Pain Touches Sensitive Political Nerves Among Americans

Apr 28, 2014
B. Rose Huber
Woodrow Wilson School
America has long struggled over pain. Liberals "understand" your pain while conservatives say "grin-and-bear-it." Such political stances and today's debates over who is in pain, who feels another's pain and what relief is deserved continue to form new chapters in America's history of pain. 

In his new book, "Pain: A Political History," Keith Wailoo, vice dean of Princeton University's Woodrow Wilson School, explores the political pain divide between liberals and conservatives, tracing the development of pain theories in politics, medicine and law as well as legislative and social quarrels over the morality and economics of relief.

Listen to the podcast by clicking play. A partial transcript follows.

Q. Keith, your book seems to really point toward the tension between two groups: liberals and conservatives. How does each party view pain?

Wailoo: A caricature would be that liberals "feel your pain," which was a phrase made popular by Bill Clinton during his first presidential campaign, and it's a phrase that was frequently mocked by conservatives who were really skeptical about liberals' claims to compassionately feel the pain of others. Now this wasn't, as it turned out, just a rhetorical debate, or even a debate specific to that year. But the underlying concern was that conservatives were wary of the social programs that would emerge in the wake of these claims to compassionately feel the pain of others.

This tension was an unfolding one that defined the line between what it meant to be liberal and what it meant to be compassionate in terms of one's social programs. And this debate really dates, in my book, to the post-World War II era. It evolves. In some ways it defines what it means to be liberal and what it means to be conservative in this time period. …

Keith WailooQ. So, which moments in history, specifically, have really strengthened this divide between conservatives and liberals?

Wailoo: … When Ronald Reagan came into office, he sought to roll back the Social Security disability rules, particularly by reviewing and aggressively removing people who claimed disability based on subjective reasons. People in chronic pain were really singled out by this; about a half a million people were removed from the Social Security disability rules. It was really Reagan that powerfully articulated the argument that liberal society and the expansion of government and dependency and welfare was based on this gullible, liberal notion that pain was real, and the first thing we should do is relieve it through drugs, medications or through the expansion of relief programs. ...

In recent years, issues like fetal pain have become the rallying point for conservatives, while liberal states have focused on end-of-life pain. There are other issues, like oxytocin overuse, that have continued to inflame pain politics and often sharpened the liberal-conservative divide.

Q. So, how do you think policy makers, medical physicians and everyday Americans can learn from your book?

Wailoo: ...The debates that we have today about Obamacare, the role of government in relieving people's distress or the role of government in creating dependency—these debates go far back to the origins of American society. There is something reassuring about seeing the current debates through that historical perspective.

For people who have to judge who is in pain, how much pain they're in and how they should be relieved, it's important for them to weigh evidence clearly. What you see in the history surrounding pain debates has really changed dramatically over time. ...

This book is really intended to inform physicians, policy makers and others about the baggage that can unduly influence the kinds of decisions that they make about people in pain and whether that pain is real or whether they regard it as false. ...

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