Expressing that we’re in pain is one of the most basic things we can do with language, whether by yelling “ouch” (or something worse) or by attempting to tell someone exactly what’s wrong so we can get help. Public policy scholar Grant Duncan writes that the word “pain” itself has a history that tracks with changes in our understanding of bad feelings.

While the Romance languages derive their most common words for pain from the Latin dolor, the English “dolour,” meaning anguish or misery, is rarely used. Instead, Duncan writes, “pain” comes from poena, Latin for penalty or punishment. And that’s just what pain meant in English as far back as the fourteenth century. Today, we still use the word in this sense occasionally, as in the phrase “on pain of death.” This makes a certain kind of sense since, for many centuries, European systems of punishment centered pain: torturing confessions out of suspects, using grotesque public displays of violence like burning at the stake, and so on.

The meaning of pain changed gradually. In the seventeenth century, Thomas Hobbes distinguished between “punishment”—physical harm used by lawful authority to promote obedience—and “pain”—inflicted illegitimately without concern for future good.

Around the turn of the nineteenth century, Duncan writes, legal systems shifted toward imprisonment, forced labor, and “humane” execution methods. Of course, these often caused physical pain, but the pain was no longer the point. The use of torture didn’t disappear, but it shifted to less visible corners of society like penal colonies and, eventually, “black sites” (secret jails and detention centers).

At this same moment, English philosopher Jeremy Bentham was thinking about the subject of pain in a very different way than had Hobbes. His utilitarian ideas called for public policy to optimize for increasing pleasure and avoiding pain. And his idea of “pain” was capacious. Beyond punishments, and even beyond the kinds of physical harm we usually associate with the word today, he included other unpleasant bodily sensations like thirst or cold, and all sorts of emotional and social hurts.

As the idea of pain as a positive good for maintaining legal order continued to decline, Duncan writes, fighting against pain became a greater focus for medical science. The nineteenth century brought better opiate drugs for pain and effective surgical anesthesia. This didn’t sever the link between pain and moral issues—particularly in the case of the pain of childbirth. But it did turn pain into a topic that was largely the domain of medical professionals, who tend to focus on the kinds of harm inflicted by injuries or disease.

Duncan argues that this sidelined other sorts of “pain” like grief and led to suspicion of chronic pain patients whose conditions may not be directly connected to tissue damage. While many doctors today subscribe to a “biopsychosocial” model that attempts to account for such complications, communicating about pain can be stymied by the many differing ways we think about what it is.

Support JSTOR Daily! Join our membership program on Patreon today.