The multimodality and temporality of pain displays

The present paper takes an interactional approach to the problem of communicating pain. We ask how a shared understanding of this subjective and internal experience is accomplished. The focus is on the multimodal features of pain displays and the way they emerge and progress at the micro level of turn construction and sequence organisation within health care interactions. The setting of the study is family doctor-patient primary care consultations. Using multimodal conversation analysis, we show the emergent, temporal unfolding nature of pain displays. Initially there is an embodied reflex-like action where an immediately prior cause can be attributed retrospectively. An interjection or non-lexical vocalization may follow. An expression of stance on the pain is routinely made as talk is resumed. The other party's understanding can be shown early in the pain display shaping its unfolding with empathetic vocalizations and/or comforting touch which results in a jointly produced change in the trajectory of action. The implications of the findings for theoretical understandings of sound objects, language and communication, and for clinical practice, are discussed.