Cohen argues that medieval pain is an individual phenomenon but also something that’s communal and shared. People either accepted pain as a holy experience, deliberately sought out pain, or ran from pain. Medical discourses, meanwhile, saw pain as an unfortunate but unavoidable fact of life. Although there were attempts at eradicating pain, generally it was seen as a part of life, if not a desirable spiritual outcome. This is because of medieval society’s structuring around religious pain and in particular Christ’s passion, meaning that pain is not only not preventable, but prevention is not desired. The key distinction between the thirteenth to fifteenth centuries and the time after it is that pain had a positive significance and came to be desired; suffering was characterized broadly as a good thing. As an example of this point of view, she mentions William of Auvergne’s claim that pain is good because it is bad. Madness, on the other hand, is an indication of “bad pain”– suffering that will be overcome by an external force like a saint.

In her introduction, she states that “This book is not about pain in the middle ages, for pain itself cannot be known; it is about what people thought and did about pain” (3). However, each person who experienced pain recorded and transmitted it in particular ways, with particular meanings. Chapter 6 of this book deals with the ages of man, arguing that each has its own level and kind of pain that can be expected. This is where Cohen mentions William of Auvergne, and other contemporaneous ideas that sickness and pain could be positive. Illness in this view is both a punishment for sin and a (positive) distraction from worldly things, in much the same way as suffering. Just as the physician can cure the patient, only Christ can cure humanity. This association continues in her discussion of late medieval framing of Christ’s suffering as lifelong– his pain, although it was undertaken freely, was also continuous throughout his life. If experiencing pain is potentially a salvific, spiritual experience, then Christ is the ultimate model.

Cohen’s belief that pain is a shared social reality is in line with Barbara Rosenwein’s research on emotional communities and also Amy Hollywood’s thoughts on melancholy. Both also line up with Cohen’s pain scripts, how people in particular situations– women in childbirth, for example– learn to react to pain in particular ways depending on what kind of pain it is. Public manifestations of pain were discouraged, and medieval martyr narratives offered a script for bearing pain more reservedly. However, pain– whether epilepsy, visions, or headaches– was broadly seen as outside the sufferer’s control. If pain leads to madness, then both are experiences their sufferers can’t choose to have or avoid, but their manifestations must be controlled.