title: Ways of Hoping: Navigating the Paradox of Hope and Despair in Chronic Pain.
abstract: In this paper, we explore hope in the context of living with chronic pain. Individuals with chronic pain from temporomandibular disorder(s) were interviewed four to five times over the course of their 18-month participation in a clinical trial investigating the effectiveness of Traditional Chinese Medicine. We sought to understand shifts in participants' descriptions of expectations and hopefulness, particularly with regard to the work involved in counterbalancing positive thinking with buffers against disappointment. We found hope to be a dynamic and multifaceted mindset as distinct from being a single entity to be measured. Drawing upon Polanyi's concept of tacit knowing, we explore how different ways of hoping emerge and index one another in participant narratives. We offer a working typology of hope and raise as an issue the manner in which the paradox of hope--hoping enough to carry on while keeping hopes in check to avoid the ever-present possibility of despair--complicates simplistic notions of the relationship between positive thinking and the placebo response.
authors.affiliation: Department of Family and Community Medicine, School of Anthropology, University of Arizona, Tucson, AZ, USA. emerye@email.arizona.edu.
authors.forename: Emery R
authors.initials: ER
authors.lastname: Eaves
authors.affiliation: School of Anthropology, Department of Family and Community Medicine, College of Public Health, University of Arizona, Tucson, AZ, USA. mnichter@email.arizona.edu.
authors.forename: Mark
authors.initials: M
authors.lastname: Nichter
authors.affiliation: Department of Family and Community Medicine, School of Anthropology, University of Arizona, Tucson, AZ, USA. ritenbau@email.arizona.edu.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Ritenbaugh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D059350:Chronic Pain / Q000188:drug therapy* / Q000523:psychology*; D005260:Female; D065026:Hope; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008516:Medicine, Chinese Traditional / Q000379:methods*; D008875:Middle Aged; D036301:Qualitative Research; D011788:Quality of Life; D012069:Religion and Psychology; D014481:United States; D055815:Young Adult
keywords: Chronic pain; Hope; Placebo; Tacit knowing