Talking Off-Label: The Role of Stasis in Transforming the Discursive Formation of Pain Science

Abstract

This article uses Foucault's enunciative analysis and stasis theory to explore the rhetorical work of the Midwest Pain Group (MPG) as its members struggle to collaborate across disciplinary difference to transform the discourse and practice of pain science. Foucault's enunciative analysis explains how discourse formations regulate statements, but not how formations can be transformed. We argue that stases can be thought of as nodes in the networks of statements Foucault describes and that stasis theory explains the rhetorical means through which members of the MPG work to transform the discourse of pain science. As the members of the MPG confront the epistemological incommensurability that exists between their individual disciplines, they establish a meta-discourse in which the definitional and jurisdictional stases help them invent a new definitional topos. We describe the way this rhetorical work occurs “off- label” in violation of the discursive restrictions of scientific disciplines, regulatory agencies, and insurance institutions.

Notes

¹MPG is a pseudonym, as are all subject names.

²Unlike many pharmaceuticals-sponsored events, presentations are almost exclusively delivered by unpaid MPG members who focus on results and limitations of research reports. In two years of data-collection, no more than a half-dozen paid pharmaceuticals stump-speeches were observed. In fact, the MPG has semi-routine problems with funding because of their insistence on open, limitations-focused, and off-label discussions.

³Critics often equate Foucault's concept of discursive formations in the Archaeology with disciplines, but we take a discursive formation to be a larger entity that includes individual disciplines. Thus we are interested in the transformation of pain discourse, which supersedes the disciplines such as neurology or psychology that participate in the discourse on pain. Our doing so is justified by Foucault's comments in the Archaeology that “Archaeology does not describe disciplines. At most, such disciplines may, in their manifest deployment, serve as starting points for the description of positivities; but they do not fix the limits: they do not impose definitive divisions on it; at the end of the analysis they do not re-emerge in the same state in which they entered it; one cannot establish a bi-univocal relation between established disciplines and discursive formations” (178–179).

Additional information

Notes on contributors

S. Scott Graham

S. Scott Graham is a Lecturer in the Department of English at Iowa State University, 203 Ross Hall, Ames, IA 50010, USA.

Carl G. Herndl

Carl G. Herndl is Professor in the Department of English at the University of South Florida, 4202 E. Fowler Ave., CPR 107, Tampa, FL 33620, USA.