A Philosophy of Pain

Arne Johan Vetlesen

a philosophy of pain
A Philosophy of Pain
Arne Johan Vetlesen

Translated by John Irons

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This book was first published in  by Dinamo Forlag

under the title Smerte by Arne Johan Vetlesen
© Arne Johan Vetlesen and Dinamo Forlag 

English-language translation © Reaktion Books 2009

English translation by John Irons

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Printed and bound in Great Britain

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British Library Cataloguing in Publication Data

Vetlesen, Arne Johan, 1960–

A philosophy of pain.
1. Pain—Philosophy. 2. Pain—Psychological aspects.
I. Title
128.4-dc22

isbn: 978 1 86189 541 7

 Contents

Introduction 7
one: Pain in Extremis: Torture 15
two: Lasting Pain: Illness 26
three: Psychic Pain 32
four: A Critique of Sartre’s Existentialist View 44
five: Pain as a Phenomenon 50
six: Anxiety and Depression 58
seven: The Unalterable Fundamental Conditions
of Existence 69
eight: Transportation of Psychic Pain 74
nine: The Role of Culture in Dealing with Pain 88
ten: Pain and Evil 98
eleven: When Pain is Imitated and Enacted:
Violence in Culture 108
twelve: Pain as Compulsive Choice in a
Multi-option Society 128
Conclusion 156

references 161
bibliography 164
 Introduction

Without pain our life is unthinkable. With it, life is hardly to

be endured. When pain becomes total, it deprives us of life
while still alive and causes us to long for the absence of pain
– even though that would ultimately be synonymous with
an end to life. If life is only a matter of pain, the question is
whether it is worth living.
Living involves being exposed to pain every second – not
necessarily as an insistent reality, but always as a possibility.
The presence of pain varies from person to person. But the
actual exposure to pain is something all human beings share
– it is, quite simply, an essential part of the definition of the
human condition.
The individual’s relation to pain – to pain in his or her
life – is one that cannot be exclusively determined by that
individual. The society in which we live and the age to which
we belong equip each one of us with a vocabulary and a
yardstick for communicating about pain and assessing its
significance. In terms of the body and the senses, pain is
something we experience spontaneously, directly, in a non-
circuitous way. The nature of our body and senses makes us
susceptible to the sensation of pain, as we are to its opposites:
pleasure and well-being.
Pain directly inflicted on the body reveals most clearly
what pain is: pain is negative. I miss the block of wood with
my axe and what I hit is my lower leg. I give a start, grimace,
see the blood pour out of the cut – warm, dark, ominous. I

7
scream. The sequence of events is so simple; everyone recog-
nizes it: when pain is a stimulus, suffering is the response,
understood as the protest made by the organism, a ‘no’ to
what has been inflicted, since it is experienced as something
that ought not to be, ought not to happen. The meaning of
pain, if we can talk of such, is thus to be understood as the
inherent negativity of pain. As a creature equipped with a body
and senses, I cannot determine, cannot consider, whether pain
is negative or not. No, to be affected by pain is synonymous
with being affected by something negative, something unde-
sirable. Pain presents itself as something which by its very
nature is against me; therefore, my spontaneous response is to
be against pain. Pain assumes the form of my enemy, the
opposite of everything I desire for my own existence.
But is it that simple? Is pain unambiguous to that extent?
Is there no room for interpretation, for evaluation – in short,
for culture and communication?
There is, of course. That pain is to be considered as exclu-
sively, by very definition negative – meaning that our rela-
tion to it consists of wishing it to disappear – is in itself the
expression of a view that to a very high degree is historical-
ly and culturally determined. My assertion is that we, people
living in one of the world’s most affluent countries, have in
the present age developed a conception of pain’s position in
human life that is possibly the most negative ever.
What do I mean by that? Do I wish to contest the fact that
pain is something negative? That what is undesired grows
out of pain itself, so to speak, rather than being something a
particular culture has come up with?
The assertion I will seek to justify is not based on the idea
that pain has been misunderstood when it is regarded as
being something negative. The assertion is that this negative
experience is not as obvious and not as spontaneous as we
tend to believe. To be more precise, what is not obvious is
that the negativity of pain is exclusively to be judged as nega-

8
tive. In short, that since something hurts, we are dealing
with a type of experience that we ought to be without, and
that we ought to do everything in our power to remove and
prevent it.
For that is where we are, the culture we belong to in our
part of the world. The most official confirmation of this
really being so is, in my opinion, the World Health Organi-
zation’s (who) definition of health as an optimum human
state: by ‘health’ is meant the complete absence of pain and
discomfort. The positivity of health is based on the (absolute)
negativity of pain, so that the most ambitious goal for health
is attained when pain, its enemy and opposite, is combated
to such an extent that it is eliminated. We are dealing here
with a declaration of war against pain ‘and all its works’, a
declaration that is both supported and articulated by mod-
ern medical science. That Gro Harlem Brundtland, a
qualified doctor and with a past as a social-democratic prime
minister in ‘the best country in the world’ to live in, was the
leader of the who when this definition of health was
announced, is in every way apposite.
Such a conception of health, one that includes the wish
for pain to be eliminated, does not only say something about
the who. It also says a great deal about the prevalent view in
our present-day society. If by ‘pain’ we are referring to every-
thing that hurts, and consider everything that hurts to be
undesirable, it seems logical to concentrate all our resources
and our knowledge on winning the human fight against
pain. And it seems as if a goal that in earlier and more prim-
itive ages must have appeared to be totally unrealistic, incon-
ceivable even, can now be reached – especially thanks to
advances in medical science and the technologies it utilizes
in its fight against all kinds of disease.
Why should there be anything wrong with such a goal?
Will not all of us, given our common exposure to pain, tor-
ment and suffering, unanimously and unhesitatingly back

9
such an aim? Is it possible to hold the opposite view and be
entitled to be believed and be in one’s right mind? What
would such an opposite view be based on: that pain is good,
that it contains something inherently desirable? In this book
I am prepared to be a spokesman for such an opposite view,
though with important qualifications, as we shall see. Let us
take an initial look at what the point of view represents.
A first step on the way to demonstrating a view of pain
that refuses to accept that it is exclusively negative in human
life and that it ought to be removed as far as is practically
possible is to ask the question: Is it really true that we only
experience pain as being negative and unwanted? The axe-
blow to the leg is painful, it does hurt, and all I want then and
there is for the pain to stop. So the experience of pain is one
that is negative through and through. Have I not thereby
also answered the question as to whether pain can appear to
be anything else that negative and unwanted? Have I not,
with the aid of a completely unambiguous example, shown
that it cannot – not for any normal human being exposed to
pain who is still in possession of his faculties? Why want
anything that is painful?
That human beings naturally, and without needing to con-
sider it, strive for what they regard as good, or what seems to
promise pleasure (not least bodily and sensual pleasure), is a
claim on which all of moral philosophy rests, although admit-
tedly in such differing variants as the ethics of virtue à la
Aristotle and utilitarianism (the ethics of utility) à la Jeremy
Bentham. The connection can be expressed most directly by
saying that something is good because we connect it with
pleasure. Thus we have a natural disposition for seeking the
good – that which from a moral point of view is felt to be
worth striving for since it will be identical with – or at least
part of – what we as corporeal-sensual beings are disposed to
do. The task of morality is to create a recognition of the fact
that all people have a right to seek to maximize the experience

10
(utilitarian: amount) of pleasure by means of their acts, but
that everyone must at the same time respect the principle of
not seeking personal pleasure in a way that will hinder the
right of others to do the same. Admittedly, there can be dif-
fering conceptions of how this can best be achieved and
guaranteed in a way that is good for everyone. But the fact
that everyone, presumably spontaneously and without stop-
ping to consider, is prepared to agree with this understand-
ing as the perfectly natural point of departure for every form
of ethics and every plan for developing a good society can
hardly be doubted, if at all. Or can it? As I intend to show
later, strong arguments can be advanced against this point of
departure, including ethical ones. Let me, however, begin the
problematization elsewhere.
That we as human beings detest and fear pain is not some
invention of the modern father of utilitarianism, Jeremy
Bentham. Even if this were to be true – of all human beings
and all known societies – it is far from being the whole story.
For while it is true that we shun pain, it is equally true that
it turns us on, it excites us and that we actively seek it. In
short, pain is not something neutral: we are not indifferent
to it, and those instances where we actually are seem strik-
ing and call for an explanation. In line with what I have said
above, pain, then, is charged. What we need to realize is that
the chargedness of pain is not synonymous with its negativ-
ity. It is quite common to experience something fascinating,
attractive and in that sense positive about pain or the
prospect of pain. That this is so is not excluded by the fact
that a moral assessment will usually consider pain as being
negative, as something that ought not to exist and should
therefore be relieved or eased to the extent it is encountered.
Our moral propensity to condemn and banish pain, to pur-
sue every person who deliberately inflicts (unnecessary and
unwanted) pain on others, thus contrasts completely with
our (from a psychological point of view) quite normal

11
propensity to be fascinated by pain, in recognition of the
fact that there is more to pain that its alleged negativity.
To see where this leads us we need to delve deeper into
the phenomenon itself, deeper than both the oversimplified
moral understanding and the common-sense psychology
that we have used so far. And it is certainly necessary to ask
some fundamental questions that have not yet been raised.
One such question is: is pain something unavoidable? or,
more precisely: by ‘pain’ are we talking about a phenomenon
that unavoidably is, and always will be, present in the life of
every individual? A second, just as basic question is: is pain
as uniform a phenomenon as we have provisionally
assumed? Is the pain released when I hit my leg with an axe
an adequate image of what pain is, or how pain behaves and
what it means in human existence?
Once these questions have been asked, it strikes us that so
far we have tacitly allowed physical, externally inflicted pain
to be the model for what pain is and what reactions it caus-
es. There are many reasons for a description of the phenom-
enon of pain beginning with physical pain: it is visible
(observable), not only to the person involved but also to
others; its cause and effects are in principle possible to ascer-
tain and possible to intervene in medically, although the
prospect of relieving and curing will depend on the degree
of seriousness as well as the medical action available. The
pain we are dealing with here is an injury. As such it is con-
tingent, i.e. something that occurred, that has the nature of
a particular event (the blow of the axe), an event that, how-
ever, can be considered as avoidable: the injury resulted
from an accident. We can examine the example from other
angles to reveal other aspects. If you strike me on the leg
with an axe, the assessment of this event will depend on
whether the pain inflicted on me in this instance was due to
your striking me deliberately or inadvertently. In the former
case the fact that the infliction of pain was deliberate will

12
give rise to moral indignation, maybe even a punitive reac-
tion. In the latter case the moral condemnation will not
materialize or will be milder. And, finally, if I am considered
to have intentionally injured myself, the initial reaction will
be psychological rather than moral, in the form of wonder:
why on earth did you hit yourself on the leg with an axe?
That someone intentionally harms another person is some-
thing we know constantly happens; it is something we learn
within our culture to detest and condemn; however, it is not
something that necessarily rouses our wonder. Motives for
doing something like that can be many, and the stuff of
which they are made will be familiar to most of us, since we
cannot, hand on heart, claim never to have wished to inflict
pain on somebody else. To decide to inflict strong physical
pain on oneself where it could have been completely avoid-
ed is, however, something of a mystery in many cases. It is an
act that raises questions of whether the person in question is
of a completely sound mind, of whether he knows what he
is doing, about his reasons for doing it. Intentional serious
physical self-injury is a psychological challenge rather than a
moral one, a task for therapy rather than for the guardians
of morality and punitive institutions. It is instructive to
examine why this is so – something I intend to do below.
Physical pain – inflicted by others or by oneself – is, in
other words, not synonymous with pain as such, even though
we feel it is perfectly natural to take it as our point of depar-
ture for an understanding of what pain is. If we do so, we are
in a sense starting from the outside. We are adopting a visual
perspective, we are observers, and we can observe other peo-
ple’s pain, just as we can observe our own. As stated, the cause
– what it is that triggers the pain – is normally easy to deter-
mine, as are the effects. If the pain is serious, it is a task for
medicine to alleviate; pain makes us sufferers, the type of
sufferers who become patients and who require the help of
doctors to have it relieved. Relief here is what could be called

13
the human response and intervention that pain regularly asks
for: the inherent aim of physical pain is the cessation of pain.
Anyone afflicted by this pain, in this way, will experience it in
the same way, will desire the cessation of the pain, in a kind of
universal human state, where all other differences between
those afflicted with pain (the sufferers) that are otherwise real
cease to have any meaning. Two soldiers who are fighting
against each other and who define each other on the basis of
mutual and reciprocal enmity will naturally expect the same
reaction to physical pain in the other person as in himself.
True enough, we can feel ourselves all alone in our intense
physically inflicted pain, especially in situations where no one
around us has, or has had, a corresponding pain. My pain is
my loneliness; it strengthens and clarifies the feeling I have of
being alone in the world, alone with and in my body, which
separates me physically from everything else in the world. The
mineness of the body is identical with the mineness of the pain:
both are now in a radical – or unknown and unsensed – sense
‘mine only’, not other people’s. Pain forces me backwards, or
downwards; it forces me back to a purely physical-biological
level, stripped of all abilities, dispositions and dimensions of
my human existence that are over and above – precisely over
and above – elementary physical existence.
Let us pause for a while and consider two states of intense
pain, the one extreme and relatively rare, the other all too
common – torture and serious illness.

14
 one

Pain in Extremis: Torture

Torture is man’s most refined method for forcing a person to

an utter, total abandonment of – or withdrawal from – every-
thing that normally constitutes the extra-physical in existence.
Torture is to bring the person to the point where the specifi-
cally human qualities of existence are abandoned, where they
are eliminated, and in a way that the person can do nothing
but helplessly register, unable to prevent or reverse this
process. The person enters torture as a human being and is
dragged out as an animal, still alive when considered as a
body, but lifeless as a human subject. Every blow, every jolt,
every shock of pain inflicted on the body aims at speeding up
this transformation from human to merely animal existence.
Torture is considered an extreme form of inflicting pain,
but precisely for that reason it sheds light on aspects of pain
that lie concealed in our everyday lives. In her pioneer study
The Body in Pain, American scholar Elaine Scarry begins by
pointing out that physical pain is unique among all our men-
tal, somatic and sensuous states by virtue of the fact that such
pain does not have any object: physical pain is an intentional
state (it is about something, not blind), but what pain is
‘about’, that which gives it its content, does not have the form
of an object, something it is possible to refer to in the world.
Even though the ability to experience physical pain is a just
as elementary, indeed primitive, fact of being a human being
as is the ability to hear, to touch, to desire, to fear, to be hun-
gry, it differs from all of these and from all other physical and

15
mental characteristics by not pointing towards an object in
the outside world. While the basic senses – hearing, sight,
taste, touch, smell – take us out of ourselves, out towards par-
ticular objects in the outside world, pain is not ‘about’
something or ‘for’ something. We say: ‘it’s painful’, possibly ‘it
hurts’. But what is ‘it’? Shouldn’t we rather say ‘I hurt’, or ‘the
hurt is me’? Language, with its tendency to link everything
that is to be communicated to particular referents, falls sadly
short. And that is because pain as such is object-less. At this
elementary level the object-less is also the language-less. We
thus express pain by regressing in terms of language, by turn-
ing to sounds that are reminiscent of our animal existence,
sounds that originally come from a repertoire that precedes
socially learned verbal language.
According to Scarry’s analysis, physical pain is what above
all other states marks an absolute division between persons,
between you and me. To be in pain is to have absolute cer-
tainty; my pain contains an indubitability I do not know
from any other context. My physical pain cannot be taken
away from me; since it has a bodily location, I cannot flee
from it, even though it is well known – not least from liter-
ary representations – that people in extreme pain try to flee
from their own bodies, out of their bodies, to escape the pain.
Contrasting with the indubitability and unremovability of
my pain, we have the dubitability of the other person’s pain.
The one who has the pain will without any effort grasp it, be
filled by it; the one who does not have the pain will without
any effort not grasp it, not be filled by it. To see other people’s
pain, to hear about other people’s pain is, according to Scarry,
like a model of what we believe can be doubted. From this
derives pain’s dual nature, according to whether it is mine or
someone else’s: pain is in existence as that which absolutely
cannot be doubted and that absolutely can be doubted.
In Scarry’s terminology pain is not an emotion (for emo-
tions take objects, as fear towards the danger I am confronting)

16
but a state. Pain resists language, as we have seen, since it is
unsuitable for the kind of objectivization on which language
depends. Absolute or total pain involves the annihilation of
language; from a political perspective, the targeted infliction
of pain on particular victims is a method of annihilating their
language, their language as their specific cultural way of being
in the world, of having, talking about and interpreting a
world. (Scarry talks in this sense about how the self of the
victim as well as his voice is sought to be annihilated, ‘voice’
understood as an individual’s ability to articulate mental con-
tent and thus communicate his ‘world’ to others.) So pain, as
the pain in the person who experiences it, is ‘inexpressible’. It
is significant that we, as we fumble in our attempts to find
words for pain, use phrases like ‘it is as if . . .’ or ‘it feels now
as if . . .’ without ever precisely being able to grasp this thing
that pain is similar to. We have an urge to make something
that can be communicated and shared out of what above
everything else in our lives is originally internal and not capa-
ble of being shared.
The nature of torture is stable to a rare degree. Its distinct
forms and methods are repeated everywhere, from age to age
and culture to culture, with only small variations on the same
basic elements. Torture consists of two acts: the mainly phys-
ical act, the infliction of pain, and the mainly verbal act, the
interrogation, asking the victim questions. The first act sel-
dom takes place without the second. How is the relationship
between the two to be understood?
Scarry maintains that the relationship is often misunder-
stood. It is misunderstood because the way in which the aim
of torture is presented by the torturers – or the political
powers behind them – is so easily accepted as the gospel
truth, i.e. that the pain inflicted is the means to an end, in
the form of the information divulged at the interrogation.
But this is turning things upside-down. The pain is the end,
not the means to something else; the reference to informa-

17
tion is nothing else than a pretended motive of the torturers,
one that gives pain a purely instrumental function and that,
logically assessed, opens up the possibility of obtaining the
information it refers to without the use of pain – which is
precisely what is not practised. In the interrogation, the tor-
turer asks the victim questions as if the as yet unanswered
questions are what motivates the cruelty, as if the answers to
them are what is absolutely crucial. But the fact that ques-
tions are asked as if the answers mean something does not
prove that they mean anything at all. So what is the real pur-
pose of the interrogation, of all the questions? If the answers
that are finally extorted do not have the importance they are
claimed to have, why could you not just as well drop the
interrogation and exclusively inflict pain?
The answer Scarry gives is that the interrogation – the fact
that one party asks questions and the other has to answer –
gives the torture a psychological-motivational basis and a
moral justification, or, more correctly, gives the appearance
of this. The point is that when the interrogation is carried
out, ‘confessions’ will often follow, and such confessions –
where other persons are often betrayed, sometimes including
those closest to the victim (spouse, child, friends, political
allies) – have the status of a breach of faith, the seriousness
of which depends on who is being betrayed, and what the
betrayal might mean for their subsequent fate. To talk of a
breach of faith, confession and betrayal, to talk of those who
crack up and those who manage to resist, those who crack up
easily or quickly and those who never do so, no matter the
trials and tribulations – this is to talk in a non-neutral, i.e.
morally charged language.
This brings us closer to the more profound point, the one
that answers the question why torture contains interrogation.
For what happens is that the victim of torture is ascribed a
moral responsibility, a kind of agency: the victim is a person
who offers resistance or who betrays, one who is strong or

18
one who is weak, one who can put up with much pain or one
who can put up with little, one who unselfishly puts up with
the greatest stress so that others may go free, or one who suc-
cumbs when the pain is felt and the fear of one’s own skin
and own welfare overshadows everything else. In short, as
outsiders and as societies we all participate in this kind of
morally charged use of language towards, and assessment of,
the victim, of the individual victim’s ‘efforts’ or ‘performance’
under what we – without realizing the seriousness of it – refer
to as ‘inhuman conditions’. The answer to the question we
asked is therefore that the function of the interrogation in
general and the confession in particular is to block the other-
wise spontaneous preoccupation with the victim’s actual
pain, in the form of possible sympathy or pity. By presenting
torture as a somewhat ‘random’ method for achieving a goal
that is supposed to be external to torture in the form of infor-
mation/confession/betrayal, attention is shifted – that of
everyone, the torturer and the victim no less that the outsider
– away from the infliction of pain to which the victim is sub-
jected, and thereby away from the victim as a person who
arouses sympathy. Attention is diverted instead to the victim
as the centre of the entire process, though not as victim but as
a player (himself responsible), as the party whose actions –
to speak or remain silent – determine the degree of pain that
is inflicted. Being a player and an important element in the
ascribing of moral responsibility are thus diverted from the
torturer to his victim – just as the torturer wants. In short, it
is the victim’s so-called ‘active’ contribution in determining
his own fate that is placed centre stage.
When the victim confesses as a result of the infliction of
pain during torture, outsiders tend to describe this as aban-
doning everything that until then has been important for
him: family, friends, fatherland, the cause and the ideal he
has fought for, been willing to sacrifice his life for should it
be necessary. Everything that the self is composed of in a

19
psychological sense is betrayed and renounced. For the tor-
ture victim himself, however, things are different. For what
the infliction of pain achieves is that this created world, with
all its psychological and mental content, everything that lan-
guage normally objectifies, communicates and maintains,
this entire created world outside the body ceases to feel real,
to feel valid. The only real and valid thing – reality pure and
simple – is now turned in on the subject himself instead of
outwards towards a common world. All that is real is the
body. The body consists of pain, the body is pain and pain is
the body. Everything else is non-existent, non-important,
lightness itself. The pain is intensified until it mimics death,
where all sensations point towards death as the real, and away
from life. Since death is now something ‘imminent’, or can
occur ‘at any moment’, it has already begun.
Pain and power are the two absolutely incompatible enti-
ties in torture. They are inversely proportional to each other:
the greater the victim’s pain, the greater is the power of the tor-
turer. The presence of pain means the loss of a world, the
familiar world of mental content, of initiative and meaning;
the absence of pain means the presence of a world. To the same
extent as the torturer increases the victim’s physical pain – the
pain that causes him to lose his world – the torturer increases
his power to define that world completely. What happens in
torture is that a person’s physical pain is transformed into and
is perceived as another person’s power. While, as we have seen,
it is usual to ascribe the torturer a motive, and thereby a par-
ticular mental content, namely to extort so-called ‘valuable
information’, the confession of the victim, the fact that at a cer-
tain point he ‘cracks up’ and starts to talk, is such that he
abandons all his mental content, that he forgoes his specific
mental world. What ostensibly means everything for the tor-
turer finally means nothing for the victim.
This touches on a general condition of strong physical
pain. Only when the body is taken care of, when its functions

20
are intact and the body operates within secure surroundings,
can consciousness interact with all the senses and address the
outside world; only then can the person have a world full of
mental content. This outward orientation, which is so crucial
for human intentionality and agency – and so taken for
granted by all of us in our normal everyday lives – is radically
undermined in the event of torture in particular and of
intense physical pain in general. Pain causes the body to turn
in towards the person; more precisely, the bodily functions
are twisted – the ability to move, hunger, thirst, defecation,
the sensory apparatus – outwards, in a perverse enlargement,
distortion and transformation of their distinctive nature
under normal conditions. The trick of the torturer is to make
the victim’s body his worst enemy: to turn the victim’s body
into the most effective tool in the infliction of pain, in the
absolutization of the person as a body quite simply, and
thereby in the loss – the annihilation – of the person’s world,
of his ability to ‘have’ a world outside himself, outside the
body. The body becomes absolutely present because it is being
annihilated, because the annihilation of it is so painful that
the pain forces the person to abandon all other mental con-
tent, all other objects of his attention and sensory ability.
Torture demonstrates that physical pain possesses the power
to annihilate a person’s world, self and voice.
In normal instances a person’s pain will be subjectively real
but non-objectivized and invisible to everyone else. In torture
a solid objectification of the pain is undertaken, since it is
turned outwards and becomes visible to everyone who can see
– an indubitable reality in a common outside world – only to
be denied at the same instant. For that is precisely what hap-
pens, according to Scarry’s analysis. The ‘world’ that is formed
by those observing the pain, first and foremost by those
directly inflicting it, who have the power to increase and
decrease the pain in the victim and stop only to begin once
more, is a world of observers who see the pain in the victim

21
only to deny its (mental-human and moral) real nature. This
is where we glimpse the structure of torture: first the inflic-
tion of physical pain, then the objectification (the visible
manifestation) of the subjective attributes of pain (the
screams, the blood, the spasmodic jerking, the twisted limbs)
and, finally, the translation or transformation of pain’s objec-
tivizing attributes to the insignia of power, to a demonstration
of the omnipotence of the torturers and the regime they rep-
resent – an omnipotence that functions as a parasite on (a
direct function of) the powerlessness in the form of aban-
donment of self, world and voice that is extorted from the
victim and that has the ‘confession’ as its preferred form of
proof. In short, the outwardly turned, now visible repertoire
of inflicted and inflictable pain is interpreted as if it is a
demonstration of the power of the torturer and the regime.
The more massive the former, the more increased the latter.
What can make the torturer stop? That the reality of the
other person’s pain enters the consciousness of the torturer
(Scarry) or, to put it my way, that the torturer opens himself to
being emotionally affected by the victim’s affectedness. That
this does not take place is, of course, not coincidental. It is the
very condition for torture being able to take place and to con-
tinue, no matter how annihilated the victim gradually
becomes as a result of the pain. Inflicting pain and objectiviz-
ing pain have the denial of the human reality of pain as both
cause and effect in a self-increasing spiral: the denial is the act
on the part of the torturer that is increased by what he does
and that increases what he does as he continues. What hap-
pens is not that the power experienced by the torturer makes
him blind, or that his power presupposes his blindness; the
relationship is instead quite simple: ‘his blindness, his willed
amorality, is his power, or at least a large part of it’.1
The relationship of all known civilizations to the human
body consists in the body being transcended in ways that are
reconcilable with, indeed, that guarantee the body’s basic

22
needs: by building a house, by providing warmth, by procur-
ing and preparing food, by ensuring toilet facilities, etc.
Cultural arrangements and rituals contribute to the body
being taken care of in an adequate manner, with the result
that human consciousness in all its functions can turn out-
wards towards the world, in going beyond the body in a way
that has, then, the intactness of the body as its vital – and
usually unspoken – prerequisite. Torture can be defined as a
reversal of this civilizing element. As we know from docu-
mented cases of torture throughout the world – most
recently from the much-discussed Abu Ghraib prison run by
the Americans in Iraq – the victim is exposed to the absolute
shock involved in being a witness to – indeed, quite literally
being the subject of – the various normally body-caring cul-
tural artefacts and rituals being transformed one by one
from a caring and body-transcending function into the exact
opposite, i.e. into a weapon in the annihilation of the body’s
intactness and capacity to turn its attention to the world
outside it.
How does this take place? Concretely, by the torturer, as
one of the first things he does when the victim is led in, act-
ing as a guide in the surroundings where the torture is about
to start: ‘Look,’ he says, picking up certain kitchen utensils the
victim is familiar with from their everyday use, ‘here we have
a sharp carving knife, here you can see an empty glass bottle;
over there are a table and a chair. We are going to find plenty
of uses now for all of these things.’ In other words, everything
that prior to the torture is part of the protection and security
offered by the physical outside world, everything that used to
help protect the body and satisfy its needs, is now ruthlessly
turned against it in the form of a number of implements
designed to annihilate the body, with its needs and functions
now changed – turned inside out – so as to turn them into so
many means for the intensification of pain. That which used
to be synonymous with pleasure and enjoyment – eating,

23
drinking, the sexual organs – are methodically changed into
embodied possibilities (scenarios) for the infliction of
extreme displeasure and humiliation. Scarry describes this
transformation as a zero sum game between the elements
pain and power, the physical and the mental, divided into the
roles of torturer and prisoner.

Although the torturer dominates the prisoner both in

physical acts and in verbal acts, ultimate domination
requires that the prisoner’s ground become increas-
ingly physical and the torturer’s increasingly verbal,
that the prisoner become a colossal body with no voice
[to articulate a world with, a mental content] and the
torturer a colossal voice [a voice composed of two
voices, his own and the extorted one of the other per-
son, in the form of a confession or a cracking up] with
no body, that eventually the prisoner experiences him-
self exclusively in terms of sentience and the torturer
in terms of self-extension. All those ways in which the
torturer dramatizes his opposition to and distance
from the prisoner are ways of dramatizing his distance
from the body. The most radical act of distancing
resides in his disclaiming of the other’s hurt.2

It is no exaggeration to claim that the denial by the tor-

turer of the other person’s pain is the main prerequisite on
which successful torture is based. The moment a torturer lets
go of such a denial, with the result that he begins to feel emo-
tionally affected by what he is actually carrying out – the
wholesale destruction of another human being (speaking
metaphorically: reaching from what is bodily external to
what is mentally most internal) – it will (possibly) mark the
end of his career as a proficient torturer. For what a torturer
needs to keep insisting on is that the pain that so blatantly
obviously is being inflicted upon and so utterly pains the

24
victim has only a physical reality as opposed to a moral real-
ity of the kind that involves co-human identification and
being emotionally affected. The proficient torturer is a per-
son with a sharply objectivizing insight into the victim’s weak
spots, for precisely what it is that causes most pain, and as
such is most efficient in crushing the person and his or her
entire world. In order to hold onto this insight, to cultivate it
in its one-dimensionality, the torturer has to deny and neu-
tralize every tendency to feel or empathize with the victim,
rather than just coolly observe him and in a detached manner
register the reactions caused by the infliction of pain. The
objectification involved here presents the victim as an it;
letting go of the objectification will involve allowing the
victim to step forward as a you. The ideologically conditioned
changing of another person into ‘one of them’, into a repre-
sentative – interchangeable as such – of a hated or feared or
despised group in an us-versus-them scheme, can only be
neutralized when these collective and distancing modes of
description are replaced by the spontaneous and emotionally
based meeting between two human individuals: a meeting
where both are first and foremost themselves, not embodi-
ments or reminders of collective entities one has been taught
to fear, to combat, with the other always as ‘one of them’, i.e.
one of the Jews, one of the communists, one of the capitalists,
one of the terrorists. To allow the other person to step forward
as an individual, with his individuality in the foreground,
means to allow the meeting with him (or her) – the torturer’s
victim – to assume a human and moral quality, which will
mean that the torturer for his part feels his individual respon-
sibility for what he now chooses to do to his victim.

25
 two

Lasting Pain: Illness

Torture is a drastic example, experienced by few. People with

a particularly painful illness (especially of a chronic nature)
can, however, experience something similar, in the sense that
life is reduced to pain, and that a life that only ‘is’ pain, rest-
less and hopeless pain, involves a completely different form
of existence than that previously known – and taken for
granted – by the healthy person. It is said that people with
chronic (incurable) syphilis, especially the neurosyphilis vari-
ant (where all control of bodily functions ceases so that all
movements take the form of violent spasms) are those who
have the most radical experience of the total transformation
of this life into pain. The pain experience places everything
else at a lower level, allows no space, no second to recur out-
side itself, untouched and intact. The total state of pain is
thus identical with the total emptying of meaning, of desire.
A person deprived of desire, for whom nothing in life no
longer has any meaning or purpose, is no longer a person in
the sense of a seat of human subjectivity. But what about the
pain that is not physical? The pain that is invisible, that is not
inflicted from without?
Man’s exposure to pain is not first and foremost an expo-
sure to physical pain. When the axe strikes the leg, I am
injured; the injury has its own objectivity, it can be observed
by others and those with a suitable competence can seek to
heal it. I presume that the pain released by the axe-blow
against my leg will be precisely the same and thus behave in

26
the same way and result in the same reaction and need for
alleviation for anyone exposed to the same. Simply as human
beings we assume that we are fundamentally similar as
regards exposure and reaction to such pain inflicted from the
outside. The differences between us as individuals have no
role to play. As regards the sensation of physical pain, we
believe that we are transparent to each other, eminently
understandable, across cultures and historical epochs. Never-
theless, we know – only too well – that this comprehensibility
can be blocked, that it can be put out of action and replaced
by an experience of absolute distance and non-identification
concerning others’ pain, while the suffering sensation of one’s
own pain persists. While Elaine Scarry, as we have seen, pos-
tulates such an absolute difference – indeed, abyss – between
my pain and your pain as an ‘ontological division’, I would
conversely claim that visible physical pain in someone else
spontaneously seems to be something understandable to me,
something I recognize because of my own experience and
that I now naturally ascribe to the other person who seems
to be experiencing ‘the same’. The division Scarry postulates
as being original and ontological is not so in my opinion,
rather something that calls for an explanation, something
that is produced and becomes dominant under special con-
ditions. That such conditions are real in many situations and
that they are continually being re-created is something I
accept beyond a doubt, which gives Scarry’s above analysis its
empirical topicality.
Why do we believe that our physical exposure to pain is
understandable, or even transparent, for each other, as I
claim? Is it because the physical pain directs attention to what
has to do with the body, and that we consider the corporeal as
being what, above everything else, we share with everyone
else? This is how medicine and science view humans as cor-
poreal beings and it is also a common-sense view of the body.
In terms of both its functions and its exposure to pain the

27
body is one, in the sense that it is the same for all individuals
– although with certain variations based on gender and age,
though not so great that any woman cannot get to know her
body by reading the book Woman, Know Your Body – a book
for all is precisely what the topic ‘body’ allows. Only by
assuming that the body is identical in all individuals (of the
same gender) can the professions that specialize in the needs
of the body – its illness, its ageing process, etc. – use their
knowledge of the average human body on all the individual
examples of it that they actually have to subject to treatment.
So the body’s specific and physiological homogeneity pro-
vides a scientific basis for the general conception that
physical pain is something that behaves in a fundamentally
similar way for all humans exposed to it. To put it another
way: it is my body as a human body that determines what
causes pain, not me as a unique individual and as a bearer of
my own body. True enough, the body that shudders with
pain as a result of the slash wound inflicted on me is my
body, no one else’s; I experience my body’s pain in the first
person singular, and I may well doubt your expressed assur-
ance that you know and not least feel ‘exactly what I am going
through’. In my physically inflicted pain I therefore experi-
ence myself as anything but interchangeable. To the extent
that the experience of pain changes anything at all in my
relationship to the outside world in general and other peo-
ple in particular, the change consists in my being cast out
into a kind of aloneness I had not experienced before pain
invaded my life. The more total, the more all-pervasive the
pain becomes, the more the presence and possible variations
in depth, intensity and length of the pain assume the nature
of being the sole theme in my existence, the more strongly I
can experience it as a withdrawal from a common human
universe of which I was a member prior to the pain striking,
on an equal footing with everybody else. When it is only pain
and me everything is all about, it is as if I cannot manage to

28
tear myself away from myself, myself reduced to a body, and
thereby to what philosophers call pure immanence: the body
as a prison, with its physical-spatial extent, and thus limits,
as being one with the limits of my world. Since pain throws
me back on myself, myself as a body and only a body; since
the body is scarcely capable of bearing me, of supporting my
mere physical-biological existence, I hardly have the strength
to cope with my body and thereby my own existence any
longer. I am reaching the point where I hardly have the
strength to live, since life has ceased to be stretched out
between pleasure and discomfort, joy and fear, spark and
extinction. The alternation between what causes me to feel
good and what causes me pain has ceased to exist – only one
of the dimensions is still valid.
In other words, I maintain that physical pain understood
as exposure to pain has something universally human about
it, something we can share an experience of. But as soon as
we start to dwell on what such pain does to me, especially
when it is particularly intense or long-lasting (perhaps
chronic), a strongly individualizing element enters. I am
exposed to something all human beings can be exposed to, in
principle. But it is my way of tackling this state that we are
dealing with here – and precisely this can be experienced as
radically separating me from all other human beings.
The taking over of my life and my vitality by bodily pain
does not only threaten to isolate me, cause me to feel alone
in relation to everything around me. It does not only threaten
to restrict the entire world to one single point: pain’s non-
dislodgable reality, that turns the world into a place for pain
and nothing else, that makes my pain my world. For when
pain, now exclusively a seat of all that causes pain, restricts
my existence in the world, I lose the experience of being of
equal value with and fully intelligible to other people. From
now on it is, on the one hand, me and my pain, and on the
other, all the rest, those without pain. The more I merge with

29
my body as a sufferer, the more I slide away from other people
and all their projects that transcend the body and pain out
there in the great big world.
Did we not, though, speak earlier of a species-specific sol-
idarity and an eminent transparency and intelligibility based
on the basic similarity of all human bodies – a similarity in
everything essential, a dissimilarity in everything unessential?
Are we unable now, gazing with the eye of a sufferer at the
world, to see that if the body takes up all of existence, noth-
ing would seem to be more threatened, more unattainable,
than precisely such a self-evident, all-inclusive solidarity and
intelligibility? Is it not so that the person whose existence is
essentially nothing but suffering experiences himself as dif-
ferent, as not being understood by others (those fit and
healthy), as one who is almost ostracized?
The insight that crowds in is that the body – the body’s
exposure to pain – can just as well be claimed to be some-
thing that divides people as something that unites us all. It is
the pain that decides: the pain determines whether I experi-
ence myself and my existence in the world as fundamentally
equal with, and a part of, the existence of other people in it,
or whether I conversely experience my existence as radically
disconnected from that of others. So there is no point in giv-
ing an unequivocal answer based on the body as such; the
pain that takes over, dominates, annihilates the body makes
a considerable difference, determining whether my experi-
enced equality and equal value with everyone else as human
beings is simply replaced by a demarcating isolation from
what is universally human. Anyone who has experienced this
is well aware of the difference.
The message of this analysis, in other words, is that phys-
ical pain, because it is bound to the body, individualizes –
indeed, that such bodily pain individualizes more the
stronger the sensation of pain is, i.e. the more strongly its
presence stamps the person’s being-in-the-world, experience

30
of himself and everything else in the world. The ability of
physical pain to individualize, in the sense of mark the differ-
ence, between the sufferer and everyone else, is often
overlooked. As I have pointed out, the medical-scientific view
and the common-sense view of physical pain have opposite
messages: that since such pain is something everyone as bod-
ily beings are exposed to and what is more, exposed to in a
similar way, such pain is one of the phenomena that connect
and unite all human beings, by virtue of the exposure to pain
as something we all have.
The overriding difference – one that creates so many oth-
ers – is between exposure to pain as a universally human
potential and as an experienced reality: the latter is always
bound to the individual and therefore dependent on the per-
son. We live our lives as beings exposed to pain. That applies
to all of us. The exposure is something we have in common.
But the pain that strikes always strikes in the form of a par-
ticular event in a particular person’s life.
Where has this brought us? Is the point I wish to arrive at
the well-known one that ‘it’s not how you feel but what you
make of how you feel’? That the same type of pain infliction
gives rise to different reactions in different people? That as
soon pain shifts from a universally human potential to a con-
crete here-and-now reality for me, but not for you, there is a
shift from the similar to the dissimilar? That how I deal with
my pain even says in a special way something profound and
essential about who I am, i.e. a pain-transmitted exposure
and clarification of my individuality, my differing nature? In
short, am I making an assertion about pain as principium
individuationis?
To answer such questions we need to broaden the per-
spective on what pain actually is and what forms it can take.

31
 three

Psychic Pain

The perspective I have adopted so far must be broadened in

highly dissimilar directions. First, I will shift the focus away
from pain as something physical, inflicted from the outside,
to pain as something mental. Later, the perspective on pain
will change from seeing pain as something we detest and fear
to something we are fascinated and attracted by, so as to do
full justice to the Janus face of pain.
What is psychic pain? Can such pain display characteris-
tics that correspond to the visibility of physical pain? Is the
objectivity that traditionally applies to physical pain replaced
in the case of psychic pain by something completely subjec-
tive? Can we make any general statements about what psychic
pain is and (not least) what forms it takes for the individual,
as we are used to doing with physical pain?
As mentioned, from both a common-sense and medical-
science point of view, physical pain is considered to be the
most indubitable and ‘objective’ form of pain. Psychic pain, on
the other hand, is something second-rate, or secondary and
derived – a phenomenon with a weight of explanation that
physical pain is exempt from as a matter of course. When the
doctor has not found obvious ‘physical’ causes of the patient’s
pain, the general view has been that the patient is not in any
pain, or alternatively that ‘it’s only mental’, i.e. it is not some-
thing that is real, rather something the patient is simulating.
This is – yet again – an indication that the classical divi-
sion between physical and psychic pain does more harm than

32
good, as regards both understanding and treatment. We also
see the problem in an opposite variant, namely when psychi-
atric patients complain of bodily pains and psychiatric staff
say that the patient is ‘somatizing’ his afflictions. We can see
that both traditions of treatment – somatics and psychiatry
– have a selective approach to what pain is: pain is either
something physical, or it is something mental. In concrete situ-
ations this creates the well-known problem that the patient
risks not being believed in his attempts to communicate his
subjective experience of pain to the staff.3 Having said that,
I would add that in present-day treatment practice we rela-
tively seldom meet unadulterated versions of the one or the
other conception of pain.
Let us for the time being hold on to the idea that pain – as
I intend to understand it from now on – always has both a
physical and a mental (psychological) component; these two
main components ‘compose’ the concrete experience of pain,
which, viewed thus, is a complex phenomenon. In the sim-
plest sense pain is physical in that it is experienced in the
body as ‘I am in pain’. The point is that this applies – though
less obviously – to psychic pain as well, i.e. not only for such
experiences as the pain felt at the blow of an axe. Grief or
experiences of loss, major defeats or powerful fear are all
examples of a pain with a mental origin, but that neverthe-
less can find expression in diffuse stomach pains, headache,
nausea, dizziness, stiffness, etc. Sorrow is certainly a form of
mental suffering – just think of the English word ‘heartbreak’,
for example. Heavy, long-lasting sorrow, however, is always
something physical in the ways mentioned. As we shall grad-
ually clearly see, it is this complexity of the corporeal-somatic
and the psychological-mental that in my analysis I include in
the phenomenon of pain.
I would like to start my account of psychic pain by refer-
ring to the insight into such pain that, in my opinion, is
offered by psychoanalysis, in preference to all competing

33
approaches. By making this detour to psychoanalytic think-
ing about pain we can also place classical medicine’s
understanding of pain in critical relief. And that is important,
since medicine has strongly influenced – we could say ‘made
scientific’ – the general conception of what pain is in the
modern age. The fact that the psychoanalytic approach has
been controversial in our culture ever since Freud began writ-
ing about it does not make the detour any less instructive.
The first psychoanalytic interpretation of a patient’s suf-
fering of which we have documented knowledge was made
in Vienna in March 1881. It was Freud’s medical colleague
and early collaborator on hysteria, Josef Breuer, who was to
treat the patient ‘Anna O.’ For two weeks, Anna O. had been
completely dumb, unable to say a word. Breuer told her how
he interpreted this: that he assumed that in some way or
other she had been offended and had decided to herself not
to talk about it. Breuer noted: ‘When I guessed this and
encouraged her to talk about it, the inhibition that had also
made all other types of utterance impossible for her disap-
peared.’4 What Breuer ‘guessed’ was that in order to maintain
dumbness about one thing, the offence, Anna O. had
decided, subconsciously, to become dumb about everything
else as well, and so generalized her voluntary silence about
something (the offence) into a universal, subconsciously
desired silence.
Breuer’s insight is just as simple as it is revolutionary:
silence that is desired about one intention can lead to silence
that is also desired about another, without the person being
conscious of the fact. Breuer’s insight leads directly to what
psychoanalytic interpretations have as their special charac-
teristic, what they are about: they are interpretations of
intentions of which the subject of the interpretation (the
patient) is unaware. Freud seizes on Breuer’s insight, devel-
oping it into a theory about subconscious mental processes.
The special thing about the interpretation that Breuer pro-

34
vided of Anna O. is that it does not base itself on an utterance
at all. On the contrary, it is based on a non-act, a non-speak-
ing, in a person who normally had a very great deal to say.
But for the observant onlooker Anna’s silence was paradoxi-
cally enough an equivalent of speech. Silence is eloquent,
conspicuous; it is a symptom, it refers back to something, in
other words it has a meaning. But what? The answer psycho-
analysis suggests brings us one step closer to understanding
the strange nature of psychic pain. Let us see what, broadly
speaking, this answer is.
If the traditional story is true, it was the well-known
French doctor J. M. Charcot who first inspired Freud to sus-
pect that hysterical symptoms have a meaning. That which
can be observed, the physical movements that can be read
from the outside – the contractions, paralysis, trance – rep-
resent something else other than themselves. They are
something physical that refers to something mental. If we take
the hysterical symptoms of a woman whose husband is
impotent, the idea is that there is a link between enforced sex-
ual abstinence and a mental experience. Medical science prior
to Freud distinguished between symptoms and causes: symp-
toms are ascribed to causes, and a treatment is prescribed
that is directed towards the causes and not the symptoms.
The point is that the symptom can be visible and recognized
medically as an ‘indication’, or it can be reported as a subjec-
tive event, but in both cases a medical interpretation will
ascribe a cause to it that is of the same type as the causes of
physical illness.
Freud’s great leap forward, inspired by Charcot and
Breuer, consists in his not abandoning the doctrine of causal-
ity (that symptoms can be traced back to causes) but
enlarging it to include a new area: the symptom does not
need to be explained by a physical process, as do a tumour or
an inflammation. The cause of the suffering (pathology) in
the patient can be an event. ‘Trauma’, the original meaning of

35
which was solely physical, understood as an injury, can now
be used as a term for a causal event, but as an event it is a his-
torical explanation: the patient is ill because something
happened in the past, and what happened had a mental –
psychological and emotional – significance from the very
outset. While Charcot had used ‘trauma’ when talking about
a physical injury that had a mental effect, Breuer and Freud
used the term about an event that does not need in any way
to be physical, but that has resulted in repression. Freud calls
a trauma ‘an event of incompatibility’ or an experience, an
idea or an emotion that has roused such a strong feeling of
discomfort that the subject had decided to forget it. We are
dealing here with impressions from the outside world that are
so strong that they overwhelm and put out of action the ordi-
nary defence and protection mechanisms of the self, as Freud
formulates it in Beyond the Pleasure Principle.5 A traumatic
experience leaves behind a need on the part of the self to
make an effort to refind its bearings, to be healed after the
upheaval. According to Freud, this is a mental process that
feeds on symbolic material, i.e. on the creation and integra-
tion of meaning.
What Freud makes us realize is that mental sufferings are
caused by events that have made a strong (epoch-making)
influence on the person. As far as the suffering (pathology)
is concerned, however, it is not a question of the event as such
but of the impression that arises in the patient’s psyche. And
such impressions do not need a physically and indubitably
‘happened’ event in order to be aroused, although it should at
once be said that this is a controversial issue in psychoana-
lytic therapy, made topical by cases in recent years of
individuals who claim to have been sexually abused (who
indicate experiencing themselves as such, with accompany-
ing symptoms in the form of emotional afflictions), but
where there is considerable doubt as to whether actual or
imaginary events underlie such claims. Mental sufferings –

36
and subsequent sufferings – can have a causal justification
that, as far as other people can judge, is completely without
correlating physical events (in the form of actual acts that are
ascertainable facts in time and space, external and generally
visible). Freud first assumed that patients had been exposed
to real sexual assaults, that they ‘were right’ when they
reported these as actual events. He later revised this theory
(something he has been much criticized for), saying that the
patients’ accounts did not have physical correlatives in the
form of actual events but only dealt with fantasy about events
that were either strongly desired or strongly undesired. The
important thing is that the fantasy – the mental content – in
itself is causally sufficient to bring about, for example, a neu-
rosis, i.e. a manifest mental affliction. It is this purely physical
causality, its inner logic, that is the foremost discovery and
theme of psychoanalysis in both a theoretical and therapeu-
tic respect.
The causal connection we are dealing with exists between
a past conflict situation – that which initially created the
trauma – and the compulsively repeated reactions under
which the person now suffers: the symptoms (in Anna O.’s
case, the inhibition against talking freely that led to her not
talking at all). The crucial idea, therapeutically speaking, is
that when the source of the suffering is explained and under-
stood, the actual fact that the individual gains insight into it
– into what is creating the pressure that the symptoms are
strategies for holding in check – contributes to the suffering
being overcome. In other words, it loses its causal-determin-
ing power over the person’s behaviour, e.g. in the form of
compulsive thoughts and compulsive acts, often just as
incomprehensible to the individual himself as to others, but
that he, because of a violent inner pressure, feels ‘compelled’
to carry out, to repeat time after time.
It must of course be said that medical science, ever since
the days of its pioneer Hippocrates, has been well aware that

37
human nature is not restricted to what can be observed by
examining the body. Every individual is the bearer of a history,
his own history, and this history must always be taken into
account when the individual’s actual situation is to be under-
stood, with the sufferings it may contain. An individual’s
earlier experiences are of invaluable importance for getting
‘behind’ the present sufferings and afflictions. What we are
dealing with here is not what happened in a purely physical
sense, that which is factual and can be confirmed and attested
by everybody. No, it is what particular events have come to
mean for the individual, what meaning the events have
assumed and continue to exercize, maybe subconsciously
rather than consciously. It is this highly subjective dimension
of human exposure to pain that Freud points to via his
original understanding of mental causality, i.e. that a person
experiences something at the event level, is exposed to some-
thing that creates an inner impression, that latches onto the
subconscious in a way that generates symptoms, that creates
sufferings that are visible at the physical level, but whose trig-
gering cause is mental.
Do not let me make this more cryptic than it is. Even
though many of the assumptions and ideas of psychoanalysis
are now considered speculative and unscientific, a great many
of Freud’s insights have become part of everyday language
and the common understanding of our age. How then is it
that Freud can help use to see what characterizes psychic pain
as opposed to physical pain?
Man’s reality is more than – does not coincide with –
physical reality, that which the natural sciences study via
observations and measurements. Man’s primary reality is a
mental reality. Only that which is mentally real for an indi-
vidual is actually real. What, then, is this mental aspect?
As humans, we have no other conception of the world than
that which is constantly transmitted by our memories, con-
scious and unconscious, about everything we have experienced

38
during our entire lives. What plays a role – the decisive role –
is not the objective or physical characteristics of what has
happened, that has the nature of events and actions, but how
the person experiences it, what meaning it assumes for him
or her. ‘Something’ can only assume meaning for ‘someone’
because this ‘someone’, the human individual, is a mental
being as well as a physical one. By ‘mental’ (= with a mind) I
am referring to such things as ‘experiencing things’, ‘gained
experience’, ‘thoughts’, ‘feelings’ and, above all,‘a person’: all the
former must be able to be connected to the latter, who is the
person who has them (the experiences, thoughts, etc.). The pri-
mary characteristics of persons do not belong to the objects
that exist in time and space outside persons.
The best example of what this implies is perhaps death.
Persons are living physical beings that exist in time and space
just like all other such beings. But we are – as far as can be
ascertained – the only such beings that live conscious of the
fact that our life will one day come to an end, that we shall
die. Death – my certainty that I shall die, as the philosopher
Heidegger emphasized – is a highly significant mental reality
in my life long before it becomes a physical reality, something
that actually happens to me. As a mental reality, death is a
reality in my life that stands on its own two feet, separated
from the nature of death as a physical event. Death means
something particular for me now, even though its existence
is in the form of not-being rather than being, of an experi-
enced not yet. As persons we are beings that recall a past, not
the past as such, or as something general, but my past, under-
stood as the significance and meaning which that in the past,
with which I exist in a (conscious and unconscious) experi-
ential relationship, has acquired for me, and precisely for me
as opposed to all other people, who may have ‘taken part in’
many of the same situations and events. Likewise, every one
of us projects a future – not any future but my future, formed
as ideas about it, hope for it, fear of it, plans for it, all of

39
which, influenced by what my past has done to me, has pre-
disposed me to – whether I will enter it with peace of mind or
unease, erect or discouraged, hoping for the best or fearing the
worst, made wise by good fortune or wise by adversity. The
important here is that everything that has the nature of an
event in a person’s life is internalized by the person. Instead of
things just ‘happening’ – happening in the world or happen-
ing to us – everything that has happened, is happening and
may happen are taken inside us, populating our subjective
world, equipping it with its ‘mineness’. To be incorporated
into this inner, subjective world means having the nature of
what I call mental reality.
The concept of mental reality has aptly been summed up
by Chateaubriand: ‘Everyone bears within a world that con-
sists of everything he or she has experienced and loved’ – and
hated or feared, I would add. The point is that we live at one
and the same time in an outer and inner world; the relation
between them is what is crucial: a relationship that in one
person can be characterized by interactive flow and supple-
ness, in another by separation and rigidity. This notion of
two worlds is not restricted to a psychoanalytical perspective;
in fact it is a core element in all contemporary variations of
object relations theory and theories of attachment. Each and
every one of us, then, houses an inner world of thoughts,
emotions and experiences: a world that consitutes my men-
tal reality, and that brings together all fixing of meaning and
significance. Maturity is characterized by a person’s recogni-
tion of being dependent on good (real, outer) objects (i.e.
persons, but also symbolic-cultural artefacts) that lend them-
selves to being introjected into the individual’s inner world,
thereby forming an invaluable source of positive meaning
and self-awareness, while the temptation to assume control
over such good inner objects is resisted. What does that
mean? Why? Because – and this is a crucial insight, power-
fully formulated by Melanie Klein and Donald Meltzer in

40
particular – if we strive to take possession of our good inner
objects, to have them at our disposal, their goodness, beauty
and richness will be ruined. Only if these good inner objects
are granted free passage, based on the conviction that they
will not desert us, will they grant us their solicitude, their love,
and thereby provide vital nourishment for our creativity, zest
for life and working capacity.6 In short, we are dependent on
forces outside ourself that we cannot control; we remain vul-
nerable to the most important sources of experiencing that
life is meaningful and that we are valuable. Gratitude is the
attitude that corresponds to this realization.
An example of what I mean by psychic pain is mourning.
Mourning is a cognitive and (not least) emotional reaction
to loss. Mourning can invade a person to such an extent that
everything that happens is blacked out by grief. Mourning is
the state that synthesizes the world and all it contains for the
mourning person; mourning is the ‘organizing principle’ that
determines the value and meaning of everything encoun-
tered, in all thoughts, all feelings, all experiences. Life is lived
in the hands of the mourning brought by loss, by bereave-
ment. When the psychic pain released by, for example, the
death of a dear one does not pass after a certain period of
grief, when the person instead links his energy and his emo-
tions to the lost object (the loved one), Freud speaks of
healthy mourning turning into melancholy, i.e. a state typi-
fied by the person constantly dwelling on the past and
cultivating the loss, and so blocking the person’s ability to
reengage with the world and to love anew.7
No matter whether we are speaking of sorrow or melan-
choly, it may sound as if these are states that control the
person, rather than the reverse. Is that possible? Or is it really
that sorrow only apparently controls the person? Does not
sorrow only have the power it appears to have over the per-
son on the condition that the person chooses to give sorrow
such power?

41
 Jean-Paul Sartre is famous, and notorious, for answering
yes all the way. Sartre describes a time when he is sitting alone
in a room, feeling sad. There is a knock at the door. I then,
says Sartre, make ‘an agreement with my sadness to leave it
aside for a while and come back to it later’, i.e. after the peo-
ple visiting me have left. Since, according to Sartre, we ‘don’,
put on, the emotion, we can also ‘lay it aside’ and resume it
when the situation suits us better. For Sartre, this example
shows how ‘consciousness affects itself with sadness as a
magical move against a situation that has become too trou-
blesome’. As with other emotions, ‘being sad means first
making oneself sad’; sadness itself is a kind of behaviour that
I choose.8 Sartre presupposes a distinction between person
and emotion, a distance that in every situation allows – or
requires – the person to face his own emotion as a kind of
object. So Sartre believes that I show, call back and modulate
the emotion as something that is at my free disposal, that is in
my sovereign power in the sense of being formable and deter-
minable by me.
My disagreement with Sartre’s view of emotions is impor-
tant for understanding what I mean by psychic reality. When
we examine what distinguishes physical pain from psychic
pain, we must have a clear idea of what it is that has the
nature of physical reality for us as persons. We have seen that
physical reality arises and is maintained because of an effort
on the part of the human subject: it is a question of how I as
a person, with a highly individual life-history and with all the
events and acts that are part of it, continuously give meaning
to everything that has happened, is happening and may be
going to happen. I am, then, an active interpreter of every-
thing around me, everything that is part of my world,
everything that is within my horizon; the mere fact that I
interpret something to mean and signify something means
that it assumes the nature of a mental reality for me. As a
human, I am a being that is dependent on meaning. I am just

42
as dependent on meaning in order to live as I am on food.
I am hooked on symbolic nourishment. As far as we know,
man is the only species that can become ill because of a loss
of meaning, of not finding meaning or of only experiencing
(interpreting) a meaning for that which occurs that is nega-
tive, that creates fear and, in the worst instance, destroys the
zest for life. Without meaning I cannot live but not any old
meaning will do. My existence depends on the meaning I
manage to see in that which happens, that I come into con-
tact with and am affected by. When I no longer have any clear
idea of what means something and what something means,
my very existence is threatened. I am of course in this world
in the physical sense but in the psychic sense I am ailing and
my physical survival depends on my psychic survival, which
in turn depends on the access to meaning.
We are now ready to make the following assertion: psychic
pain can be just as fatal as physical pain. Additionally, what
causes psychic pain, what determines its seriousness, is far
more complex and involves the individual’s personality and
life-history to a far greater extent than is the case with phys-
ical pain. As humans we are beings exposed to pain, although
the exposure is of a very different kind when we are afflicted
by psychic pain as opposed to physical pain.
Let me now provide a more detailed account of Sartre’s
position, with a subsequent critique, in order to clarify where
that leads us.

43
 four

A Critique of Sartre’s
Existentialist View

Sartre is a so-called existentialist philosopher, one who I

claim is in tune with the spirit of the present age. I am think-
ing in particular of Sartre’s striking individualism, his
emphasis of the fact that being a human being involves mak-
ing choices, and that all of us make our choices in what is
both total freedom and total aloneness: I and I alone am
totally responsible for everything I do, and my freedom to
choose cannot be de-chosen, rather, I am eternally sentenced
to carry the responsibility that freedom involves, no matter
how little that may appeal to me. In philosophical terms
Sartre is a voluntarist because he places such emphasis on the
freedom of the will in all our doings, the unique power of the
will to determine meaning and significance for us.
Sartre’s relevance for our theme consists in his assertion
that my psychic reality is my own work and therefore com-
pletely my own responsibility. But have I not advanced
precisely the same view above?
In fact my view differs from that of Sartre, and now we
must look more closely at the resulting consequences in order
to understand what psychic pain is.
For Sartre, feelings – like moods and mental states – are
something chosen and willed by the individual. When, for
example, some people claim that they ‘were overcome with
fear’, Sartre’s comment is that such people are what he would
call ‘in bad faith’. By referring to fear ‘overcoming’ them, they
are attempting to escape from full responsibility for the way

44
in which they acted in that situation. It is a question of pre-
senting oneself as passive vis-à-vis the feeling and the mental
state that was dominant, so that the stronger the feeling and
state are asserted to be, the more the person will be in their
power, be surrendered to them. Sartre reacts against such a
view for two reasons. He believes that it is directly erroneous
as a description of what actually happens, and that the
description constitutes a highly questionable strategy from a
moral point of view.
The truth is, Sartre maintains, that it is we who make our-
selves passive in regard to our feelings, and on that basis we
then renounce our responsibility for them, because of the
(unpleasant) fact that we are the source of them and that feel-
ings express judgements (judgements of value, to be more
precise) about something or someone in the world that
means something to us, that is not indifferent to us. Accord-
ing to Sartre’s theory of emotions, we are always at a certain
cognitive and will-based distance from them.9 In short, a par-
ticular feeling (shame) or state (fear) is something we as
persons decide to have, in the sense of ‘assume’, ‘put on’, in a
given situation. Sartre is particularly interested in the fact that
we assume feelings in order to tackle situations that seem
threatening or troublesome to us. Feelings represent a kind
of ‘magic’ – we use them to trick the situation, to make it less
shameful, so that we can escape from it without losing face.
In everyday social interaction with other people this is a strat-
egy that is made frequent use of, more automatically as time
goes on, without any appreciable awareness of what is hap-
pening; it is a strategy which we discover we can use with
great success when with other people and that we allow oth-
ers to use with great – though perhaps slightly less – success
with us.
As I see it, there is something right about Sartre’s analysis,
but there is also something wrong, something that has con-
sequences for our attempt to arrive at the distinctive nature

45
of psychic pain. Sartre’s conception gives us a good grasp of
what can be called the cognitive dimension of feelings, i.e.
that a particular feeling – shame, for example – is about
something and in terms of judgement and value has an opin-
ion about its object, since what the feeling refers to appears
to be meaningful, in a positive or negative sense, to the sub-
ject. Sartre is good at depicting how the meaning and
significance of a feeling are not to be considered neutral data
in an objective world but instead are a dimension of the feel-
ing (as with every experience) that is constituted by the subject,
i.e. created and maintained by the subject as an intentional
being, a being that actively has thoughts, feelings and a will-
based initiative regarding everything encountered in its
world.
But this does not catch all the dimensions of a feeling. For
the strange thing about feelings, unlike thoughts and judge-
ments and other characteristics of our cognitive abilities, is
that they contain an affective dimension: the dimension of
our being affected by them. And here I am not referring to
affectedness in Sartre’s one-sided sense of self-affectedness:
that which a subject does to itself, including its own inner
states, that which together populate and constitute his or her
psychic reality. Via the affective dimension of the feeling I am
rather in contact with a quality of being moved, shaken, hit,
touched, as opposed to moving, shaking, hitting, touching
(i.e. Sartre’s position). In the feeling of shame and the state
of fear I am precisely in the feeling and in the state, not facing
it, as I face various objects in the world, in a relationship of
externality to them, with the accompanying cleft between me
on the one hand and the objects outside me on the other.
Unlike that, I as a feeling, affected person am in an internal
relationship with what the feeling or state is all about, with
what it does to me, and with the whole particular world as
presently disclosed to me by virtue of this feeling. As someone
placed in shame or in fear I now am this shame and this fear,

46
rather than someone who has them. The feeling defines me
here and now, it marks the standing point from which I here
and now sense and interpret everything in the world, every-
thing that this special standing point in the world allows me
to discover in it, given the horizon that comes with the point
of world access and that bears its mark.
Sartre is without a doubt correct in saying that a feeling is
always an interpretation, that we never feel anything particular
in a cognitive vacuum (in terms of interpretation and evalu-
ation). By placing all emphasis on the subject’s interpretative
contribution and responsibility for this, however, Sartre avoids
answering the fundamental question as to what a feeling is, as
distinguished from a thought or an act of cognition.
To use Sartre’s example as an illustration: Sartre is right in
saying that I can (try to) lay aside a particular feeling – the
present feeling of sadness, for example, that I am so influenced
by when sitting in the room as someone knocks at the door.
But to point out that we can behave towards our sadness in
this way is not the same as saying anything apposite about
what the feeling – sadness – is. Sartre’s many examples,
despite being so vital and recognizable, only say something
about how a person chooses to behave towards a particular
feeling in a particular situation. The examples say nothing
about the basic issue, i.e. what a feeling is. In other words,
Sartre succeeds in saying something about the person who
has the feelings, about the person’s way of acting towards the
feeling. But nothing has been said or shown about the feel-
ing as such. It simply is there, like a fact in the world Sartre
depicts (locates) the person as an observer of, and therefore
always at a certain distance from. This means that Sartre loses
sight of how the feeling arises. He loses what we could call the
crude and the gut firstness of the feeling, the feeling such as I
am it – am it as an affect, unlike some possible object for my
thoughts and my will, with regards to what I, given the nature
of the situation, can want to ‘do’ with it, e.g. suppress it or

47
inflate it. The feeling – seen in terms of affect as opposed to
thought and evaluation – as I am in it is to be seen as prior
to, indeed a prerequisite for, the split between me and my
feeling, which is what Sartre bases himself on from start to
finish. Sartre, we could say, begins the analysis of the feeling
too late. He does not grasp its original affective dimension,
as there is nothing that separates between me and my feel-
ing. We are (in) the feeling before we observe it, objectify it;
we sense the feeling (blushing, sweating) before we describe
it, and before we eventually consciously go in for doing
something particular with it. This entire cognitive dimension
and its distinct work comes afterwards. When we are really
seized by something, this means that we are moved, not that
we move.
Admittedly, we must ‘let’ this object – this person, this situ-
ation – mean something to us; otherwise the being seized
by it would not happen. This brings us to the absolutely cru-
cial ontological point, that we have not chosen to be beings
existing – living our lives – in such a way that we allow things
to mean something for us, have meaning for us. That objects
– events and acts, persons and situations – ‘out there’ mean
something in an affective-moving sense is one aspect of our
existence over which we do not exert choice. In the emotive
response’s how – that I feel so and not otherwise – my indi-
viduality towards the outside world and towards myself is
foreshadowed, as Sartre rightly maintains, though at the cost
of making this feature the most fundamental one. I answer
for the response I display (jealousy, envy, shame) being my
response, I vouch for it, it reflects me, says something about
who I am, what is important for me, what is at stake for me
in the particular situation. But – contra Sartre – the sensitiv-
ity, the affective susceptibility, that I am moved by how
others are moved in a situation (via my capacity for empa-
thy), is something about me that I am, not something I have
chosen. Nor have I, as a human subject, decided all the modes

48
of expression and manifestations of this sensitivity as they
vary from one situation to the other (blushing as a bodily
expression of my shame, sweating as an expression of my
nervousness). Just as fully, I recognize these affective expres-
sions as unmistakably mine.
And let me hasten to add: If I do not recognize myself, the
distinctly personal, in my displayed repertoire of feelings, this
is to be considered a sign of something being badly wrong
with my self-relationship. In cases of fundamental non-
recognition this is a symptom of psychopathology, of mental
illness. From a clinical and therapeutic perspective, a far
advanced ability, or even urge, or experience of coercion to
lay aside an actual feeling (it could be shame, but also some-
thing positively charged, such as joy or pride) in order to take
it up again later is not an innocent theoretical point about
what it means to feel something (as Sartre believes). If any-
thing, a person’s urge to go in and out of his own emotional
state, according to whatever for some reason or other
(unconscious as well as conscious) is judged to be ‘suitable’
in the situation, can be a warning sign that the person is liv-
ing out his feelings in an unauthentic way, more as an
observer of them than one who completely is them. The
more pronounced and persistent such a split between the
person and the emotions is, the stronger the need for an
explanation as to why things have become as they have in this
person’s life.

49
 five

Pain as a Phenomenon

I have discussed Sartre in order to make some progress

towards gaining a good understanding of psychic pain. How-
ever, the question of what a feeling is, which we have dwelt
on in Sartre’s company, is not the question of what psychic
pain is. What is the connection between them?
To begin with a simple answer: psychic pain is a feeling. Or
put more generally: when I sense pain, I sense it as a feeling
and when the pain is great, or its intensity violent and/or
long-lasting, I experience pain as a state. That is the connec-
tion, at a basic level, between pain and feeling. Because there
exists such an intimate connection between them, the points
from the critical discussion of Sartre’s theory about emotions
can help us take the next step. If it is so (and who would
protest?) that the way pain expresses itself is as a feeling, so
that to be exposed to pain is the same as being able to feel pain,
what difference does it make if the pain is physical or psychic?
Much would seem to indicate that the division between
physical and psychic pain does more damage than good for
an understanding of what pain is, although the division is so
ingrained that I have not been able to avoid making use of it.
The axe-blow to the leg is beyond a doubt an example of
inflicted physical pain, as we have seen earlier. But, as we also
saw, how I interpret this situation plays an important role in
my experiencing of this (physical) pain; I give it a meaning
in my situation, I fear that it will stop me carrying out cer-
tain plans I had made, I experience that the injury bothers

50
me and that it ruins my good mood. It would be possible to
go on giving examples like this of my leg injury, despite the
fact that seen from the outside, considered in isolation and
from a medical point of view it is ‘only’ a matter of – fully
curable – physical pain, it pains me in ways that break with
and go far beyond its purely physical nature. As a definitively
entered constituent of my mental reality even the simplest
physical injury (or somatic affliction) is an event in my life
that always has more dimensions than the physical. In other
words, even the simplest physical injury has a meaning for the
person injured. And the question of what the meaning more
precisely consists of obliges us to shift focus from the physi-
cally describable (and medically manipulatable and curable)
side of the injury to the role the injury plays as a mental real-
ity in the injured person.
When I claim that the way in which we ‘have’ pain as
human beings is via feeling pain, via the full sensing of it, that
means that the feeling of pain cannot be separated from the
conscious understanding (cognition) of pain. The principal
characteristic of pain is precisely the feeling of something
causing pain.
Let us make use of the insights we arrived at in the dis-
cussion of Sartre. He claims that as human subjects we always
choose the quality of our experience, including the actual
feeling we might have, and consequently we are free to de-
choose it, to exchange it with a different feeling that will
contain a different interpretation, a different strategy for
mastering the situation. Against this, I assert that pain is par-
ticularly suitable for demonstrating that there are feelings
and states that we are obliged to live with and that we there-
fore are not in a position to go in and out of at will. In a
fundamental sense, the feeling of pain is not a product of
thought. The feeling of pain has an autonomy, an independ-
ence and sovereignty vis-à-vis the person who senses it. If we
ignore situations where persons more or less intentionally

51
inflict pain on themselves, and that form the exception (I
shall address phenomena of that type in a later chapter), we
have to say that the rule is that pain comes and goes inde-
pendently of human thought and will. The reality of pain is
the reality of the feeling of pain, its persistence, its entry into
my life-world, its nature of being an uninvited guest, or should
we rather say intruder, one that comes without my wanting it
or having thought of it being thus, and that does not go away
even though I might wish for it more than anything else. Pain
possesses an utterly sovereign power, a sovereignty that marks
the limit for my belief in my own power, my freedom and my
determining right over everything in my life, over all its sig-
nificance and meaning. Pain heaves the ego down from the
pedestal.
Against this (call it ‘phenomenological’) background, we
can see that physical and psychic pain can indeed be separated
from each other purely analytically and as regards theoretical
discussion. But it would be contrary to the experienced nature
of pain – and it is pain as something experienced that interests
us, for how else are we to approach it, to be able to say any-
thing about it? – to hold onto a strict division between the
psychic and the physical when examining the experience of
pain, i.e. what it means to have pain. Common to all types of
pain, no matter their actual causes (etiology), is that pain
has to do with hurting, that hurting is what the feeling is
quintessentially about. As we touched on in the discussion
of Freud and psychoanalysis, bodily pains (symptoms of a
somatic nature) can originate in mental or psychological
(emotional) factors. Anna O. suffered (probably, if the story
is true) from enforced sexual abstinence in relation to her
husband. The mental and emotional meaning of living in
this situation, i.e. in a situation of subjectively interpreted,
felt and suffered dissatisfaction, dissatisfaction regarding
something to which the person Anna O. attached great impor-
tance, leads to an affliction that has physical as well as

52
psychological symptoms. The general point is that pain moves
in both directions: psychic pain can be caused by bodily-
physical factors, just as physical pain can be provoked by
mental causes. Psychic pain can bring about as well as intensify
physical pain, and vice versa.
This assertion entails a particular view of the body’s role
in relation to pain. Because I am my body, because my body
is me, the pain in my leg as a result of the axe-blow is not a
product of my thought, my interpretation or my will. Simply
as hit by the blow and hence as addressed by the pain imme-
diately and inadvertently accompanying the blow, I cannot
not relate to it. In being hurt I am affected by and involved in
something non-optional and non-voluntary. Just as little as
my feeling has primarily been given me as an object among
other objects in the world can I have such an objectifying dis-
tance from the painfulness which I sense is located in one of
my limbs. In a full sensuous-experiential sense, I am where
the pain comes from, its enforced here-and-now, its peculiar
way of centering my world, even (sometimes, as we shall see
below) shirking it; I am not outside this brought-about
painfulness and at a distance from it. I am the pain in my body
because I am that body. And I cannot otherwise have a world,
be in the world, in the manner characteristic of humans.
The French philosopher Maurice Merleau-Ponty, upon
whom I draw here, puts it like this: ‘My body is not only an
experience among many. It is the yardstick of everything, the
reference point for all the world’s dimensions.’10 My body is
not an object. While I am able to leave all objects in the
world, in the sense that that I can influence and manipulate
their presence and absence, my proximity to or distance from
them, I cannot leave my body. It defines my being-in-the-
world by determining and demarcating the standing point
from which I at any time sense, think, feel and move around
in the world. Where I am, my body is; where my body is,
there am I.

53
 That pain is corporeal does not say much. It only says
something about its localization: that it is mine, that it has
me as its residence. When experiencing physical pain, my
awareness of the pain will vary, depending on the nature of
the pain; pain can come and go, be transient or lasting, even
chronic. Pain can grant me a break, allow me to fetch myself
in again and regain some strength, or it can hold me in a grip
of steel that never relaxes and is perhaps constantly being
tightened. Generally speaking, pain is what makes the body
a particularly important concern for the individual. The fact
that the body, often quite suddenly and unprepared for by
me, becomes a place for a concentration of pain, forces me to
have a new relationship with my own body. Merleau-Ponty
is one of those who has pointed out that it is because of pain
(illness, injury, dysfunction) that I become aware of my body
at all. Normally, especially as long as I am still young, I do not
want to ‘know about’ my body. Obviously, I am keenly aware
of it in certain situations and in connection with particular
experiences – sexual ones are perhaps the best example – but
as a rule I will not have my attention fixed on my body. If any-
thing – in the spirit of Merleau-Ponty – I will in all my
activities, actions, experiences and plans sense, feel, and act
with my body, my body as the self-evident, unreflected and
unnoticed centre in the sequence of everything I happen to do,
experience, feel, want, etc. My body is not among the things or
themes in the world I ‘take in’, focus my attention on. On the
contrary, my body is the actual condition of possibility that I
am located as I am in the world at all, am active, movable in
this way, that I can focus my attention and energy on anything
at all of what exists outside me (outside my body).
This is what is so dramatically changed, even turned
upside-down, from the moment the body becomes a centre
for pain. Pain steals the focus. Pain commands my total atten-
tion, it drains me of energy, it demands everything of me,
finally more than I am able to give – it wears me out. Pain is

54
voracious: it wants to consume me, have all of me, not share
my consciousness, my thoughts, feelings and will with any-
one or anything else. Pain is intensely jealous: it eliminates all
rivals of my attention and energies as soon as they emerge, so
that finally all that is left is pain, as the all-consuming and all-
penetrating centre of my life. I am pain, the pain is me, there
is nothing else, nothing outside. Admittedly, I can attempt to
use cunning, to protest. I can attempt to take a mental time-
out from it, to rest from it so as to make it leave me in peace.
But where pain is intense enough, pervasive and long-lasting
enough, the thought of – as well as other people’s well-meant
advice to try – ‘thinking of something else’ is nothing more
than an ineffectual gesture that does no good at all, being
thoroughly impotent. Pain catches up with me, reminds me
where I belong and have to stay put: at home, at home with
my body, in my body, as my body. Absence of distance – or
better: distancelessness – is what physical pain at its most
intense is all about, ineluctably at that; it is how such pain
works, as it were. When experiencing severe pain my entire
life-world, my horizon, is narrowed down; my perception of
time and space, my relations with other people as well as with
myself are dramatically changed. The final point is reached
when existence is reduced to the body. That which was pos-
sible as something self-evident and calling only for a
minimum of effort becomes impossible. The eminent and
apparently limitless, unforced and unhindered openness to
the world of the senses, the openness to everything it might
contain, is replaced by a solid closure. The outward-looking
nature of the senses, their levity and mobility, their non-stop
curiosity towards everything and everyone, not least what-
ever might seem to be new and unfamiliar, worth pausing
and looking at, everything that enables, maintains and inten-
sifies our actual contact with the world, our engrossment in
it, withers away. Like muscles that atrophy when not used,
our hearing will decline and our gaze become limited. Nurs-

55
ing scientist Per Nortvedt, speaking of patients with severe
pain, puts the characteristic alteration of their world-experi-
ence like this: ‘The room I am placed in is emptied of content,
it becomes cramped, impossible to gain an overview of, not
because of some objective features of the room, physically
speaking, but because one does not have the strength to look
at what is there. One sees and yet does not see, because one
does not have the strength to see.’11
Painfulness thus creates a distance from everything except
the pain itself. Pain is like a magnet that attracts all attention,
all energy, towards itself. At the same time as all attempts at
openness towards the world outside are killed at the moment
of birth, are strangled by pain’s never-resting presence, pain
does not allow itself to be shut out. Pain becomes a tyrant, an
all-organizing centre in the person’s consciousness, sensual-
ity and physicality, something that mercilessly dictates all
significance, all meaning. The life-world of the person
shrinks to this single hub; one is powerless and surrenders
totally to the omnipotence of pain. If pain becomes com-
pletely autonomous, the person in its power becomes
completely heteronomous, under alien control. And here, in
keeping with what existentialist philosophers like Martin
Heidegger help us to appreciate, loss of (outside) world
means loss of self; the former assumes the form of the latter,
the two becoming experientially indistinguishable. For even
if the pain is unmistakably mine, no one else’s, it forces me to
abandon myself, my determining of what I will do and what
has meaning to me. I experience it as if something alien and
deeply hostile has taken up residence in me. I am consumed
from the inside; the outer limits of my body to the world no
longer help me to keep out what is threatening and unpleas-
ant. No, the opposite applies: the limits of my body as a
marker of my separateness from everything else and every-
body else in the world makes any retreat from that which
hurts in the world possible for me, since my body is now the

56
vessel that keeps the pain inside, that ensures that it becomes
lasting in me, as that which defines my entire existence. In
philosophical terms this means that the pain by means of its
body-located reality transforms my whole being into imma-
nence, since every attempt to go beyond (transcend) it
becomes impossible.
The phenomenological perspective I have adopted, fol-
lowing Merleau-Ponty, is well suited to explain how pain, if
it is particularly intense and long-lasting, transforms my
sense of myself as a body, as existing in the world as a corpo-
real being. The more unbearable my bodily pains are, the
more fundamentally my entire existence is reduced to the
physical. But what about pains that do not have so strong a
localization in the physical?
We have touched on the form of causality that deals with
how something purely physical can cause – be sufficient
cause of – something physical, in the form of somatic-
corporeal suffering. That a physical change (dysfunction,
inhibition, injury) can be effected by something non-physical,
that something somatic can be effected by something non-
somatic, something corporeal by something non-corporeal,
is an insight that goes right back to Hippocrates, the father of
medicine, but of which Sigmund Freud in particular has
influenced our modern understanding. The question we need
to examine, however, is whether we can talk about a purely
mental causality as far as pain is concerned, in such a way
that a cause of a mental nature can bring about a purely
mental effect, in the form of psychic pain.

57
 six

Anxiety and Depression

Anxiety and depression are two especially salient instances of

psychic pain. Let us explore what is distinctive about them.
While fear is a feeling with a particular object in the world,
where the person experiencing fear has a clear idea of what
he fears (the object of fear), anxiety is different. To have anx-
iety – or, more precisely, to be in anxiety – is to find oneself in
a state where the cause is unknown to the person experien-
cing it. While fear is in principle easy to tackle because of the
possibility of removing or in some other way taking action
against its object, with anxiety no such easy options or exits
are available. Many philosophers within what is loosely
labelled existentialist thought, including Kierkegaard, Heid-
egger and Sartre, have devoted much attention to the
experience of anxiety (Angst). The assertion is that anxiety
has a potential to rouse the individual to a new, deeper
insight into his own life: to realize that this is my life, these
are my possibilities, and it is my responsibility to assume
these possibilities and make the best of them, and to answer
for the choices I make as those that reflect what sort of a per-
son I wish to be. Anxiety is the royal road to a privileged
recognition of the fact that I am obliged to adopt an attitude
to universal and general characteristics of each human
being’s existence in the world in my way. As Heidegger says,
anxiety can rouse me to a recognition of the fact that it is not
first and foremost a question of one being mortal but that I
shall die. Anxiety individualizes what otherwise is held at

58
arm’s length by being viewed as universally human, by being
generalized and thus having its sting removed, its nature of a
challenge to me personally, for example, the marking by mor-
tality of an absolute limit for all my projects. As humans, all
of us are mortal. But only I can live – interpret, tackle, count
on – my mortality: no one else can do it for me, no more than
I can step in for other people.
It is in the spirit of existentialism to ascribe to anxiety
what I here will call a characteristic pathos of genuineness.
Sartre and Heidegger talk about authenticity (Eigentlichkeit).
Anxiety brings me back home to myself. It forces me to be
confronted with myself, with the normally so obscured, over-
looked and repressed fact that the only instance for ascribing
meaning and significance – of everything that constitutes
mental reality – in my life is myself. Thus anxiety and the
experience it provides is in stark contrast with my everyday
existence. This is dominated by a mentality that tells me that
significance and meaning are something that is received,
something I regularly meet up with and that falls into my lap
when encountering objects in the world and by virtue of all
my experiences. I think about things in the way that one (das
Man) thinks about them; I experience as good what one ex-
periences as good; I fear what one fears (alluding here to
Heidegger’s famous analysis in Being and Time of everyday-
ness and the conformity it supposedly entails) – and I do so
in the same fashion and for the same reasons as everyone else
does; for that is what I assume they do, just as others assume
that I experience the same in the same way as they do.12 In
short, everything that has to do with meaning and signifi-
cance is received passively by me on my journey through life,
in all I meet up with and am exposed to.
It must be said that not much effort is required to spot
weaknesses in this conception of the origin of meaning.
However, the point is not to present it as a robust philosoph-
ical position. It is rather to see how and why anxiety – anxiety

59
more than anything else – can give rise to the outlined one-
fixated mentality being broken and subsequently rejected.
What happens in anxiety? Anxiety typically comes
abruptly, completely without warning. The culturally favoured
metaphors are those of being ambushed by a violent and unex-
pected force, nay, enemy: anxiety conquers me, tears me to
shreds. It can wear me out, drain my energy. It can be experi-
enced as a battle, where anxiety is my enemy, the stranger in
my midst who knocks me down, who springs up without my
being able to prevent or control it. I can try taking up the bat-
tle, mobilizing my energy to outwit the anxiety, conquering it,
neutralizing it. I can try avoiding the paths where it lies in wait,
playing ‘safe’, avoiding provocations.
But a life spent pussyfooting around, where all my doings
are low key so as not to awaken and get embroiled in anxiety,
is just as much a life in anxiety’s power. When anxiety has
first announced its arrival, it is as if I do not have a chance of
warding off its attack. It is in command. Gradually, I can best
describe my situation as completely characterized by a fear of
anxiety, of its presence and the suffering this presence inflicts
on me. Anxiety is thus the perhaps most unadulterated ver-
sion of psychic pain. When all of me is ‘just anxiety’, when
anxiety is all I am, when everything that exists exists within
anxiety and is contaminated by it, when nothing outside it is
sensed and has meaning, then anxiety has become one with
my psyche. Having merged with me and all I sense, feel and
can think of, being one with me and all that I experience,
anxiety is no longer separable from my bodily being either.
Anxiety paralyses my corporeal-sensual openness towards the
world. It hampers my movements, and it may force me to
make certain movements – in the form of rituals, often tak-
ing on a most exhausting because compulsory nature – that
I feel dictated to do, and precisely in the detailed and rigid
manner required by it, at that, no deviations, no small free-
doms allowed me. The movements and acts I carry out

60
compulsively grant me the prospect of a certain quietude, a
time-out in the maelstrom of anxiety. While the break is only
temporary, obeying the dictates of anxiety and scrupulously
doing as it dictates does not give me any victory over it, does
not liberate me from it, but merely serves to consolidate its
almost total power over me.
What we are seeing here is that anxiety does to me what
we earlier saw that painfulness can do. Even though anxiety
can be cultivated in its purely mental aspects, and even
though the painfulness we discussed earlier can have a purely
physical injury as its triggering cause, this contrast between
a mental and physical origin is of virtually no importance
with a view to how the pain behaves. The phenomenological
and experientially oriented analysis yields almost identical
results in both cases.
In the significance existentialist philosophy grants to anx-
iety there lies, however, a message of a positive nature. How is
that possible? Has what we have said about the nature of anx-
iety not been exclusively negative?
When anxiety is portrayed as a royal road to a novel and
deeper recognition of a person’s responsibility for his own life
and own choices and possibilities, we are dealing with a
potential in the experiencing of anxiety that can seem to be
positive. Anxiety is understood something that more than
anything else rouses the individual to take responsibility for
and in his own life. This is particularly the case in Heidegger,
since he links anxiety to ‘the call of conscience’, a call that
contains an exhortation to stop living in the power of non-
self-sameness, typified in terms of thoughts and acts by what
one does and regards as being important and right, in con-
formity with what is established, practised and executed
without reflection. Anxiety forces me to have it out with such
‘other-orientation’, to use the concept of the sociologist David
Riesman.13 Anxiety throws me into my own arms, throws me
back with great violence from the concerns of others, from

61
everything outside me and the ‘inherent’ significance and
meaning I have more or less passively received and adopted.
Anxiety creates an opening, in the final instance an abyss,
between me and everyone else, between me and the world in
which others exist, see the significance of and find meaning
in. For the fact is that I do not do so – not any more, not after
anxiety has entered the scene. Now there are two lives, that
prior to anxiety and that since. I have lost the connection
between them. I am fumbling for the way back, but have to
acknowledge that nothing can be as it was before.
Out of the existential distress into which anxiety casts me
unawares hope arises – a possibility for change. Anxiety has
such a potential because it takes the form of experience. Ex-
perience (Erfahrung) is something else than ‘an’ experience
(Erlebnis). Anxiety is the reference point of existence – anx-
iety is human discomfort and alienation in this world par
excellence. Anxiety is this void, that which I am simply in but
cannot point to, cannot objectify, make into something out-
side me and that I thereby can distance myself from and
control. I can no more distance myself from the body than I
can distance myself from anxiety. Both define and determine
the possibilities and limits of my existence, what I am and
what I can do. Once anxiety lodges itself in the body – which
is what it does, for it does not let anything that is me go free
– the body is permeated by anxiety. What then?
We have hitherto depicted the way into anxiety, but not
said a word about the way out. To do that, we must examine
more closely the assertion that anxiety is experience. What is
experience? Experience in the German-inspired (as it were)
sense intended here, is a tremor, a shock. I am struck by what
is happening to me; it changes my view of the world. Experi-
ence takes me out of the familiar, smooth flow of existence.
Experience introduces a break, a radical discontinuity, into
my life, causes an upheaval. What was formerly familiar to
me is no longer so, or no longer means anything to me. But

62
experience does not only represent such negativity, such a
stimulus of a break and of something new. It also contains
elements of what is necessary for me to establish new mean-
ing, find a new foothold. So experience opens me up towards
the world, it enables, indeed even promotes, transcendence,
the going beyond the given, the usual and the familiar. Ex-
perience is subversive in challenging and not leaving unaltered
what is (felt, thought, done, planned); it is revolutionary in
paving the way for something completely novel and unknown,
promising a new beginning: that my existence in the world
start afresh.
Experience, then, can turn anxiety into something else
than mere negativity, unadulterated painfulness. That is how
Heidegger sees it.14 By anxiety containing a call of conscience,
it instils an experience that forces me to make a new depar-
ture. And by the nature of things, this departure is felt –
experienced – as something unpleasant, unwanted – in short,
as painful. As the ancient Greeks pointed out – and as Heid-
egger later reminded people – there is a strong affinity
between pain and experience. Experience cannot be anything
else than painful. Pain signals the sting of experience, the
challenge it confronts me with: the challenge to scrutinize
myself, to recognize and fully accept that no other instances
than myself can establish meaning for me in this life, since
there is no meaning in itself. To take the consequences of this
new departure, this waking to assuming responsibility for
ascribing meaning as well as all acts and choices I might make
is something that creates anxiety. But – paradoxically enough
– it is at the same time the task that anxiety – and in a privi-
leged sense – prepares the ground for in me, that it sets me
in motion towards being able to assume. In other words, anx-
iety has a dual function in this picture: on the one hand, it
rouses the person to assume responsibility in the mentioned
(strictly individual) sense; on the other hand, the discomfort
regarding such a responsibility can intensify the anxiety. So

63
anxiety is not simply something that paralyses; by containing
a call to assume responsibility for my own life and all my
choices, it also has a truly rousing and so constructive effect.
To what extent anxiety is rousing is very much open to
discussion. For a start, both the person plagued by anxiety
and the professionals who treat people with anxiety will more
probably confirm its paralysing than its rousing effect. As far
as the aspect of meaning is concerned, it is just as common
to see anxiety as emptying things of the meaning they once
had, as sabotaging the assignment of meaning rather than
enabling it. I do not deny that this is so – nor does Heideg-
ger. Indeed, we should acknowledge that anxiety contains
more elements than those most striking from a clinical point
of view – say, the psychiatrist’s. From a philosophical per-
spective, there are without a doubt grounds for claiming that
anxiety can be a benchmark in a person’s life, that it can mark
a great upheaval, make life go out of control and turn every-
thing upside-down – and that precisely because of this
negativity, this undermining of everything that was, it con-
tains the germ of a new beginning. On the other hand,
anxiety can extract so much energy from the person involved
that there is none left to take up the gauntlet which, as Heid-
egger says, has been thrown down in the form of a ‘call of
conscience’ – to give a realistic clinical corrective to Heideg-
ger’s analysis. The philosophical point that anxiety is a type
of experience that contains such a – positive, innovative –
potential, is valid, even though statistics might indicate that
the paralysing effect is greater than the rousing effect. For
many people, the confrontation with themselves, with their
own wounds as well as with the most difficult sides of life that
anxiety has brought about, may have produced greater self-
insight and encouraged that a different future course be
chosen. There are many ways out of the darkness of anxiety.
But to find them and have enough strength to set out on
them, a person needs allies – allies in both a physical and

64
symbolic sense. For anxiety does not itself provide the
resources required for leaving it behind. Anxiety may rouse
one to heightened awareness of the necessity of wrestling with
one’s own life, abandoning conformist or rigid ways of feel-
ing and thinking and helping a person to discard inauthentic
goals and reject false values. But still it is only I who, when all
is said and done, can save myself from anxiety. The fact that
I myself have to find the way out of anxiety, pull myself up
out of it by the hair, can of course intensify the anxiety. In
such cases, anxiety – or rather the constant reference to anx-
iety as paralysing – functions as a kind of cushion, a ‘reason’
for my not getting any further. As is often pointed out, not
least by person’s talking from firsthand experience, anxiety is
anxiety’s worst enemy – the fear of its enduring embrace can
contribute to its precisely tightening its paralysing grip.
There is, however, a more profound question that needs
to be addressed. On several occasions I have observed that to
be a human being means to ascribe meaning and significance
to everything around us, and that each and every person has
a responsibility to do this, and to vouch for the meaning – the
interpretations, evaluations and priorities – that results. In
short, meaning is actively created, not received; it is created
from the subject outwards, not from the objects inwards;
meaning has the nature of being something for me, not some-
thing in itself.
This way of seeing things – that of existentialist philoso-
phy if you like – contains important insights; moreover, I
believe it is strongly represented in the thinking of the pres-
ent age. But it does not tell the whole story of humanity and
pain. As will become clear later, the question of the nature of
pain, its meaning and significance, is not only a subjective
concern, something that is decided on by the individual sub-
ject. No, the question forces us in addition to dwell on the
characteristics of the pain phenomenon as such, characteris-
tics of the reality of pain that are as they are independently

65
of the subject’s abilities to decide things. Over and above
looking more closely at the particular nature of the phenom-
enon (pain), the contribution of society – or in my
terminology, culture – must be recognized as being highly
important for how the individual interprets and tolerates
pain in his own life and in that of other people.
Let me begin by correcting Sartre. We recall Sartre’s asser-
tion that I choose my own feeling. He claimed this on the
basis of a theory about feelings that implies that we as per-
sons are in a separate, outward and manipulative relation to
our feelings. So it is up to each and every one of us to mod-
ulate – to give appearance, form and content to – the feeling
we display in a given situation. Sadness, we recall, can be
annulled; I can come back to it when my visitor has left and
the situation once more makes sadness appropriate, i.e. when
it does not involve a loss of face or in some other way make
me feel embarrassed.
As we recall, I rejected these implications of Sartre’s the-
ory. A central argument was that we find ourselves in an
internal and pre-reflective – as opposed to an external and
manipulative – relation to the feeling we actually have. We
have the feeling by being it, being fully and completely pres-
ent in it, and thus stamped by it. I am not the one who forms
the feeling; it is the feeling that – precisely here and now –
forms me, gives a direction to my way of ‘taking in’ the world,
of sensing it in a broad sense. Heidegger talks in this connec-
tion of attunement (Befindlichkeit), i.e. that a feeling places
me in a particular mode in terms of mood, senses and inter-
pretation, determining my receptiveness towards the world,
what I notice and the way I do so. We could crudely say that
while Sartre wants the feeling to be in front of me, for it to
have the nature of an object and be capable of being manip-
ulated in the way external objects can in principle, Heidegger
shows that the feeling, with the specific mode of atmosphere
it is part of, is behind me; I am not at a distance from it, but

66
am controlled by it as something ‘at the back’, something I am
one with, something that determines how I sense and see the
world, but which I myself cannot see. It is a way of being in
the world.
When we changed focus from feelings in general to the
state of anxiety in particular, we saw, however, that Heideg-
ger strongly emphasizes the role he believes choice plays. The
positive, creative potential of anxiety understood as experi-
ence consists in the possibility of the person in anxiety being
able to be roused to assume responsibility for his life, a
responsibility for his or her actually being the one who –
alone – constantly chooses what is to have meaning (be
important or unimportant) and what meaning various
events, phenomena and actions are to have. So we arrived at
the conclusion that meaning is always for me.
What has happened? A certain shift has taken place. While
Sartre claims that I choose the feeling as such, Heidegger
rejects this (and rightly so), only to claim later on that in the
particular feeling constituted by anxiety, there I do choose,
there I show my true face – and precisely because my self-
sameness and authenticity are at stake here (what I show
myself capable of, or avoid, and thereby continue to live and
life of non-self-sameness), anxiety acquires such an existen-
tial seriousness, such a pathos of genuineness, as I called it
earlier. In short, the choice shifts from the feeling to anxiety,
from having to apply to all feelings as such (Sartre) to apply-
ing to – be an enabled experience of – the distinct feeling of
anxiety. Correctly understood (in Heidegger), I do not
choose anxiety as such; instead, it could be said that I am in
anxiety, or as ‘an anxious person’ am in a position to make
my most crucial decisions, decisions that say something pro-
found and genuine about who I am and seek to be. Anxiety is
a springboard for existentialist choices, for my taking on my
possibilities and thereby assuming responsibility for my life.
That raises the question of whether this emphasis on choice,

67
on the possibility of being able to choose, and choose freely,
can be defended at a closer look. This is an important ques-
tion for our theme, because it sheds light on pain: is pain
something we can choose, insofar as pain (in one of its
dimensions at any rate) is to be considered a feeling?
Without dwelling further on what the answer looks like
for Sartre and Heidegger, my claim is that we are not free to
choose the pain we feel, and thereby to de-choose it. We do
not have the reality of pain, the difference between its pres-
ence and absence at our disposal. Nor is it up to me (and my
capacities as an intentional subject, capable of thought, will
and emotion) to determine the intensity of pain, if it is strong
or weak, temporary or lasting, keen or just a dull ache.

68
 seven

The Unalterable Fundamental

Conditions of Existence

But is this answer not inadmissibly general, bordering on the

platitudinous? And who is likely to disagree? Is this not some-
thing everybody knows and can readily agree with? There is
nothing wrong in claiming something that is generally
accepted as being true. However, this general consideration
is not the whole story as regards pain on the one hand and
freedom of choice on the other.
Feelings in general and their affective aspect in particular
reveal the ontological dimension of human existence, point-
ing to the given and the unalterable, i.e. the non-choosable,
about certain fundamental conditions of existence. Feelings
relate us to, bring us into contact with and to recognition of
aspects of existence over which we have no control. According
to my view, feelings are not only about, i.e. directed towards,
something that shows the limits for our control and our free-
dom. Feelings as such, especially the most basic ones, also reveal
something uncontrollable in ourselves, namely our existence
as affectable and hence violable beings.
Dependence, vulnerability, mortality, the fragility of rela-
tions and existential loneliness: these are examples of the
unalterable fundamental conditions of life. That we are
thrown into a world with a dependence (on food, on the care
of others, on meaningful experiences, etc.) we can never com-
pletely detach ourselves from, and with death as that which
finally makes all our possibilities impossible (Heidegger),
means that we live our lives in insurmountable vulnerability.

69
That we live our lives under the givenness of these funda-
mental conditions is a fact, one that applies to each and every
one of us. How we live – in the sense of relating to these fun-
damental conditions and their unalterable givenness – does,
on the other hand, vary from one person to the next. What
applies to all of us here is that we cannot live the fundamen-
tal conditions in a neutral way. The many answers to the
question of ‘how’ are so many ways – individually distinct
ways – in which we live the fundamental conditions. The real-
ity of the fundamental conditions is, then, general, whereas the
way in which we handle them is individual.
To grasp where this leads us, consider anxiety. Anxiety re-
duces me to a zero point: a state where nothing any longer has
any meaning, where everything becomes flat, grey, indistin-
guishable. This particularly applies when anxiety is part of a
depression. When I have been reduced to such a zero point, such
a darkness, everything that has to do with the meaningful has
to be created anew. Within existentialism this is considered
a unique opportunity for me to generate all meaning out of
myself, to look straight in the eye the unpleasant and normally
repressed fact that it is not the world as such, or society, or the
others that continually create, maintain and communicate
meaning, but myself.
What is peculiar about the unalterable fundamental conditions
I introduced, however, is that they cannot be chosen. They mark
the limit of what I can determine shall or shall not be: the fun-
damental conditions are real, whether I wish it or not. They con-
stitute a framework within which I have to live. According to
Heidegger, anxiety can rouse me to a recognition of my mortality,
as we have seen. I see that I have to adopt an attitude, in my free-
dom, in my individuality, to something that I have not brought
about myself and am unable to remove. Understood thus, it is
a question of freedom as insight into necessity: freedom as the
conscious assumption of responsibility for how I live – tackle –
the characteristics of my existence that cannot be chosen.

70
 Sartre has a different view of this, which has consequences
for the understanding of pain. In his major work Being and
Nothingness Sartre uses the following example. I go for a walk
in the mountains along with some friends. After walking for
several hours we approach our first destination; there is only
a long uphill slope left before we are at the top, which we can
glimpse up there. Halfway up the last ascent I suddenly throw
myself down on the path, fling away my rucksack and
exclaim: ‘I can’t go any further, I can’t take another step –
we’ve got to stop here!’ My fellow hikers are amazed and ask
me why. I produce a long list of reasons why I cannot con-
tinue: how many hours we have been walking, how long it is
since we have taken a rest and drunk any water, how steep the
ascent is, how hot it is, how heavy my rucksack is. And so on
and so forth. The others reply that they do not want to stop
now, that they have walked just as far as I have, that they are
carrying as much as I am, that they are just as thirsty. Why
should I not be able to carry on? By means of this example,
Sartre wishes to show what it means to be in ‘bad faith’. When
I offer this long list of objective facts – the length of the trip,
the weight of the rucksack, the steepness of the ascent – as
reasons why I absolutely ‘have to’ give up at this point, I am
placing everything that explains and motivates my action in
conditions outside myself, in circumstances. I present things
as if the circumstances, or the sum of their effect on me, dic-
tate my action. In short, I refuse to recognize that I have a
choice, that the action I am taking reflects me, my free sub-
jectivity, rather than being a kind of determined product of a
series of objective and impersonal circumstances.
Sartre insists that my not being able to go any further is a
totally free – a completely chosen – act on my part. All the
reasons I advance can be considered equivocations: they
betray my strategy to flee from the responsibility for the act,
to deny my freedom as the principle that solely determines
all my actions. For to act is to choose, and to choose is to be

71
free – it is how freedom manifests itself in the world. It follows
from Sartre’s position that I as a subject, as consciousness,
completely decide the meaning of pain – for example in a situ-
ation where I notice that I am tired. When I then say: ‘I can’t
go on’, what happens is that I decide that I can’t go on. I
choose myself as a person who in this situation cannot go on,
while my fellow hikers on the other hand choose themselves
as persons who can go on – we make opposite choices in the
same situation.
Sartre’s assertions regarding the example he provides are
persuasive. Even so, I do not think he gives us a convincing
analysis of the reality of pain in human existence. Why not?
As we recall from Sartre’s theory about feelings, he presup-
poses that we are always at a distance from our feelings.
When I walk in the mountains and notice that I am becom-
ing more and more exhausted, until I suddenly throw myself
down and cannot take ‘a single step further’, Sartre assumes
that I am at a distance from my state, in the form of my ex-
perienced fatigue, that my powers are exhausted, that my thirst
is intolerable, as is the heat. His assertion is that I – nothing
else, no one else – am the one who completely, from begin-
ning to end, determine my weariness, i.e. my present state.
The question it is important to clarify is this: Do I decide
that I am exhausted, or do I decide what meaning the fact I am
tired out is to have – for example, in the form of my lying
down and being unable to take a step further? The more radi-
cal point of view is, of course, the first one, namely the claim
that I decide I am exhausted, or, to put it more generally, that
I am totally free, and therefore totally responsible, for every
state I might happen to find myself in and every feeling I might
happen to have. The alternative, that I unfold my freedom and
my responsibility with regard to the specific meaning of the
state I am in, represents a far more moderate view.
My suggestion is that pain is particularly well suited for
demonstrating that Sartre’s position – interpreted in the first

72
alternative – is untenable. And not simply that. It is also pos-
sible to challenge the moderate version of the position when
we focus on pain. For pain is not just any state or feeling. As
I have pointed out, pain is characterized by its lack of dis-
tance, by its directness: my pain fills me, marks me, with an
immediacy and permeability that are in stark contrast to
Sartre’s analysis. Let us assume that Sartre admits this. Can
he not just as well insist that I, the one who has the pain,
decide its meaning – for how else is the meaning otherwise
to be determined? In short, is Sartre’s assertion not saved that
I am the one who completely decides that my pain is unbear-
able, and thereby also decide – in the sense ‘choose’ – the
consequences I allow this to have, e.g. that I do not take
another step?
No, I do not believe that this – more moderate – assertion
can be maintained on a closer look at what sort of phenom-
enon pain is for us humans. Pain does something to us,
changes and transforms us, and the reality of this aspect of
experiencing pain – that pain is an experience in the strict
sense that strikes and shakes us and causes everything to be
altered – is lost in Sartre’s insistence on freedom and choice.

73
 eight

Transportation of Psychic Pain

My main idea is that pain belongs to human life, as opposed

to Sartre’s idea that the person – continuously and freely –
gives (this or that) meaning to pain. Certain forms of pain –
or more precisely, inflictions of pain – are of such a nature
that pain destroys all meaning: everything that had been
established as meaningful, as secure, from earlier on, as well
as every prospect of finding new meaning in the future, after
what has now happened. It can be felt as a threat to all mean-
ing in one’s existence that one is suddenly struck down by a
serious illness or accident, or that those close to one are. An
even harder assault on meaning in life, security in the world
and trust in it takes place when a person is exposed to out-
rages from others without knowing what is taking place and
why. To be struck down with an illness or accident is, of
course, bad enough, and many people will seek in vain for
answers to the questions ‘Why did this happen to me, why
precisely me; what meaning, what justice is there to this?’ In
such cases, there are no particular persons the questions can
be addressed to, no one who can give a definitive answer,
since there is no particular person who has wished – and
thereby caused – what has happened to me. In cases where
the pain involved is a result of one person’s actions or several
people’s the questions the outraged person seeks an answer
to are partly simpler and partly more complex. The matter
may seem to be simpler in those cases where my pain is
assumed to be precisely what the other person wished to

74
inflict on me: as a victim I have not been hit ‘at random’, on
the contrary, I have been deliberately singled out by the per-
son behind the abuse. But why have I been so? That there is a
person the question can be asked of does not necessarily
mean that a meaningful answer can be obtained. An assailant
only knows perhaps that he has wished to harm precisely me
and may be lost for an answer as to why that wish originated.
The phenomenon we are addressing here can be called the
transportation of psychic pain. When person A transports
some of his psychic pain onto person B, this is something
that can take place in a host of different ways, between the
two following extremes: as a one-off occurrence or as some-
thing daily and lasting; as something both parties, or just
the one, or neither of them are aware of; as something both,
or only one, or neither of them can give an account of and
articulate plausible reasons for. What is it that is transported,
to be more precise?
We have a need of getting rid of what is experienced as
painful. One way of doing this is to pass what is painful on to
someone else, someone who is susceptible to it. The aim is
alleviation, relief. To shift something painful onto someone
else is not the same as wanting to share the pain with some-
one else. The shifting has more the nature of a relocation: out
of me and over onto you, so that what is moved leaves me
and is absorbed by you. You bear it instead of my doing so.
For someone has got to bear the pain. It can be noted that this,
from a psychological (as well as moral) point of view, is a
primitive, even infantile, way of considering the problem of
human pain. Even if it can – indeed, ought – to be replaced
by a more mature way of looking at things, we cannot omit
mentioning its status as completely fundamental for all of us.
I can – to explore this view further – attempt to remedy
my helplessness by causing someone else to feel helpless; my
self-disgust by humiliating someone else; my loss of control
by controlling someone else; my fear by making someone else

75
afraid. Only someone who is just as susceptible to, and thus
vulnerable to, what is felt to be painful to bear as I myself am
will be suitable as an object for my relocation; a thinglike
object will not do. It is in this way that pain, in all its various
mental qualities, is exchanged between people. To enjoy and
relish that the victim has been struck down by pain, that he is
abused, loses self-respect and loses his foothold in life calls
for such strong terms as evil and sadism. And when such a
mode of behaviour is part of an enduring pattern in a per-
son’s actions towards others, we talk of psychopathy. The
psychopath is someone who exploits his social intelligence,
his ability to perceive (cognitively) how other people are feel-
ing, what it is they fear and hope for, can tolerate and cannot
tolerate, as a weapon in his efforts to hurt people at their very
weakest spots, so that the pain is as great as possible. To cause
impotence and helplessness, in extreme cases even self-aban-
donment, in another person can give the person committing
the outrage a feeling of omnipotence. And with this experi-
enced – or rather imagined – omnipotence comes the illusion
of having made oneself invulnerable: it is the others who are
vulnerable, who are clearly hurt and lack the power to strike
back, in short: those who via their eminent vulnerability
‘demonstrate’ that they only exist to be hurt. Particularly self-
centred individuals will only experience other people as an
extension of themselves, as mere means to their own ends,
and thus devoid of independent wishes, wills and needs, with
the limits and the respect that the recognition of such sepa-
rateness ought to give rise to.
The mode of thought in individuals who most clearly dis-
play such traits of behaviour has been described as follows:
‘To rely on is to need; to need is to be vulnerable; to be vul-
nerable is to be hurt; and to be hurt is once more to
experience the utmost and desperate helplessness of a little
child that is deprived of its feeling of greatness.’15 Even though
this description, made by psychiatrist Otto Kernberg, was

76
meant for psychopaths, it contains a core of truth that I
would claim is universally human. It is an important point
for me that we avoid pathologizing the phenomenon the
transportation of psychic pain, even though psychiatrists may
be right that psychopaths – individuals with serious and
morbid narcissism (self-centredness) and an inability to see
and respect the needs and limits of others – are to be consid-
ered the most active and above all dangerous transporters –
inflictors and locators – of such pain. What we see fully devel-
oped in the psychopath are traits all of us can – and ought to
be able – to recognize in ourselves: a tendency to be self-cen-
tred, to give our own needs a higher priority that those of
others, and thus to consider and treat others, especially those
who seem to be particularly weak and vulnerable, as means
rather than as ends in themselves; to compensate for our own
vulnerability by dominating others; to conceal uncertainty
behind a mask of certainty; to glorify what is strong and
tough, and the demonstrated ability to tolerate quite a lot of
it without becoming ‘soft’.
The psychotherapist Eva Tryti writes that she, on the basis
of many years’ clinical experience, finds that ‘evil acts are a
very important cause of mental afflictions’.16 At the same time
she is worried that the insight into the extent to which men-
tal afflictions would seem to be interpersonally created is not
taken sufficiently seriously. Both in the public health sector
and the predominant organization of treatment, in public
debate and the leading professional approach, it is at present
factors within the individual that are seen as the cause of
mental afflictions, especially biological and genetic causes.
One of Tryti’s important points is that as the intrapersonal
approach – and thus the individual-centred treatment –
becomes increasingly universal, people are losing sight of the
extent to which pain, always individually lived and suffered,
has its origins in circumstances and persons outside the suf-
ferer himself. The everyday and in many ways subtle, indirect

77
and invisible infliction of pain by one person on another thus
also remains hidden. When the interpersonal dynamics are
not focused on, a playing down of the origins of pain in acts
by others takes place, which in the final resort turns the pro-
fessional aid apparatus with all its experts into loyal allies of
those responsible.
To downplay pain inflicted on the other person, or to deny
that it has taken place at all, is the favourite strategy of all kinds
of inflictors of pain, and not restricted in any way to offend-
ers that psychiatry would term psychopaths. It manifests itself
as a conception that the abused person has deserved it. Un-
fortunately, this way of perceiving and describing the person
is often taken over by the person himself, as a confirmation of
the abuser’s picture of reality. If nothing else, the self-rebuk-
ing and self-despising provides a certain ‘meaning’ for what
takes place: to get what one deserves can be said to have a cer-
tain logic, possibly even a kind of moral. In a way, the world
is left intact – it was only oneself who was at fault, and now
the balance has been re-established. If this mode of thought,
launched by the abuser, confirmed by the outside world and
internalized by the injured party, is taken to its extreme, the
abuser may even seem to be someone who has acted in the
service of good rather than evil.
No matter how perverted such an interpretation might
seem to be, it does suggest a certain order, a certain pre-
dictability between cause and effect, the sinner and the pun-
ishment, the psychological importance of which for the
abused party should not be underestimated. The premise is
that not finding any meaning can make a person ill; this is the
clinical sense in which humans are meaning-dependent and
so meaning-craving beings. When the truth about the abuse
and the abuser is forbidden, is linked to the destruction of the
world, to losing everything and everyone, to getting everyone
against one because one knows one will not be believed, since
the truth is so painful for all those involved and any other (i.e.

78
untrue) interpretation is to be preferred, and feels less shame-
ful, then even the abused person can end up supporting the
abuser’s version. In such abuses as incest and paedophilia,
where the most forbidden and outrageous acts have taken
place, in an absolute breach of trust and security, of the
adult’s responsible and loving care for the vulnerable child, the
abused party can easily become – and always remain – a vic-
tim in the (interpretative) sense in addition to the physical
sense. To risk experiencing that no one will believe one as one
is defying the taboos and speaking out can be so painful, so
lonely and hopeless that it affects the mind. It becomes an
abuse on top of the original one, a second rejection. The
abused person starts to doubt: since nobody will confirm
what has been experienced, seen, heard, smelled, done as
being identical with what is most forbidden, secret and un-
utterable, it has perhaps not happened, it is perhaps simply
something I am imagining. Mental reality does not thrive
when completely on its own, as the reality of just one person,
as incapable of being shared with and confirmed by someone
else, a living soul somewhere, sometime. The mental reality
of one subject needs an anchorage in the world outside its
inner space, needs confirmation as can only be provided by
intersubjectivity. The person who remains unseen and that
which remains overlooked do not exist. Other people are
needed to lend validity to what has been experienced, to
make it feel real. This goes for all persons, in all phases of life,
not only childhood.
That this is so may appear mind-boggling and down-
right irrational. It is a profound fact about human existence
nonetheless: it is better to have a meaning that causes pain,
that presents one as ‘deserving’ even what is most painful,
than to have no meaning at all. For when meaning exists,
or rather is established and maintained by the person in-
volved, the possibility is created for a reconciliation with
what has happened.

79
 To blame the victim is not only tempting for the person
who abuses others, but also for outsiders. If nothing serious
has taken place, nothing that is wrong, one does not need an
outsider to intervene. One does not need to expose oneself to
the anger and resistance of the abuser, to quarrel with a per-
son who has already shown himself to be ruthless. By
excluding the recognition of others’ infliction of pain on yet
others, one avoids having to accept all the discomfort that
accompanies the insight into what humans can do to each
other, including oneself. The cost of this denial of reality is
furthermore paid for by the weaker party, the one unable to
offer resistance (in the short term, it should be noted, not in
the long term).
The list is long of the costs of playing down and explain-
ing away the interpersonal – characterized by interaction –
element of psychic pain, the fact that pain does not at all have
to originate from its present bearer here and now. As the
famous Swiss psychologist Alice Miller has argued in a num-
ber of books, victims often become perpetrators.17 The pain
B was inflicted by A, and is passed on to C who, unable to
directly retaliate, will in turn pass it on to D. And so on, in
one long chain of person-to-person transported pain.
Miller’s pithy formulation is: ‘Every abuser has once been a
victim of abuse’, and she takes the traumatic childhoods of a
number of well-known people as empirical material, includ-
ing that of Adolf Hitler. Along with most specialists I feel that
Miller’s formulation is a considerable exaggeration, and that
there are abusers that are genuine ‘first movers’, i.e. the start-
ing point for the above chain reaction. Nevertheless, Miller
succeeds in directing our attention towards an indisputable
phenomenon, the need to get rid of something that feels
unbearable by sending it away, by directing it at certain other
people, although these are often ‘selected’ for random rea-
sons. She thus draws our attention to the importance of
breaking the evil circle of pain transportation.

80
 The picture that Miller paints needs to be supplemented.
As she herself has discussed in some of her books, being
given a function as an object and ‘container’ for another
person’s psychic pain can lead to a wide range of different
reactions, not only depending on the nature of the abuse
and the pattern of the interaction between the parties but
also on the personality of the person assigned such a role. In
adult–child relationships characterized by ‘reverse parent-
ing’, where the child from an early age learns to be considerate
towards a mother or father who gives the impression of being
extremely fragile, of possibly falling to pieces as a result of
the most minor error or lack of attentiveness, a child that is
particularly sensitive will gradually develop a form of super-
sensitivity, an incredibly finely meshed ability to pick up the
fragile adult’s mood and needs in a broad mental and affec-
tive sense. The child will always have the task of being able to
take a hint, of being on the spot to give the desired refill, to
be affected by the adult’s affectedness. And guess what? Quite
often, these super-empathetic, ever-attentive children end up
as therapists in their professional adult life, in a lifelong prac-
tising of the role of caring and refilling that they have learned
in their early childhood, and that in certain cases takes root –
is internalized – as the only possible and conceivable ‘script’
for the person’s way of living and acting, the only role he or
she will ever become familiar with. To be made invisible
regarding one’s own needs, wishes and projects as a child, so
that the will and ability to have anything like that of one’s
own – and to have the courage to communicate it to other
people, and possibly even to demand something of other peo-
ple – have been neglected and have lain fallow from the
outset, can just as easily lead to an adult life characterized by
the continued practising of the self-effacing giver role as to a
change of roles of the kind Miller originally postulated, where
one fine day the cowed child, now an adult, will do to others
what others had first done to it – assuming the opportunity

81
presents itself and children or other particularly vulnerable
people are available for passing on the pain.
Against this background, it is understandable that thera-
pists say that the most important thing they work on in their
therapy with many patients is to stimulate the emergence of
a ‘healthy egoism’. The patients are not self-assertive enough,
they demand too little on their own behalf – not too much
or everything, as do psychopaths. Some of these patients,
whose afflictions have to do with the feeling of insufficiency,
emptiness and apathy, with cooped-up rage whose origins are
unknown and which they are scared to lift the lid on, are per-
haps victims of the type of mental abuses Miller depicts with
consummate skill. When pain is located in a defenceless and
uncomprehending child, when an adult attacks imagined and
asserted errors and shortcomings in the child as a result of
having split off precisely these characteristics from them-
selves (by what, following psychoanalyst Melanie Klein, is
called ‘projective identification’)18 the boundaries between
the child and the adult are blurred or even extinguished. That
which is real, and the meaning that is to be assigned to it, is
not something that is established by a mutual exchange
between the two; instead, there is something that is completely
dictated by the one party, who does not tolerate the slightest
reminder that something which has happened is experienced
in any other way by others. As the saying has it: when the all-
dominant person in the family is cheerful, everybody else is
and when he is the opposite, everyone is anxiously watchful,
fearing the fits of anger that might be imminent.
The attack on the other person’s self, on the other person’s
positive self-esteem and value, goes hand in hand with the
annihilation of the mental reality of the other person, by its
being denied any form of validity or value; psychopaths are
particularly active as well as harmful in doing this, of course,
but it is not their prerogative: the inclination at work is
human, all too human. With such a life-story a lot of hard

82
work is needed to rebuild all that has been pulled down for
good – work the person is unable to do alone but which
requires another person’s independent support and confir-
mation. Since anyone who from an early age has been most
familiar with disrespect will tend to meet every giver, every
approver, with distrust, we are dealing with an enormous gap
that has to be bridged. For anyone who has been abused time
after time, the meeting with a person who seems to be good
and unselfish can release a strong feeling of ambivalence. It is
hard to completely believe that it is true, that one deserves
something like this, that something that is really good and that
it is a question of being given, not just taken (from), will be
able to last. The need for that which is good, for another per-
son who both has something good and is willing to give one
part of it is immeasurable yet at the same time so fragile and
supercharged that the person cannot tackle it. Love is
destroyed while it is only just starting, before the relationship
has really got going. The wounded person prefers to be the
rejecter than to risk rejection; prefers appearing as the active
party so as to conceal a deep sense of being impotent and
unworthy. This is how a self-destructive pattern is confirmed
at the very moment the possibility of breaking it was there, of
experiencing that one is wrong, that others can be good and
that one’s own goodness can be valued rather than exploited
or denied or ridiculed. As Freud was so good at pointing out,
terming it our deep-seated compulsion to repetition: we
engage in self-fulfilling prophecies even when their content is
sinister and their effect nothing but self-destructive, a dead
end in every respect; we are even wont to return to and to
enact our worst traumas – an inclination so deep it requires
years on the couch to break free of it and so use one’s energies
on seeking out what is truly good in life as opposed to what is
most painful and spells continued misery.19
To return to the main topic: what we need to consider
next is the peculiar feeling of envy, and the enormous pain it

83
may bring about. That what appears to be genuinely worth
admiring in others can give rise to anything but displayed
admiration is well known. To ruin the good precisely because
it is good, and because one would wish to have it oneself, is
the essence of envy, a feeling whose profoundly destructive
power within personal relationships is too rarely appreciated
in academic psychology and too seldom recognized by those
affected in real life.
Envy transports a great deal of psychic pain. To envy
someone can be terribly painful, something that motivates
one to disguise the feeling as something else. Envy is the
other-directed feeling we are least capable of admitting to
ourselves and others; it is easier to admit jealousy and greed.
Envy is based on my making a comparison between myself
and the other person, where the other person comes out as
the one who has, does or is exactly what I would most wish I
had, did or was, but who I fall pitifully short of in compari-
son with. I suffer because of this lack. The unbearable thing
about the other person consists in his embodying precisely
what it pains me most that I lack. To meet him is synony-
mous with being reminded of what I lack, and what I am
making every effort to repress. When the repression is no
longer possible, I can try another defensive move. I can
develop an interpretation where what the other person rep-
resents is worth nothing at all. When admiration causes pain,
because the admired person merely makes my own short-
comings visible, I can invalidate the admiration by declaring
it without an object: what the other person stands for is in
actual fact worthless, ignoble, disgusting. Possibly, the other
person imagines and pretends to be superior to the rest of us;
he believes he is something really special, and either he is spe-
cial (it is just that the special – correctly understood – is
negative, not positive) or he is not special at all, and must be
punished for his deceit. No matter what the other person
does – is proud of himself, gives up everything that is his, or

84
begins to run it down – he cannot win. By attacking it, by
physically removing it from this world, by combating it sym-
bolically by denying it any form of quality or validity, the
envious person can seek to solve the problem created by
envy’s gnawing pain once and for all. This is done most effec-
tively where the person or persons who are the subject of
envy are forced to take over the assailant’s running down of
them, i.e. in a Nietzschian ‘reassessment of all values’
expressed by the best qualities of the envied persons – their
goodness, or wisdom, or creative ability – being transformed
into their diametric opposite, i.e. to the utterly ‘negative’
characteristics that will now justify their fall and destruction.
What started out as psychologically worth admiring for the
person who was roused to envy ends up with a quasi-objec-
tive and pseudo-moral stamp as valueless in itself.
Have we, then, now uncovered the nucleus of psychic
pain? Have we answered the question of what comprises its
essence? What its deepest sources are?
The Norwegian psychiatrist Svein Haugsgjerd poses the
same questions, and answers that by psychic pain he is refer-
ring to what Jacques Lacan calls ‘lack’, or what the British
psychoanalyst Wilfred Bion, using an expression from Freud,
calls ‘caesura’, a sudden transition from one state to another,
i.e. trauma.20 Desire, urges and violence are, according to
Lacan, cultivated forms deriving from the fact that lack and
transience are given conditions of human life, while anxiety
and mental conflict are to be seen as more complex effects of
the mentioned fundamental elements. We cannot experience
the lack as such; it is beyond consciousness. What we can
experience, and which motivates our behaviour, is only the
above-mentioned derived forms of the lack, according to
Lacan’s theory. The psychic pain that is generated by the fact
that we exist in a state of lack, that we are lacking beings, that
we thus live in the absence of fullness of being and perfec-
tion, does not, therefore, have to be experienced by the

85
subject as pain, but it is, however, always accompanied by
pain in relation to, and in the exchange with, other human
beings. In that sense, all such person-to-person relations and
communications are arenas for the transportation (shifting)
of psychic pain. The fact that such pain is transportable at all,
that it allows itself to be shifted, is because we assume that
others are lacking beings – beings existing qua lack, as it were
– like ourselves, sensitive to pain like ourselves.
Is then the transportation of pain, so to speak, the only
thing going on, the only way we can try to tackle our own
lacking being and exposure to pain? Of course not. We can
also, as Haugsgjerd does, talk about the transformation of
such pain, in the form of a reshaping of the lack from its
most basic and primitive forms into the increasingly
processed, sophisticated and mature forms. Even though the
main contrast involved can seem to be extremely simple and
well known, I regard it as so fundamental that I want to make
it fully explicit: instead of experiencing the meeting with
goodness and ability to provide in other people as something
threatening, as triggering off uncertainty, feelings of inferi-
ority and anxiety, it does no harm to show gratitude for
something like that existing in this world, and to concrete
individuals who are bearers of it. Instead of having one’s
journey through life coloured by self-centredness and greed,
it does no harm to colour it with the joy of giving and with
generosity regarding what seem to be different and strange.
Instead of fearing that the – large or small amount of – good-
ness one might possess will be taken away from one as soon
as it is displayed, it does no harm to display it confidently in
the belief that it will be taken care of and highly valued, not
debased and destroyed. Instead of considering others limit-
lessly good or limitlessly evil, it does no harm to see that
others – like oneself – contain both parts, with all the
ambivalence that inevitably involves. Instead of denying and
repressing one’s own aggression and rage, even impulses to

86
attack and one’s own fallibility, it does no harm to admit that
one actually carries such characteristics around too, like
everybody else does; thereby the need is diminished for hav-
ing to project everything painful/evil onto other people, with
the subsequent desire to destroy it there, since that is where it
is taken to stem from. Instead of denying the damage one has
caused others because of such aggression, it does no harm to
acknowledge that the damage has been done, that it was one’s
own fault, so that shown anger can be met with reconcilia-
tion in the injured party. The alternatives that I have played
off against each other here, and that mark the difference
between a primitive and a mature attitude, correspond
roughly to the distinction Melanie Klein makes between a
schizoid-paranoid and a depressive position.21

87
 nine

The Role of Culture in

Dealing with Pain

We have now reached a main theme in any discussion of pain

as looked upon in a social perspective: namely that culture is
of vital importance if individuals are to succeed in taking the
step from transportation to transformation of psychic pain.
The key word is reshaping, and such reshaping of pain
depends on what is called symbolization, i.e. the individual is
given the chance of processing that which hurts, that gener-
ates pain and thus exerts pressure on the inner life of the
individual – a pressure that seeks release. Such processing can
only take place in a mature and non-destructive way if the
individual can make use of various types of symbols from
various media. To convert and process psychic pain with the
aid of symbolic forms means getting the chance to create
images, put words to, give form to the otherwise unbearable
inner pressure. This pressure hurts so much and creates such
inner tension that it will turn inwards as self-destruction or
outwards as destruction aimed at others if it is not released
in some third way – as words or sounds, images or represen-
tations about what hurts and creates pain, thus making its
underlying sources into something I can relate to as a sym-
bol-using and communicative – i.e. social – being. In this way
the ‘forms’ of these symbols will be experienced as having
enough power in them to bear (contain) what hurts so much.
In other words, the symbolic-indirect relief of everything
connected with and felt to be painful, as anxiety-creating and
dangerous, must be recognized and experienced as a superior

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alternative to concrete-direct relief in the form of trans-
portation aimed at others (physical enactment).
By culture I shall mean something very specific: the sym-
bolic resources a society places at the disposal of its members,
and that every one of them can make use of to tackle every-
thing that makes life painful. While Lacan, as we have seen,
places most emphasis on human existence meaning to be in
– and suffer under – a state of lack, I place greatest emphasis
on it meaning to be placed in this world within a framework
of certain non-choosable fundamental conditions, such as
dependence, vulnerability, mortality, fragility of relations and
existential loneliness. The fundamental conditions are not
necessarily the direct causes of experienced pain. Rather,
what matters and so needs to be appreciated in some detail
is the way the conditions are typically interpreted and evalu-
ated within a given society at a given point in its history,
whereby culture is the all-important medium for such sym-
bolic activity. The conditions I am referring to should
therefore be seen as what provides an origin and breeding
ground for our common exposure to pain, so that it pains us
to be maltreated because we are fundamentally vulnerable, so
that it pains us to be abandoned and alone because we are
fundamentally dependent, so that serious illness gives rise to
anxiety or even depression because we are mortal, etc.
If I let my gaze slide along the walls of the Edvard Munch
museum I can recognize many of my own existential con-
cerns in the pictures on display. I can immediately see which
pictures have to do with fear, sorrow, melancholy and jeal-
ousy. There is a great deal of pain in Munch’s pictures –
created as they probably were out of what was often utterly
painful in Munch’s own life – such as his sister’s illness and
early death, or his own bouts of anxiety, bordering on nerv-
ous breakdown in certain periods. These biographical facts
are – precisely – not the point, however. What is instructive
for my argument here is how Munch the artist has managed

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to shape his existential pain in a way that directly addresses
me in my pain and you in yours. This is because Munch has
something universal as his theme: he is preoccupied with
the five fundamental conditions I have just mentioned. By
painting so many variations on this limited set of basic
themes, Munch presents – archetypally, as it were – some of
the various ways a human being can try and deal with them
in his own life. What Munch does, then, is partly to use him-
self and partly to explore and expand a symbolic space in
order to express such universal concerns as angst, fear, lone-
liness, melancholy and jealousy. By our visiting the pictures,
entering into their universe, making use of the symbolism in
the displayed interaction between the persons, in the contact
or estrangement between them, in the ties entered into or
broken, cherished or feared, in the two persons’ interde-
pendence or loneliness, Munch allows us to process our own
experiences. We can open up to the pain we carry round
with us, the pain of hoping yet also knowing that we can be
disappointed, of daring to love yet also knowing that we can
be rejected, of feeling deeply for others yet also knowing that
we can be hurt. The pressure within us finds release, made
possible by the reshaping force of the symbolization, this
being the major alternative to a physical-concrete enactment
of the hurt in the form of relocating it in others so as to
attack it there – as if everything that creates pain in the
world had originally come from these other persons and
not from ourselves and the substance of which our own life
has been made.
To be sure, to some readers this may seem a highly banal
rendition of Munch’s art. It is true that his paintings create dis-
quiet for many people rather than calm, that they have a sting
in them that can intensify anxiety and depressive thoughts
rather than soothe them. In that sense, you may leave the exhi-
bition of his paintings more confused than you were before
seeing them, not less. My concern here is the unashamedly

90
humanist one: that great artists – forgers of symbols more
than anyone else – lend meaning the expression that ‘noth-
ing human is alien to me’, not even the greatest anxiety,
despair and loneliness. Cultural products of the type that
Munch’s paintings are examples of can be said from this per-
spective to be results of the transformation of psychic pain –
and to be potential vehicles for such transformation in their
onlookers. To watch a film, play or dance can give rise to the
same experience, that of entering an artistically created
human universe, a space one can enter in order to dwell on
as well as marvel at the depths of the human repertoire, at
who and what we are, for better or for worse. At best, culture
functions as both cause and effect in this respect: culture
enables humans to enter and use all the resources for pro-
cessing and reforming that a particular society’s symbolic
universe offers, at the same time as the cultural manifesta-
tions themselves produced by experiencing the fundamental
conditions of existence in general, and psychic pain in par-
ticular. As especially Melanie Klein has sought to demonstrate,
all transformation processes presuppose that there is not only
pain or lack but also a force – fed by the capacity for guilt and
remorse – that continually pulls us in the direction of what
she calls reparation, understood as the desire to make good
again what has been attacked, to heal what has been broken
because one was envious of its goodness or was too greedy to
share it with others.
This brings us to an important insight. The fact that we
are beings exposed to pain, that we live in lack and as lack
(Lacan) should not be interpreted as meaning that what
causes pain is what dominates and will inevitably dominate
our lives. Our exposure to pain and our lack as beings admit-
tedly tinge our lives with gravity. But these basic characteristics
of our existence certainly do not pull us unambiguously in
the direction of dwelling on what causes pain. For to be sus-
ceptible to pain means being sensitive and to be sensitive

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means to be able to experience what is good: to be given what
is good by others, in the form of love and care. That is why
when sensitivity is worn down, when hardening and numb-
ness replace it, the individual not only avoids the vulnerability
of possibly being rejected and insulted but also the joy of
being met, seen and accepted when one opens up, exposes
oneself in one’s vulnerability. The person who for some rea-
son or other is no (longer) capable of being affected, cannot
be affected in a good way either, in a life-supportive and affir-
mative way. To encapsulate oneself as a result of self-imposed
or dictated hardening risks becoming a strategy for losing
affectedness with all that is good in the world, all that makes
life worth living. A zest for life and joy, an urge to make con-
tact and the appetite for gaining knowledge and wisdom,
curiosity regarding the unknown and untried – all these
things also derive from the mentioned fundamental condi-
tions. That we are in a state of lack in a basic sense disposes us
to want to enrich and expand ourselves through contact with
the good in the world, that which others might happen to
have in greater measure than ourselves; this provides a basic
motivation to protect everything that is good instead of seek-
ing to destroy it. While the transportation of psychic pain is
the common denominator of all the ways in which inner lack
and pain are enacted, with the maltreatment or ruin of other
human beings as a result, the transformation of pain is the
alternative and corrective to the transportation of pain. The
incentive to affirm and protect the good in the world is just as
basic and eradicable as its opposite.
One of the advantages of placing such emphasis on how
pain is shifted, how it is located here and there because of
social interaction is that the distinctly psychiatric look at the
frozen forms of human suffering, i.e. the various states of suf-
fering, are supplemented by a keen eye for the dynamic
processes – the actions – that cause the sufferings.22 Here, we
recall Eva Tryti’s words about the vast extent to which mental

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sufferings are the result of abusive acts by others, of having
been forced or manipulated into the role of a bearer of some-
one else’s pain. What is suffered subjectively has been brought
about and maintained intersubjectively, i.e. interpersonally.
Consequently, the wounds can only be healed by trying to
change the patterns of interaction that continuously produce
and intensify such sufferings. In my opinion, this is not first
and foremost to be seen as a task for experts, for professional
therapists, for I warn against pathologizing (morbidizing) as
well as professionalizing our exposure to pain and ways of
dealing with it. No, it is a task for each and every one of us, a
task that refers us to culture’s accessible symbolic resources –
as I allowed Munch’s paintings to illustrate.
I have maintained that culture in the sense defined above
has an immensely important role to play: culture decides
what possibilities we have to deal with our pain in ways that
are not dangerous or even directly fatal for others, and ulti-
mately for ourselves, if we do not control our tendency to attack
those who are associated with something bad and hurtful,
or with something that is so good that our own lack of this
goodness causes us to devaluate it and destroy it (the motive
force behind envy). Svein Haugsgjerd is maybe overdramatiz-
ing a bit – though only a bit – when he says ‘the contrast
between transportation and transformation of psychic pain’
corresponds to ‘the contrast between barbarism and culture’.23
Now that we have emphasized the role of culture in
enabling us as individuals to transform our – and other peo-
ple’s – pain instead of moving it by relocating it in other
concrete beings, we must ask the question: can our culture,
that which characterizes our society today, be said to be car-
rying out this task, or is culture presently letting us down in
this respect?
By placing a reservoir of symbol-transmitted representa-
tions of basic human experiences, effects and states of mind
at our disposal, a culture offers forms and ways that allow us

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to adopt an attitude that is not repressive or denying but con-
cessive and recognizing to all aspects (including the darkest
and most dangerous) of our repertoire as human beings. If
culture lets us down in this function, the result can be an
enactment of what is prevented in its symbol-utilizing pro-
cessing. One way culture can fail is by offering individuals
representations and pictures of aggression and destructive-
ness that are too concrete, in the sense that the hurtful is
imitated and thus in a way repeated within the symbolic
medium instead of being given an abstract and thereby
processed form. The point is that the richer and more elastic
the internalized images of destructiveness are in an individ-
ual, the less will the need be to enact the destructive impulse
towards other real people. The meaning of culture, therefore,
has to do with stimulating the ability to imagine the painful
and dangerous aspect of being a human being instead of
enacting it: to imagine the hurtful and painful as the alterna-
tive – the only one – to actually doing it.
For individuals who lack images for their own destruc-
tiveness, it will, in the absence of symbols, be intimately
linked to the body. The body then becomes in an over-con-
crete way the tool for getting rid of one’s urge to hurt, to
move the painful out and away, the bodily enactment the
result, no matter whether it is turned inwards (self-injury) or
outwards. The more impoverished the inner symbolic uni-
verse, the shorter the path to bodily action, understood as the
externalization of the forces that did not find room and were
‘carried’ into an inner world of ideas. Admittedly, imagina-
tion and creativity are characteristics of the individual
person, more developed in some than others. Nonetheless, to
be able to imagine and ‘make’ something in a symbolic form
of what must feel difficult within oneself can be seen as abil-
ities in the individual that feed on nourishment provided by
the symbol-bearing culture outside the individual, and that
occupy the space – the in-between area – between the mental

94
inner life of the individual and the outside world. Culture
has to do with creating meaning, with allowing individuals
to do so, successfully, in their distinct individual ways, always
in situ and for their own purposes, a meaning that different
persons utilize in their highly individual ways, depending on
the experiences they make and the resources they bring to the
encounter with them. Symbols indicate here that something
relatively abstract stands for (represents) something concrete,
something that actually exists, just as Munch’s pictures of and
about anxiety give me an image of my anxiety, a picture of
my jealousy towards that person, etc. From a psychological
point of view, the formation of symbols has to do with the
child’s need to protect its – both loved and hated – objects
(i.e. mother, father, who the child is abandoned to and
dependent on and that it can therefore feel rage towards as
well as gratitude) from the effects of its attacks. The symbol
is needed in order to shift aggression from the original con-
crete object (mother, father), so that the feeling of guilt is
alleviated to the extent the object avoids aggression.24 Aggres-
sion can now be enacted in a mental universe, towards
substitutes for its real objects in the physical world – substi-
tutes that can be precisely that since they have been given a
symbolic form. Accordingly there is an element of moving
also in what we formerly referred to as the transformation
(processing, reshaping) of psychic pain. More precisely, the
alternatives have either to do with the experienced and suf-
fered pain being shifted onto other actual people so as to be
combated and attacked there, with any damage that might
cause, or the actually experienced pain being shifted from its
original concrete objects (aims) onto a symbolic substitute,
where it is subsequently ‘taken out’ within the symbol-using
space – that of culture.
The idea is not that the urge to destroy completely will
cease to be a basic aspect of the individual psyche. The idea
is that culture allows the urge – uneradicable as it is – to

95
remain within a world of fantasy and imagination or, to put
it another way, to remain an imagined potentiality instead of
an enacted actuality. It is important to realize that my mes-
sage is not that the individual’s aggression and desire to
destroy is to be suppressed, locked in. On the contrary, what
really threatens society is precisely the suppression and denial
of individuals’ personal aggression. Why?
In their famous work The Dialectic of Enlightenment,
Frankfurt School philosophers Max Horkheimer and
Theodor Adorno have given the following answer to the
question I posed above concerning the state of culture in our
present-day society.25 They contend that the control that
modern man has gained over outside nature plays no role in
the attainment of freedom and happiness unless man has
learnt how to control himself, i.e. his own destructiveness as
a source of disorder, unhappiness and cruelty. This does not
mean that one’s inner nature only is dangerous and only has
to be controlled. Not at all. Too much self-control and too
strong renunciation – an inner regime characterised by zero
tolerance – regarding every spontaneous instinctual urge can
create individuals who are ‘on the lookout’ for opportunities
to finally find an outlet for all that is shut in and forbidden –
opportunities promised by ideologies which praise violence
and violent practices – with total freedom of action for a
physical enactment of everything that is hurtful. What is
decisive, then, is to reach a self-knowledge, a self-composure
as regards the equal potential of the inner nature to want evil
as much as good – something which, according to Melanie
Klein, gives rise to a deep-seated fear in humans of infecting
the good with the bad, of spoiling love with hate – in short, of
being unfortunate enough to ruin everything that is dearest
to us.26 Such self-knowledge – of being the source of both
good and evil and which is which – will lessen the need in the
individual person to project his own inner conflicts onto oth-
ers (Klein’s projective identification) and to attack and defeat

96
them there. The most violent – potentially violence-creating
– effects and sources of unrest are inside us; we are driven by
them, and we need to put up with the fact that we are driven
in this way, by inner forces we have not chosen to be there but
that we, even so, depending on the maturity of the afore-
mentioned self-composure, have a responsibility to decide
what attitude we should adopt towards.

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 ten

Pain and Evil

At this juncture we cannot avoid confronting the relevance

of evil for our theme of pain and what we do with it. Evil –
or sadism for that matter (which is not identical with evil but
an important aspect of it) – is naturally not a new theme for
us, not least because we discussed torture earlier. In the fol-
lowing discussion, however, the perspective is a different one.
The relevance of evil for my insistence on the connection
between pain and the fundamental conditions of life consists
in the fact that evil, to quote the American philosopher C.
Fred Alford, ‘is what reveals to us the limits of what it means
to be human’.27 The desire to do that which is bad, to wish to
inflict suffering, has got to do with evil transcending bound-
aries. Let us look at this in more detail.
As I have only hinted at so far, the accepted and often
repeated assertion that pain is something humans hate and
seek to avoid is only half the truth about the human attitude
to pain. The other half has to do with how we seek it, intensify
it, create it and are fascinated by it – whether it be our own
pain (difficult to understand) or that of others (easier to
understand). As will gradually become clear, pain has a great
deal to do with limits: with limits being given, being met with,
and with how we – as a culture and as individuals – react as
regards limits. Limits represent a challenge. Limits in the sense
in which we are dealing with them here are something we are
faced with, something we are forced to tackle. How do we do
so? The two main alternatives are that we either respect limits

98
and treat them as untouchable and unalterable, that we adjust
to them, adapt to them or that we do everything in our power
– both as a culture and as individuals – to defy them, change
them, move or remove them, in so many different attempts to
manipulate and control them for our own purposes.
Evil has to do with the willed causing of suffering in
another person and against that person’s will. I said that evil
takes the form of a transcending of limits. The question is:
why is such a transcendence something we are driven
towards? I think there are a number of valid answers, and that
evil is a good way into an important partial answer. C. Fred
Alford writes that ‘limits are just as frightening as their
absence, because they tell us that we are human, subject to
constraint, isolation, contingency, morality and death. Every-
thing we are, everything we will become, precludes our being
and becoming a thousand other things.’28 To do something
evil to a real, as opposed to an imagined, object is to defy the
given limits, to cross them out: to kill is to make oneself a mas-
ter over life and death, to experience – if only for an instant –
omnipotence, to be invulnerable, immortal, autonomous. It
is to make demands on existence’s element of vitality, or force
and life, as its only element, and thereby deny that existence is
‘only had’, that life is only lived, as both parts: as vitality and
death, where the one cannot have any meaning without the
contrast – and so endured cohabitation – of its opposite.
Alford links evil to sadism. Our theme is not evil as such,
with all its possible causes, forms and effects. I will refer to
Alford’s analysis because it sheds light on certain aspects of
pain that we have not yet looked at. Sadism is used here as a
term for a person’s active attempt to create and control suf-
fering (pain) in others, instead of – as the sadist’s only
conceived alternative – experiencing the suffering himself.
For the sadist there is – broadly speaking – only an either-or
solution: me or the others. The underlying logic is that all
pain that I do not inflict on or relocate in others I will have

99
to bear myself. In short, the sadist deals with his own pain by
shifting it onto something (someone) outside himself rather
than processing it, in the form of a sequence in the outside
world, not a reshaping with the aid of symbols in the inner
world, in the form of using (misusing) others in the service of
relieving pain. Sadism is taking matters – the pain – into
one’s own hands, quite literally. It is to actively carry out
something with it, in order to remove the burden of it, i.e. in
the form of pushing it away from oneself over onto others –
as if pain was a physical, transportable thing in the world,
some sort of object (read: person) that can be controlled
(planted, intensified) in the other person by shifting it away
from oneself.
The sadist acts on the assumption that the only way the
pain of being human and thereby in a state of lack, of not
being perfect, can be dealt with is by involving some other
living person in it. If this is to work, the sadist must assume
that the other person is just as vulnerable as he is himself.
We have to realise that sadism is not a question of dehuman-
ization, of blankly denying the other person’s (co-)humanity;
on the contrary, it is a project that crucially relies on per-
ceiving the other person as just as suitable for suffering as
oneself, i.e. as equally vulnerable and sensitive to pain. Alford
remarks that we now can see why sadism is most accurately
referred to as sadomasochism – it is the identification of the
person with his chosen human victim that is the core of the
action; without that there would be no point to it.29 Things
in the physical world are not considered suitable for the re-
location of pain; only what is alive and exposed to pain as
one is oneself can offer the prospect of being able to take in
and house the pain and the discomfort that burns inside one
and is felt to be intolerable. Pain in this sense can only (be
attempted to) be moved around in those similarly disposed,
in beings whose exposure to it and discomfort at it are basi-
cally identical.

100
 From this perspective the difference between sadism and
sadomasochism is small, the transition almost imperceptible.
However, the aim of the sadomasochist is not quite the same
as that of the sadist, i.e. one’s own pleasure deriving from the
generation of pain in others – it is in fact far more radical. The
aim of the infliction of pain is deeper than the psychological
motive that lies in the legendary sneer at the victim’s screams
of pain, pleasure at the discomfort caused – mental as well as
physical – in the other. The aim is profound – to destroy real-
ity, i.e. the reality of difference and individuality, the fact that
the other person is also different, not just like me. The com-
pletely intolerable is not restricted to the non-chosen fact that
consists in having been born into a world as dependent, vul-
nerable and moral, and thereby as exposed to the experience
of pain that are the inevitable result of such conditions (in
addition to the ways in which they enable joy, contact and
recognition, as we saw above). It can also be felt as intolerable
that others have different ways of tackling these universally
human conditions, or that some people evidently imagine
that they are above pain, above immanence; that they believe
themselves better than I, I who have feared it as the worst of
all discomforts. Those who seek to transcend pain, make it
marginal instead of experiencing it as fundamental, I will
reach via my targeted infliction of pain, pull them down from
such an arrogant delusion; down to my level, reminding them
that precisely at this basic level we are similar rather than dis-
similar, fellow human beings rather than unique individuals.
When pain catches up with each and every one, high and low,
it also brings about impressive levelling within the social area.
Pain unites, creates equality where there were differences,
forces even the seriously thinking person to abandon all
energy and projects related to transcendence, going beyond
the body – or denial – that we first and foremost are animal
beings, imprisoned in our physical nature as the scene of
intolerable infliction of pain. To link back to the section on

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torture with which I began the book, the sadistic element in
torture seems to extort a self-abandonment out of the other
person, an abandonment initially of the person’s values here
in life, and ultimately – when the pain is so overwhelming that
all vitality ebbs away – a rejection of the actual value of life,
i.e. a of the wish to go on living. This is the total victory – if
such an expression can be used – that the sadist can seek to
achieve: that the victim is induced to hate himself, to hate his
existence and to curse the day he was born – that not to live is
preferred to going on living.
It is here that sadism as a project can be said to enter into
a particularly strong and dangerous alliance with envy. As we
know from many sources, not least literary ones (Claggart
who hates the eponymous character in Melville’s novel Billy
Budd, for example), it is in particular the virtuous, splendid
and fine that are the subject of envy and that are sought to be
destroyed, which means that these qualities acknowledged as
being positive – and that others precisely feel they lack – are
exposed to violent attacks, verbally and mentally as well as
physically. The sadist views the pain of others as an aim in
itself, so that pain, as well as actually creating it oneself, give
rise to joy. Envy, in the strong variant we are dealing with
here, expresses itself as the felt pain at certain others appear-
ing to be happy or good; pain born of others’ happiness can
only be transformed into a situation full of one’s own happi-
ness if the other person is no longer able to feel any
happiness, but only pain instead. Other ways of dealing with
one’s own unhappiness (lack) in the light of others’ happi-
ness are not recognized.30
While the project of overcoming having to suffer oneself,
the sensitivity to pain, is undoubtedly a characteristic of
many aggressors, it is just as important to look at the experi-
ence of relief (even if only for a brief respite) experienced by
causing and witnessing suffering in another person only
actually being possible if the aggressor admits to himself that

102
he ‘knows’ what it feels like to suffer in the way the other per-
son is now doing. He knows this because he is a human being
like the other person; and he has to let the other person
remain a human being like himself if the identification at
issue here is to be retained. Indeed, there are reasons for
claiming that the sadist acknowledges the reality of suffering
in human life to such an extent that he is tempted to idealize
it – by considering the ability to withstand suffering a sign of
inner strength, as Alford believes Nietzsche tends towards on
several occasions, and as we – to change from a philosopher
to a practician and organizer – recall that Reichsführer-SS
Heinrich Himmler advocated in his speeches to the officers
who were responsible for the systematic killing done at the
extermination camps:

We all know what it means when 100 dead women and

children lie there, or when 1000 do so. Even so, I think
I can say that this – the most difficult order we have
been issued so far – was executed without allowing our
men to suffer any damage in mind or in spirit. The
danger was very real: the line between the two poten-
tials – to become cruel and heartless and to lose respect
for human life, or else to turn soft and break down – is
incredibly fine. To have persisted and at the same time
to have remained decent men … this is a page of glory
in our history that has never been written and is never
to be written.31

We must recognize that the step from idealizing one’s own

suffering to idealizing inflicting it on others is short, espe-
cially if withstanding pain is glorified as a sign of strength, as
the great test of character in life and ‘the struggle’, so that the
way one reacts when encountering intense pain is seen as
revealing more than anything else who one is, what stuff one
is made of. From historical examples – with the extermination

103
of the Jews by the Nazis as a climax so far – we know that
hardening, in the form of targeted ‘exercises’ to tolerate a great
deal of pain, ever more pain, without noticing it, functions as
a preparatory manoeuvre and thereby a condition for later
being able to inflict the greatest suffering on the selected vic-
tims without being affected by it. To stay hard in situations
where it would be easy to become soft, to be able to continue
when to stop would possibly seem to be an immense libera-
tion – that is what the test of character is about, a test that
only ‘the very best’ (Himmler) will pass. The (illusory) final
result of such hardening processes is to consider oneself as
beyond the reach of pain, as so ‘hard’ that sensitivity to pain
has been overcome.
The corrective to this perversion of the essence of one’s
moral nature is not only a question of learning to accept that
one will come to suffer and inevitably come to inflict suffer-
ing on others in the course of one’s life, since life and pain are
two sides of the same coin (as Nietzsche points out). No,
the important thing is to regret that it is so, to regret it while
holding onto the insight that it is so. In short, Nietzsche’s
idealization of the reality of suffering has to be supplemented
with Melanie Klein’s insights if it is not to become dangerous
– with Klein’s emphasis on reparation, that is to say, on one’s
ability to wish to put right the damage one has caused.
We need, however, to go beyond an intrapsychic perspec-
tive as well as a dyadic (I–you) one in order to recognize the
importance of culture in teaching individuals good rather
than damaging ways of dealing with the peculiar pressure that
is formed inside one as a result of unbearable pain creating
fear and a pressure towards shifting everything hurtful onto
other people. Culture understood as a public space in a wide,
symbol-transmitted sense shows – holds up to individuals –
that aggression and fear have other places to go, to be tackled
and processed, than the concrete place constituted by the
physical meeting between two people. In creativity that unfolds

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and is stimulated in the cultural space, ‘a voice is given the
creature for its woe’,32 a voice to live with the pain of existence,
instead of placing pain out alive by causing it in real persons.
Understood in this way, culture is itself psyche. Via cycles of
projective identification with gods and other cultural ideals
and artefacts and the subsequent reintrojection of these (that
they are once more taken ‘into’ individuals) a given culture
starts to acquire the form of a psyche, albeit in an exaggerated
or distorted way. This does not mean that culture lives its own
life, that it acts as a group self. As Alford points out: ‘Cultural
forces are psychological forces; they become so via projection
and introjection. As a psychological defence, culture will
reflect many of the most intense mental conflicts and defences
to its members.’33 What makes the tragedians of antiquity such
discerning psychologists is the way in which they depict
external conflicts in such a way that they can represent – give
a shape to and offer images and representations about – inter-
nal ones. Fairytales and myths still have the same function. At
the level of culture, inner conflicts and effects must be given a
symbolic form in an outer – in the sense of publicly accessi-
ble – medium. The point is that we acknowledge the fact that
what is symbolized in something external is not external, does
not originate in something or someone outside us, but in
something internal.
How are we to understand the task of culture more closely?
When we can say that culture is successful – or possibly
unsuccessful – in forming our attitude and strategies regard-
ing the reality of pain?
Expressed positively, what a culture is able to do is to offer
individuals symbolic resources in a wide sense so that they
can manage to acknowledge the most unpleasant thing of all:
that pain follows human life from birth to death, that pain is
always and for everyone a present possibility, if not an experi-
enced reality, and that an all-too-human way of reacting to
the discomfort this gives rise to is to seek (consciously or

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unconsciously) to shift pain away from oneself onto others,
to turn something internal into something external. Freud
talked about ‘the culture and its discontents’ (Das Unbehagen
in der Kultur); here we are looking at the potential that exists
in culture as a symbolic relief for discomfort in the individ-
ual. Culture can allow me to extract, feel, dwell on whatever
creates discomfort in me, by offering symbolic substitutes
(representations) of what is hurtful, so that these become my
objects, what bears the brunt in my way of handling the
painfulness of existence. The child who is angry with his
mother bashes his teddy bear and mother escapes. The teddy
bear is a ‘transitional object’ (to make use of psychoanalyst
Donald Winnicott’s concept); it naturally has a physical exis-
tence – which means that in a non-reparable way it can get
broken – but psychologically it is its function as a symbol –
as the imagined ‘stand-in’ for mother, the real object of the
child’s rage – we are dealing with here. When we grow up and
hopefully become more mature, the same need to ‘extract’
inner pain and inner conflicts will assume increasingly less
physical, increasingly more abstract forms. Now dwelling on
figures, states and mood that remind me of the real objects
(persons) or events (traumas) in my life that exert pressure
in the form of discomfort and psychic pain inside me, can
help me to gain greater clarity as to what the discomfort is
about, so that patients in successful psychotherapy declare
that ‘just putting difficult things into words to somebody else,
giving pain a form in a common space and a common lan-
guage, helped – by taking something of the danger and
intensity out of pain’. To share within a common space, with
the aid of language or images or representations, offers relief,
takes away something of what had felt so heavy to carry
alone, and thus makes the need to force pain out onto oth-
ers, to locate it in them and only them, less urgent.
Although I would add – so as not to paint a rosy picture of
the healing potential of conversation regarding the individual’s

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psychic pain – that our existential loneliness (one of the five
fundamental conditions I have introduced) marks a boundary
vis-à-vis others and what others are at all able or willing to
share with me, about me. As the Norwegian poet Halldis Moren
Vesaas aptly puts it in a poem: even in the closest relationship,
in the lifelong love between two, two that achieve the greatest
intimacy with each other – even there the other person will not
be able to get behind ‘the innermost gate’, that which for ever
marks off me and my inner universe as opposed to you and
yours. Both sides are true: the fundamental conditions con-
demn us to an unalleviable loneliness in this existential sense,
while language, images, narrative and fantasies as the culture
of which we are members offer us the chance of transcending
our loneliness, of sharing something, although never everything,
of what we carry with us in our inner world.

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 eleven

When Pain is Imitated and Enacted:

Violence in Culture

I would argue that the prevailing culture in present-day soci-

ety is failing in its task as described here. Today, cultural
criticism is, in certain circles at any rate, the most unoriginal
and least daring exercise that could be imagined. The sort of
criticism I would like to promote here, however, is not of the
general kind. Rather, it is directed at particular characteris-
tics of the present age, characteristics on which the topic of
pain and attitudes to pain is particularly well suited to shed
light. Let me explain.
One of the main reasons for culture failing the task we have
described is that much of what is presented in the symbol-
using public space is too similar to the hurtful and evil as
enacted in a physical-concrete manner. By too much resem-
bling the originals, i.e. that for which the individual needs
relief, these representations cannot succeed in their alleviative
and stand-in functions. The images, metaphors, narratives on
offer are too imitative – too little abstract, too little symbolical
in a psychological sense – in relation to the impulses and
affects that need to be processed (transformed) in ways that
lessen the pressure towards enactment regarding real, as
opposed to imagined, objects or persons. Examples include
the fact that the vampire – especially in American popular
culture – is now in the film industry and many genres the
image of evil, instead of Satan, who is of course only mean-
ingful as a contrast to and in a constant struggle with the
Good, i.e. within a universe where good and evil are equally

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real forces: a typical example of how culture promotes rather
than prevents the path from impulse to action. The implicit
message in fictions where an evil misdoer takes over all con-
trol and where the good is conspicuous by its artistic absence
is that vulnerability and dependency appear to the onlooker,
listener or reader as even more dangerous, even more unde-
sirable and sinister than before – with the possible result that
attempts to rid oneself of the undesired qualities in oneself
become more dramatic and direct, the effects increasingly
destructive and directly life-threatening. The end-result of
such a trend is films of violence that function quite simply as
user manuals.
How does reality tv fit in here? I am no expert in this
genre and will restrict myself to a few selective comments.
One feature of the changes in the upbringing of children and
young people that German researchers in particular have
written about is that so-called secondary experiences are
increasingly taking over and marginalizing primary experi-
ences.34 What is meant by this? Not all that long ago, it was
usual for young people who went to bed with each other for
the first time, who were debutants in a profound sense, not
to know all that much, let alone the details, of what happened
in sexual intercourse before they tried it out for themselves,
i.e. as a primary experience. Likewise, a great many emo-
tional, psychological and social phenomena had to wait for
their own experience for the person to gain precise ideas
about them and what they involved. The primary experience
had undisputed pride of place: one’s own debut provided the
input for a new and until then unknown world. Today, the
balance of power is the opposite: it is the secondary experi-
ences – in the form of disseminated knowledge about other
people’s experiences and representations of phenomena that
are talked about – that have pride of place; they steal a march
on the primary experiences. The result is that the debutant
in his own life has a long-standing career behind him as a

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reader of magazines with representations that are erotically/
pornographically explicit, as a viewer of tv programmes,
films, videos, games and dvds, as a surfer on the Internet of
sites with this type of content, etc. Obviously, one’s own
debut will still mean breaking new ground but not with the
same breadth and depth as before, and with the added dif-
ference that what one experiences firsthand has precise,
detailed and in every respect ‘strong’ precedents, models and
expectations to live up to (just think how teenage magazines
of the most widely read kind have changed in the course of a
few years to containing ever more detailed and realistic
accounts of ‘everything about sex’: every possible position,
technique, ‘preference’, etc. – a kind of user’s manual for the
young and perhaps still (primarily) inexperienced readers).
This means that the primary experience can easily run the
risk of becoming a pale copy, with the secondary as the orig-
inal, instead of vice versa.
Arguably, in the concept of reality tv this reversal of the
original balance of power between the primary and the sec-
ondary has been acted out more fully than in any other
popular genre. So far we know little about the consequences
for the viewers, especially the youngest. In accordance with
the inner logic that is given a free rein here and that therefore
does not encounter any other limits than those that it possi-
bly creates itself in the process (and what are they, if there are
any?), the trend is for increasingly daring, or strong, or
provocative and spectacular concepts to be developed to con-
tinually replace the old ones, which quickly pale (lose their
provocative, not to say sensational power) and appear bor-
ing. In philosophical terms we could say, invoking the Danish
philosopher Knud E. Løgstrup’s concept, that what previ-
ously constituted and demarcated the zone of inviolability
around the individual human being, a protective space
around its innermost sphere of modesty, shyness and poten-
tial ashamedness, is now gradually being annulled as such a

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space: instead of being that which a representation (e.g. on
tv) avoids, it has become what is zoomed in on, the actual
centre, the focal point of the actual course of events, what we
as viewers are invited to look straight at.
That these series are quickly developing into concentrating
on the lowest common denominator of our age, in the form
of sex, violence and various excesses and barrier-breaking
activities in a combination of the above, comes as no surprise.
Here voyeuristic viewers can at close quarters dwell on pre-
cisely the phenomena and acts that the art and culture of
earlier epochs were content merely to suggest, and then in the
form of fiction, unlike now in the form of filming/monitoring
real actions carried out – in the tremendously effective here-
and-now of direct transmission, provided by omnipresent,
never-resting cameras – by real people, people who are not
‘playing the part of ’ someone else but who are themselves in
everything they do. Here, someone’s primary experiences are
the secondary experiences of the many: the viewers. It is just
that, unlike fiction and thereby the classic artistic-symbolic
expressions/representations, the actor-participants of the
reality series neither represent nor imitate nor suggest the
actions we are dealing with: they quite simply perform them,
without art’s usual technique of estrangement (Brecht), indi-
rectness and displacement, that is to say, without mediation.
What is being shown and those who show (do) it are just
themselves, are originals as good (or bad) as anyone else. The
question to which we do not know the answer as yet is what
such directly transmitted directness leads to in the viewers,
what this double directness does to the experience of and
respect for limits: between others and oneself, between the
desirable and the non-desirable, between fantasy and reality
(for here everything is given the nature of reality). Crucially,
this series of dualisms or distinctions used to be based on that
between the private and the public, or the hidden and the dis-
played. Yet what we witness here is that this distinction is

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blurred to the point of being extinguished: the private has
become public, not per accident, but per programme and
thus deliberately and systematically so.
Many reality series (especially the British – tremendously
popular – The Weakest Link) are based on a vulgar-Darwin-
ist premise: weeding out and removing the weakest, so that
the strongest person among the participants is left at the end
of the series as the winner. The reality that is depicted and
that asks for general approval is that life is everywhere a mat-
ter of survival, of ‘taking’ (out) others before they take you
(out). In short, the not-so-subtle message, to which children
and young people may be particularly receptive, is that ‘it’s a
jungle out there’, making mistrust of others, especially
strangers, into an imperative and so displaying mistrust as
the basic condition, and expectation, on which to act towards
others. This picture of what the real – meaning adult – world
is like is also known as ‘The Mean World Syndrome’, a pic-
ture much reinforced by the fact that an average American
ten-year-old child has seen some 8,000 simulated murders on
tv, making aggression appear as the natural – even inevitable
– reaction in the face of frustration (however trifle the
resistence that triggers it) and physical violence the natural
way of dealing with interpersonal conflict. One’s own survival
is crowned as having supreme value, as being the only real
aim, ignoring all such moral values as care, sympathy and
respect; everything else – or more precisely everyone else – is
only to be thought of and treated as a means to attain this end.
The same premise appears to apply in the computer
games that are now extremely popular. ‘When you play com-
puter games, you are the hero in the story, and you are the
one who decides if someone is going to die or not. Nearly all
the games involve killing as many people as possible. In cer-
tain games you get extra points if you make the victim suffer.’
This is reported by Stig Rune Lofnes, head of information at
the Norwegian organization ChildCare.35 What does this say

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about culture in our society? Well, it shows a corner of a com-
plex reality, extremely familiar to some, still unknown to
others. I will content myself with pointing out the following.
In his book on people’s (Americans’) conception of evil,
C. Fred Alford asked a group of teenagers what they thought
about the crimes Adolf Eichmann had committed in con-
nection with the Nazis’ extermination of the Jews. What
surprised Alford was that a great many of the young people
completely avoided answering the question he asked them.
What happened? Well, they came up with a series of objec-
tions to having to criticize Eichmann’s actions, let along
condemn them in moral terms. Perhaps one would have done
precisely the same as Eichmann? Who knows what Eichmann
thought, what his real motivation was? He would certainly
have been killed if he had not obeyed the orders of his super-
iors, wouldn’t he? The typical tenor of the responses is that to
the extent one is asked to identify with anyone in the scenario
of the actor Eichmann and his victims, people identify with
Eichmann and do not distance themselves much from him.
The effort made consists of seeing oneself in Eichmann’s sit-
uation, of being in his shoes. In short, the answers exclusively
address Eichmann, his victims are altogether left out of the
picture, i.e. the very party to the situation which help raise the
moral issues that Alford wanted to shed light on, those to do
with evil, responsibility and guilt.
It is as if the challenge to reflect on evil, on causing pain
and death to others, can be met with satisfactorily by solely
making use of one standpoint and one perspective, that of the
actor, in this case the perpetrator. The young people never
visit the victims in their thoughts, let alone their feelings; they
do not try to take the place of the victims for so much as a
second. Alford’s interpretation is this: being a victim – even
just fictively and in the imagination – is something that is
considered absolutely unbearable, a position one will seek to
avoid at any cost. Everything that can be marshalled in the

113
way of intellectual resources is used instead in order to
explain – and to a certain degree defend – the course of
events, seen from the point of view of the perpetrator. In
other words, when pain and suffering come up, it is a ques-
tion of placing oneself as the one inflicting them, not the one
on whom they are inflicted – with the one who is active not
passive. It is as if the entire social field is characterized by a
‘win or bust’ situation, with a corresponding assignment of
roles that is just as simple as it is unsubtle and symbolically
impoverished; as if the only alternatives consist in having
power over others, being able to crush them, or being in the
role of someone completely helpless, at the mercy of the
superior strength of others. The role of victim becomes syn-
onymous with helplessness, weakness with defeat and death.
I am not saying that the teenagers who identify with Eich-
mann the perpetrator and do not give his victims one second
of their time are sadists. But I am noting that the cast of
thought they make use of – win or bust, vanquish or perish –
reminds one in its either/or and black/white mentality of the
logic of sadism: a logic where the only possible way of deal-
ing with pain in life is to relocate, produce and control it in
others. What is needed as a corrective is not simply for empa-
thy to be sharpened rather than blunted, so it becomes
possible to place oneself spontaneously in the victim’s place,
rather than (only) the misdoer’s. A language is also needed –
in the broad sense, not just narrowly verbal and intellectual –
to express that the world is not that simple, that the white
also has shades of black in it and vice versa, that most things
find themselves in the in-between area between extremes,
and that violent enactment (neutralizing the other person) is
as a rule the least optimum way imaginable of dealing with a
conflict – for all parties, it should be noted.
Is there a direct link between computer games and violent
films – with the strong-acting survivor as the centre and model
of the narrative/plot – and Alford’s discovery that teenagers

114
in the United States of the 1990s, as a matter of course and
without entertaining any alternatives, respond to moral ques-
tions and dilemmas with the aid of explicit identification
with the standpoint, motivation and projects of the perpetra-
tor? In the social and cultural field causality is rarely – maybe
never – as simple an entity as implied here. But perhaps we
have been given something to think about.
Especially in environments characterized by symbolic
impoverishment, by the symbolic means to process, put words
and images to mental frustration, aggression and conflict
being few, coarse and primitive, and where much acquired
life-experience would seem to justify viewing the world as a
terribly dangerous place to be, where others represent danger
and sinister intentions and therefore have to be met with dis-
trust rather than trust and hope, where it is a better survival
strategy to be cynical and tough and to attack first than to be
trustful and considerate, in short where goodness is weak-
ness and altruism stupidity, the path may prove very short
from impulse to action – since impulses from the inside do
not have other paths to follow than directly out to what
really exists in the outside world. When adult role models –
especially male ones – for societal rather than psychological-
individual reasons display physical means of providing an
outlet for pain, for ‘resolving’ conflicts, as opposed to the
symbolic-abstract strategies that a well-functioning culture
will provide, it is hardly surprising that violence is handed
down from generation to generation as the main – some-
times only – experienced path of mastery. Dealing with
psychic pain ultimately becomes synonymous with the phys-
ical enactment and thus the relocation of pain. For lack of
symbolic avenues to turn to, both seeking and getting relief
become equivalent to physical acting-out.
In environments where violence is the favoured answer to
pain, just as violence is the answer to indifference, boredom,
uselessness and meaninglessness, an almost imperceptible

115
transition takes place from the first to the last: from pain via
indifference to meaninglessness, so that indifference hurts,
causes pain, and the lessening or removal of such pain is then
sought by shifting it over onto others, who in turn pass it on
to yet others in a spiral movement that includes more and
more people and where the methods of violence used so as
not to be left ‘holding the baby’ – as the place where the shift-
ing of pain stops, is collected together in all its consequences
– become successively more violent and more artful, sophisti-
cated, ‘fascinating’ – at one and the same time. A situation and
an atmosphere are created where violence is both depicted
and takes place for no reason. Violence has become so much
a matter of course, so everyday and inseparable from existence
that no one asks for its raison d’être any more: for what it is
the answer to. A criminologist records the depiction given by
some teenagers of an act of violence in a small town in France:

It is winter in Cergy. Two out-of-work teenagers (about

18) that have an important position among the young
people in the neighbourhood, are en galare, i.e. hang-
ing around without anything to do. They meet a third
teenager, known to be an alcoholic, someone who is in
an obvious position of weakness. They jump on him,
beat him up, burn him with cigarettes and end up by
throwing him, naked and with his hands bound behind
his back, into the river Oise. The lad telling me the
story finds this very funny. He volunteers no reasons
that would justify or explain what happened. What he
does emphasize on the other hand are the spectacular
aspects of the incident – that the victim was naked, that
the water had almost frozen to ice, that he had not had
the slightest chance of defending himself. He does not
feel that the attackers did anything wrong at all in
attacking someone who was normally one of their
friends and neighbours. The consequences of their

116
 action were given no attention at all. Everything hap-
pens as in a game. The sequences of the incident have
their own logic, but no human characteristics. The
action has its own impetus and intensification. The
boys begin by mishandling the other one slightly, after
which they become progressively involved in increas-
ingly dramatic violence. They end up by trying to take
the life of their victim, without anger but with sophis-
ticated cruelty.36

The French sociologist Loic Wacquant places this teenage

violence in a larger political context:

The American ghetto gives us a realistic picture of the

type of social conditions that will probably develop
when the state abandons its essential task of ensuring the
infrastructure that is indispensable for complex urban
communities to be able to function: when the state
fosters a policy that aims at the systematic undermining
of public institutions and allows the development of
market forces and mentality characterized by ‘every man
for himself’.37

What, then, is violence in the ghetto about? The Norwegian

criminologist Lill Scherdin answers that it can be interpreted
as ‘an answer to an abandoned subject’, i.e. at finding oneself
in a situation of ‘no-future predictability and helplessness’.
She cites her American colleague Elliot Currie’s account of
what he refers to as ‘the ethos of thoughtlessness’, ‘a culture
of callousness’:

A culture where it is routine to fire people in the name

of ‘restructuring’ is to an increasing extent being
defined as completely admirable business practice;
where losing one’s foothold in the ever more intense

117
 fight for subsistence to an increasing extent opens up
the possibility of ending up in a social vacuum, where
those who ‘lose’ are only granted the most elementary
support, where even the risk of disability and death
depends on income, and basic health offers can be
denied those who need them. Where, in short, those at
the top always make it clear that they only have mini-
mal concerns for those at the bottom – is a society
where the risk of violent crime increases because those
who find themselves at the bottom will probably inter-
nalize and copy the predominant ethos of callousness.
As has been said: ‘The person who has been forsaken
by everyone can no longer have any feelings towards
those who abandon him to his fate.’ What we can call a
culture of callousness, where concern for the welfare of
others is weakened, is not a ‘subculture’ restricted to
young people from the ‘lower classes’ but a fundamen-
tal tendency in the predominant culture itself that the
poor young people adopt and beyond a doubt inten-
sify, but which it cannot be said to be the origin of.38

As Scherdin comments, the degree of acceptable suffering –

where no one intervenes out of an experienced obligation to
help – is on the increase for many people in the society being
described here. When President Clinton laconically remarked
in the early 1990s that ‘It is the end of welfare as we know it,’
he put his finger on a dawning mentality the consequences of
which can hardly be exaggerated: the attitude that various
kinds of suffering, need and defeat are to be seen as self-
inflicted by the individuals concerned. This is the immoral
downside of the apparently moral invitation to everyone to
be the architect of his own fortune – and according to the
same logic, his own misfortune. When everything that has to
do with responsibility (often called accountability these days,
revealingly using a legal word for a moral phenomenon)

118
becomes bound to the individual – individualized – to an
extreme degree, the overall impersonal and anonymous
causes of increased social misery and the use of violence are
lost sight of. The overall framework – the system and its
structures – is now no longer criticized; instead, by stripping
down to basics, meaning to individuals, everything that is
complex and that exerts power over agency and choice, cur-
rent individual-focused ideology helps protect the political
and economic framework against the frustration, rage and
protest of those who are the highly personal victims of this
impersonal ‘modernization’, ‘rationalization’ and ‘restructur-
ing’. And so the energy generated by frustration is directed
against one’s own, or those who are, or have recently become,
even lower than oneself on the social ladder. Helplessness as
regards the established power hierarchy and impotence as
regards the system in its anonymity and impenetrability are
compensated for by creating situations of total power and
dominance at the micro-level of society, at neighbourhood
level, where potential hate-objects, preferably ‘strangers’ or
‘scroungers’ or ‘losers’ (or all at one go, in one and the same
person) can at a moment’s notice be transformed into real
hate-objects, with the promise of direct enactment of all
accumulated pain. To put it sociologically, the less real power
a person or group possesses in the present circumstances, the
more that person or group is likely to become an all-too-easy,
all-too-present target of the aggression of indiduals deemed
as losers in an ever more individualized and competitive soci-
ety. Those at the top, with power to pull the strings and to
occupy the commanding heights within globalized com-
merce and politics, are effectively beyond the reach of those
at the bottom and at the receiving end of their policies.
The violence that occurs in such a situation – a violence
that exemplifies the shifting of pain in the almost total
absence of symbol transformation of it – is one that has its
own virtually unstoppable dynamism: one thing leads to the

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next, ‘things just happen’, without any clear idea in anyone’s
mind as to motives or consequences. The search on the part
of outsiders – social workers, the police or the judiciary, for
example – for a moral perspective on all that is taking place
is conspicuously absent among, indeed foreign to, those
involved, as the story quoted above illustrates. The perspec-
tive typically adopted is instead an aesthetic one, with the
accompanying criteria for assessing if the displayed sequence
of aggression is ‘spectacular’ and ‘inventive’ or ‘amusing’.
What is negated in the process is not the conception of a
major society of what is good behaviour, so that something
intentionally ‘wrong’ or even ‘evil’ is done instead. No, what is
denied is ennui, boredom, lack of meaning, the fact that
nothing means anything and that nothing meaningful takes
place. Participation in particularly ‘inventive’ or reckless vio-
lence promises a break with this experience, even if only a
brief respite. The expressions used to add something distinc-
tive to the performance of the person perpetrating violence
use aesthetic rather than moralizing (and thus possibly cen-
suring) vocabulary. To get the adrenaline pumping becomes
an end in itself, as does the excitement.
The fact that tormenting others is punishable seems
unimportant. What matters is the prospect of having fun, of
fifteen minutes of fame. For one thing that is certain is that
there will be no lack of attention paid to young people who
are behind particularly inventive acts of violence that result
in death. The German journalist Regina General lists three
highlights in the course of two randomly chosen weeks’
media coverage of serious youth crime in present-day Ger-
many.39 In the first instance, the offender is a twenty-year-old
man, inconspicuous, apparently friendly and likeable. Stated
desired occupation: killer. Executed deed: the murder of two
old ladies. In the second instance, five friends are before the
court, accused of having throttled a neighbour until he died.
Stated motive: some more money to buy liquor. They state

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that the amount they receive in reduced social aid is insuffi-
cient. Something has to be done to get hold of what is
needed. In the third instance, half of the students of a voca-
tional school class are accused of sexual abuse of a
fellow-student and to have placed the worst of their perver-
sities on the Internet, with thousands of hits and considerable
demand from the general public as a result.
The journalist reports that youth crime shows no signs of
being on the increase at the moment in Germany. That is not
the point. The changes she thinks she can observe lie some-
where else and are highly relevant for our theme. It is the way
violent crime is perceived and marketed that is changing.
The perpetrators can guarantee getting considerable public-
ity – a state they would normally not achieve via their ‘usual’
activities. It has to do with being the centre of attention for
all those in society who otherwise would not be the slightest
bit interested in such young people and the lives they lead.
There have been several cases, particularly in Germany, with
the famous tragedies in the United States such as the mas-
sacre at Columbine High School as a possible model, where
so-called Amokläufer – always young lads – break out of their
‘young lad’ space heavily armed with automatic weapons, the
deadly use of which they have learned from dozens of vio-
lent videos, and launch into a killing spree by storming into
a school to ‘take out’ students and teachers. Though often
taken by the public to happen impulsively – say, due to some
recently suffered setback or insult – subsequent police inves-
tigation typically concludes that the killing spree and the
identities and number of its victims have in fact been pre-
meditated in great detail by the young killer, often for
months or even years.
We like to talk in our society about optimum op-
portunities for development, not least for the young. Such
opportunities are often a rare commodity (or the converse,
where young people are bombarded with so many of them

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that they are confused and become indifferent, lose their
direction and are incapable of making decisions – on which
more later). For many young people, the future is simply a
black hole. Something higher or more long-term than the
next ‘rush’, the experience of being ‘high’ again along with
some friends, does not exist. What is behind this? Perhaps it
is a real misunderstanding on the part of society, a collective
category error that is displaying one of its consequences here
– that it must be permissible to seek one’s own satisfaction at
any price. As society now is, as it appears to those who are
young and who notice what the adult world does, it appears
to have an overall message, one to be found across the board
as a uniting theme: never share with anyone. We never pays
off – all that pays off is I. It does not pay off to take care of
others, only to take care of oneself. The one who deceives is
only exploiting his chance; the one who does not, has no
chance, or is too naïve or ignorant to have understood the
basic rules of the game.
Much is going wrong between the generations. A word
such as ‘upbringing’ has in many circles – among adults as
well as young people – something cramped about it, some-
thing old-fashioned and moralistic, something superior and
anti-progressive. To try to pass on moral values to one’s own
children is becoming increasingly difficult, among other
things because parental authority is being challenged from
many directions – not least by advertising aimed at children
and tailor-made to forge an alliance against adults said to
‘know nothing’ about what children desire these days – and
because ‘negotiations’ and compromises are a dominant
trend in much popular pedagogical thinking. Moreover, to be
an adult that tries to communicate standards of right and
wrong to other people’s children (as well as one’s own) is
regarded in many circles as almost wrong in principle; exam-
ples from everyday life indicate that overt correction of other
children’s behaviour will soon be considered taboo, with the

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adult bearing the entire burden of proof in the event of
conflict, and with the corrected child as the offended party,
with every prospect of getting support from its own ‘liberal’
parents. Indeed, it is becoming rare for adults to initiate con-
versation – meaning a friendly one – with children not their
own. Today’s ten- or thirteen-year-olds report that it virtu-
ally never happens that a so-called ‘stranger’, be it on the
street or the bus seat next to one, makes contact at all. Chil-
dren are for the most part taught that strangers will often be
dangerous, anything but well meaning and deserving of trust.
Everything to do with how to behave, with intervention in
cases even of one child’s visibly molesting and abusing
another, is – so the prevalent attitude has it – to be left either
exclusively to the child’s parents or to some professional per-
sonnel assigned to the task. As a consequence, the social
world as one in which children and teenagers experience
active and reciprocal communication, including a lively
exchange of experiences, attitudes and values, is radically
shrinking – at the peril of all involved, meaning all three gen-
erations. It is as if all people who are now deemed ‘outsiders’
to the child in question have no purchase on the codes of
conduct that its actions are expected to conform to. Rela-
tivism abounds, plurality of life-views and lifestyles is the
name of the game, and it takes enormous confidence on the
part of an ‘outsider’ to engage actively in cases of conflict –
not to mention bullying – between children. From an early
age young people learn to follow the requirement – and
thereby everyone’s right to – ‘self-realization’, which they see
that adults are so obsessed with – if not in word, then in deed.
And what about those who are old – really old? Well, they
cost money, they are expensive and work-intensive to keep
going, an item of expenditure that is always on the increase.
What is more, they do not understand the rules that now
apply. They think in terms of their own youth long ago, their
experiences and values coloured by a society that no longer

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exists – a society where duty went before rights, where what
one had to do was far more important than what the indi-
vidual chose to do – if there ever was a choice.
Many young violent criminals are characterized by their
lack of remorse – not only do they not show remorse but they
cannot comprehend why anyone should be interested in it.
Isn’t making a career as a professional killer a quick way of
earning lots of money and fame and thus of achieving aims
that are recognized by society? Even in cases of spectacular
bestiality those who have taken part claim that no one really
wanted to hurt anyone else. The motives professed are any-
thing but sadistic or deeply personal; they do not involve
strong feelings or carefully considered aims. The tormenting
of others is excitement, a little extra fun – after all, there are
so few ‘extras’ one allows oneself. The opportunity was there
– what else do you need to know? And if pressed, the fallback
position is always available, in the form of the conversation-
ending counter-question: who are you to dare to criticize?
Who has the right to correct the behaviour of others? Indeed,
who is entitled to judge and to criticize?40
Have I now proved my assertion that culture is failing in
its task, as defined above?
In its original form, the assertion can be seen as an unten-
able simplification. It gets hold of certain characteristics of
present-day reality but misses others. Which? Two qualifica-
tions are necessary: first, the culture of a society such as ours
is not at all an unambiguous, homogeneous entity but a
many-headed affair. Culture comprises many phenomena,
expressions and tendencies; these appear alongside each
other, even though they are often incompatible. But the point
is that they can perfectly well exist parallel to each other,
without necessarily creating conflict or excluding each other.
Why? Partly because – and this is qualification number two
– culture has just as many (and diverse) addressees, users and
practitioners as it itself is diverse and non-uniform. Socio-

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logically speaking, this is referred to as different social classes
within the same major society practising and mediating ‘its’
respective cultures, understood as ways of doing things and
of interpreting things with the aid of symbolic-linguistic
effects and media (to allude to the French sociologist Pierre
Bourdieu and his famous notion of habitus).41
Where do these qualifications take us in regard to the
question of culture failing its task? My answer is that one can-
not hold that culture as such fails in its task to give all
members of society good symbolic-linguistic resources for
dealing with the whole range of challenges, trials and crises
that human life contains – in short: to meet pain in life (that
of others and one’s own) without creating more of it, inten-
sifying it, passing it on. The reason for this is not just the
obvious one that culture – in the singular – does not exist;
that there are as dissimilar transmitters as there are receivers,
to use that language. What is relevant for our discussion is
that what there is in the way of good symbolic resources –
everything from literature via fairytales to drama, film, danc-
ing, music, painting, etc. – does not reach its destination so
as to be used by the people and groups of people who per-
haps need these resources – for handling and alleviating pain
– most of all. Note that this statement is not exclusively
intended for the underprivileged in our society – whether it
be those with little education, no work, the poor, drug
addicts, etc. As we will see in the next chapter, among the
declared ‘resource-strong’ – those in the middle of life, with a
strongly ascending career curve and likewise salary – there
are also clear signs of a lack of being in touch with the most
difficult sides of life, with defeat, loss and adversity. It is as if
those who have specialized in an existence on the sunny side
of life, on the ascent of the high summits, those only reached
by a few and only after a particularly hard effort, turn out to
be just as poor and helpless at the instant the crisis should
happen to strike and they are suddenly caught up with by the

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realities of the drawbacks of life. It is a question of a lack of
practice – biographically as well as symbolically, physically as
well as mentally – in looking such fundamental conditions as
dependency, vulnerability and mortality in the eye, i.e. the
characteristics of existence one has not been in contact with
for so long (right up until the acute crisis, perhaps) and has
not needed to have an attitude towards. Why should a drug
addict not have just as great a competence in this area as a
business director, the man who is now in an existential free-
fall after his marriage has broken up or his company gone
down the tube? At the moment of crisis low culture can be
existentially just as resilient, just as symbolically saturated
with meaning, just as wise as high culture: a Janis Joplin just
as true to reality as an Edvard Munch or a Marcel Proust.
What, then, is the danger? There are many dangers, not
only those usually most discussed such as the unequal access
for different classes and environments to the finest treasures
of culture(s) and the most durable expressions, as the differ-
ences in this approach increase systematically according to
the general increase in economic-material differences between
those who have most and those who have least. As men-
tioned, I see no direct correlation between wealth defined
socio-economically and wealth as a share of, knowledge of
and use of vital symbolic resources: in that respect the rich
may prove to be poor and the poor rich. The danger I wish
to indicate here is, however, of a different nature than one
that is suited to statistical overviews. It consists in a fear of
seriousness. The Swedish film creator Roy Andersson puts it
like this:

With the word seriousness I am thinking of taking

things seriously, doing things properly, getting to
the bottom of things, taking consequences, making
things clear – something that does not in the slight-
est involve grumpy looks or an absence of fun. In

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many ways I believe that our lives – indeed, our
whole society – are characterized by a fear of seri-
ousness and a hatred of quality . . . Expressions of
quality and seriousness remind us of this fact, and
since they occur so rarely, they are surprising and
discomforting reminders of the prevalent skimping
and superficiality. This creates aggression.42

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 twelve

Pain as Compulsive Choice in

a Multi-option Society

In present-day Western societies there is a widespread belief

that the individual – and nowadays everything begins and
ends with the individual – desires freedom more than any-
thing else, in the sense of individual self-realization. Freedom
understood in that way, lived in that way, has many prob-
lematic aspects that have much to do with the creation and
shifting of pain. The developments we have witnessed over
the past couple of decades lead to various forms of social
pathologies. What is it that creates such pathologies?
My assertion – which is, of course, only part of the answer
– is that an increasing number of the pathologies I am talking
about are created by choice becoming compulsory in a multi-
option society. Pathologies such as burn-out, action paralysis,
anxiety and depression can be considered as unintentional
consequences of social conditions that are otherwise per-
ceived to be conducive to the individualistic realization of
freedom. Key words for the conditions I am referring to are
mobility, flexibility and adaptability. Readjustment is at the
heart of this, taken as a demand targeted at each individual
that he or she needs to internalize and prove loyal to at all
times and across the entire social board, as it were. While the
prevalent ideology of our time, neo-liberalism, would have
the conditions mentioned above represent positive condi-
tions for realizing freedom, my assertion is that the converse
applies: because these conditions are imposed on individuals
and force them constantly to choose, and constantly to choose

128
right, and constantly to update and thereby annul previous
choices, individuals reach an impasse of non-freedom rather
than any real freedom – an impasse of exhaustion and self-
coercion rather than an expression of creativity and
individuality. Furthermore, individual identity is not/no
longer seen as an expression of an essence, something that is
fixed and constant. Instead, identity – we are told by all sorts
of pundits who have their finger on the pulse of things – has
to do with something that is completely constructed – some-
thing fluid, plastic and staged, something heterogeneous and
multi-dimensional (identity is ‘pluralized’ when the roles and
arenas are multiplied, etc.). Nevertheless, this newly won
‘freedom’ to constantly recreate oneself comes at a high price
– as we shall see.
The consequence of this trend is not that people are
becoming increasingly egoistic and less altruistic. This
dichotomy misses the point; it misses what is novel here. The
simple contrast between egoism and altruism is breaking
down, in the sense that the compulsory choices of the multi-
option society force the individual to ruthlessly exploit
himself – something that is bad not only for the individual
himself but also for his capacity to show concern for others,
to have any kind of surplus of involvement, initiative and
strength left for other people – especially those who are striv-
ing themselves. Social pressure on the individual – adapt,
adapt – is internalized and finds expression in the individ-
ual’s merciless and restless pressure on himself, so that
healthy self-assertion – mental and emotional ‘taking care of
oneself ’, paying attention to one’s own vulnerability and the
limits for one’s stamina – suffers as a result, as does one’s abil-
ity to care for others. The ability to care that we are dealing
with here is both for oneself and for others. In the former
instance it has to do with how the individual behaves towards
himself in a broad psychological sense: what he demands of
himself in the form of making choices that indicate mastery

129
and success, which needs he gives priority to, and which he
rejects, plays down or represses.
To be happy or successful (can we appreciate the dif-
ference?) has become a requirement, something everyone
believes is a god-given right. And it is without a doubt a his-
torical fact that people in today’s Western and materially
speaking rich societies generally perceive that the possibili-
ties for realizing themselves are constantly improving. The
options multiply, the opportunities are literally unlimited –
there is a plethora of them and the only thing to make sure
of is that I choose the right thing. ‘Only thing’? With the
increase in potential choices, the compulsion to choose also
increases. The fall is greater, and the safety net increasingly
coarse-meshed and fragile. The individual has to take the con-
sequences of his own choice. Doesn’t that sound reasonable?
Is there anything wrong in that? Isn’t precisely that a sign of
progress when it comes to freedom and responsibility?
In one sense, yes; in other respects, no. For a start, and
even though it has become politically incorrect to observe so,
the fact is that for an individual agent to realize his de jure
freedom, resources in a comprehensive sense – involving eco-
nomic capital no less than the fashionable cultural one – are
required and such material resources still tend to be distrib-
uted along lines of class, notwithstanding assertions to the
contrary, and according to which radically individualized
human resources constitute the only difference that now truly
makes a difference – that between winning or losing.43 In a
society where the reign of the collective and the great narra-
tives is past, where the individual has been ‘liberated’ from the
yoke of tradition and religion, where there is no longer any ‘as
father, so son’ compulsion, where the older generation abdi-
cate their authority regarding the younger generation – in such
a society the downsides of gaining freedom, in an individual-
istic sense, are often lost from view, although not clinically lost,
not psychosomatically. It is here that the downsides are inter-

130
cepted, here they are stored – well understood or misinter-
preted as they may be by the individual himself and by the
current interpretations and values of society at large.
I acknowledge that a great many people tackle the chal-
lenges of a societal era of adaptation and freedom/coercion of
choice quite well. There is no lack of examples demonstrating
that laying aside old competences and acquiring new ones
often results in personal enrichment and is a source of growth
and wellbeing; in short, a chance that previous ages did not
offer people to make use of new facets of themselves. For that
reason there is often a good match between what dynamism
in working life calls for and what the individual experiences
as stimulating. In addition, it is important to point out that
many people manage to get through things well if a crisis or a
defeat should occur – not only by virtue of their own
resources but also thanks to unselfish efforts by friends, col-
leagues and life-partners. In short, there is a vital in-between
area between the individual and the companies or institu-
tions, an area consisting of a network and environments that
can help contain individuals about to crash. It is perhaps in
the nature of things that this interception and backing-up
rarely reaches the front pages of the newspapers or becomes
a theme for popular academic study; there is something silent
about the phenomenon we are dealing with here, about, say,
the continued importance of friendship, unlike the visibility
attached to such defined problems as a marked increase in
eating disorders among young people or in the use of Prozac
among get-ahead 30-year-olds. Everything that is doing well,
or is prevented from going wrong, does not really come to
light, compared to what really goes awry.
In other words, there is much positive mastery – at both
individual and group level – in so-called option society. But
my aim in this book is not to dwell on this but instead on
where pain is created, shifted and enacted. I turn my atten-
tion in that direction – and find a great deal.

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 I am thinking about the signs of an increase in factors that
contribute to the individual experiencing the more rigorous
expectations regarding self-realization in the outside world
as an ever greater burden, as something that involves major
mental strain. When being happy has become a requirement,
when being successful is so too, something happens to the
gained freedom that previous generations and societies did
not have: increased freedom becomes increased strain. It has
to do with many simultaneous trends, most of which I can-
not do justice to in this discussion: among other things, how
we in the space of two decades have gone from welfare as we
knew it to minimum effort based on the ideology of self-
inflictedness and self-sufficiency, so that the person ending
up in unemployment or the dole queue is under pressure to
get out of this situation as soon as possible. Fundamental
conditions that simply have to do with being a human being,
especially dependency and vulnerability, have acquired an
imbalance that is unambiguously negative: to be in need, to
need the help and care of other people, is seen as morally sus-
pect in itself, a state that ought to be as short-lived as possible
and that society at large in general and ‘the public sector’ in
particular must not fuel under any circumstances – perhaps
avoiding it through propping up those in need with state
benefits. Dependency and vulnerability nowadays tend to be
associated with shame, with revealing something about one-
self that ought not to be displayed and ought not to be there
in the first place.
The Norwegian psychiatrist Finn Skårderud puts his
finger on the relationship between cultural change and a
change in the feeling of shame. Traditional shame in the form
of embarrassment is on the decline. Nevertheless ‘the story of
present-day Western culture [is] not that of a lost shame but
rather of a transported shame.’ This formulation accords well
with the picture I have tried to present. As Skårderud makes
clear, the most important transportation – and change – is

132
from a collective to an individual norm. The transportation
of shame towards the individual and his psychological regis-
ter and resources does not mean that shame disappears, but
that ‘we lose a language about it. Shame becomes more silent
and more lonely. It becomes less distinct.’44 Why less distinct?
One of the main reasons is that the premises and ideals of our
age’s one-sided preoccupation with self-development are
unclear. For what is self-realization when it comes to it? What
is authenticity? Are there undisputable and generally valid
standards to go by? How can the individual feel certain of
having reached the goal?
There are no simple answers here, no answers that remove
the individual’s doubt about the tenability of his own efforts
and performance, let alone the never really overcome doubt:
am I good enough? The situation is indeed confusing and
ambiguous. On the one hand, much would seem to indicate
that the form of individualization we are talking about has
increased with subjectivism and relativism as a result. A strik-
ing sign that this is true is how difficult it has become in our
society to criticize the choices of action another person
makes. What right have I to criticize your choices, your pref-
erences, your values and ideals? Especially explicitly moral
criticism, with a tinge of condemnation (other people’s pri-
vate consumption, for example) constantly runs the risk of
being perceived as moralistic, as a paternalistic ‘know-all’ atti-
tude, i.e. something everyone would like to be spared. To have
the nerve just to come here and interfere, without being
asked, in my private decisions and preferences – who is enti-
tled to such mingling with the affairs of others? What is
reprehensible is not the object of the criticism. It has been
shifted from the object or issue to the criticizer, or more pre-
cisely to a person at all raising any criticism of others’ actions.
Individualization in general and the ideal of authenticity in
particular are undermining the potential of criticism and
correctives, because issue and person are now so intimately

133
interwoven – in terms of both experience and norm – that
the former division between them disappears. Correction has
almost become synonymous with molestation.
However, this – conventionally culture-critical – picture is
far from being the whole story. With the aid of Skårderud, we
can see that although the moral practice of criticizing the
behaviour of others has become more difficult, this does not
necessarily mean the end of shame in our culture. The basic
structure of shame remains intact: shame about oneself in
relation to the other/others. All the same, what is changing is
the three instances that constitute and determine the struc-
ture of shame in a lived, psychological sense, namely, the self,
others, and the culture that mediates the relationship
between the former two. Modern culture is open. Therefore,
more possibilities means an endless number of alternatives
but at the same time, fewer sheet anchors, less clarity, less
unambiguity and objectivity – and limits that become
increasingly unclear. Just as in previous ages, shame, as
Skårderud says, is ‘an affect that, consciously or uncon-
sciously, is fuelled by the discrepancy between self-ideal and
realization. Shame emerges from this tension between how I
wish to be perceived and how I feel that I am perceived.’45 The
radical openness of culture, its porous nature, its quality of
being a melting-pot for the new, for all sorts of change,
means that the individual is thrown back on himself and his
own ongoing choices of cultural yardsticks – knowing full
well that all such supra-individual references are themselves
in a process of restless change and are therefore unable to
provide the individual with a hold, something firm to hold
on to in his efforts to ascertain whether he is being successful
in his self-realization.
Neither party has the answer. To be thrown back on one-
self and one’s own resources, since culture – like the
omnipresent market – is constantly supplying new option
portfolios rather than answers and yardsticks, means being

134
reminded of one’s own dependency and vulnerability, one’s
own aloneness in the throes of choices, because it now
becomes apparent that mastery cannot be attained by relying
solely on one’s own, individualistically conceived resources
from one’s own breast. Independence and autonomy begin
to crack, to betray the fact that they are not what is given, but
presuppose more profound and underlying fundamental
conditions, conditions that reveal that the self-realization
project in an individualistic sense is an illusion, and a dan-
gerous one at that. The uncovering of this arrogance causes
pain, pain in the form of shame that is fuelled by a sense of
sub-optimal performance, by not realizing enough of one’s
presumed potential: my shame is more about myself than
towards the other/others. Shame takes the form of self-
conflict – manifested as self-disgust, as strict self-control
regimes such as eating disorders, or sadomasochistic sex, or
piercing or other forms of self-injury – more than the conflicts
of the individual with others or the major society, a conflict
traditionally fuelled by the individual realizing ‘too much’, by
way of transgressing limits of behaviour and violating stan-
dards of conduct established by tradition and upheld by the
‘collective conscious’ of society (to refer to the perspective of
Emile Durkheim’s classic work The Suicide).46
In times of violent societal changes that individuals do
not perceive they can influence themselves, changes of the
type they feel they are subject to and steamrollered by, it
becomes a question of finding something at any rate that can
be brought under complete control, something that allows
the feeling of powerlessness to be replaced by a feeling of
power and actual control, where I do the forming rather
than being formed – even if the price of gaining such control
means, among other things, withdrawing from the big,
unsafe world out there to what is close and my own – to I,
me, mine: depoliticization and narcissism as two sides of the
same process.

135
 What could be more natural in such a situation than to
focus on the body? After all, the body is mine, it is myself. The
‘artists of starving’ that Skårderud writes about illustrate an
outcome of what I am referring to. The anorexic girl who
walks past the outdoor restaurant where all the others are sit-
ting stuffing themselves with rich food, with their bodies
distending, can experience this moment, this eminently visi-
ble contrast, as proof of her own sovereignty and power and
of other people’s weakness. To form the body, to compel it,
to conquer one’s needs and their dictates, to let the will
decide over or regularly set everything ‘natural’ and biologi-
cal out of action, is one of the many possible interpretations
of people who present it as a choice – against the large back-
drop of all that is non-chosen, that which is inflicted or
imposed on one’s life – to place everything to do with the
body under a particularly strict regime of self-control where
the body is punished or rewarded, depending on the nature
of the disorder, in its enforced subservience to its lord and
master. Interpreted as an extreme exercise in self-control, the
need to control manifested here is something that calls for an
explanation, that reveals that something has got completely
out of control, so that the attempt to control the body com-
pensates for a loss of control – a mastery strategy precipitated
by powerlessness.
Applied to the youth violence we mentioned earlier:
inconsideration towards others can go hand in hand with
inconsideration towards oneself. The lack of care for others
can exist side by side with a lack of care for oneself. Hardness
towards others – often expressed as cynicism – is fuelled by
working hard to be hard towards oneself. More profoundly, it
is fuelled by denying, by trying to eradicate one’s own vul-
nerability. For vulnerability, one’s own no less than that of
others, is now looked upon as identical with weakness. And
weakness is what this world will not tolerate, because this
world is all about each and everyone’s survival, that is to say,

136
being strong and fighting so as always to come out on top.
Moral admonishment regarding this way of ‘reading’ our
society and claiming that egoism now rules supreme is to
miss the point. Of course, I believe that the type of violence
we are dealing with here in the examples from Germany must
be condemned and punished. Of course, the guilty have a
responsibility they must assume and that no analysis of soci-
ety can alter. Let that be quite clear.
What we have to examine in greater depth, once the con-
demnation has been voiced and the courts have had their say,
is the question of ‘Why?’ Leading on from the perspective
adopted in this book, a possible explanation is offered by
understanding such violence as the shifting of psychic pain.
We know that the young people involved here in many cases
indulge in self-injury as well as inflicting violence on concrete
individuals. In both cases, limits are being transcended, put
out of action; it is possibly the case that only the limits that
one has created oneself are respected, those which by an act
of will one has chosen. Seen in this way, the young people
perhaps illustrate a more overlapping, widespread phenom-
enon than the one that has directly to do with violent crime
and its causes: the fact that we live in a society that generally
speaking has a sinking understanding and acceptance of lim-
its of the kind that people – those who clash with and are
subject to limits – have not created by a personal act of will,
in the sense of having been able to choose. We only want to
know about what we can choose for ourselves – and de-choose
everything else.
The individuals that the capitalist economy requests in an
age of neoliberalism, where the trend is for the whole of
society with all its various organized activities to be trans-
formed into a marketplace and arenas for everything that is
consigned the nature of a commodity, have, to use a psycho-
logical term, weak egos. The individuals requested today are
not strong-willed, independent-minded and autonomous,

137
true to their own ideas; rather, they are heteronomous, driven
by anxiety and insecurity and so easily manipulated by out-
side forces. The paradox is not to be denied: though this is
often declared the era of individualism, conformism – in the
gestalt of the individual’s obsession with adapting to the
demands addressing him, especially in the workplace – is
tightening its grip.
As convincingly shown in rich detail in C. Fred Alford’s
book Whistleblowers: Broken Lives and Organizational Power,
individuals who take the ethos of individualism at its word
and who take an independent stand on ethically sensitive
issues, for instance by openly protesting against unethical
policies practised by their own organization, are typically met
with a whole battery of devices of rejection, being frozen out
by colleagues and being ignored by those at the top, thus set-
ting in motion a process often ending with the autonomous
individual being declared psychologically unstable and unfit
to continue work for the corporation in question.47 As Alford
documents from the United States, where he did interviews
with whistleblowers, a ruined life – a lost job, a lost home, a
lost family – is quite often the (rarely anticipated) price of
defying the powers that be in the name of autonomous judg-
ment. Such individuals are not heroes but a pain in the arse,
exploited by bosses as a warning and despised by colleagues
who have their own lack of nerve put into sharp relief by the
protester in their midst. So much for the ideology hailing the
independent-minded individual! The alarming thing is that
the individuals, to the extent to which they make an effort to
adapt to the demands for change (in education, in the labour
market, in their private lives and love-lives), are in danger of
considering and treating other human beings as means rather
than as ends in themselves.
Furthermore, I am claiming that the ‘flexible’, adaptable
and change-willing individual we are dealing with is in dan-
ger of turning himself exclusively into a means – not just

138
others – that is to say, a means for intentions and interests
that are not the individual’s own but that have been taken
over and internalized from market players and advertise-
ments that intensify seeing human beings as commodities, so
that all that is human – all needs, all aims, all fantasies – can
become the object of satisfaction, meaning instant and always
available (accessible) gratification, by being transformed into
so many commodities. Ultimately, this imposed commodity
nature – how much something is worth and for what price it
can be sold, measured on the basis of a demonstrated
demand – will become characteristic of all of existence. From
a critical point of view, it must be said that the optimally
change-willing and adaptable individual – the one who in all
his doings ‘is’ just as flexible as the changing outside world it
has to adapt to so as not to fall off, fall outside – is the unfree,
non-autonomous, weak-egoed individual perceived as not
only willing to treat others as means, and thus inconsider-
ately, but also to make himself – as a mind and a body – the
object of just as gross inconsideration.
The attitude to the self in such a situation is one of ruth-
less exploitation. And this exploitation creates pain, the pain
creates a need of mastery now typically understood as
removal, and the removal of pain creates a need for contain-
ers, for someone out there who is suitable for housing it. In
short, the pain in the subject creates and exerts pressure on
the subject’s relations to other people and the outside world
in general. Alternatively, if others are not available for this
purpose, or we are dealing with a person with a genuine con-
cern for others, the pain in a self will be locked inside the
self-relation, with various types of self-destructive behaviour
as a probable consequence.
A provocative question: is there a link between the
teenager with a drug problem who engages in self-injury,
who slices his own skin with a knife, who forces himself to
cut slightly more, slightly larger, slightly deeper than the last

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time, and the businessman who walks slightly faster, almost
breaks into a run, checks his watch for the umpteenth time:
will I reach the plane, the meeting in time, will I land the con-
tract for the company, what will my boss say if it falls
through, how much have I actually slept this week, when was
I last out with the kids? Two modern persons, side by side in
the same society, but miles apart on the basis of outer char-
acteristics to do with status and success? Or not so far apart
after all? Father and son, perhaps?
The two of them are at opposite ends of the spectrum,
admittedly. They belong to vastly different environments,
have different goals, command few and many resources
respectively. The drop-out kid and the go-ahead businessman
in his prime and for whom everything is possible. But are
they so different? Are there no resemblances? Yes, perhaps the
fact that both are exploiting themselves, pushing themselves,
making themselves hard, and both, apparently, can put up
with more and more – mind and body, two in one – and who
get increasingly hard and, apparently, can withstand more
and more. The stimuli have to be intensified to get ‘high’
again, yesterday’s excesses and new conquests have to be con-
stantly replaced by new ones, stronger ones, if there is to be
any chance of a new kick – perhaps not totally unrelated to
how earlier career success has to be topped by advances char-
acterized by even greater boldness, risk-taking, falls – much at
stake, yes, but it has to be so if one is to feel alive. How much
can I put up with? To what extent can I surpass myself, exceed
previous merits and records?
Produce the pain in your life. Endure it. Don’t expose
yourself to other people’s – in a double sense: the pain oth-
ers have, and that is theirs, not mine; and the pain they might
inflict on me, if I do not protect myself. The same strategy is
used in both cases: to harden myself – against myself and self-
inflicted pain no less than any inflicted from outside. Pain is
a sign of being alive. But living and being able to go on with

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life does not have to do with pain as such. It has to do with
withstanding it, more precisely with constantly being willing
to do what can be done to be better able to withstand it: the
pain limit. Yes, what about it? It is my ability to withstand,
that’s what it is. To live is to be able to experience pain: so I
must be able to withstand pain so as to put up with life. So it
is not at all a matter of denying or repressing the presence of
pain in existence. No, it is a question of mastery, as it is of
most things at present: of training myself to take my sensi-
tivity to pain in my own hands, making it a project to shift
the point where pain feels completely intolerable, to stretch
it farther and farther forward: formerly, the point it became
intolerable was there, now it is here. And I figure I still have
considerable potential for improvement.
In other words: I am vulnerable, much as I don’t like to
admit it. But what I do is to subdue my vulnerability, in the
form of a pain level. I compel it, seek to gain control over it by
dictating its meaning and power over me, in my life.
Is this a true picture? Don’t solemn ceos tell us that we are
a nation of wimps, of people always complaining of being ill
and worn-out for no reason, who can put up with less and
less – with all the negative spin-off effects this has on our pro-
ductivity, with the burdens it imposes on our social budgets
and our health service? Isn’t it high time someone did some-
thing about the economic catastrophes absence from work
is causing?
Can we withstand less pain than before, or less than what
we – based on an assessment that at some point has to be
normative – ought to be able to withstand? Or do we with-
stand more than before, in the sense described of having
become our own worst slave-drivers, of carrying out psycho-
somatic exploitation on ourselves, so that our capacity is
stretched a little more, like the famous elastic band – the one
that we both are and that we stretch? Or is it perhaps not so
simple as the one description killing off the other?

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 I do not think the descriptions completely exclude each
other. The fluctuations in absence from work and its causes
are not something I am qualified to determine. The director
and like-minded people in business life and politics are put-
ting out an unambiguous message, even though the diagnosis
on which they base themselves may prove to be erroneous:
the message that each and every one of us must demand
more of himself, must push himself to ever greater efforts
than is now (presumably) the case. And it is a signal that the
businessman we outlined has taken in – an internalization
that can have far more illness-provoking consequences than
the person concerned is prepared for.
As mentioned earlier: a lot of successful coping is taking
place in the encounter with the challenges I am depicting. My
analysis is deliberately selective by dwelling on the pain that
is created in cases where the ability to master it and the
resources available fall short, partly because of the influence
of the powerful ideological view of our age that the individ-
ual ought to tackle his own problems and that to say to others
‘Look, here is my pain, here is my vulnerability’ involves a
shame-inducing defeat and betrays a weakness that each and
every one of us would prefer to hide and deny rather than
openly admit.
One thing has been well documented in recent years: the
number of emergency cases in psychiatry has led to an
increase in the number of people hospitalized and treated
who belong to the category ‘go-ahead men in their prime’,
men with high status on the basis of all socio-economic cri-
teria who after a period of overloading in their job and in
their career/family life suffer a terrible crash and flatten out
completely. What is the overall picture such a phenomenon
has to be placed in if we are to understand its societal signifi-
cance, what warning signal is it sending?
The development of society I am referring to has to do with
how readiness to change replaces perseverance and integrity as

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a core virtue, especially among employees in the private sec-
tor – though in our times of privatization increasingly also
in the public sector. To the extent to which a present-day
employee is encouraged to show loyalty (an honourable
virtue), this loyalty is towards economic targets to do with
increased production and increased profit; or alternatively
towards projects that are often short-term and a working
environment that at any moment can have its staff downsized
or outsourced: this represents a reality that is taking over an
increasing number of sectors and employees, and that is
undermining loyalty understood as long-term obligation to
companies that are stable, secure and place-bound.48 To
‘improve competitiveness’ stops being a means to a higher
end and becomes an end in itself: a system imperative com-
ing from the outside that everyone has to submit to.
Structural changes and their enormous dynamics in today’s
turbo-capitalism are the silent but incredibly power-concen-
trated origin of presented, ‘given’ requirements that each and
every individual has to adapt to as best they can, each alone.
A major consequence of individualization in our age is that
the cause, no less than the symptoms (being burnt-out,
lonely, impotent, apathetic, feeling a loss of meaning, being
depressed), appears in an individualized rather than a polit-
ical-structural form, i.e. as depending on the individual, as
self-inflicted, and as a sign of failure or neglect, or lack of
effort. The German sociologist Ulrich Beck has put it like
this: in our society economic-systematic contradictions and
conflicts are transformed into biographical and individual
‘mistakes’, into shortcomings of the kind for which the indi-
vidual only has himself to thank – blame.49
This gives the following picture. While former generations
became ill because of a disciplining that prevented them from
forming and pursuing their own aims and ideals, the people
of today’s option generation become ill because of having to
choose between too many possibilities. The downside of the

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much-celebrated freedom of choice is that choice becomes
compulsory: choice is the one activity from which the indi-
vidual enjoys no escape, no break, no exit. The over-
production of possibilities by the option society – here you
have all possible types of education and training to choose
between, all sorts of occupations, lifestyles, identities – so that
everything is possible, given the multiplying of alternatives
provided by the market in terms of commodities – is not a
luxury problem, tempting as it may be to see it as such. The
normatively charged requirement to realize one’s capacities
and assume responsibility for one’s own life – life understood
as the accumulatively produced sum of all the choices made
– has within a relatively short time become so intense and
omnipresent that it now produces considerable amounts of
pain: it contributes to making individuals ill who have inter-
nalized the requirement. With the Danish sociologist Rasmus
Willig we can talk about ‘an internal tribunal where individ-
uals have to defend their lack of skills and proficiencies
regarding the normative expectations of the option society’.
The question is: isn’t this defence work exhausting in itself?
Willig comments:

The omnipresent suffering from indeterminacy (Hegel’s

Leiden an Unbestimmtheit), the suffering involved in
putting up with changes as the only thing that is per-
manent, in always having to be in motion, thereby
emerges and places the individual in a position of in-
sufficiency where he is left with an eroded self. The
fact that the individual has to maintain the illusion of
everything being possible leads to personal exhaus-
tion.50

We can now glimpse the price that has to be paid for con-
temporary society’s advocated, even dictated, form of
self-realization. It has to do with the price that arises by the

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focus – all demands, all psychological and mental energy –
being directed at the self and not, as in previous ages, at collec-
tively handed-down contexts of order that the individual could
gain support from to a great (although varying) extent, in an
elementary assurance of his identity, his social roles and his
worth – these experienced as relatively stable entities, as some-
thing that was fixed, and out of reach of dramatic shifts and
changes. Now, on the other hand, the individual’s orientation
has made an about turn, zooming in on the resources of the
self, the so-called ‘human capital’ said to reside in each indi-
vidual (employee), the cultivation of which – for competitive
success in the marketplace – is hailed as the prerogative of its
individual bearer. The freedom always to be able to choose
turns into a compulsion to choose the right thing, into a fear of
taking a wrong turning at the ever-growing series of crossroads
that make up contemporary social existence, and so risking
losing momentum vis-à-vis one’s competitors.
The change in mentality I am referring to has made a con-
siderable impact on psychotherapeutic practices. From my
point of view the changes here attest to comprehensive cultural
change. The ‘guilty’ and conscience-stricken individual that
Freud placed at the centre of his analyses, where the neurosis
bears witness to the mental pressure from the conflict between
the individual’s desire and what the norms of society allow and
forbid respectively (internalized in the voice of the superego),
is in the process of disappearing – from theories as well as from
therapy. Present-day individuals do not concentrate on the
division between obedience and prohibition, but on that
between the possible and the impossible – the point being that
the division is perfectly fluid and open to never-ceasing alter-
ation, making it imperative that the individual learns to
negotiate it deftly. What turns out to be possible, and what
impossible, is precisely a question of one’s own ability to seize
the initiative in a world where ‘everything’ is said to be possible,
as long as the individual can make full use of his inner

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resources. Society or the ‘system’ cannot be blamed for wrong
choices or untried possibilities; the individual only has himself
to thank, whether he succeeds or fails.
To be sure, present-day men and women have liberated
themselves from morals in the conventional sense that
applied at the time of Freud. The fear of outer coercion, in
the form of clear prohibitions indicated by unambiguous
authorities, has been replaced by the fear of self-inflicted fail-
ure, of one’s own limitations. The opening up of possibilities
and emphasis on the all-overshadowing importance of indi-
vidual initiative for all of life’s areas means that human
beings have set themselves in motion. The very meaning of
being a human being, of what identity qua being human
centres on, is up for grabs. Nothing is laid down once and for
all. Nature is no longer an unchanging reference and instance
– neither nature in the subject nor that outside, as novel
technologies allow us to intervene into both realms – or
objects – in an object-altering manner unthinkable until
recently. Nor is there any longer any fixed and normative ref-
erence of a transcendental nature, in the form of a god that
sets moral limits and maintains an order. In this context the
French psychiatrist and sociologist Alain Ehrenberg notes
that ‘depression is melancholy in a society where everyone is
equal and free; depression is the illness par excellence in
democracies and market economies’.51 Depression is the
downside of the sovereignty man has achieved via civiliza-
tion, i.e. with the one who is paralysed by possibilities and
unable to act, rather than the one who acts in the (morally)
wrong way. As the moral forms of compulsion decline
(understood as compulsion in the tension and conflict
between individual and society – think of Freud once more),
the purely intrapsychic forms of compulsion increase: the
coercion the subject imposes on himself. The yardstick of
depression is not made up of individual-transcending ideas
about justice but of the displayed ability to act; not of suf-

146
fering under pressure from outside authorities in a world
where so much is forbidden and out of reach but by the indi-
vidual’s revealed fallibility in making optimal choices in a
world where everything is said to be permitted and within
reach. To act is in a strict sense a quality of the concrete indi-
vidual, and it is measured on the outside, just as exposed to
the scrutiny of others as one’s own gaze.
Against this background, depression is the form illness
assumes in the era of self-determination and practical auton-
omy. Sartre’s once so bold thesis – that you are condemned
to freedom and that you ‘are’ your act, that your act defines
you at any time, and that thinking otherwise is a proof of
‘bad faith’ – has become true of society in an age of indi-
vidualization. The ideal of authenticity – admittedly in an
aestheticized version rather than an ethical one, and inter-
preted in a constructivist manner in the form of so-called
continuous staging – has lost its critical historical sting and
has long since been taken over by advertising as the language
everyone speaks; there will soon not be a product that is too
trivial to symbolize the ‘choice of identity’ of the consumer,
signalling who he or she wishes to be. The ideal of the
uniqueness and authenticity of the individual has in no time
at all made a brilliant career for itself as the lubricant of con-
sumerism. While Sartre’s militant, atheistic existentialism,
with its mocking of the formative power of tradition, con-
vention and the classes (especially the hated bourgeoisie)
over the individual’s self-understanding and choice of action
created a furore in the 1940s and ’50s, such individualism is
now the opposite of a philosophical provocation: it has been
caught up by the age and has merged with it. What would be
provocative nowadays is the diametrically opposite move to
the early Sartre’s: to play the collective against the individual,
to give community, tradition and experience priority over
individuality, fixation on the moment and on gaining instant
gratification for all sorts of perceived needs.

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 To sum up: as long as the question was ‘Am I allowed to
do this?’, the individual could to a certain extent blame soci-
ety if he went beyond what was permitted. Society set the
limits for the individual’s actions. In Freud’s classic neurosis
there was thus an element of outward aggression, of the indi-
vidual’s opposition to what society had established. Though
a social critic in his own right, Freud also believed that this
tension between the drives of the individual and the norms
of society in many instances would prove productive,
enabling – by way of sublimation – the overcoming of prim-
itive narcissism and the creation of great works of art and
science. However, as soon as the question changes to ‘Am I
able to do this?’, the aggression that arises in the wake of
doing wrong – now synonymous with choosing wrong, i.e.
non-optimally – is turned inward rather than outward. This
is perfectly in accordance with psychology’s original defini-
tion of depression: depression is auto-aggression, the attack
of the individual on himself. Today, this means that depres-
sion intensifies the paralysis of action that helped produce it
in the first place.
The idea that the individual lives his life in an ongoing
process of self-creation, that we are entrepreneurs should, in
my opinion, be recognized for what it is and what it indeed
functions as: namely, an ideological conception in the nearly
forgotten Marxist sense of the word. That it is far removed
from expressing the truth about human existence is some-
thing I have tried to indicate by drawing attention to what I
call the invariable fundamental conditions of life: depend-
ency, vulnerability, mortality, the precariousness of
interpersonal relations and existential loneliness. It is not
individuals spontaneously and separately but the culture of
which they – we – are members that forms the individuals’
perception of these fundamental conditions, of whether they
are acknowledged or denied, assessed as being meaningful or
something entirely negative that has to be fought against or

148
manipulated or controlled by shifting their reality over onto
certain others so that one can hope to avoid the discomfort
they give rise to. In social reality what is experienced and so
acted upon as true is more important that what may be held
to be philosophically true. The idea of the individual always
and without exception only having to thank himself, only
having his own ‘choices’ to refer to in order to explain why
things turned out as they did, assumes a certain sociological
validity to the degree that more and more people actually
believe it, interpret others and themselves with the aid of it,
and act accordingly. This notion has been encouraged by the
most widespread and discussed sociological diagnoses of our
present time. Such writers as Anthony Giddens and Ulrich
Beck have not been clear enough in their criticism of the vol-
untarism, of the illusion of the almost total freedom of the
individual to create (construct) and recreate himself that so
obviously fits like a glove the view of the market as the arena
of freedom (i.e. of all choices) in particular and with the
entrepreneurial view of humanity in general. Seen from the
point of view of this ideology the young people of today are
to be considered ‘life project constructors’ obliged to keep all
their options open as long as possible and constantly main-
tain the ability and willingness to re-choose. Whatever you
do, whatever you attempt, do not let anything stick to you.
Never rest on your laurels. Do not take anything for granted.
Remember that the only sure thing is that everything is in a
state of flux, that everything you have gathered in the form
of knowledge, experience and competence can tomorrow be
said to be outdated (or to have exceeded its shelf life). Always
remember you have to sell yourself to survive. Work on the
ongoing perfection of the commodity that you are.
Richard Sennett talks about the ‘corrosion of character’.52
The corrosion must be seen in connection with the exhaus-
tion that results from the individual constantly having to
consider and restlessly assess and re-assess his choices (those

149
taken and those to come) and to update his mental capaci-
ties. The demands of the workplace as regards flexibility,
mobility and ability to adapt lead to disorientation and grad-
ually to a meltdown or dissolving of the personality, of the
intactness and vitality of the self, if we are to believe Sennett’s
empirically based analysis. In a society where work continues
to maintain its position as a key element in the individual’s
sense of self-worth, increased competition and the compul-
sion to be flexible lead to a permanent fear of losing one’s job,
of being weighed and found wanting, at any time at all. The
individual is taking part in an uninterrupted exam; he ends
up constantly chasing his own rentability and his ability to
sell himself, not only to a potential employer but also as a
general asset. Attractiveness, understood as present market
value, has become the standard of evaluation that all arenas
have in common, no matter how dissimilar they otherwise are.
As a consequence of his fear of falling short, of falling through
or landing up on the outside of society and becoming ostra-
cized, the individual must always be at top-performance level,
even though he does not have the necessary time to concen-
trate. And to the extent a space for stillness and contemplation
should happen to arise, the individual starts wondering what
can be done with it – apart from instrumentalizing it in the
form of ‘recharging the batteries’. Did someone say quality
time? Ask the youngsters. Quality time is when dad is out with
the kids and still has his cell phone on, since switching it off –
even in the evening and at the weekends – is regarded as taking
time out and thus committing the mortal sin of not being
accessible. The dream of consumerism, to create a situation of
instant gratification of all one’s wishes, catches up with and
engulfs individuals in the selfsame dynamics – in the form of
the unlimited accessibility of the individual, exemplified by the
entry of email at all workplaces and in all modern homes with
career-conscious adults and (especially) by the omnipresence
of the cell phone. Where are the free spaces where the pressure

150
to perform and the anxiety it produces are conspicuous by
their absence? Where – to shift the emphasis slightly – are the
possibilities of developing a freedom from the role of consumer
and customer?
There are many reasons for such free spaces becoming
fewer. For a start, consider the changed role of medicine. In
modern Western society, people do not expect to find the
meaning of life by turning towards an inherent cosmic order
(the thinking of antiquity), towards an all-powerful God, or
towards moral authorities in society. Instead, they expect to
find it by turning inwards. As I touched on earlier, authen-
ticity – the ideal with roots in Romanticism of being in
contact with one’s innermost feelings, wishes and aspirations,
understood as marking one’s uniqueness – has attained a key
position in recent times. The language of authenticity has
become a natural way of describing all this inner world that
the individual carries around with him. What is relatively
new, however, is how medicine in general and doctors in par-
ticular now participate in the efforts to realize the wish for
self-change. Over the last couple of decades doctors have
begun to offer physical treatment to alleviate psychological
and social problems. Synthetic growth hormones are given to
boys to help them avoid the stigma of being short; Propecia
is given to middle-aged men to help them avoid the stigma
of being prematurely bald; shyness has recently become diag-
nosed as a distinct psychopathology – one can only wonder
what’s next . . . Gradually, as the increase of psychological
wellbeing is regarded as a legitimate aim for modern medi-
cine, there has been a tremendous rise in the medical states
that can apparently be treated.
Again, I am not denying that this development has many
good sides to it. Nevertheless, in the context of our discus-
sion here we need to ask a question concerning what I shall
call ‘cultural complexity’. While on the one hand we find it
difficult to condemn individuals (often people we know)

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who, for example, use plastic surgery to transform themselves
in accordance with prevailing aesthetic standards, it must on
the other hand be admitted that these ‘aids’ contribute at a
social level to consolidating and strengthening the problems
it set out to solve. The more people in East Asia use cosmetic
surgery to make their eyes look more European, the stronger
the social norm becomes that says that East Asian eyes are
something one ought to be ashamed of and therefore some-
thing the individual must be responsible for doing something
about, insofar as such transformation has now become pos-
sible: there’s a market out there offering remedies and
promising improvement. The list of examples of the same
phenomenon is long: just think of pale skin, large breasts,
‘Jewish’ noses and big butts. There is no end to the list.
The pressure from the market, from leading commercial
companies, intensifies the trend. Anti-depressants have been
the most profitable type of pills in the United States for sev-
eral years now. The troubling fact, however, is that
anti-depressants are not only used to treat serious clinical
depression. To an increasing extent, they are used to treat var-
ious forms of social anxiety, post-traumatic stress symptoms,
various forms of compulsive behaviour, eating disorders, sex-
ual obsessions and compulsions, premenstrual dysphoric
troubles, etc. Once again, the list is continually being added
to, without stopping at any natural and necessary final point.
Several of the disorders I have listed were considered either
rare or non-existent until recently. But as soon as a pharma-
ceutical company develops a treatment for a psychological
disorder, it has a vested economic interest in ensuring that
doctors make the diagnosis in question as often as possible.
The more people who become convinced that they have a
disorder and who are persuaded by experts and advertising
that it can be treated, the more medicines the company will
be able to sell. And, as we have seen, the more customers, the
stronger the social pressure on those with the disorders in

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question who have yet to visit the market and make use of
what is on offer. When cosmetic surgery is becoming more
and more normalized, this just raises the bar, so that what
looks beautiful today will look less beautiful tomorrow. The
huge fashion industry, by creating iconic figures – celebrities
– of worldwide fame and reach, insists that it promotes indi-
viduality and variation. But the effect is the opposite: it is to
suck out variety and to undermine the confidence of the large
majority of not-so-famous people that their – meaning my –
looks, and so my difference from those deemed iconic mod-
els of beauty, are perfectly ok as they are, and so in no need
whatsoever of makeover and ‘improvement’.
This being so, what is worth criticizing about this mixing
of psychology, medicine and commerce is the lucrativeness
of putting pressure on people’s self-esteem and constantly
reminding them of ‘faults’ that can be removed or relieved.
Generally speaking, the consumerism driven by present-day
global capitalism thrives on making us detest our bodies and
being dissatisfied with our looks. Anxious and needy, we are
better customers. To be comfortable with and so ready to rest
content with the way we are and the way we look, would
indeed be disastrous for capitalism in general and the self-
help industries in particular. Even more important to my
main argument is another aspect, however. What does the
development in question tell us about pain, about the view
of pain and about tolerance regarding what I call invariable
fundamental conditions?
I cannot help but see the advance of medicinal technolo-
gies – self-modification technologies – and their status as ‘the
solution’ to ‘problems’ as a new stage in our culture’s yearn-
ing for mastery. The technologies reflect a sensibility where
the world is seen as something to be manipulated and con-
trolled. Positive eugenics (i.e., that parents shall have the right
to determine their children’s genetic profile, so as to optimize
their preferences) can be seen as a sign that as a culture we

153
are in the process of ‘playing God’.53 I am concerned about
this sensibility’s lack of humility: the arrogance of having
such a boundless belief in man-made technology being able
to ‘solve’ all ‘problems’ connected to our imperfection in both
a physical and a (wide and increasingly over-stretched) psy-
chological sense. The step from declaring that something
ought not to be to attempting to make sure in the future that
it will not be is also short. Here I am not just thinking of all
sorts of psychological afflictions (what used to be referred to
as ‘complexes’) but also of fundamental aspects of what it
means to be a human being; aspects which until recently
have been viewed as unchangeable, such as ageing and, ulti-
mately, death. The presumption I am referring to consists in
changing, redefining and transforming what initially was
non-optional, and as such given unrequested, to something
optional, something that is an object of choice, of forming,
of a repertoire of alternatives, made accessible by new tech-
nological discoveries. A twofold promise is being made: on
the one hand, enhanced self-confidence and sellability; on the
other, the reduction or, ultimately, end of pain in one’s life.
Both promises are presented as within reach in the form of
so many incessantly ‘improved’ products in an ever-expand-
ing ‘lifestyle’ and ‘quality of life’ market – a market targeting
the most well-off segments, to be sure, yet effecting a change
in how people in general tend to look on such a phenome-
non as ageing. Across socioeconomic and class-based
divisions, pressure is growing to make use of and so profit
from the methods now emerging to fix or preempt whatever
imperfections one becomes aware of. The hubris at work in
this whole development consists in individualizing the trans-
formation of the non-choosable to the choosable, i.e. placing
the responsibility for a successful development of the possi-
bility of making choices on the shoulders of the single
individual, ‘liberated’ as he is said to be from collective bonds
as well as supernatural authorities of every kind.

154
 My normative assertion is that the limitless freedom to
choose, to choose between an ever-increasing number of
alternatives in an ever-increasing number of areas of life, is
actually for very many people the exact opposite, i.e. an
increased – and ever-increasing – coercion of choice. Fur-
thermore, by this coercion being linked to every single
individual, as the very proof of that individual’s ability to take
‘responsibility’ in the form of demonstrated self-modifica-
tion and self-improvement, the pressure increases to choose
correctly, to always use one’s energies in an optimal way, to a
point where this takes the form of self-exhaustion, apathy
and depression. The result of contemporary culture’s formi-
dable efforts to master pain in existence, namely by trying to
outwit all the sources of pain within man as well as the out-
side symptoms, seems to be that life becomes more painful,
not in a physical sense, but in the sense of psychic stress.
When everything that exists is open to intervention for the
sake of so-called improvement, when nothing can be allowed
to remain as it is, when every achieved change has to be
replaced by and outdone by new and yet newer ones, when
the psyche – the identity, self-esteem – is included in the all-
encompassing imperative of self-modification just as much
as are our physical natures, it is high time to ask the question
of what – and whom – this tyranny in the name of freedom
and individuality is really benefiting.

155
 Conclusion

In what was to be her last book, Regarding the Pain of Others, Su-
san Sontag contrasts the religious and secular views of pain. In
an understanding rooted in religious conceptions, it is possible
to see pain – even extreme pain, even that of a child – as some-
thing more than pain by linking human suffering to sacrifice and
renunciation, and thus to exaltation, the gaining of a higher spir-
itual level, beyond the frailty and (apparent) meaninglessness of
earthly life. For the modern sensibility, on the other hand,
shaped as it is by the loss of religion’s authority, in terms of both
morals and interpretation, it is impossible to see anything else
than sheer negativity in pain, understood as human suffering:
‘Suffering is regarded as something that is a mistake or an acci-
dent or a crime. Something to be fixed. Something to be refused.
Something that makes one feel powerless.’54 In short, pain in the
form of suffering has assumed for us today the form of what ab-
solutely should not exist, what is completely without purpose
and justification. A kind of metaphysical fault, in other words –
something faulty about the world, perhaps? Or an anthropo-
logical fault – something faulty about us humans? Or both?
Suggesting an answer to ‘Why pain?’ can easily appear like
allying oneself with the – highest earthly – powers that actively
inflict pain, that assert that the suffering they cause has a pur-
pose, one that justifies it. Let us instead take the question in
a different direction.
Elaine Scarry records a shift in society’s attitude towards
pain from the nineteenth to the twentieth century, a shift that

156
is still getting stronger. She quotes various aphorisms by the
most prominent thinkers and writers of the nineteenth cen-
tury. Karl Marx wrote: ‘There is only one antidote to mental
suffering, and that is physical pain.’ Oscar Wilde: ‘God spare
me physical pain, and I’ll take care of moral pain myself.’ And
George Eliot lets one of the characters in a novel remark that
‘physical pain might lift me out of my self-absorbed boredom
long enough to help me avoid damaging myself’.55 Only a cen-
tury – the twentieth – that produces previously unattainable
material and physical welfare for humanity (more precisely,
for the best-situated classes) can develop an endless fascina-
tion with the details of psychic pain, discomfort and disorders.
Earlier eras were on the other hand familiar with the privileges
implicit in psychiatrically diagnosed madness.
Scarry is drawing our attention to something important.
She apparently believes that it is the prejudice of our age that
psychic pain is more powerful than physical pain, that sig-
nificance and meaning – so central to twentieth-century phi-
losophy, especially existentialism – are determined by mental
rather than physical reality, by a subject-related relationship
rather than anything objective; that the physical is psycho-
logically as well as morally inferior, second-rate, measured
against the mental.
Is this how it is? Have we who live today forgotten the
dominance of physical pain over psychic pain – over all men-
tal (cognitive as well as affective) content whatsoever? Have we
forgotten the validity of Scarry’s remarks such as: ‘Physical
pain is able to obliterate psychological pain because it oblit-
erates all psychological content, painful, pleasurable, and neu-
tral. Our recognition of its power to end madness is one of the
ways in which, knowingly or unknowingly, we acknowledge
its power to bring to end all aspects of self and world.’56
What is the message? That the above – dwelling, so typi-
cal of the age, on the individual’s exhaustion and the mental
sufferings that accompany it – is to be thought of as a luxury

157
problem? Does not the fact that psychic pain in our era seem
to overshadow physical pain betray the fact that we are in the
process of forgetting what real pain is? Could the truth be that
the obsession with our own welfare, our own success and per-
fection, both of and in the purely external, is a sign of – pos-
sibly morbid – narcissism? That since the problem of pain is
well on the way to being resolved in our society, as that of
hunger is, we are investing increasing amounts of energy – in-
cluding the latest innovations within psychotherapy and bio-
medical technologies – in the ostensible ‘combating’ of what
objectively seen are ever-diminishing problems, ever more
trivial forms of pain, in an age where pain in some strange way
has become identical with ‘mental’ pain, to the almost com-
plete disparagement of physical pain?
Scarry’s reminder that physical pain not only subjectively
but in an undeniably objective way is to be regarded as the
pain par excellence given humanity’s constitution, is certainly
pertinent. As she points out, once intense physical pain first
occurs, it removes everything else from our consciousness and
bodily sensual perception. It reduces to nothing the self that
has a world – and the world only an intact self can have. This
reminder is an important corrective to the priority of the
mental which is increasingly being taken for granted in our
culture-formed perception of pain, and which has – for good
or bad – informed my discussion in this book.
As we have seen, pain born of physical wear and tear has
diminished in our society at the same time as pain nurtured
by psychological stress has dramatically increased. In the
above analysis one of the aims was to show that in times of
comprehensive societal change violent pressure is exerted on
the single individual. In our age the individual is conceived as
the instance where everything has both its beginning and its
end – as the yardstick of all values. When the individual be-
comes his own yardstick, when the relation to the self becomes
the place where success is to be developed and evaluated,

158
where all required resources and capacities are to be acquired
and the batteries recharged, the consequence is that the risk
of a solid ‘Erschöpfung an sich selbst’ (Hegel) – the exhaustion
of the self from itself – is intensified. This pain is conspicuous
by its absence in Scarry’s perspective. Can it compete with
physical pain (in Scarry’s sense of the term, bound to the
body) as the most painful that a human being can experience?
What can be said to be pain’s trump card, the pain over all
pains, is perhaps not the most important thing. Whether it is
physical or mental, or a combination of both, pain is equi-
primordial with human existence as such, and must always be
lived – tolerated – by the single individual; although it is
more shareable with others, more accessible for cultural sym-
bolization, than Scarry would have us believe when she allows
physical pain to be a paradigm for the phenomenon of pain
as such. If we ignore torture and illness/injury, physical pain
is the product of necessity, of the wear and tear of the body,
its efforts and occasional exhaustion in man’s interaction with
outside nature. Wear refers to work, to the loads imposed by
physical labour. For most of us, that pain – born of necessity
and compulsion, as opposed to being sought voluntarily –
belongs to a bygone age. Our pain – yes, let us say our, not
even mine or yours, in accordance with the ideologically pos-
tulated either/or of individualization, also within the field of
pain – is a quite different pain. It is, most simply expressed,
the pain of still being vulnerable to the reality of pain, as hu-
manity has always been – with the important historical and
cultural difference that everyone today tolerates his own vul-
nerability just as badly as that of others.

159
 references

1 Elaine Scarry, The Body in Pain: The Making and Unmaking of

the World (Oxford, 1985), p. 57.
2 Ibid.
3 Per Nortvedt, personal communication, 2004.
4 See Stanley Leavy, The Psychoanalytic Dialogue (New Haven,
ct, 1980), chap. 1.
5 Sigmund Freud, Beyond the Pleasure Principle (London, 1984).
6 Jon Morgan Stokkeland, personal communication, 2004.
7 Sigmund Freud, Mourning and Melancholia (London, 1984).
8 Jean-Paul Sartre, Being and Nothingness (New York, 1956), p. 104.
9 See Jean-Paul Sartre, Sketch for a Theory of the Emotions
(London, 1971).
10 Finn Nortvedt and Per Nortvedt, Smerte – fenomen og forståelse
(Oslo, 2001), p. 60. See also Maurice Merlau-Ponty, The Pheno-
menology of Perception (London, 1970).
11 Nortvedt and Nortvedt, Smerte – fenomen og forståelse, p. 72.
12 See Martin Heidegger, Being and Time (New York, 1962).
13 David Riesman et al., The Lonely Crowd (New Haven, ct, 1950).
14 Heidegger, Being and Time, pp. 269ff.
15 Alv Dahl and Eva Dalsegg, Sjarmør og tyrann. Et innsyn i psyko-
patens og ofrenes verden (Oslo, 2001), p. 167.
16 Eva Tryti, ‘Dagliglivets ondskap’, Samtiden, iv (2002).
17 Alice Miller, For Your Own Good (London, 1987); The Untouched
Key (London, 1990).
18 See Melanie Klein, Love, Guilt and Reparation and Other Works,
1921– 1945 (London, 1988).
19 See Freud, On Metapsychology (London, 1984), pp. 290ff.
20 See Svein Haugsgjerd, Lidelsens karakter i ny psykiatri (Oslo,

161
 1990), p. 307.
21 See Klein, Envy and Gratitude and Other Works, 1946–1963
(London, 1988).
22 Haugsgjerd, Lidelsens karakter I ny psykiatri, p. 309.
23 Ibid., p. 314.
24 See Hanna Segal, ‘On Symbol Formation’, in The Work of
Hanna Segal (London, 1986).
25 Max Horkheimer and Theodor W. Adorno, The Dialectic of
Enlightenment (London, 1974).
26 Klein, Envy and Gratitude.
27 C. Fred Alford, What Evil Means to Us (New Haven, ct, 1997),
p. 108.
28 Ibid., p. 102.
29 Ibid., p. 126.
30 See Colin McGinn, Ethics, Evil, and Fiction (Oxford, 1999),
pp. 70ff.
31 Heinrich Himmler quoted in Gitta Sereny, The German
Trauma (London, 2000), p. 295.
32 Alford, What Evil Means to Us, p. 108.
33 Alford, The Psychoanalytic Theory of Greek Tragedy (New
Haven, ct, 1992), p. 63.
34 Thomas Ziehe and Herbert Stubenrauch, Ny ungdom og
usædvanlige læreprocesser (Copenhagen, 1983).
35 Stig Rune Lofnes quoted in Aftenposten (9 August 2004). See
also Knud E. Løgstrup, The Ethical Demand (Pittsburg, 1994).
36 Lill Scherdin, Kontrollkulturer og etikk satt på spissen (Oslo,
2003), p. 608.
37 Loic Wacquant quoted in Scherdin, Kontrollkulturer, p. 614.
See also Pierre Bourdieu et al., The Weight of the World
(Oxford, 1999).
38 Elliott Curries quoted in Scherdin, Kontrollkulturer, p. 614.
39 Regina General, ‘Qualen macht spass’, Freitag (18 June 2004).
40 See Arne Johan Vetlesen and Jan-Olav Henriksen, Moralens
sjanser i markedets tidsalder (Oslo, 2003), chap. 1.
41 See Pierre Bourdieu, Distinction (London, 1984).
42 Roy Andersson, Vår tids redsel for alvor (Oslo, 2003), pp. 17f.
43 See Zygmunt Bauman, Freedom (London, 1988) and Richard
Sennett, Respect in a World of Inequality (New York, 2003).

162
44 Finn Skårderud, ‘Tapte ansikter’, in Skam, ed. Trygve Wyller
(Bergen, 2001), p. 49.
45 Ibid.
46 Emile Durkheim, The Suicide (London, 1964).
47 C. Fred Alford, Whistleblowers: Organizational Power and
Broken Lives (Ithaca, ny, 2001).
48 See Zygmunt Bauman, Globalization: The Human
Consequences (Oxford, 1999); Liquid Modernity (Oxford,
2000).
49 See Ulrich Beck, Risk Society: Towards a New Modernity
(London, 1992).
50 Rasmus Willig, ‘Optionssamfundet og dets patologiske
udviklingstendenser’, (Roskilde, 2002), p. 17.
51 Alain Ehrenberg, ‘Die Müdigkeit, man selbst zu sein’, in
Endstation. Sehnsucht. Kapitalismus und Depression, ed.
Claudia Hegemann (Berlin, 2000), p. 125.
52 Richard Sennett, The Corrosion of Character (New York, 1998).
53 See Jürgen Habermas, The Future of Human Nature (Oxford,
2004).
54 Susan Sontag, Regarding the Pain of Others (London, 2003),
p. 88.
55 Elaine Scarry, The Body in Pain, p. 33.
56 Ibid., p. 34.

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