When you get an itch, try to scratch yourself until the nail penetrates the skin: suddenly the initial pleasure will turn into pain; that is, it is something so omnipresent that it comes about whenever sensation reaches a certain threshold,2 being perceived in our indeterminate felt-bodily isles (small pangs, intense itching, heat and chills, etc.) every time the dominant feelings are put aside. Whatever the specific characterization one chooses for it, pain is a kind of basso continuo of existence: a melody full of changes (Valery) relentlessly claiming its rights over life, provokingly indifferent to any value or merit.3 When it becomes chronic (hence possibly the millenary Greek-Christian hostility towards the body), it convinces whoever suffers from it—that is, statistically speaking, almost half of the population—that everyone else doesn’t.4
Even though it is likely that one should suffer from only one type of pain at a time, its definition implies rather “a syndrome synthesizing various signs and symptoms” (Wall, 1999, 58) partially unified by language; in any case, it’s a cultural and symbolic experience and not only a sensorial one,5 so it cannot be reduced to the banal health/illness dualism. In my view, its indeterminate and very mixed dimension, hard to formalize and even to express in words, renders pain a particularly interesting example of a quasi-thing. In fact, it is neither a thing in the proper sense nor the property of something; it cannot be objectified6 nor detached from the person suffering, as it is impossible to imagine “a pain that doesn’t hurt somebody” (Grüny, 2004, 65). Sometimes it even turns into an atmospheric force that, pervading our (lived) pericorporeal space and creating a gloomy and pathological climate in it, has a dual action: on the one hand it calls for a kind of “helpless activity” (precisely reflected by a sense of oppression or wheezing in the chest);7 on the other hand it promotes attention, even of a social kind, for the sufferer. Besides, the sufferer is powerfully led by pain to emotionally pay attention to certain things and qualities of his or her environment.
It is surely true that physiological pain, problematizing our relationship with both the world and ourselves inevitably points to the symbolic if not even the sacred as memento mori, revealing the limits of humankind.8 However, what interests me here is rather a phenomenology of pain, understood as an experience that can’t be reduced to specific neurobiological activities (which can’t be phenomenally experienced) or intentional ones (indeed, what would be the noema corresponding to the noesis of pain?). The experience of pain here analyzed is peculiar to the felt-bodily dimension that, temporarily circumscribing the way one feels—how does this or that pain feel for me (what does it mean9 for me)?—appears unrelated to the doctor’s rational and strictly quantitative approach, without deserving to be taken as an obscurantist regression (as posited by an irreversible pessimist such as Adorno).
The first thing to note is that, testifying the dominance of feeling (the pathic) over knowledge (the gnostic), and involving not only the failure of normal functions but an overall restructuring of existence—following which contraction and solitude replace expansion and the relative self-oblivion implied by external perception10—pain is nothing short of the antithesis of seeing and hearing. I cannot say I have it, as I could say of a thing: in fact, more properly, it is not “in” the body, but that “in which” the body finds itself. We are exposed to it, it “happens” to us, it assault us, it is “inflicted” upon us, it “hits” us, it “comes” unexpectedly who knows when, just like any other quasi-thing; and we apparently can’t foster it nor can we avoid it, just like any other involuntary vital experience.
However, here the pathic is always also gnostic: in fact, while colonizing our attention, pain makes us aware for the first time of our felt-bodily isles and, paradoxically, also of the outside world, despite implying a retraction from it. Take being slapped, as an example. On the one hand it proves the existence of the outside world more than simple pressure and inertia (see Dilthey and Maine De Biran), to the extent that it interrupts the body’s usual functioning and generates (painful) places that were imperceptible before and in fact unexpected in the body schema; on the other hand, it also sheds light on the whole felt-bodily dimension and its problematic belonging to the subject.11 The situation appears instructively contradictory: any felt-bodily area, be it outside or inside (this is the emblematic case of the transplanted heart, according to the well-known example offered by Jean Luc Nancy) becomes really mine only when it is painful, and yet that very pain shows its contingent belonging to the sufferer.
These neophenomenological considerations obviously prescind from the natural philo- and ontogenetic tendency to functionalize pain—that is, to give a meaning at all costs to what should not be. In any case, we can see the inconclusiveness of the arguments for which pain is a pathological indicator and possibly a general warning sign of the body, or even the punishment for inappropriate acts compensating for environmental risks for humankind and thus acting as a warning for the future.12 In fact, there are too many exceptions to this semiotic teleologization of pain, which is convincing only with regards to circumscribed lesions and wrong motions, but certainly is not as a comprehensive explanation. This is due to a number of reasons: the late appearance of the most serious diseases (especially cancer), the often “differed” nature of pain (a pain in your ear can actually result from an inflamed molar!), its coinciding with the pathology itself (think of trigeminal neuralgia), as well as its occasional hindering therapeutic objectivation. In short, stating that “every animal mainly learns through unpleasant experiences” (Buytendijk, 1961, 88) or, in an evolutionary perspective, that pain is a warning sign aimed at preserving the species works as a thesis only when it comes to moderate pain; otherwise it has rather grotesque implications—and, in any case, it doesn’t explain the paralyzing and organically catastrophic effect of intense pain, or of pain understood as a quasi-thing devoid of teleological cautions.13 Over the question of the meaning of pain—which is typical of any metaphysics and relatively explicit theodicy, implying the equivalence between pain and guilt—I shall here prefer the phenomenological question regarding the specificity of the experience of pain.
Let’s start from the supposed (and overestimated) incommunicability of pain: while obviously being “not exactly replicable” (Wittgenstein) and therefore only certifiable through introspection, pain has its own typicality—otherwise it wouldn’t be even recognized by the subject feeling it. Also, pain is communicative in the sense that—evidently echoing something universally human and acquiring stable social masks14—its description is so easily understood that it generates an imaginary pain even in the simple spectator.15 Due to its “porosité de soi à l’autre” (Le Breton, 1995, 189), thanks to which we often empathically feel the other’s symptoms, the experience of pain seems to be no more incommunicable than any other first-hand experience.
So we do talk about it. And sometimes the topological, qualitative, and agentive description of pain, while proceeding by approximations and exclusions up to reaching full evidence with the last adjective of the list—“yes, that’s exactly how I’m feeling!”16 is a legitimate verbalization also endowed with great diagnostic and prognostic value. Of course, whenever we are describing pain, we are powerfully affected by the interlocutor’s status (doctors, friends, or relatives) as well as by metaphors that are both efficacious and devoid of any reference to actual experiences (who really knows what it feels like, say, to be stabbed or bitten by a dog?).17 Most of all, we are forced to resort to an agentive language that, while being partly erroneous, not only favors the externalization and therefore the communicability of pain,18 but also turns out to be particularly enlightening about the nature of a quasi-thing. In fact, the aggressive entity that we distinguish from the patient partly hides the dynamic of the experience of pain,19 and yet partly brings to the fore the pathic and unintentional character20 of our felt-bodily communication with quasi-things.
However, verbalizing pain does not mean only communicating it. Temporarily bracketing Job’s question regarding the lack of meaning of the “ontological assault” (Garro, 1992, 103)—whose only outcome seems to be to worsen pain by making any “metaphysical heedlessness” illegitimate (Buytendijk, 1961, 22, 27)—verbalizing pain also means subjecting it to a progressive hermeneutics. In fact, as soon as someone takes our pain seriously, “believing” and pitying us, we feel comforted. The same happens with the simple naming of pain, which partly mitigates the anxiety of non-meaning, partly responsible for the intolerability of pain itself: the name that my pain “deserves,” were it even a neologism coined ad hoc, is something that, in fact, orders and controls an otherwise absurd experience, which leaves us no option other than screaming. It eliminates the guilt that inevitably weighs on undiagnosed pain, all too superficially classified by medical science as only “psychological” pain (that is, imagined)—at best taken to be a self-complacent exaggeration aimed at demanding attention, and at worst regarded as a socially (and financially) harmful simulation. However, once named, pain may be subject to the expert interpretations of the shaman, the doctor, but also the psychologist, who is maybe interested in discovering that what is coded as pain is actually some other meaning of life.21 Unless, as an event without a cause, it is an exception threatening the fabric of habit necessary to the lifeworld (à la Husserl), our pain turns into the “particular case of some pathology” (Gadamer, 1996, 120): hence the full social legitimacy of suffering. However, and this is what interests us here, it also turns into the qualified aggression of an external agent that is even more active than things proper.
Yet, at first glance, the quasi-thingly nature of pain seems to be contradicted by its more popular scientific interpretation. According to the latter, pain is not so much a state or the reaction to a stimulus but rather the very motion by which we try to escape or stop pain (a motion that is painful insomuch as it is vain).22 In other words, pain would be the pathic, contractive consequence of an “escape” that, non-coincidentally, finds great relief in any practice of relaxation that manages to make the initial contraction fluid again. Be it more or less realized, in any case pain is a dual motion in which—contrary to what happens in pleasure, hence the well-known convertibility of the one into the other—the centripetal prevails over the centrifugal. Differently put, pain is “a conflict between restriction and expansion internal to the felt-body, which takes the shape of a withheld push to move away. Extending itself, this push grows as opposed to an obstacle that, stopping it with the greatest strength, rejects it” (Schmitz, 1989, 157). What makes it clear that pain is an impulse to flee, inhibited and then pushed back into narrowness,23 is the fact that what is therapeutic is not to obey to it (to “bite the bullet” and “man up” possibly to the point of heroic algophilia24 in the sign of contraction, with clenched fists, lips, and teeth), nor to escape it by means of distraction, given that pain completely takes over one’s mind. What is therapeutic, rather, is the externalization of it,25 whether it consists in following the impulse to flee, with (possibly culturally coded) cries and lamentations or in disabling the contraction through stillness, as in relaxation, hypnosis, autogenous training, etc.
Therefore pain, proper of and foreign to us at the same time, is somewhat a misunderstanding. In fact, both pain and the sufferer “tend to move in the same direction; that is, they both tend to flee, but they do so in mutual opposition so that the expansive impulse encounters a very powerful obstacle. It’s as if two escapees stumbled into each other” (Schmitz, 2003, 225). But the agentive interpretation, ontologizing a state (“it hurts”) into an opponent (“it hurts me”) that must be “defeated”26 makes it so that we phenomenologically experience pain as a quasi-thing. This is also due to the already mentioned bipolarity of quasi-things: in the case of pain, the physical cause is surreptitiously and conceptually—that is, non-phenomenologically—added (say, by the doctor) to the action/effect relation, thus also underestimating all kinds of pain blatantly caused by non-physical causes.
Thus, the fact that pain is not a homogenous state but a dynamic conflict does not exclude at all that it is felt (and long before the seventeenth-century establishment of the ontological and no longer humoralist conception of diseases) as an external and aggressive quasi-thing—besides, a quasi-thing that is so indispensable that it unexpectedly rises to the role of legitimating self-awareness. Indeed, any felt-bodily affective involvement individualizes “my” presence, reaching its peak especially with felt-bodily narrowness in which anxiety, and even more so pain, restrict my previous exposition in the world, nailing me to a felt-bodily localization that is as oppressive as the physical-bodily one. Pain forces me to regress to a “primal place” (Schmitz, 1964, 196) and an absolute presence that is both spatial and temporal,27 obviously inaccessible to stoic heroism. Ultimately, the presentification induced by pain as authentic principium individuationis (from the simple pinch on up) and, therefore, as a guarantee of experience otherwise prey to confusion and subject to doubt—and, in the case of happiness, annihilating and largely incommunicable28—is something extremely penetrating, because it is the indirect result of a failed escape from presence.
Therefore the quasi-thingly presence (of pain) contributes to the genesis of the subject. This is all the more so if it is true that “the constitution of the self is not realized ontogenetically in the mirror stage or in the relations of recognition”—which are precarious moments—” but rather in the primary negative experiences of pain and disease, rejection and prohibition. It is from the narrowness of a life folded onto itself that the self emerges” (Böhme, 2008, 142). As experimentum crucis, through which an adult “can always repeat the birth of his or her self” (ibid.) or consciousness,29 pain—certainly not sharp pain, entirely seizing and destroying the person—finds here a felt-bodily positivization that is obviously neither doloristic nor masochistic. As an “experience of affected self-givenness, that is, as the certainty that it concerns me,” pain can definitely be considered, with Adorno, “memory of the nature of the subject” (Böhme, 2003, 108): a pathic-affective experience that is-always-mine and that only later, ontologized and externalized in the dimension of the third person, turns into having pain.
If health is a form of self-forgetfulness and organic silence that medicine cannot produce but only help nature restore,30 being something that cannot be extrinsically certified,31 pain unexpectedly turns out to be even the outcome of chance. This certainly holds not for the autonomous person, psychotically armored against any external threat to the point of ethical heroism, but for the “sovereign” person, who is superior because “able” to make a task of her felt-body, not always and obsessively resisting pain (up to the loss of dignity), but training to welcome pain, thereby often making it more tolerable. This is not, of course, about accepting any pain or rejecting analgesic therapies, which are still possible within precise limits and have palliative value,32 but about learning how to let something happen to us. Not necessarily bound to diversionary techniques,33 the sovereign person, knowing that the pain gets worse just when she opposes it, “flattens out, does not […] want anything and […] accepts everything that happens” (Böhme/Akashe-Böhme, 2005, 68). Thus it is by the virtue of this “good” everyday regression from the “I” to the “to me” (sleep, sex, light pain, etc.) of primitive presence (which, in its subjective certification, cannot be reduced to a merely nostalgic-archaeological function or to a vegetative limit point), that, provided we do not consider any immediacy an occult mediation, we learn not to obsessively resist the experience of pain and, simultaneously, to make an “ought” of the “nature-that-we-are.”34
Some have said that, tragically showing our vulnerability, pain certifies our felt-bodily existence in the very moment in which it risks devastating and almost annihilating it. This position is obviously opposed by the views for which pain is rather an alienation of the body from the I, or a scission of being and bodily zones between an I and an Es:35 in these cases, there is actually an escamotage, thanks to which the individuation (or production: self-harm) of an epicritic pain attempts to hide the evidently unmanageable, protopathic pain, and thereby re-establishing some relation to the world.36 On the other hand, for those who think that the subject “becomes” the pain he feels37—to the point of being unable to project himself other than in pain and feeling out of sync compared to the others’ and the world’s time frame38—far from being an individuation of the subject, pain is rather the collapse of his identity. Taking the future away from the sufferer—forcing her to be pathologically sensorially hypervigilant towards the next “attack” and to idealize a deceptively suffering-free past—pain would be so senseless that it “prevents any appeal to thought, will, or feeling” (Buytendijk, 1961, 131). In short, it would inhibit the expression of the suffering subject, often socially stigmatized, so as to almost induce alexithymia.
However, in the case of pain (normal pain, that is) as a quasi-thing, the situation is different. After all, even isolation, the relative loss of the power to expand in the world,39 is but a variation of the ordinary relationship with the world. As for the predictable objection that the genesis of the subject is proven not so much by pain but rather by happiness, the answer is easy: individuation could make no use of a state such as happiness, which annihilates every hetero-relation, erases differences, and gives everything the same tone. Differently put, individuation needs failure,40 a problematicity arising exclusively in the presence of “the division into subject and object, the experience of an opposite something,” whereas “to dwell in happiness, to experience happiness within ourselves, is foreign to everything which has a problematic character” (Buytendijk, 1961, 22).41 In my terms, what certifies the subject—of course, a subject-to rather than a subject-of—is especially the encounter with quasi-things and, most of all, with pain.
It is well known that “the new state of health is not the same as the old one” (Goldstein, 1995, 310), as recovery is never a simple going back to the prior state: it entails experiential “scars” (both on the body and in memory). Yet the conservative paternalism that stigmatizes today’s algophobia, by treating it as a reductionist medicalization of life and a desymbolization that makes pain all the more intolerable and chronic the more it considers it (deceptively or not) curable,42 certainly doesn’t seem highly desirable. Its reasons, which can be summed up in the critique of the dogmatically Enlightenment-like trend to degrade pain to intolerable atavism,43 must never be exaggerated.44 It is surely ethically suspicious to deceive the patient about the total success of algology, thus falling from algodicy into a no less metaphysical algophobia, for which all pain would be anachronistic—as long as the pain is not too intense or long-lasting, and as long as the waiver to analgesics and anaesthesia is a free choice and not a discriminatory condition. However, it is just as suspicious, if not more so, to patronize the sufferer by talking about the (supposed) meaning of pain in the universe,45 perhaps even considering him to be in a privileged position.
The will to soothe pain, thus adapting to progress (with a small p, of course), does not mean necessarily to join a mass hedonism that, being the true reverse of scientistic utopianism, considers pain to be just a nuisance without any experiential value. On the contrary, what we are also stems from how seriously and with what “competence” we welcome the quasi-thinghood of pain,46 thus claiming a right to chance (also of suffering). To be clear: I do not intend to generalize the need of traumatism inherent in rites of passage or the nihilistic-destinal view that pain, being a fixed tribute for humans, is directly proportional to the artifices with which one tries to limit it.47 What I wish to do is simply restate that, despite being apparently threatening for the subject—as a limit-situation (Jaspers), presentifying par excellence and particularly revealing of emotional and felt-bodily involvement—pain actually guarantees the subject’s genesis and awareness. Accustoming us to (well) regressing up to absolute presence and showing us situations over which we have no control, pain—as such neither punishment nor redemption—makes us better and often, with its socially unifying force, generates the community of destiny that at least partly soothes our condition.48
In this sense, being mature “patients” does not mean only participating in each therapeutic choice and being apprized of the feasible alternatives, or accepting the disease, claiming not to “be disenfranchised by the authority of the experts” (Gadamer, 1996, 19). It also means valorizing as much as possible every declination of the pathic existence, without always and immediately resorting to the doctor,49 thus turning even the unpleasant sensations we happen to feel in (felt-bodily) self-care into an estesiological possibility for and of the individual. That’s why, even when doctors, as they say, have “found” nothing about our pain, we have always found something: that is—“doleo ergo sum”50—our irreducible, pathic subjectivity, by virtue of a form of initiation hopefully less tragic and less theologically oriented than that of Job. In accepting the contingency of pain and its intrusive quasi-thingly nature, pathos, aisthesis, and ethos unexpectedly converge. Ultimately, pain ceases to claim the arrears, so to speak, only when we do not obsessively try to eradicate and minimize its uncanny presence. That is, in a nutshell, when we turn it from mere non-entity to an uncanny quasi-thingly partner.