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``The pain isn't as disabling as it used to be'': How can the patient experience empowerment instead of vulnerability in the consultation?

Centre for Women's Studies and Gender Research, University of Oslo, Norway, awe{at}htil.no

Kirsti Malterud

Section for General Practice, Department of Public Health and Primary Health Care, University of Bergen, Norway, Research Unit and Department of General Practice, University of Copenhagen, Denmark

Aim: This study explores how doctors can help patients transform vulnerability into strength, instead of increasing a feeling of disempowerment. Methods: The authors analysed their findings from four previously written articles based on qualitative interviews with 10 women with chronic pain, comparing the reported negative consultation experiences with the beneficial effects of good treatment experiences, in order to identify potentials for change. Results: Altering the way in which the women are encountered may empower and help them deal with a painful life. Doctors can challenge stereotyped macro-structures of women's ``unexplained'' pain as hysteria by admitting the shortcomings of medical knowledge. The blame is then put on the medical discipline instead of the individual patient who presents bodily symptoms or reveals help-seeking behaviour that does not fit with biomedical expectations of what illness is and how it should be performed. Thus, the vulnerable position described by the patients can be converted or transformed into strength or resources in spaces that promote empowerment through recognition. Conclusion: Although doctors may feel helpless or puzzled in the consultation, they must take the responsibility for turning the consultation into a space for empowerment of the patient.

Key Words: Chronic pain • doctor—patient relationship • gender • medically unexplained disorders • qualitative interviews • recognition `recovery competence' • rehabilitation • (women) patients' perspectives

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