Behavioral economists agree that market value is based not only on the vicissitudes of financial markets, but in a system of symbolic exchange which trades on the meanings that consumers attach to goods. If we agree that value creation is entwined with meaning production, then managing brand equity is tantamount to managing brand semiotics (Oswald 2012, 2015). In this article, I discuss the advantages of semiotic research methods for decoding consumer experiences and translating them into marketing strategy.

I focus specifically on the innovative research techniques we used to decode the meaning of chronic pain for patients, one of the most elusive areas of consumer behavior. Pain research poses unique research challenges because patients have trouble verbalizing what they actually feel. The case illustrates the advantages of semiotic ethnography and metaphor elicitation to decode the nonverbal discourses consumers use to describe their pain experiences. Findings led to a new understanding of chronic pain based not so much on its effects on the body as on consumers’ lifestyles and goals.

What is Semiotic Ethnography?

Semiotic ethnography accounts for tensions between the codes that structure cultural norms and the messy, unpredictable nature of human behavior. On the one hand, semiotics brings a degree of objectivity and science to ethnographic research inasmuch as it is rooted in linguistic science and the theory of codes. It draws from Levi-Strauss’s ([1963] 1974) famous structural approach to culture, which exposes the underlying code system structuring the meaning of goods and consumer experiences in field sites. Semiotic ethnography accounts for the multiple code systems at play in the ethnographic situation, including consumer speech as well as nonverbal signs such as designs, consumer rituals, social interactions, and the disposition of goods in the lived environment. Because semiotic ethnography seizes consumer behavior in action, it also exposes the unique ways that consumers perform these codes in everyday practice.

Research Design

Two-hour ethnographic interviews were conducted in the homes of 24 men and women, ranging in age from 35 to 65 and spread over three U.S. markets. All respondents had been suffering from chronic pain for one to ten years and were looking for alternatives to the pharmaceuticals and over-the-counter pain medications they were currently using.

Semiotic ethnography was used because it provides access to an array of nonverbal codes in the home environment that reflect consumers’ lifestyles, mood states and social life. We also introduced an unorthodox methodology to the ethnographic toolkit by using projective tasks that invited consumers to associate their experiences of pain with nonverbal symbols. This two-pronged methodology exposed parallels between consumers’ psychological projections and the semiotic analysis of their domestic space.

The Semiotics of Pain

Early in the interview, respondents were exposed to projective exercises that prompted them to associate visual symbols and designs with their experiences of both pain and pain relief. The visual stimuli consisted of two-dozen abstract paintings by modern artists such as Appel, O’Keefe, Picasso, Mondrian, Kandinsky, Pollack and Delaney where the emphasis is on form and emotion rather than on the characters, stories and landscapes of figurative painting. Respondents chose the top two images that best represented pain and pain relief in terms of visual elements such as color or shape. Even though none of the respondents met each other and even though they were chosen from the phone book rather than from a database, there was a high degree of consensus in their image choices. In fact, the symbolism they associated with pain developed into a kind of shared code system.

Over the course of each interview, consumers learned to associate a certain sensation of pain with specific colors and designs in the images. Over the course of 24 interviews, there emerged a high degree of agreement about the association of pain sensations with specific symbols and colors in the images. For example, blue stands for the self, red stands for intensity, jagged lines represent the jabbing, pulsing sensations of pain and squiggly lines stand for chaos. Pain relief softened the red to pink, smoothed out the jagged lines and brought order to one’s life. Respondents eventually stopped using words like “pain” or “heat” and used these symbols to communicate instead. Over time, a kind of “pain lexicon” emerged that enabled researchers and respondents to communicate about pain sensations by means of these nonverbal symbols.

Consumers most frequently associated two paintings with pain: Appel’s Angry Landscape1 (1967) and Delaney’s Untitled2 (1954). A semiotic analysis of the two images suggests that pain’s effects on the patient’s spirit and lifestyle outweigh its physical sensation. Consumers chose Angry Landscape (1967) because the jagged lines and haphazard movement of red, yellow and orange against the black3 background resemble the chaos and disorder that pain has introduced into their lives. The eerie figures suggest the threatening, dark mood brought about by pain. And the streak of yellow moving on a diagonal from top to bottom represent pain’s heat and intensity. Respondents associated blue with the cooling, stabilizing state of the Self without pain. The patch of blue in the Appel painting suggests a reduced Self that is subordinated to the overall violence and chaos produced by pain. Consumers chose the Delaney picture because the irregular squiggly lines communicate the chaos and lack of control caused by pain. The blue shadow behind the lines represents the diminished Self, overwhelmed by the chaos of pain.

Pain Relief

Consumers reported that treatments never fully eliminate pain. They associate pain relief with visuals that soften the intensity and heat of the colors, smooth out the jagged lines and bring harmony to chaos. They also said that the color blue, a symbol for the Self in the pain lexicon, gets bigger, suggesting that pain relief represents an enhanced sense of control and personal integrity. They most frequently associated two paintings with pain relief: Georgia O’Keefe’s Music Pink and Blue, II,4 (1918) and Mark Rothko’s White Center (Yellow, Pink and Lavender on Rose) (1950).

The Semiotics of Domestic Space

A shared consumer discourse emerged from the picture sort exercise that emphasized the effects of chronic pain on consumers’ emotions, social lives and life projects. This message was also reiterated in the semiotics of consumers’ lived environments because life with chronic pain dramatically alters consumers’ ability to keep house, complete projects, organize their possessions and even manage their pain treatments.

A dwelling is a kind of text that is organized by cultural codes for decorating and furnishing the home. Codes articulate the domestic space into binaries such as sacred versus profane and public versus private. Social norms shame us into keeping house and organizing our possessions in tidy cabinets and closets with adages such as “cleanliness is next to godliness.” Although each individual interprets these codes according to personal tastes and lifestyles, cultural norms account for the fairly consistent arrangement of spaces, possessions and traffic flow within the home. For chronic pain sufferers, the home reflects the gradual decline of personal control over one’s life as the pain continues. Hoarding discarded goods is the most obvious manifestation of their inner chaos.

In the early stages of chronic pain, consumers contain the chaos by storing discarded goods in closets or extra bedrooms. In the advanced stages of pain, discarded clothing, junk and boxes gradually extend from the private areas of the home into the public spaces. The mess fills up hallways and bedrooms and crowds the living room. Even the kitchen is piled high with dirty dishes, pans and refuse. [Figure 1.]

At one home, the respondent told researchers to enter by the back door because piles of discarded newspapers and Christmas decorations blocked the front door entrance. In these kinds of households, researchers had to remove junk from chairs and sofas in order to find space to sit down for the interview. Even respondents’ beds were piled high with clothing and papers, leaving only a small space for the individual to sleep. The goods in these homes seemed to possess the people rather than the other way around. As the chaos takes over their homes, consumers increasingly dissociate themselves from their surroundings, frozen in a state of mental denial about the dysfunctional state of their environments. In one household, a young teenager arrived home from school and dodged stacks of hoarded goods when he went upstairs as if habit had desensitized him to the environment. Patients and family members alike seemed frozen in a state of mental denial about their dysfunctional homes.

Consumers living with long-term chronic pain also collapse boundaries between sacred and profane areas of the home that traditionally define where one stores prescription drugs. Rather than storing their medications in special cupboards and cabinets in the private areas of the home, patients would leave them in public areas such as the living room and kitchen, on coffee tables, kitchen counters and bookcases. Pain treatment consumed their daily lives. Over time, patients often lost control of their medication use, leading some to addictive behaviors such as taking double and triple the recommended dose of over-the-counter medications such as ibuprofen.

Implications for Qualitative Research

Projective tasks are designed to elicit information about consumers’ deep emotional and mental states whereas ethnography traditionally focuses on the social and cultural factors associated with consumer behavior. By embedding the picture sort exercise within the ethnographic interview and observation of patients in their homes, the study exposed the paradigmatic implication of the physical, emotional and lifestyle effects of pain on consumers’ lives.

The two-pronged approach illustrates the reliability and objectivity of semiotics-based research. Rather than relying upon researchers’ subjective interpretations, semiotics methods draw inferences about consumers based upon the iterability of findings on more than one level of consumer experience. From the psychological projections to the semiotics of the lived environment, consumers reiterated – nonverbally – that the most troubling effect of pain was the chaos and lack of control it introduced into their mental states, their lifestyles and their environment. Researchers discovered that “what chronic pain patients want” is a restored sense of order and purpose in their lives.

The multi-dimensional design of the research also bridged the gap between consumer insights, marketing strategy and advertising. Findings inspired ideas for new pain treatment products and pharmaceutical brand positioning. Furthermore, by linking the experience of pain to visual symbolism, the picture sort exercise provided insights for developing marketing communication strategies.


Lévi-Strauss, Claude ([1963] 1974). Structural Anthropology. Trans. Claire Jacobson and Brooke Schoepf. New York: Doubleday Anchor.

Oswald, Laura (2012). Marketing Semiotics: Signs, Strategies, and Brand Value. New York: Oxford University Press.

____________ (2015). Creating Value: The Theory and Practice of Marketing Semiotics Research. New York: Oxford University Press.