Introduction: Pain, Trauma, and Philia in Middle English Literature

Medical assessments of pain in contemporary practice often rely on pain scales. These scales might take the form of images that are presented to a patient who is asked to identify with a visual representation of a face that ranges from one that is happy or satisfied to one that is in a state of excruciating pain. Or, they might take the form of different orders of pain scales that rely only on numerical registers to determine levels and degrees of pain from 1 to 10. In the latter case, the use of the highest number is best employed in conjunction with an example, and childbirth or the loss of a limb are the two most commonly used examples in this scenario. Medical researchers often investigate the somatic and psychic links between registers of pain and perceived levels of anxiety. In general, it is agreed that higher levels of anxiety result in higher levels of perceived or experienced pain.¹ Different research methods result in varying attributions of causes, sensations, and expressions of the experience of pain. These range from what are categorized as psychological or neural disorders such as anxiety, depression, or nerve damage, to hormonal releases of leptin, to the longevity and degree of pain as temporary or chronic.² In both contemporary and medieval documents the presumed sources or causes of pain may be as varied as lovesickness, depression, anxiety, chronic pain associated with musculo-skeletal harm from physical labor, diabetes, epilepsy, terminal pains such as those associated with the plague, or being impaled, quartered, decapitated, or burned alive.³ Although researchers continue to investigate the expression of and responses to pain, they tend to agree that the pain scale itself is a supplement for the inarticulability of pain.

It is generally accepted that pain scales are suspect.⁴ They are useful less in discrete moments of diagnosis than over the course of time, and most usually when a patient has an illness or pain that may be traced and recorded over a significant period of time in a predictable setting. Such longevity and consistency are significant not only because they allow a base level of understanding of the patient’s reported experience of pain, but also because they aid in the treatment of pain.

The temporal consistency of this narrative of the recognition of pain enables an understanding of why we must consider the literature in Middle English as a category of texts based on a shared (though varied) linguistic chain that reflects narratives of pain and its companion, trauma. Despite their companionship, pain is distinct from trauma. Pain is a symptom and a sign of a somatic or psychic ailment. Often pain is causally linked to a physical or psychical traumatic event; however, this is not always the case. Whereas trauma is the result of a singular, identifiable event, and may be addressed through the narrative process, pain tends to resist narration. The traumatized response may emerge symptomatically in the form of pain, yet is always linked to a specific traumatic event. Even when trauma is manifest repetitively (through repetition compulsion, memory or affect traces, or obsessive compulsive behavior), it is bound to an originating event. Pain, on the other hand, resists singular determination. Even pain that results, for instance, from the singular trauma of a physical accident (such as an automobile accident) or a psychical rupture (such as the loss of a loved one) resists singular determination and is manifested multiply across time. Trauma ruptures moments; pain endures temporal difference. Although they are grouped together in literary and medical discourse, pain and trauma are distinct in their temporality and in the way they relate to the narrative process. Despite its resistance to narration, pain is a form of expression; trauma, on the other hand, is a form of repression.

The historical distance that the contemporary moment brings to a reading of the past influences the way that narratives of pain and trauma come to signify over time. The extension of literature in Middle English to contemporary discourse on pain might assist in the production of a narrative of...