ESHS/HSS Annual Meeting

“Ten Steps from Patient to Person”: The American Chronic Pain Association and the Habits of Self-Help

• In Event: The Science and Medicine of Habits III: Habits, the Body and Disorder

English Abstract

In 1980, Penney Cowan founded the American Chronic Pain Association (ACPA), the world’s first mutual aid organization for chronic pain. With its ten-step program, the ACPA helped those with incurable pain build habits of “self-help.” Through meetings, videos, and workbooks, the organization sought to transform a “patient” passively treated by doctors into a self-reliant “person” who learned how to control their pain. This paper examines how the field of “pain research” made possible the bodily habits the ACPA wished to cultivate. Since the 1960s, scientists and physicians in and beyond the United States had begun to meet at interdisciplinary conferences to move beyond the mind-body divide that seemed to plague the study and treatment of chronic pain. Such pain, many agreed, blurred the boundary between the physical and the psychological. Its treatment therefore required a holistic approach, one that depended on the agency of the patient. Encountering this approach at the Cleveland Clinic, Cowan came to believe that it was mind-body dualism that had led her to overlook the role of her thoughts, emotions, and actions in her fibromyalgia. Only by learning new habits of self-control could she manage her disability. Ultimately, Cowan’s personal transformation became the foundation for the self-help activism of the ACPA. By analyzing published and archival materials from Cowan and the ACPA, this paper argues that the ACPA repurposed pain medicine to put patients at the center of their own care.

Author

• Matthew Soleiman, University of California, San Diego