Agency in endometriosis pain communication in English and Spanish

Authors

  • Stella Bullo Manchester Metropolitan University
  • Mariana Pascual Pontificia Universidad Católica de Santiago
  • Dalia Magaña University of California, Merced

DOI:

https://doi.org/10.1558/cam.20075

Keywords:

endometriosis, transitivity, social actors, agency, health communication, pain

Abstract

This article interrogates the linguistic construction of agency in accounts of endometriosis pain in English and Spanish. Endometriosis is a reproductive condition causing incapacitating pain which is often dismissed or normalised, leading to delayed diagnosis. We take a patient-centred qualitative approach and analyse data gathered from 10 semi-structured interviews with women with endometriosis in British English and Argentine Spanish, using the transitivity and social actor representation frameworks. The findings indicate that the women across the two settings represent pain as an agentive overpowering actor and themselves with varying degrees of decreased agency. However, pain is more closely related to mental representations of the patients’ experiences in Spanish than in English, where it is construed as an actor performing physical actions. The findings of the study have implications for pain communication practices and cross-language healthcare communication and should inform local pain assessment measures.

Author Biographies

  • Stella Bullo, Manchester Metropolitan University

    Stella Bullo is a Senior Lecturer in Linguistics at Manchester Metropolitan University. Her research is in health communication, investigating discourses of women’s health and in particular endometriosis, pain communication and cross-cultural discourses of health.

  • Mariana Pascual, Pontificia Universidad Católica de Santiago

    Mariana Pascual is an Associate Professor in the Language Sciences Department, Pontificia Universidad Católica de Chile. She has conducted research in the language of evaluation in discourse, with a focus on the linguistic construction of social memory and pain. Her research also includes inter-personal relations in academic discourse. 

  • Dalia Magaña, University of California, Merced

    Dalia Magaña is an Assistant Professor of Spanish Linguistics at the University of California, Merced. Her research raises awareness about the role of interpersonal language in improving healthcare communication with Spanish speakers and developing intentional pedagogy for teaching Spanish to serve Latinxs in high-stakes situations such as in healthcare. 

References

Ahearn, Laura (2001) Language and agency. Annual Review of Anthropology 30: 109–137. https://doi.org/10.1146/annurev.anthro.30.1.109

Armour, Mike (2017) Pregnancy doesn’t ‘cure’ endometriosis, so where does this advice come from? The Conversation, 17 December. Online: https://theconversation.com/pregnancy-doesnt-cure-endometriosis-so-where-does-this-advice-come-from-88951.

Asad, Talal (2000) Agency and pain: An exploration. Culture and Religion 1 (1): 29–60. https://doi.org/10.1080/01438300008567139

Bacchini, Simone (2012) Telling Pain: A Study of the Linguistic Encoding of the Experiences of Chronic Pain and Illness through the Lexicogrammar of Italian. Unpublished doctoral dissertation, Queen Mary University of London.

Bernard, Taryn (2018) The discursive representation of social actors in the corporate social responsibility (CSR) and integrated annual (IA) reports of two South African mining companies. Critical Approaches to Discourse Analysis across Disciplines 10 (1): 81–97.

Bravo, Diana (2012) Cortesía lingüística y comunicativa. In Susana de los Heros and Mercedes Niño-Murcia (eds) Fundamentos y Modelos del Estudio Pragmático y Sociopragmático del español, 114–169. Washington, DC: Georgetown University Press.

Bulletti, Carlo, Maria E. Coccia, Silvia Battistoni and Andrea Borini (2010) Endometriosis and infertility. Journal of Assisted Reproduction and Genetics 27 (8): 441–447. https://doi.org/10.1007/s10815-010-9436-1

Bullo, Stella (2018) Exploring disempowerment in women’s accounts of endometriosis experiences. Discourse & Communication 12 (6): 569–586. https://doi.org/10.1177/1750481318771430

Bullo, Stella (2020) ‘I feel like I’m being stabbed by a thousand tiny men’: The challenges of communicating endometriosis pain. Health 24 (5): 476–492. https://doi.org/10.1177/1https://doi.org/10.1177/1363459318817943

Darics, Erika and Veronika Koller (2019) Social actors ‘to go’: An analytical toolkit to explore agency in business discourse and communication. Business and Professional Communication Quarterly 82 (2): 214–238. https://doi.org/10.1177/2329490619828367

Diller, Anthony (1980) Cross-cultural pain semantics. Pain 9 (1): 9–26.

Duranti, Alessandro (1994) From Grammar to Politics: Linguistic Anthropology in a Western Samoan Village. Berkeley: University of California Press.

Duranti, Alessandro (2004) Agency in language. In Alessandro Duranti (ed.) A Companion to Linguistic Anthropology, 451–473. Malden, MA: Blackwell Publishing.

Fausey, Caitlin M., Bria L. Long, Aya Williams and Lera Boroditsky (2010) Constructing agency: The role of language. Frontiers in Psychology 1: Article 162. https://doi.org/10.3389/fpsyg.2010.00162

Gilmore, Leigh (2012) Agency without mastery: Chronic pain and posthuman life writing. Biography 35 (1): 83–98.

Halliday, Michael A. K. (1998) On the grammar of pain. Functions of Language 5 (1): 1–32. https://doi.org/10.1075/fol.5.1.02hal

Halliday, Michael A. K. and Christian M. I. M Matthiessen (2004) An Introduction to Functional Grammar (3rd edition). London: Arnold.

Hay, M. Cameron (2010) Suffering in a productive world: Chronic illness, visibility, and the space beyond agency. American Ethnologist 37 (2): 259–274. https://doi.org/10.1111/j.1548-1425.2010.01254.x

Hirata, Masayuki (2011) A lexicogrammatical perspective in encoding dictionaries – with reference to ‘pain’ examples in English and in Japanese. In Igor Boguslavsky and Leo Wanner (eds) Proceedings of the 5th International Conference on Meaning-Text Theory, Barcelona, September 8 – 9, 2011, 98–107. Previously online: http://meaningtext.net/mtt2011/

Karini, Neda and Sepideh Gharaati (2013) Why do brains drain? Brain drain in Iran’s political discourse. Critical Approaches to Discourse

Analysis across Disciplines 6 (2): 154–173.

Kelly, Susan (2010) Qualitative interviewing techniques and styles. In Ivy Bourgeault, Robert Dingwall and Ray de Vries (eds) The SAGE

Handbook of Qualitative Methods in Health Research, 307–327. London: Sage.

Lakoff, George and Mark Johnson (1980) Metaphors We Live By. Chicago: University of Chicago Press.

Latour, Bruno (2005) Reassembling the Social on Actor Network Theory. New York: Oxford University Press.

Lascaratou, Chryssoula (2007) The Language of Pain: Expression or Description. Amsterdam: John Benjamins.

Lysaker, Paul H. and Bethany L. Leonhardt (2012) Agency: Its nature and role in recovery from severe mental illness. World Psychiatry: Official Journal of the World Psychiatric Association 11 (3): 165–166. https://doi.org/10.1002/j.2051-5545.2012.tb00121.x

Montgomery, Kathleen and Miles Little (2011) Enriching patient-centered care in serious illness: A focus on patients’ experiences of agency. Milbank Quarterly 89 (3): 381–398. https://doi.org/10.1111/j.1468-0009.2011.00633.x

Nnoaham, Kelechi E., Lone Hummelshoj, Premila Webster, Thomas d’Hooghe, Fiorenzo de Cicco Nardone, Carlo de Cicco Nardone, Crispin Jenkinson et al. (2011) Impact of endometriosis on quality of life and work productivity: A multicenter study across ten countries. Fertility and Sterility 96 (2): 366–373. https://doi.org/10.1016/j.fertnstert.2011.05.090

Pagano, Adriana and Giacomo Figueredo (2011) Gramaticalização da dor em português e espanhol: Uma abordagem comparada com subsídios da linguística de corpus e da linguística sistêmico-funcional. In Vander Viana and Stella E. O. Tagnin (eds.) Corpora No Ensino de Línguas Estrangeiras, 25–94. São Paulo: HUB Editorial. https://doi.org/10.5007/2175-7968.2011v1n27p294

Pascual, Mariana (2020) Discurso, salud e información desde el relato de pacientes de endoetriosis. Discurso & Sociedad 14 (2): 421–442

Pragglejaz Group (2007) MIP: A method for identifying metaphorically used words in discourse. Metaphor and Symbol 22 (1): 1–39.

Pugh, Judy F. (1991) The semantics of pain in Indian culture and medicine. Culture Medicine & Psychiatry 15 (1): 19–43. https://doi.org/10.1007/bf00050826

Rashidi, Nasser and Shiva Ghaedsharafi (2015) An investigation into the culture and social actors representation in Summit Series ELT textbooks within van Leeuwen’s 1996 Frame-work. SAGE Open 5 (1). Online. https://doi.org/10.1177/2158244015576054

Sarangi, Srikant (2010) Practising discourse analysis in healthcare settings. In Ivy Bourgeault, Robert Dingwall and Ray de Vries (eds) The SAGE Handbook of Qualitative Methods in Health Research, 397–416. London: Sage.

Seear, Kate (2009) The etiquette of endometriosis: Stigmatisation, menstrual concealment and the diagnostic delay. Social Science & Medicine 69 (8): 1220–1227.

Semino, Elena (2010) Descriptions of pain, metaphor, and embodied simulation. Metaphor & Symbol 25 (4): 205–226. https://doi.org//10.1080/10926488.2010.510926

Sullivan, Mark (1995) Pain in language: From sentience to Sapience. Pain Forum 4 (1): 3–14. https://doi.org/10.1016/S1082-3174(11)80068-1

Tolchinsky, Liliana and Elisa Rosado (2005) The effect of literacy, text type, and modality on the use of grammatical means for agency alternation in Spanish. Journal of Pragmatics 37 (2): 209–237. https://doi.org/10.1016/j.pragma.2004.08.008

Van Leeuwen, Theo (2003) [1996] The representation of social actors. In Carmen R. Caldas-Coulthard and Michael Coulthard (eds) Texts and Practices: Readings in Critical Discourse Analysis, 32–71. London: Routledge.

Vickers, Caroline and Ryan Goble (2011) Well, now, okey dokey: English discourse markers in Spanish-language medical consultations.

Canadian Modern Language Review 67 (4): 536–556. https://doi.org/10.1353/cml.2011.0025

World Health Organization (2021) Endometriosis. Online: https://www.who.int/news-room/fact-sheets/detail/endometriosis

Wright, Kallia O. (2018) ‘You have endometriosis’: Making menstruation-related pain legitimate in a biomedical world. Health Communication 34 (8): 912–915. https://doi.org/10.1080/10410236.2018.1440504

Young, Kate, Jane Fisher and Maggie Kirkman (2014) Women’s experiences of endometriosis: A systematic review and synthesis of qualitative research. Journal of Family Planning and Reproductive Health Care 41 (3): 225–234. https://doi.org/10.1136/jfprhc-2013-100853

Published

2022-12-31

Issue

Section

Articles

How to Cite

Bullo, S., Pascual, M., & Magaña, D. (2022). Agency in endometriosis pain communication in English and Spanish. Communication and Medicine, 18(1), 22–36. https://doi.org/10.1558/cam.20075