Saunders’s Use of ‘Total Pain’

In this first chapter, I explore how Cicely Saunders herself used ‘total pain’, focusing on her publications in medical, nursing and other journals. Starting with early ideas that might seem suggestive of ‘total pain’, I chart the various accounts of the term in Saunders’s output from its first mention in 1964 as Saunders repeatedly uses ‘total pain’ in various forms and contexts to describe her practices of attention to the whole person and open communication, as well as to raise support for better care for dying people and their families. Far from the static concept often assumed, Saunders’s own approach to the definition of ‘total pain’ across forty years is flexible, changing emphasis and content depending on her audience. This ‘definitional confusion’ makes it unclear whether ‘total pain’ is an experience, an approach or something else. I end by considering the seemingly endless permutations and interpretations of the term that now exist.