Femme âgée qui se tient la tête de douleur

The expression of pain, learning under constraint

Oct 14, 2021

Throughout life, we continue to learn how to behave in society . Each age brings with it new roles, new situations in which we can learn to behave appropriately. This behavior is expected by the other members of our social group and allows us to save time and energy. It also makes it possible to limit the risks of misunderstanding and confrontation. If these social norms did not exist, we would indeed have to ask ourselves what to do each time we interact with other people.

Learn to behave in society

It happens of course to all of us to be obliged to do so in certain circumstances: abroad for example or more generally, when we are confronted with a social group to which we do not belong and whose rules we do not know. . This social learning is most often done in situation, in the context of education when we are still young, by observation and imitation as soon as we begin to interact, by many other channels over time and experiences.

Express your pain and be heard

Pain can be present punctually or chronically in life. Almost everyone experiences it. This phenomenon has a particularity: the pain itself is invisible. It becomes perceptible only through its expression.

The presence or absence of pain is often questioned. “Is he really in pain? "Isn't she exaggerating?" » ; "It's not possible that he doesn't feel anything!" » are all reflections that can come to comment on the expression of the pain of others. Why is this so?

For socio-cultural reasons, the expression of pain is not seen as a reliable indicator of its presence and intensity. It is for this reason that, in good care practices, an adage always applies to pain: any expressed pain exists. However, compliance with this principle – a priori simple – constantly poses problems in practice. Focus on learning under constraint: that of the expression of pain.


A child cries after falling while slipping on the grass. His grandmother picks him up and says, “But it's nothing! ". The big brother who was running after him said to him, “Don't be a sissy! » Do not say anything, do not cry, act as if nothing had happened.

Learning how to react when in pain begins early in life. The learned reaction is directly out of step with the spontaneous expression of the child's feelings. It constitutes a social facade and enhances – here obviously negatively – the expression of pain for the child, the very one who will become a man/woman, then an elderly person. The teenager may come back to this learned rule, but perhaps not or in an incomplete way.

Hand of a woman treating the scraped knee of a little boy

Oh ! My poor heart, come here while I look at this wound

A little girl cuts her finger with a sheet of paper. The finger is bleeding, it hurts. “Ouch! ". The father, seeing the finger full of blood: “Oh! My poor heart, come here while I look at this wound. »

Attracting attention to oneself by shouting, expressing pain and receiving the attention expected. Behavior has always been known, it is instinctive, some would say. The baby cries and screams to call his mother. In itself, it is no different from the spontaneous behavior of a child sliding on the grass. But here, this behavior is valued positively. By doing so, the little girl learns that she can express her pain and that this expression will allow her, at least to obtain attention and perhaps even to be relieved. It is accepted that she does. From there to say that all girls complain to get attention…

It is quite obvious that the cliché is not always valid. Even learned, this behavior can of course be rejected over time and another, more in line with our values ​​or the expectations of our age, adopted.

That'll teach you !

Following a forbidden acrobatics, a child falls and is injured. He is hurt. The adult launches a "That'll teach you!" ". The pain appears as a punishment, that of not having behaved as he should have done. The adult's remark confirms that the pain is deserved, that it is the punishment for inappropriate behavior. This reading of events is directly inherited from our religious culture. In the Bible, after Eve encouraged Adam to bite into the apple – after the only thing God forbade in the Garden of Eden had been done – the consequences came quickly. God chastises Adam and Eve for disobeying him. This punishment will take several forms: pain and submission for one and the arduousness of the work for the other.

Look what I can endure!

A sporty young man pushes cast iron and suffers during his training. He is proud of his work on him, proud of the work on his body, proud of what he is capable of enduring to achieve his goal. Pain is consented to because it is necessary for self-transcendence. Others will look at him thinking, “Why is he doing this to himself? ". One way to understand the origins of this posture would be our religious culture. Wouldn't we find there, for example, pain as a way of purifying the soul and the body? This young man may also be the child who didn't want to become a sissy, who knows?

“Oh well, you know, the pains with age…”

"When you wake up without pain anywhere, it's almost a miracle", people of a certain age often reply to the traditional "How are you this morning?" The audience is then suddenly interested in the age of the person in question, before formulating their answer.

Beyond a certain age, having pain would become a perfectly normal attribute. Being painful is then trivialized. Again, those affected will adopt different strategies depending on their life history. For some, talking about their ailments becomes a real topic of conversation, for others, the pain is not worth talking about. The learning of the reaction to adopt continues until the end of life. It will also condition the expression of pain in the elderly , in addition to their education and more generally their life history.

The words to say it

Other social representations of pain still exist and other behaviors are attached to them. No wonder that in the end, the pain felt is so difficult to describe. On certain occasions, you should know how to express your pain in an almost scientific way, its intensity, its depth, its location, know how to say when and how it occurs, on pain of not being taken seriously, of not being really Painful, of not being a painful “good”!

The expression of pain is always colored by culture, the socio-cultural origins of pain and of course its life story, but the converse is also true. The listener decodes the pain expressed according to his own socio-cultural origins, whether he is loving or indifferent, profane or professional.

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• Nadia Péoc'h, Social representations of pain – the praxeological perspective of support and health education practices, Les dossiers des sciences de l'éducation, 2014. CAIRN • Isabelle Levy, Pain: significance , expression, Mediterranean syndrome, Medicine & Hygiene, International Journal of Palliative Care, 2013/4 vol28. CAIRN

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