Rusty Gentry Independent scholar
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Pain, Addiction, Patience, and Possibility: A Phenomenological Exploration of Chronic Pain and Addiction Abstract: In this paper, I address the issues of chronic pain and addiction within the context of a Levinasian framework, giving special attention to the notions of freedom, consciousness, the will, and patience. Initially, I address the character of pain, using Levinas to elaborate a phenomenology of pain. I then make a distinction between two types of pain: acute and chronic. I show how chronic pain essentially over-determines the will. In so doing it presents a serious threat to our very self-identity by locking us in something like an eternal present dominated by the consciousness of pain. In short, chronic pain involves us in an ordeal of freedom, the outcome of which may very well be addiction. Here I elaborate the notion that addiction, while arresting the eternal present of chronic pain, constitutes a more significant menace than that presented by pain in and of itself by virtue of the fact that it limits even the possibility of our conceiving of the future as a space of freedom. Addiction is a totalization. It makes one hostage to a future radically foreshortened by the imperative that one answer its only call: to fill the hole it has excavated in us. I show that addiction involves us in a cognitive, physical, and moral quagmire. Finally, I use Levinas’s work to point the way out of this situation. In particular, I develop his notion of patience showing that it offers the possibility for the addict to reconceive the future as a space of meaning, freedom, and moral recovery.
“By the grace of time, my friends!” Athos explained, “time is the father of opportunity; opportunity is the martingale of man.” Alexander Dumas, The Three Musketeers I. THE CHARACTER OF PAIN Pain, as Levinas contends in Time and the Other, nails us to the instant. He explains that “The content of suffering merges with the impossibility of detaching oneself from suffering. And this is not to define suffering by suffering, but to insist on the sui generis implication that constitutes its essence. In suffering there is an absence of all refuge” (T&O,69). In pain we are entirely engaged in, embattled by existence. Physical pain is the issue here, though as Levinas notes, this pain can only be “lightly called physical.” Despite the apparently counterintuitive nature of the assertion pain, even pain “of the body,” is primarily a conscious, which is to say mental, phenomenon, not a physical one. One may maintain, in fact, that pain is insignificant until it reaches a certain intensity at the level of consciousness. Levinas characterizes this settling of pain into consciousness as “The privileged situation where the ever future evil becomes present—at the limit of consciousness—is reached in the suffering called physical” (T&I, 238). Such suffering is especially problematic for one who has chronic pain, for one who suffers day-in-and-day-out from the same dominating consciousness of pain. Indeed, in pain there is no other consciousness.
Or rather, there is no
consciousness that can compete with it. Pain teaches us in an exemplary way that, phenomenologically, there are layers or formations of consciousness. Chronic pain is by definition, a strong formation. All else – hunger, desire, pleasure – is weak in comparison. At least initially, until the long process of learning how to cope with such chronic, quotidian pain is achieved – in so much as it can be — there is little else in life for the sufferer. Chronic pain is dominating. It is dominating precisely because it is manifested not primarily at the physical level, but at the level of consciousness. It strips us of our freedom, which is to say of our futuriority, of the condition of the possibility of possibilities, as Heidegger might say. We are not allowed to envisage the future because we are necessarily over-determined, immersed in the present. Levinas tells us that consciousness is what allows us to avoid and resist violence, because it leaves us time, and time – the future of which we spoke above – is the medium of freedom. “To be conscious is to have time—not to overflow the present by anticipating and hastening the future, but to have a distance with regard to the present. . . To be free is to have time, to forestall one’s own abdication under the threat of violence” (T&I, 237). This freedom, however, is precisely what is stripped from those who suffer from chronic pain. The violence of chronic pain cannot be forestalled; it is always already present in the form of strong consciousness. To be in pain is to be conscious of an Other from which no goodness can come. There is no freedom for those in chronic pain because this type of consciousness entails the “impossibility of detaching oneself from the instant of suffering” (T&O, 69). Thus, to be in chronic pain means to lack a certain consciousness of freedom and to be exposed to the violence of being at all times. “It is,” to cite Levinas again, “the very irremissibility of being” (T&O, 69). Pain not only creeps into and determines consciousness in general, it is especially transformative of our self-consciousness. It profoundly affects the way that we experience our power over life and its vicissitudes. Suffering violates one to the very core of one’s being. Pain transfigures one’s selfconception; it may irremediably cripple it. In its grips, one cannot feel protected in oneself from oneself. Levinas argues that the fear of death is one that is constantly deferred, “whereas suffering realizes in the will the extreme proximity of the being menacing the will” (T&I, 238). Here the connection to pain of the body and our experience of it in consciousness is abundantly clear. II. TWO TYPES OF PHYSICAL PAIN At this point we must explicitly distinguish between two types of physical pain: chronic and acute. The body and consciousness react to these in analogous, but different ways. Acute pain is intense, short-lived pain. For example, that which is experienced after surgery or a broken bone is disabling in a way that severely affects certain bodily activities. When one breaks one’s arm, it cannot be used for a period of time. It is expected, however, that such pain and the accompanying disability will abate as the body heals. The psychological consequences of acute pain are of a particular nature because of the knowledge that, though one may be unable to perform a particular action, X, at the present time, this function will soon be regained. Despair may be avoided by the awareness that the future offers respite. Acute pain thus does not fully qualify for the description of pain given above. While such pain may very well and most often does make one a hostage to the moment, the psychological effect is soon alleviated. This alleviation is the result of the gradual dissipation of the mental and physical manifestation of the pain, as well as, knowledge of the fact that such pain, along with its accompanying disability, will soon no longer affect one’s body. This knowledge makes a qualitative difference in the way that pain is experienced.
Similarly, understanding that pain is chronic in nature has qualitative effects of its own in terms of how it is experienced. Here we step into the profoundly disconcerting psychological realm that was elaborated in Section I. Chronic pain is persistent in nature, becoming the baseline of one’s existence. Moreover, it is generally accompanied with a permanent disability. It is often the case, however, that the disability is as much perceived as it is real. This perception is the result of the scarring psychological effect of ongoing pain. For instance, one of the most important activities for those suffering with some types of chronic pain is to exercise the affected area, perhaps alleviating the effect of the injury insofar as one strengthens the surrounding musculature. The resolution to carry through with such activity, however, proves to be very difficult for many. This is not only because of the actual pain involved in the activity; there is also the anticipation of pain or the exacerbation of existing pain. Of course, the less the sufferer exercises, the more muscles atrophy thereby potentially increasing pain because of a lack of support to the injured area. Moreover, one is more likely to re-injure an area that is weakened by nonactivity. Fear, however, plays a major role here, a fear not just of present pain but of pain to come, which can easily lead to a Sisyphean cycle the results of which may very easily, given what is often the necessity of a regimen of narcotic intervention, become addiction. The logic here is quite simple and ultimately devastating. One takes medication in order to alleviate present pain. Even if this medication works in that instance there remains the fear of pain to come. This can lead to taking additional medication in anticipation of future pain, which as we will see, results in a radical delimitation of the very notion of the future. The physical limitation of such pain is thus often as much the outcome of the consciousness and fear of pain as it is of the “thing-in-itself” – the physical injury and proximate cause. III. THE ORDEAL OF FREEDOM Chronic pain is maddening. While making the sufferer absolutely aware of the present instant, it awakens the despair of the impossibility of retreat, not now, not tomorrow, perhaps not ever. In pain, the “I” is turned into a thing that is subjected in the most insidious of fashions. This subjugation is tantamount to a lack of possibilities, a lack of freedom: “Suffering remains ambiguous: it is already the present of the pain acting on the for-itself of the will, but, as consciousness, the pain is always yet to come” (T&I, 238). One who lives with chronic pain must endure this double bind of suffering. Chronic pain never exists in this simple present elaborated by the indexical now; this suffering must also always be considered in the future. It will be there. This is one of the primary aspects of despair for the sufferer. Such constancy compounds the effects of pain, both physically and psychologically. Chronic pain is thus as dangerous to the soul as is moral pain. In chronic pain, we are likely to give ourselves over to the moral equivalent of masochism. Suffering becomes the focal point of life. Many hostages to pain of this nature, intensity, and endurance would certainly agree with Levinas that “The supreme ordeal of freedom is not death but suffering” (T&I 239). In suffering there is the tendency to become absolutely self-absorbed, to revel in the impotence of one’s egoism. Here we are exposed to the paradox of suffering, which is ultimately a paradox of identity. Chronic pain is a phenomenon that makes one different from oneself in a radical way. This difference may well become a negative identity. While despising oneself, one gives in to masochistic self-pity. It places one in the position of the Other for whom one can do nothing, in whose presence one feels impotent. Too often the result is that persons in pain are so self-absorbed by this Other that they ignore all others. Chronic pain can force itself into our being to such an extent that it becomes something with which we identify entirely. Thus, this type of pain is an instance of difference which obliterates difference
in its insistence on total identification. If self-absorption is one false escape of chronic pain, there is another more ravaging type of escape, one which falls at the extreme limit of this absolute identification: addiction. Indeed, freedom undergoes what is one of its greatest ordeals in addiction. In Totality and Infinity, Levinas maintains that human freedom lies in the future. In the case of addiction, we have an instance where this dictum does not hold. In fact, addiction is entirely about the future and enslavement. Pain nails us to the present moment, with little possibility for retreat. Narcotics offer one of the few possibilities for relief from chronic pain. Narcotics, however, can often be a devastatingly Janus-faced retreat, insofar as the dependency that is an unavoidable aspect of prolonged narcotic use may all too easily tilt into over-dependence, i.e., into addiction. Addiction mimics a retreat. It appears to offer a dulling of our pain in every sense, that is, physically and morally. In fact, addiction is a retreat into the future; it is entirely future oriented. Once addiction has taken hold, even in one’s most painful moments the future is all that matters: one is forever looking for the next fix. This phenomenon is, of course, self-perpetuating. Addiction is a totalization. There seems to be no opening through which the addicted person can escape. Taking drugs is no longer a choice; it is a physical and psychological imperative. In the grips of this totalitarian regime, there is no possibility for the other; one is entirely self-absorbed and future oriented. Moreover, one does not object to this self-absorption. The necessity of addiction is so great, in fact, that such a state is nothing out of the ordinary. The other cannot exist for the addicted person, because narcotics dull both physical and moral pain. This surcease of suffering is what allows for the extent of the selfabsorption, for the total lack of care that is a primary aspect of addiction. IV. SUFFERING, ADDICTION, AND PATIENCE: POSSIBILITIES. How, then, may one “escape” from such pain, from the prison of addiction? The promise of such an escape will be derived from a particular understanding of patience, and how patience allows for a re-assertion of the will, a re-conception of the future, and thus, the re-covery of a certain freedom, which seemed so hopelessly foreclosed earlier. In the section of Totality and Infinity, entitled “Time and the Will: Patience,” Levinas insists that the will contains a contradiction: on the one hand, “an immunity from every exterior attack to the point of positing itself as uncreated and immortal, endowed with a force above every quantifiable force,” on the other “the permanent fallibility of this inviolable sovereignty, to the point that voluntary being lends itself to techniques of seduction, propaganda, and torture” (T&I, 237). Thus, we have a picture of the will as both unmoved mover, suzerain of its universe, and as potter’s clay, infinitely malleable by corrupted sources; “it remains on this moving limit between inviolability and degeneration” (237). In addiction we are caught precisely in this liminal space. The will of the addict ardently wishes to believe itself to have mastered life and its vicissitudes. Yet, as we have seen, this is merely a self-protective delusion, sustainable only by virtue of the immediacy of narcotic self-absorption. Instead, what we have described is a picture of the will which has succumbed to the seduction of narcotic oblivion in an attempt to rid itself of the grinding presence of quotidian pain. The battle between these two points of view rages constantly for the addict. Such a holding-pattern of instability is the ultimate threat to the will,
endangering its very existence. Yet, faith is to be retained, for this see-saw of inversion constitutes only a threat and not a final determination. That is to say, this threat is pushed indefinitely into the future; it is postponed. The vehicle of this postponement is consciousness, which contains as its primary constitutive aspect the immanence of time. “Consciousness is resistance to violence,” Levinas argues, “because it leaves the time necessary to forestall it. Human freedom resides in the future” (T&I, 237). But, how does this not constitute a contradiction? After all, have we not spoken of the suffering of the addict, of the debilitating condition of being in which the future, far from being the arbiter of freedom, is instead the insidious iron spike which crucifies us to the eternal present? Was the situation not such that the demands of the future predetermined each approaching moment, thereby eradicating the very possibility of meaning in any significant sense? Quite simply, there comes a point for the addict when consciousness hits a wall. It is at this point that the choice is made. It is an astoundingly simple one, despite the infinite complexities of its final determination. For consciousness not only contains the sparks of the resistance of violence, it also contains the sparks of violence’s conflagration. The will may self-eradicate; it is a possibility: suicide. Indeed, addiction is, by definition, symbolic suicide. On the other hand, the choice – which, as we will see, is a choice that is nevertheless not a choosing – may be made to allow for the expansion of a space for possibilities to be elaborated by the immanent powers of consciousness. It is worth while to repeat here: “To be conscious is to have time – not to overflow the present by anticipating and hastening the future, but to have a distance with regard to the present: to relate oneself to being as to a being to come. . . To be free is to forestall one’s own abdication under the threat of violence” (T&I, 237). This choice, enabled by something analogous to a loss of consciousness, which for all that is not an end of time, is the gathering of patience: a paradoxical choice not to choose. Importantly, patience allows for the double possibility of escaping the penury of the future imposed by addiction as well as the overdetermination of the present that constitutes the menace of chronic pain. There is a lacuna created by this opening of consciousness to the present. It is possible for consciousness to pull itself up short and to comprehend time as the concrete medium of its power to endow the will with the dream of reclaiming possibility in both a renewed present and future. In Ethics and Infinity, Levinas speaks of time as the medium of the enlargement of existence, “time is not a simple experience of duration, but a dynamism which leads us elsewhere than towards the things we possess. It is as if in time there were a movement beyond what is equal to us. Time as a relationship to unattainable alterity and, thus, interruption of rhythm and its returns.” In time there is thus a double movement. There is an awakening of consciousness but also an interruption of one’s present circumstances, with the promise – a promise without content, but suffused with the power of affirmation – of the possibilities fulfilled through a consciousness with that which is other than that of our current situation. Such an “interruption of rhythm and its returns” is the condition of the possibility of a return to a consciousness of the future as freedom for the addict and also of a reaffirmation of the present as the immanence of a promise that there is something beyond pain for one who suffers chronically. To have one’s consciousness resurrected in such a way is to give birth to what Levinas calls the “heroic will” (238). It is thus through the vehicle of time and our ex-ercise of the will within it through patience, that the subject escapes definition and retains an indeterminacy opening the door for faith, for the possibility of what may come. Time here, not the vehicle of intentionality, but the opportunity to open oneself up to patience,
a passitivity which is nonetheless affirmative and productive. It is truly a mystery how any addict calls forth the fortitude to rediscover the future as a realm of possibility and freedom, that is, to give allowance for the elaboration of patience. Perhaps it relates to what Levinas, elsewhere, calls the “holy” in us. Inexplicable as it may be, there are many addicts who do embrace this space of freedom. A space wondrously allowed by time, which provides us with a multitude of possibilities, thereby arresting the determination of the present. “And,” Levinas argues, “this gives meaning to initiative, which nothing definitive paralyses, and to consolation,” that is, to faith in that which may come. In this way the present is deferred in its consummation in a way that has been radically foreign to the addict, as well as to the original prisoner with whom we have dealt the one in chronic pain. Both the future and the present may thereby be reconceived. This is not to say that the hostage is suddenly free in a markedly different way, released from bondage, as it were. Indeed, the very possibility of transformation blossoms from a uniquely precarious stem. Levinas maintains that “This situation where the consciousness deprived of all freedom of movement maintains a minimal distance from the present, this ultimate passivity which nonetheless desperately turns into action and into hope, is patience¬ – the passivity of undergoing, and yet mastery itself” (T&I,238). Thus, we find the hostage recovering freedom not as the result of some daring tactical maneuver. Rather it is vis-à-vis a paradoxical situation by way of which he takes an apparently simple step back, a step which nevertheless requires the exertion of a seemingly infinite effort to allow patience to desperately deliver its hope: the possibility of recovering freedom. As we noted above, it is not death but suffering which is the consummate ordeal. Finding a way to overcome an addiction that is the result of a struggle with chronic pain is certainly a victory; the unfortunate truth, however, is that this is but a single triumph in a war which has countless battles: one each day, each hour, each breath? Indeed, the aftermath of addiction is an ordeal supreme all its own, especially when complicated by the persistence of physical pain, which neither addiction nor its overcoming abates in any way. It is perhaps difficult to see how far we have come, more difficult still to envision the road ahead. Nonetheless, it must be traveled. Despite the difficulties of constructing a new self, one may at least find some surcease in the overcoming of the always-already determined shadow-self with which one has been burdened. This shadow-self is the masochistic lord born of the violence perpetrated upon the will by pain and addiction. It is important to note here that violence, in the Levinasian sense in which it is operative in this context, is not so much a matter of objective destruction. Rather violence – in general, and specifically as deployed against the will in chronic pain and addiction – is exercised upon persons by “interrupting their continuity, making them play roles in which they no longer recognize themselves, making them betray not only commitments but their own substance, making them carry out actions that will destroy every possibility of action…War does not manifest exteriority and the other as other; it destroys the identity of the same” (T&I, 21). Yet, there is hope. Beyond addiction there is the possibility of an Other existence, an existence which can include others. There is time to repair what once appeared irremediably shattered. This is precisely the time allowed by patience: In patience, at the limit of its abdication, the will does not sink into absurdity, for – over and beyond the nothingness that would reduce the space of time that elapses from birth to death to the purely subjective, the interior, the illusory, the meaningless – the violence the will endures comes from the other as
tyranny. But for this very reason it is produced as an absurdity breaking out on the ground of signification. Violence does not stop Discourse: all is not inexorable. Thus alone does violence remain endurable in patience. It is produced in a world where I can die as a result of someone and for someone. This situates death in a new context and modifies its conception, empties it of the pathos that comes from the fact of it being my death. In other words, in patience the will breaks through the crust of its egoism and as it were displaces its center of gravity outside of itself, to will as Desire and Goodness limited by nothing, (T&I, 239). Thus it is that traveling the labyrinth of patience we arrive at a final paradox. Patience does allow for the eventual moment of re-connecting with the other. It does so, however, only by concurrently empowering the addict to re-connect with himself, to re-introduce continuity into time and thereby into consciousness as self-consciousness. Patience is the ontological event allowing for the disruption of the violence of pain and addiction. More than permitting the endurance of life, it indulges the conjunction of life and joy, of affirmation in the midst of suffering, and thus the re-conception of the addict both in relation to himself and to every other. Indeed, patience is that which allows for the experience of the “holy” in the midst of a life that has reached the very nadir of profanity, banality, and decadent masochistic egoism. Patience, time, hope: the Desire of the will for Goodness limited by nothing.