Publications
APS Bulletin • Volume 16, Number 2, 2006
Pain as Path
Mark Sullivan, MD PhD, Department Editor
The Spectacle on the Screen: Representations of Pain in Contemporary Media
Colin Fernandes, MD
Editor’s note: What are we to make of pain as spectacle? It is certainly uncomfortable to witness another’s pain, especially someone we care about. Yet movie, TV, and newspaper images depicting pain are undeniably popular. What are we to make of these images of pain? Do they increase or decrease our humanity and our compassion? Colin Fernandes, a pain physician and scholar of the media, reflects on these issues. Fernandes concludes with the wisdom of Susan Sontag. She argues that exposure to images of pain is not itself the problem. What is central is why we are exposed to these images and what we are encouraged or allowed to do in response. To what end are we shown this pain? On what path does this pain put us?
We live in a world in which the manner that information is codified and disseminated is changing at an exponential pace. New digital technology and the Internet have resulted in a democratization of the flow of information. The boundary between what is private and public is blurred. When London’s subway was the target of bomb attacks in 2005, trapped commuters captured the mayhem on their cell-phone cameras. Within 8 hours, more than 300 photos were posted online (Story, 2005). When an airliner’s landing gear became stuck, passengers watched their own evolving story live on their personal television monitors (Archibold & Broder, 2005).
Another seminal moment in information exchange occurred during the Vietnam War, which set a new precedent for television reporting.
At the beginning of this millennium, we are at war again and exposed to an endless stream of unsettling images of human pain and suffering. Who can forget the image of the hooded Abu Ghraib prisoner standing precariously atop a box, arms extended with wires attached? Or the image of the charred remains of Americans suspended from a bridge in Fallujah (which made the front page of The New York Times)? What does it mean to be constantly bombarded by these horrors? Does repeated viewing desensitize the viewer to, or whet the appetite for, human pain and suffering?
In a previous essay (2004), I explored the representations of pain in recent art. In this essay, I extend that discussion to new images of pain contained in various media. I have chosen examples that are notable for their graphic depiction of human pain. This reflection was partly informed by the book Regarding the Pain of Others by the late cultural polemicist Susan Sontag (2003). Although her work focused on photography, her ideas can be extrapolated to other media.
Film
Although film is not a new medium, filmmakers are working hard to challenge the limits of audience endurance, by using cutting-edge special effects and the nature of the story itself. Two recent films that ignited controversy over their graphic depiction of pain are “The Passion of the Christ” (Mel Gibson, 2004) and “In My Skin” (Marina de Van, 2003).
“The Passion” chronicles the last few hours of Jesus Christ (played by Jim Caviezel). The scourging scene is one of the movie’s most difficult to watch. Chained to a post, the onslaught is relentless, punctuated only by Caviezel’s laocoön-like writhing. Pieces of flesh and blood fly through the air as Jesus is reduced to a bloody pulp. The crucifixion is equally horrific, as Gibson ensures that viewers witness from close proximity the nails passing through Jesus’s flesh.
Many movie critics were unimpressed. New York Times critic A.O. Scott (2004) wrote: “This film seems to arise less from love than from wrath, and to succeed more in assaulting the spirit than in uplifting it. Mr. Gibson has constructed an unnerving and painful spectacle that is also, in the end, a depressing one. It is disheartening to see a film made with evident and abundant religious conviction that is at the same time so utterly lacking in grace.” Scott commented further that, “Mr. Gibson, either guilelessly or ingeniously, has exploited the popular appetite for terror and gore for what he and his allies see as a higher end. The means, however, are no different from those used by virtuosos of shock cinema and it will be amusing to see some of the same scolds who condemned Mr. Tarantino’s ‘Kill Bill: Vol. 1’ sing the praises of ‘The Passion.’”
But for most Christians, “The Passion” remains a spiritual experience. Not only are they intimately familiar with this 2,000-year-old story, they also routinely reenact it during Lent. What makes the pain bearable is the assigned meaning: It is through Jesus’ suffering and death that humankind gains redemption.
Marina de Van’s “In My Skin,” the graphic account of a woman’s compulsive self-mutilation, was released with much less fanfare than “The Passion.” Esther, the protagonist, begins her obsession when she suffers a deep gash to her leg but does not feel it. The physician she visits asks her jokingly, “Are you sure it’s your leg?” before performing a pinprick sensory examination. Esther proceeds to cut, core, and eventually chew her own flesh in a film that several critics deemed unwatchable. If viewers can look past the gore, they may postulate that perhaps the pain makes Esther feel more alive. It is the starting point of her journey of sensual self-exploration and self-consumption.
The Internet
The Internet grants us easy access to images of human horror. Performing a Google search for “Nick Berg beheading” will guide you to online sites where you can easily download one of the most gruesome videos posted on the Internet. (Mr. Berg was an American who was captured and killed by terrorists in Iraq.) The video begins with a bearded man dressed in orange who stares expressionlessly at the camera while his captors read a scripted message. This continues for over 4 unnerving minutes. Knowing the final outcome makes the intervening lead-up almost unbearable to watch. But nothing prepares one for the actual beheading, which, far from a swift guillotine, is an anteroposterior sawing that lasts several seconds, throughout which Mr. Berg appears to be grimacing. The scene leaves an indelible impression on viewers that is all the more unsettling because this event, unlike those in films, is not staged.
Disputed urban legend even tells of snuff films, films—sometimes pornographic—that depict actual murders to entertain.
Gaming and Virtual Reality
Gone are the days of Pac-Man’s simplicity. Today’s gaming technology immerses players in a virtual world where they can maim and kill with impunity.
In the last essay published before her death (2004), Sontag wrote: “It is hard to measure the increasing acceptance of brutality in American life, but its evidence is everywhere, starting with the video games of killing that are a principal entertainment of boys . . . the easy delight taken in violence seems to have grown.” It is easy to delight in the on-screen violence because the assumption is that it is not real, promoting a safe distance from which to indulge sadistic fantasies.
The ingenuous duo of Volker Morawe and Tilman Reiff (Academy of Media Arts, Cologne, Germany) turned this paradigm on its head when they developed the video game Painstation, in which actual pain is inflicted on players. The Web site www.painstation.de displays an alarming gallery of bruised and blistered players. Morawe and Reiff should be lauded for making the abstract world of gaming more tangible to its young audience; perhaps it will foster a new ethos of accountability and respect.
In another curious twist, the University of Washington’s Harborview Burn Center is pioneering virtual analgesia by engaging patients in a virtual SnowWorld during burn wound care. Preliminary data support the notion that the stronger the patient’s illusions of cold and snowy or icy conditions, the more effectively they are distracted from pain (Hoffman, Patterson, & Carrougher, 2000). More information about this innovative approach can be obtained from www.vrpain.com.
In A Philosophical Enquiry into the Origin of Our Ideas of the Sublime and Beautiful (1757), Edmund Burke observed: “I am convinced we have a degree of delight, and that no small one, in the real misfortunes and pains of others.” This sentiment was echoed by Andre Breton, who remarked: “Beauty will be convulsive, or it will not be.” Perhaps there is security in beholding the suffering of others, bestowed by the belief that there is a finite amount of pain to go around because someone else is bearing our share by proxy.
Our contemporary world provides us with a nonstop barrage of images depicting pain and suffering. Sontag (2003) wrote: “An ample reservoir of stoicism is needed to get through the great newspaper of record each morning, given the likelihood of seeing photographs that could make you cry.” With the growing popularity of reality shows and the resurgence of documentary filmmaking, we have arrived at a point where fact is more titillating than fiction. As virtual reality makes great strides, it may be hard to determine which images represent actual persons or events. Perhaps we will comfort ourselves with the notion that the horrors we behold cannot be real but must be digitally constructed or altered.
Some of us may actively seek out images of pain. Some of us may turn away. Sontag asserted that by saying: “There is the satisfaction of being able to look at the image without flinching. There is the pleasure of flinching.”
As the divide between fact and virtual reality becomes ambiguous, and access to images of suffering is made easier, it is important to question our response to these representations. As Sontag astutely concluded: “People don’t become inured to what they are shown—if that’s the right way to describe what happens—because of the quantity of images dumped on them. It is passivity that dulls feeling.”
References
Archibold, R. C., & Broder, J. M. (2005, September 22). Plane lands safely in Los Angeles after landing gear becomes stuck. The New York Times [online].
Fernandes, C. (2004). Subjective made object: Pain in contemporary art. APS Bulletin, 14(4), 10–11.
Hoffman, H. G., Patterson, D. R., & Carrougher, G. J. (2000). Use of virtual reality for adjunctive treatment of adult burn pain during physical therapy: A controlled study. The Clinical Journal of Pain, 16, 244–250.
Scott, A. O. (2004, February 25). Good and evil locked in violent showdown. The New York Times, p. B1.
Sontag, S. (2003). Regarding the pain of others. New York: Farrar, Straus & Giroux.
Sontag, S. (2004, May 23). Regarding the torture of others. The New York Times Magazine, p. 24–29, 42.
Story, L. (2005, July 8). The bombings in London: New media; Witnesses post instant photos on the web to capture drama. The New York Times [online].
Colin Fernandes is director of Pain Service, VA Northern California Health Care System–Martinez. His area of interest is the larger cultural context of chronic pain. He is also a freelance writer, emerging photographer, and recreational DJ. He can be reached at colin.fernandes@med.va.gov.