Becoming “chronically pained” (Sheppard, 2020)1 is not immediate. It is a slow process that unfolds over time. Many chronic pain patients initially assume their pain is temporary, only to realize its permanence slowly. This “time of undiagnosis” (Kafer, 2013)2 can be disorienting and emotionally draining. Patients are often denied recognition, dismissed, and left without answers for years. This was certainly my experience, being blamed for my chronic pain due to a lack of ‘evidence’ only to discover, seven years later, that my chronic pain did have a ‘provable’ cause. In fact, it was shown that the physical therapy I was forced to do, and consequently blamed for not doing enough of, was harmful to my eventually diagnosed condition.
The medical model becomes an essential piece of the puzzle in discovering the location of my disablement. I was expected to justify my experience because modern science failed for seven years to find physical ‘evidence’ of my chronic pain. This leads to constant surveillance and doubt in the medical field, ripe with assumptions of addiction, laziness, and psychopathology (Selznick, 2017)3. This reflects Wendell’s (1996)4 critique of medical authority, in which she argues that medicine can confirm or deny the reality of bodily experiences. She notes that medicine “can undermine our belief in ourselves as knowers, since it can cast authoritative doubt on some of our most powerful, immediate experiences” (p. 122). As I fought for recognition of my pain, I often felt forced to choose between trusting my own experience and trusting the medical system. A choice that, as Wendell argues, disproportionately disempowers disabled people.
My chronic pain exists regardless of external recognition, yet access to disability benefits and accommodations depends on proving my impairments in ways that satisfy bureaucratic and medical expectations. This reality demonstrates that disablement is not solely in my body but is also shaped by external structures that determine its legitimacy. My disablement is not simply an inherent condition; it is a relational process emerging through the interplay between bodily experience and institutional recognition.
The suspicion of pain patients is also gendered, racialized, and class-based. Certain groups are more likely to be dismissed as ‘fakers’. Women, in particular, are framed as ‘hysterical’ or ‘overly emotional,’ reinforcing the idea that their pain is not real (Selznick, 2017, p. 53). Race and class also shape access to pain care. Black, Indigenous, and other people of color, as well as low-income patients, are more likely to have their pain dismissed or undertreated (Selznick, 2017, pp. 53-54). As Wendell (1996) notes, Western medicine has long claimed to be the ultimate authority on bodily knowledge, often reinforcing social hierarchies rather than dismantling them. This medical gatekeeping not only invalidates pain experiences but also reflects broader systems of power that dictate whose suffering is recognized and whose is ignored. Chronic pain patients’ experiences are shaped by their relationships with doctors, a relationship that is often fraught with power imbalances, skepticism, and dismissal. Medicine frames disability as an individual defect rather than a political and social experience, reinforcing marginalization.
Claiming disability requires constantly proving it to the medical field. As Selznick (2017) notes, “[p]ersons with chronic pain are suspect: their legitimacy is always up for debate” (p. 51). Though my chronic pain persists, access to benefits depends on proving it through bureaucratic and medical standards. Chronic pain patients are often assumed to be frauds until proven otherwise (Selznick, 2017). Western medicine dominates how pain is understood, positioning itself as the ultimate authority on disability and impairment. This reduces chronic pain to a problem that must be fixed, marginalizing alternative understandings (Patsavas, 2014, p. 206)5. Despite this claimed authority, medical education on pain is severely lacking. Veterinary students receive more pain management training than medical students. According to Selznick (2017), doctors have, on average, only 31-to-41 hours of pain education, while veterinarians have twice that amount (p. 9). This lack of knowledge leads to harmful assumptions, such as the belief that chronic pain patients should overcome their pain through rehabilitation and that failing to do so is a personal failure, as is evidenced by my own experience. Wendell (1996) argues that this “obsession with cure” erases the validity of disabled lives and reinforces the assumption that disabled people must be constantly seeking improvement (p. 94).
This framework suggests that disablement will disappear if impairments can be medically alleviated. In my case, while I would still have some mobility limitations, eliminating my chronic pain would drastically reduce my experience of disability. However, this does not mean that disablement is purely an individual condition. Instead, it highlights how pain, functionality, and structural barriers interact to create the experience of disablement. The cure-based mindset fails to account for this complexity, instead reducing disability to a medical problem rather than a relational and structural one.
The medical model’s failure to validate experiences of chronic pain does not just reflect scientific limitations. It exposes an unwillingness to recognize pain experiences that do not conform to biomedical assumptions. This disconnect between the medical model’s individualizing focus and the lived reality of chronic pain patients highlights the need for a broader understanding of disability. The social model offers a framework that shifts the focus from individual impairment to the social, cultural, and political contexts that shape disablement.
Series so far:
Intro
Positionality
A Personal Case Study in Disablement
- Sheppard, E. (2020). Performing normal but becoming crip: Living with chronic pain. Scandinavian Journal of Disability Research, 22(1), 39–47. https://doi.org/10.16993/sjdr.619 ↩︎
- Kafer, A. (2013). Feminist, queer, crip. Indiana University Press. ↩︎
- Selznick, H. (2017). Enabling pain, enabling insight: Opening up possibilities for chronic pain in disability rhetoric and rhetoric and composition [PhD, Illinois State University]. https://doi.org/10.30707/ETD2017.Selznick.H ↩︎
- Wendell, S. (1996). The rejected body: Feminist philosophical reflections on disability. Routledge. ↩︎
- Patsavas, A. (2014). Recovering a cripistemology of pain: Leaky bodies, connective tissue, and feeling discourse. Journal of Literary & Cultural Disability Studies, 8(2), 203–218. https://doi.org/10.3828/jlcds.2014.16 ↩︎
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