The Pain Scale Exercise

When I was in graduate school for writing I once went to office hours with one of my professors—a novelist and essayist who I was so overwhelmingly impressed by it was often difficult to speak to her. I went to office hours because I was trying to write a very specific scene in what became my eventual novel—a failed IUD insertion. I had no idea how to go about it. I had tried a couple of different methods, and none of them seemed to quite work, none of them fit easily within the book I was writing. I asked the writer if she had any advice.

She told me that in her experience, writing about difficult or painful things never quite worked until you found the right container to hold them. Sometimes the restrictions and limitations imposed by a given structure can help you more than complete creative freedom does. I took this advice and ran with it, and now when I write anything difficult I always start with an arbitrary structure. Even if that structure melts away as you edit and shape later on, you’ll have built your story on a good skeleton.

One of my favorite examples of this is the pain scale, an arbitrary structure you’ve likely encountered if you’ve ever gone to an emergency room in the U.S. I like to use this exercise when I teach the literature of illness and injury—it lends itself to those experiences! The pain scale structure forces you to write in fragments, and see what the enforced fragmentation does to your depiction of the experience.

The pain scale goes from 0 (no pain at all) to 10 (the worst pain imaginable):

0: no pain

1–3: mild pain (nagging, annoying, interfering little with ADLs (activities of daily living))

4–6: moderate pain (interferes significantly with ADLs)

7–10: severe pain (disabling; unable to perform ADLs)

Write a series of eleven fragments—one for each level of the pain scale—which discuss an illness or experience of pain you’ve had in your life. You can move in any direction, forward or backward in time. Use the structure of the pain scale to give form to the experience you’re writing about, thinking about how the unit of the fragment can be used to tell a story of pain or illness. Revise and edit the fragments until they feel like they tell the story you want to tell.

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If you enjoyed this prompt, check out Madeleine's upcoming workshop, Writing the Body, in which she shares more generative exercises that can help you explore different modes of writing and processing bodily experiences.

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