Description
- Abstract:
- In the United States, biomedical chronic pain management is inextricably entangled with the opioid crisis, creating a landscape where pain relief is heavily policed. Drawing on ethnographic fieldwork with women in chronic pain across varying intersections of race and socio-economic class in Michigan and Massachusetts, this dissertation examines the profound disjuncture between the embodied reality of illness and the structural forces governing it. As these women navigate restrictive prescribing guidelines, clinical gaslighting, and bureaucratic violence, this research asks: How is the painful body constructed by the state, and how is it survived by the individual? To answer this, I bridge the political economy of medicine with the phenomenology of the painful body. Central to this analysis is the concept of pain-full being—an embodied ontology recognizing that chronic pain is never only a biomedical symptom, but a totalizing condition fundamentally reshaping a person’s existence. By centering pain-full being, I trace how this vulnerability is simultaneously rendered suspect by the medical establishment and protected within intimate communities of care. Part I focuses on macro-structural forces shaping contemporary pain management. I argue the U.S. healthcare system operates through carceral prescribing and narcopolitics, where legacies of the War on Drugs dictate whose pain is deemed legitimate and whose is suspect. Clinical care has become a punitive apparatus disproportionately harming marginalized, working-class, and racialized bodies, effectively leveraging opioid access against those living pain-full being. Part II shifts to the experiential, mapping the lived realities of the painful body. I expand pain-full being into a triad of phenomenological frameworks to articulate the social life of chronic pain. I trace how the isolating, haunting experience of individual suffering (being-as-pain) transforms into a visceral solidarity within peer support networks (beings-in-pain). Finally, I examine fraught clinical encounters lacking empathy (being-with-pain), illustrating how systemic biases of gender, race, and class mediate pain's legibility. Ultimately, charting these ontological states demonstrates how women in pain continually forge vital, interembodied lifeworlds outside the clinical gaze.
- Notes:
- Thesis (Ph. D.)--Brown University, 2026
Citation
Votta, Amanda,
"Being and Pain: Carceral Care, Embodied Ontologies, and the Narcopolitics of Opioid Prescribing in the United States"
(2026).
Anthropology Theses and Dissertations.
Brown Digital Repository. Brown University Library.
https://repository.library.brown.edu/studio/item/bdr:tv666xk7/
