These headaches leave one like sand which a wave has uncovered - I believe they have a mystic purpose. Indeed, I'm not sure that there isn't some religious cause at the back of them - I see my own worthlessness and failure so clearly; and lie gazing into the depths of the misery of human life; and then one gets up and everything begins again and is all covered up (78).
The above quote is abstracted from the letters of Virginia Woolf, a woman who suffered from terrible headaches for nearly the entirety of her life (Coates 242, Ingram). In this quotation, Woolf considers her experience of pain in relation to spirituality and philosophy, and her sorrow and lost sense of self-value demonstrate a degree of connectivity between so-called “physical” pain and “psychological” pain. Esteemed neuroscientist Patrick Wall explores the roots of this physical- mental distinction in his final book, Pain: The Science of Suffering. In his chapter on the “philosophy of pain” (17), Wall focuses on how Western philosophy primarily developed far before modern scientific developments in the understanding of pain remain the basis of cultural attitudes toward pain in the Global North. Descartes essay "L’Homme" is mentioned in this and other texts (Hains, Hardcastle, Grahek) as one of the founding text for the theory of dualism, that concept which conceives of the the mechanical, animalistic, and rude body as “fundamentally distinct from and subordinated to the privileged term in the dichotomy” (Cherniavsky 26), espirit, meaning mind, soul, or spirit (Wall 18). Descartes develops the idea of “animal spirits” (Hardscastle 3), tubes within the body through which that which would cause pain is pulled from the bodily origin of pain to the brain, which then allows the pain to become a pure experience. For Descartes, it is the mental function of humankind, which not only makes us human but allows us to exist, epitomized in his famous cogito ergo sum and expanded in his Discourse on the Method:
From this I knew that I was a substance the whole essence or nature of which is simply to think, and which, in order to exist, has no need of any place nor depends on any material thing. Thus this “I,” that is to say, the soul through which I am what I am, is entirely distinct from the body and is even easier to know than the body, and even if there were no body at all, it would not cease to be what it is (19).
Yet in his Pain, Wall argues against the separation of mind and body, sensation and perception, and furthermore, the utter disregard and general lack of respect for body processes. Wall explains that even those events considered the most physical, such as a professional athlete running a marathon and entering “the zone” require a great deal of mental exertion as well (25). Cherniavsky furthermore emphasizes the importance of Marxism as one of the few “major intellectual tradition[s] before the twentieth century to understanding human creativity and the production of value as fully bound up in the materiality of embodied life” (27).
Wall wrote Pain while going through some of the most painful final stages of terminal prostate cancer, and explains that his composition of this book is “to give the readers the power of understanding processes in their own body” (viii). It is important to note that Wall’s use of the word “body” generally includes the mind and any spirit as part of its definition.
Wall approaches pain from a predominantly if not completely Western philosophical and Globally Northern scientific perspective, which he acknowledges later in the book (67). Yet many of his theories and even examples utilized agree with the philosophies of the Kyoto School of Zen Buddhism.
While Zen Buddhism has numerous names in various language (Chán in Chinese, Seon in Korean, Thien in Vietnamese, etc.), I will be referring to this school of Buddhism by the Japanese term Zen simply because the Buddhist scholars with whom I intend to dialogue are from Japan and write predominantly in Japanese. Furthermore, the justification for relying solely on Japanese Zen scholars from the Kyoto school simply resides in the fact that I myself read Japanese and am thus able to consider these works in their original language. All Buddhist terms that do not belong explicitly to Zen Buddhism will be listed in Sanskrit, because these terms are more accessible to an English speaking audience that, for example, uses the term nirvana (Sanskrit) versus nibbana (Pali). Furthermore, many of the modern Kyoto school, and pre-Kyoto school, translators prefer Sanskrit to Pali terms in practice (Enlightenment Unfolds, Nishitani, Last Writings). Non-English words will additionally be printed without italics, as a political statement. “The combination of the foreign term, marked by its italicization, and the explanation . . . read as an exoticization of a culture different from the one the implied reader is assumed to be part of” (Nodelman and Reimer 176). Additionally, partially in tribute to Wall and because such distinctions are not made in the Kyoto school’s philosophy (An Inquiry into the Good 49), I will not distinguish between physical, emotional, and mental pain in the remainder of this essay.
In January 2006, I was in a car accident, which has left me in constant pain ever since. This pain, which is an effect of the muscles contracting in preparation for the collision, resides primarily in my upper back, neck, and shoulders, and is likely “incurable.” Throughout the years, I have depended almost solely on mental health professionals and medical doctors to “cure” the pain through such practices and medications as acupuncture, physical therapy, physical training, narcotics, Qigong, massage, herbs and teas, anti-depressants, and Tai Chi (Untitled 3). Yet, what are the implications of “curing” pain in light of a philosophical model in which dukkha (suffering) is a reality of life, as well as a path to bodhi (Enlightenment)?
In 2009, I wrote an essay that sought to answer this question, in which I found, and argued, that “the [pain sufferer] can utilize his pain and realize it as potentially becoming or already existing as one of the eighty-four thousand dharma doors to enlightenment” (1). While the nature of the paper makes it impossible to accurately summarize without losing the overall scheme of the argument, I will highlight one key point, which is the numerous instances, noted in Buddhist philosophy, when monks subjected to extreme physical suffering experience the realization of enlightenment, including the monk Linji following the punishment of sixty blows from a senior dharma brother (Enlightenment Unfolds 132).
In this study, I will consider a number of questions with regard to pain on a both deeply subjective and transnationally significant level. For example, in consideration of the three primary United Nations documents pertinent to universal human rights, to what extent are so-called “bodily” rights addressed? As explained by Cherniavsky in her brief essay on “Body”: “to self oneself bodily is tantamount to selling oneself, to an erasure of personhood that paradoxically, would suspect the seller’s ability to enter into such a contract in the first place” (27). In order to be considered as warranting these human rights, a human body is required, yet the espirit is not, whatever its context; despite Western philosophy’s fascination with rationality, a number of U.N. charters, including the Declaration on the Rights of Mentally Retarded Persons, and the Declaration on the Rights of the Child explicitly states that “the child, by reason of his physical and mental immaturity, needs special safeguards and care, including appropriate legal protection, before as well as after birth.”
As a cultural studies scholar, I plan to consider the “historical contexts of the culture agenda” (Johnson et al. 14) with regard to the privileging of certain pain philosophies and responses to pain in U.S. Society, particularly within the current private insurance-driven healthcare system. For example, one issue with which I am keenly invested is the refusal of certain insurance companies to finance “less traditional” pain response methods, particularly those which do not seek to “cure” pain or “cure” depression associated with pain, but, rather, seek to help one come to terms with pain and/or further one’s understanding of the experiences of pain. Why will my insurance allow me to attend counseling sessions, purchase Vicodin, and attend physical therapy, but refuse payment for Qigong, meditation, or spiritual healing?
Some of the lingering questions and themes to which I plan to speak in this project include:
1. In what ways do U.S. healthcare policy and current cultural philosophies empower the dualist perspective on pain? For example, why is it assumed that I shall seek an MD for an illness, a mental health specialist for depression, and a religious/spiritual leader for spiritual despair (or philosophers for raison d’étre questions)? Furthermore, what philosophies have been elevated and which diminished in this distinction (i.e. Descartes versus Marx)?
2. How does the elevation and privileging of mind/soul over body in the aforementioned dualist theory extend to the privileging of people of certain occupations and/or non-normative physicalities? To what extent can the cultural preference for mental over physical account for the differentiation and privilege of “white collar” versus “blue collar” workers and the disempowerment of both “mentally” and “physically” disabled persons? What are and have been the implications of this philosophy on the treatments of animals?
3. Pain is generally understood as an undesired state of being. The International Association for the Study of Pain (IASP) defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” (qtd. Jackson 3). Yet, there are those who purposefully seek out pain, particularly as relates to sexual gratification. Most of the pain philosophers whose works I have encountered thus far have avoided the ideas of masochism or included extremely brief and slightly predominantly passages on the subject; Wall refers to a “quasi-legal underground sadomasochistic subculture” (14). Furthermore, athletes are often told “no pain, no gain,” and this concept of pain as a sign of achievement or means to something great can also be seen in the birthing process. To what degree can pain be understood as a not wholly unpleasant or sometimes pleasant experience?
4. The dangers of a pain-free existence are additionally well documented (Wall 49-52, Life Without Pain, Bar-On et al, Hu, et al.). To what extent is pain beneficial, even beyond medical explanations?
5. Chronic pain is generally defined as physical pain lasting for at least three to six months since its onset (Wall 117, Jackson 3, Cochran, Jr. 10, Phillips 11). As one who has experienced this chronic pain for over four years and identified as a chronic pain sufferer, I must ask myself whether or not I truly want the pain to be cured. While I certainly wish for a lesser degree of pain, the idea of living an existence pained only to the extent of a “normal” human suggests that part of my identity may be lost. In terms of the particular vocabulary surrounding chronic pain (“having chronic pain,” “my pain”), can we say that sufferers possess their pain and take ownership of it, such that they may wish not for complete alleviation, but only partial relief?
6. Elaine Scarry’s The Body in Pain: The Making and Unmaking of the World begins with a chapter entitled “The Structure of Torture: The Conversion of Real Pain into the Fiction of Power” (27). What are the implications of long-term physical pain when considered given the current political debates surrounding the use of torture in the so-called “war on terror”? In particular, how do Scarry’s theories surrounding torture as a two-part process including “a primary physical act, the infliction of pain, and a primary verbal act, the interrogation” (28), relate to negative emotions associated with pained existences and religious escapism as an accepted means of healing?
7. Because chronic pain manifests nearly always in the manner of an invisible disability, how do the additional factors of dismissal by medical professionals and lack of empathy or understanding from others affect the person in chronic pain? Furthermore, to what extent can this dismissal prompt the chronic pain sufferer to hide his or her pain, as suggested in Andrew Levy’s migraine diary A Brain Wider than the Sky, “I obsessed on the importance of making this headache in private; on making it as invisible as I could to other people” (77)?
As a means of exploring these and other questions, I will not only continue and review my web log (blog) on personal experiences with pain, but will additionally engage in conversation with many of the pain theorists, philosophers, diarists, doctors, etc. regarding their opinions and supposed facts regarding realities of pain. Additionally, I will actively work with a minimum of five other people experiencing chronic pain to further discuss themes addressed in this text-based research, my own opinions, and how their experiences with pain differ from my own. The point of these conversations are not to be ethnographic in nature, but rather to avoid beyond lost in Pain as a theory and/or focus too entirely on my own pain. Wall warns against both of these points in his Pain: The Science of Suffering, highlighting how his own theories regarding pain were reassessed when he became a chronic pain sufferer (vii-viii).
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