted through complex interactions between juridical, insurantial, and professional elements, and been coextensive with a network of body-mind dualism that evolved through liberal, welfare state, and neoliberal periods. We will find that the aforementioned institutions and their translations of pain align with and help to sustain a neoliberal version of an economy of responsibility and network of body-mind dualism. The Pain Revolution is shown to be incommensurable with the juridical, insurantial, and professional logics operating in these networks and so it has not become imbricated with them. I demonstrate that the pain field, rather than operating as a scientific subfield marked by closure and autonomy, has been open to the heteronomous logics of medical, legal and insurance fields. The Pain Revolution has not taken hold in the pain field because it does not fully align with these logics.