Rusty Gentry

Independent scholar
rgentry7@charter.net

Pain, Addiction, Patience, and Possibility: A Phenomenological Exploration of

Chronic Pain and Addiction

Abstract:

In this paper, I address the issues of chronic pain and addiction within the
context of a Levinasian framework, giving special attention to the notions of
freedom, consciousness, the will, and patience. Initially, I address the
character of pain, using Levinas to elaborate a phenomenology of pain. I then
make a distinction between two types of pain: acute and chronic. I show how
chronic pain essentially over-determines the will. In so doing it presents a
serious threat to our very self-identity by locking us in something like an
eternal present dominated by the consciousness of pain. In short, chronic pain
involves us in an ordeal of freedom, the outcome of which may very well be
addiction. Here I elaborate the notion that addiction, while arresting the
eternal present of chronic pain, constitutes a more significant menace than that
presented by pain in and of itself by virtue of the fact that it limits even the
possibility of our conceiving of the future as a space of freedom. Addiction is a
totalization. It makes one hostage to a future radically foreshortened by the
imperative that one answer its only call: to fill the hole it has excavated in us.
I show that addiction involves us in a cognitive, physical, and moral quagmire.
Finally, I use Levinas’s work to point the way out of this situation. In
particular, I develop his notion of patience showing that it offers the
possibility for the addict to reconceive the future as a space of meaning,
freedom, and moral recovery.

“By the grace of time, my friends!” Athos explained, “time is the father of
opportunity; opportunity is the martingale of man.”
Alexander Dumas, The Three Musketeers

I. THE CHARACTER OF PAIN

Pain, as Levinas contends in Time and the Other, nails us to the instant. He
explains that “The content of suffering merges with the impossibility of detaching
oneself from suffering. And this is not to define suffering by suffering, but to
insist on the sui generis implication that constitutes its essence. In suffering
there is an absence of all refuge” (T&O,69). In pain we are entirely engaged in,
embattled by existence. Physical pain is the issue here, though as Levinas notes,
this pain can only be “lightly called physical.” Despite the apparently
counterintuitive nature of the assertion pain, even pain “of the body,” is
primarily a conscious, which is to say mental, phenomenon, not a physical one.
One may maintain, in fact, that pain is insignificant until it reaches a certain
intensity at the level of consciousness. Levinas characterizes this settling of
pain into consciousness as “The privileged situation where the ever future evil
becomes present—at the limit of consciousness—is reached in the suffering called
physical” (T&I, 238). Such suffering is especially problematic for one who has
chronic pain, for one who suffers day-in-and-day-out from the same dominating
consciousness of pain.

Indeed, in pain there is no other consciousness. Or rather, there is no

consciousness that can compete with it. Pain teaches us in an exemplary way that,
phenomenologically, there are layers or formations of consciousness. Chronic pain
is by definition, a strong formation. All else – hunger, desire, pleasure – is
weak in comparison. At least initially, until the long process of learning how to
cope with such chronic, quotidian pain is achieved – in so much as it can be —
there is little else in life for the sufferer. Chronic pain is dominating. It is
dominating precisely because it is manifested not primarily at the physical level,
but at the level of consciousness. It strips us of our freedom, which is to say
of our futuriority, of the condition of the possibility of possibilities, as
Heidegger might say. We are not allowed to envisage the future because we are
necessarily over-determined, immersed in the present.

Levinas tells us that consciousness is what allows us to avoid and resist

violence, because it leaves us time, and time – the future of which we spoke above
– is the medium of freedom. “To be conscious is to have time—not to overflow the
present by anticipating and hastening the future, but to have a distance with
regard to the present. . . To be free is to have time, to forestall one’s own
abdication under the threat of violence” (T&I, 237). This freedom, however, is
precisely what is stripped from those who suffer from chronic pain. The violence
of chronic pain cannot be forestalled; it is always already present in the form of
strong consciousness. To be in pain is to be conscious of an Other from which no
goodness can come. There is no freedom for those in chronic pain because this
type of consciousness entails the “impossibility of detaching oneself from the
instant of suffering” (T&O, 69). Thus, to be in chronic pain means to lack a
certain consciousness of freedom and to be exposed to the violence of being at all
times. “It is,” to cite Levinas again, “the very irremissibility of being” (T&O,
69).

Pain not only creeps into and determines consciousness in general, it is

especially transformative of our self-consciousness. It profoundly affects the
way that we experience our power over life and its vicissitudes. Suffering
violates one to the very core of one’s being. Pain transfigures one’s self-
conception; it may irremediably cripple it. In its grips, one cannot feel
protected in oneself from oneself. Levinas argues that the fear of death is one
that is constantly deferred, “whereas suffering realizes in the will the extreme
proximity of the being menacing the will” (T&I, 238). Here the connection to pain
of the body and our experience of it in consciousness is abundantly clear.

II. TWO TYPES OF PHYSICAL PAIN

At this point we must explicitly distinguish between two types of physical pain:
chronic and acute. The body and consciousness react to these in analogous, but
different ways. Acute pain is intense, short-lived pain. For example, that which
is experienced after surgery or a broken bone is disabling in a way that severely
affects certain bodily activities. When one breaks one’s arm, it cannot be used
for a period of time. It is expected, however, that such pain and the
accompanying disability will abate as the body heals. The psychological
consequences of acute pain are of a particular nature because of the knowledge
that, though one may be unable to perform a particular action, X, at the present
time, this function will soon be regained. Despair may be avoided by the
awareness that the future offers respite. Acute pain thus does not fully qualify
for the description of pain given above. While such pain may very well and most
often does make one a hostage to the moment, the psychological effect is soon
alleviated. This alleviation is the result of the gradual dissipation of the
mental and physical manifestation of the pain, as well as, knowledge of the fact
that such pain, along with its accompanying disability, will soon no longer affect
one’s body. This knowledge makes a qualitative difference in the way that pain is
experienced.
Similarly, understanding that pain is chronic in nature has qualitative effects of
its own in terms of how it is experienced. Here we step into the profoundly
disconcerting psychological realm that was elaborated in Section I. Chronic pain
is persistent in nature, becoming the baseline of one’s existence. Moreover, it
is generally accompanied with a permanent disability. It is often the case,
however, that the disability is as much perceived as it is real. This perception
is the result of the scarring psychological effect of ongoing pain.

For instance, one of the most important activities for those suffering with some
types of chronic pain is to exercise the affected area, perhaps alleviating the
effect of the injury insofar as one strengthens the surrounding musculature. The
resolution to carry through with such activity, however, proves to be very
difficult for many. This is not only because of the actual pain involved in the
activity; there is also the anticipation of pain or the exacerbation of existing
pain. Of course, the less the sufferer exercises, the more muscles atrophy thereby
potentially increasing pain because of a lack of support to the injured area.
Moreover, one is more likely to re-injure an area that is weakened by non-
activity. Fear, however, plays a major role here, a fear not just of present pain
but of pain to come, which can easily lead to a Sisyphean cycle the results of
which may very easily, given what is often the necessity of a regimen of narcotic
intervention, become addiction. The logic here is quite simple and ultimately
devastating. One takes medication in order to alleviate present pain. Even if
this medication works in that instance there remains the fear of pain to come.
This can lead to taking additional medication in anticipation of future pain,
which as we will see, results in a radical delimitation of the very notion of the
future. The physical limitation of such pain is thus often as much the outcome of
the consciousness and fear of pain as it is of the “thing-in-itself” – the
physical injury and proximate cause.

III. THE ORDEAL OF FREEDOM

Chronic pain is maddening. While making the sufferer absolutely aware of the
present instant, it awakens the despair of the impossibility of retreat, not now,
not tomorrow, perhaps not ever. In pain, the “I” is turned into a thing that is
subjected in the most insidious of fashions. This subjugation is tantamount to a
lack of possibilities, a lack of freedom: “Suffering remains ambiguous: it is
already the present of the pain acting on the for-itself of the will, but, as
consciousness, the pain is always yet to come” (T&I, 238). One who lives with
chronic pain must endure this double bind of suffering. Chronic pain never exists
in this simple present elaborated by the indexical now; this suffering must also
always be considered in the future. It will be there. This is one of the primary
aspects of despair for the sufferer. Such constancy compounds the effects of pain,
both physically and psychologically. Chronic pain is thus as dangerous to the
soul as is moral pain. In chronic pain, we are likely to give ourselves over to
the moral equivalent of masochism. Suffering becomes the focal point of life.
Many hostages to pain of this nature, intensity, and endurance would certainly
agree with Levinas that “The supreme ordeal of freedom is not death but suffering”
(T&I 239). In suffering there is the tendency to become absolutely self-absorbed,
to revel in the impotence of one’s egoism.

Here we are exposed to the paradox of suffering, which is ultimately a paradox of

identity. Chronic pain is a phenomenon that makes one different from oneself in a
radical way. This difference may well become a negative identity. While
despising oneself, one gives in to masochistic self-pity. It places one in the
position of the Other for whom one can do nothing, in whose presence one feels
impotent. Too often the result is that persons in pain are so self-absorbed by
this Other that they ignore all others. Chronic pain can force itself into our
being to such an extent that it becomes something with which we identify entirely.
Thus, this type of pain is an instance of difference which obliterates difference
in its insistence on total identification.

If self-absorption is one false escape of chronic pain, there is another more

ravaging type of escape, one which falls at the extreme limit of this absolute
identification: addiction. Indeed, freedom undergoes what is one of its greatest
ordeals in addiction. In Totality and Infinity, Levinas maintains that human
freedom lies in the future. In the case of addiction, we have an instance where
this dictum does not hold. In fact, addiction is entirely about the future and
enslavement.

Pain nails us to the present moment, with little possibility for retreat.
Narcotics offer one of the few possibilities for relief from chronic pain.
Narcotics, however, can often be a devastatingly Janus-faced retreat, insofar as
the dependency that is an unavoidable aspect of prolonged narcotic use may all too
easily tilt into over-dependence, i.e., into addiction.

Addiction mimics a retreat. It appears to offer a dulling of our pain in every

sense, that is, physically and morally. In fact, addiction is a retreat into the
future; it is entirely future oriented. Once addiction has taken hold, even in
one’s most painful moments the future is all that matters: one is forever looking
for the next fix. This phenomenon is, of course, self-perpetuating. Addiction is
a totalization. There seems to be no opening through which the addicted person
can escape. Taking drugs is no longer a choice; it is a physical and
psychological imperative. In the grips of this totalitarian regime, there is no
possibility for the other; one is entirely self-absorbed and future oriented.
Moreover, one does not object to this self-absorption. The necessity of addiction
is so great, in fact, that such a state is nothing out of the ordinary. The other
cannot exist for the addicted person, because narcotics dull both physical and
moral pain. This surcease of suffering is what allows for the extent of the self-
absorption, for the total lack of care that is a primary aspect of addiction.

IV. SUFFERING, ADDICTION, AND PATIENCE: POSSIBILITIES.

How, then, may one “escape” from such pain, from the prison of addiction? The
promise of such an escape will be derived from a particular understanding of
patience, and how patience allows for a re-assertion of the will, a re-conception
of the future, and thus, the re-covery of a certain freedom, which seemed so
hopelessly foreclosed earlier.

In the section of Totality and Infinity, entitled “Time and the Will: Patience,”
Levinas insists that the will contains a contradiction: on the one hand, “an
immunity from every exterior attack to the point of positing itself as uncreated
and immortal, endowed with a force above every quantifiable force,” on the other
“the permanent fallibility of this inviolable sovereignty, to the point that
voluntary being lends itself to techniques of seduction, propaganda, and torture”
(T&I, 237). Thus, we have a picture of the will as both unmoved mover, suzerain
of its universe, and as potter’s clay, infinitely malleable by corrupted sources;
“it remains on this moving limit between inviolability and degeneration” (237).

In addiction we are caught precisely in this liminal space. The will of the
addict ardently wishes to believe itself to have mastered life and its
vicissitudes. Yet, as we have seen, this is merely a self-protective delusion,
sustainable only by virtue of the immediacy of narcotic self-absorption. Instead,
what we have described is a picture of the will which has succumbed to the
seduction of narcotic oblivion in an attempt to rid itself of the grinding
presence of quotidian pain. The battle between these two points of view rages
constantly for the addict.

Such a holding-pattern of instability is the ultimate threat to the will,

endangering its very existence. Yet, faith is to be retained, for this see-saw of
inversion constitutes only a threat and not a final determination. That is to
say, this threat is pushed indefinitely into the future; it is postponed. The
vehicle of this postponement is consciousness, which contains as its primary
constitutive aspect the immanence of time. “Consciousness is resistance to
violence,” Levinas argues, “because it leaves the time necessary to forestall it.
Human freedom resides in the future” (T&I, 237).

But, how does this not constitute a contradiction? After all, have we not
spoken of the suffering of the addict, of the debilitating condition of being in
which the future, far from being the arbiter of freedom, is instead the insidious
iron spike which crucifies us to the eternal present? Was the situation not such
that the demands of the future predetermined each approaching moment, thereby
eradicating the very possibility of meaning in any significant sense?

Quite simply, there comes a point for the addict when consciousness hits a wall.
It is at this point that the choice is made. It is an astoundingly simple one,
despite the infinite complexities of its final determination. For consciousness
not only contains the sparks of the resistance of violence, it also contains the
sparks of violence’s conflagration. The will may self-eradicate; it is a
possibility: suicide. Indeed, addiction is, by definition, symbolic suicide. On
the other hand, the choice – which, as we will see, is a choice that is
nevertheless not a choosing – may be made to allow for the expansion of a space
for possibilities to be elaborated by the immanent powers of consciousness. It is
worth while to repeat here: “To be conscious is to have time – not to overflow the
present by anticipating and hastening the future, but to have a distance with
regard to the present: to relate oneself to being as to a being to come. . . To
be free is to forestall one’s own abdication under the threat of violence” (T&I,
237). This choice, enabled by something analogous to a loss of consciousness,
which for all that is not an end of time, is the gathering of patience: a
paradoxical choice not to choose. Importantly, patience allows for the double
possibility of escaping the penury of the future imposed by addiction as well as
the overdetermination of the present that constitutes the menace of chronic pain.

There is a lacuna created by this opening of consciousness to the present. It is

possible for consciousness to pull itself up short and to comprehend time as the
concrete medium of its power to endow the will with the dream of reclaiming
possibility in both a renewed present and future. In Ethics and Infinity, Levinas
speaks of time as the medium of the enlargement of existence, “time is not a
simple experience of duration, but a dynamism which leads us elsewhere than
towards the things we possess. It is as if in time there were a movement beyond
what is equal to us. Time as a relationship to unattainable alterity and, thus,
interruption of rhythm and its returns.” In time there is thus a double
movement. There is an awakening of consciousness but also an interruption of
one’s present circumstances, with the promise – a promise without content, but
suffused with the power of affirmation – of the possibilities fulfilled through a
consciousness with that which is other than that of our current situation. Such
an “interruption of rhythm and its returns” is the condition of the possibility of
a return to a consciousness of the future as freedom for the addict and also of a
reaffirmation of the present as the immanence of a promise that there is something
beyond pain for one who suffers chronically. To have one’s consciousness
resurrected in such a way is to give birth to what Levinas calls the “heroic will”
(238).

It is thus through the vehicle of time and our ex-ercise of the will within it
through patience, that the subject escapes definition and retains an indeterminacy
opening the door for faith, for the possibility of what may come. Time here, not
the vehicle of intentionality, but the opportunity to open oneself up to patience,
a passitivity which is nonetheless affirmative and productive. It is truly a
mystery how any addict calls forth the fortitude to rediscover the future as a
realm of possibility and freedom, that is, to give allowance for the elaboration
of patience. Perhaps it relates to what Levinas, elsewhere, calls the “holy” in
us. Inexplicable as it may be, there are many addicts who do embrace this space
of freedom. A space wondrously allowed by time, which provides us with a
multitude of possibilities, thereby arresting the determination of the present.
“And,” Levinas argues, “this gives meaning to initiative, which nothing definitive
paralyses, and to consolation,” that is, to faith in that which may come. In this
way the present is deferred in its consummation in a way that has been radically
foreign to the addict, as well as to the original prisoner with whom we have dealt
the one in chronic pain. Both the future and the present may thereby be
reconceived.

This is not to say that the hostage is suddenly free in a markedly different way,
released from bondage, as it were. Indeed, the very possibility of transformation
blossoms from a uniquely precarious stem. Levinas maintains that “This situation
where the consciousness deprived of all freedom of movement maintains a minimal
distance from the present, this ultimate passivity which nonetheless desperately
turns into action and into hope, is patience¬ – the passivity of undergoing, and
yet mastery itself” (T&I,238). Thus, we find the hostage recovering freedom not
as the result of some daring tactical maneuver. Rather it is vis-à-vis a
paradoxical situation by way of which he takes an apparently simple step back, a
step which nevertheless requires the exertion of a seemingly infinite effort to
allow patience to desperately deliver its hope: the possibility of recovering
freedom.

As we noted above, it is not death but suffering which is the consummate ordeal.
Finding a way to overcome an addiction that is the result of a struggle with
chronic pain is certainly a victory; the unfortunate truth, however, is that this
is but a single triumph in a war which has countless battles: one each day, each
hour, each breath? Indeed, the aftermath of addiction is an ordeal supreme all
its own, especially when complicated by the persistence of physical pain, which
neither addiction nor its overcoming abates in any way. It is perhaps difficult
to see how far we have come, more difficult still to envision the road ahead.
Nonetheless, it must be traveled.

Despite the difficulties of constructing a new self, one may at least find some
surcease in the overcoming of the always-already determined shadow-self with which
one has been burdened. This shadow-self is the masochistic lord born of the
violence perpetrated upon the will by pain and addiction. It is important to note
here that violence, in the Levinasian sense in which it is operative in this
context, is not so much a matter of objective destruction. Rather violence – in
general, and specifically as deployed against the will in chronic pain and
addiction – is exercised upon persons by “interrupting their continuity, making
them play roles in which they no longer recognize themselves, making them betray
not only commitments but their own substance, making them carry out actions that
will destroy every possibility of action…War does not manifest exteriority and the
other as other; it destroys the identity of the same” (T&I, 21).

Yet, there is hope. Beyond addiction there is the possibility of an Other

existence, an existence which can include others. There is time to repair what
once appeared irremediably shattered. This is precisely the time allowed by
patience:
In patience, at the limit of its abdication, the will does not sink into
absurdity, for – over and beyond the nothingness that would reduce the space of
time that elapses from birth to death to the purely subjective, the interior, the
illusory, the meaningless – the violence the will endures comes from the other as
tyranny. But for this very reason it is produced as an absurdity breaking out on
the ground of signification. Violence does not stop Discourse: all is not
inexorable. Thus alone does violence remain endurable in patience. It is
produced in a world where I can die as a result of someone and for someone. This
situates death in a new context and modifies its conception, empties it of the
pathos that comes from the fact of it being my death. In other words, in patience
the will breaks through the crust of its egoism and as it were displaces its
center of gravity outside of itself, to will as Desire and Goodness limited by
nothing, (T&I, 239).

Thus it is that traveling the labyrinth of patience we arrive at a final paradox.

Patience does allow for the eventual moment of re-connecting with the other. It
does so, however, only by concurrently empowering the addict to re-connect with
himself, to re-introduce continuity into time and thereby into consciousness as
self-consciousness. Patience is the ontological event allowing for the disruption
of the violence of pain and addiction. More than permitting the endurance of
life, it indulges the conjunction of life and joy, of affirmation in the midst of
suffering, and thus the re-conception of the addict both in relation to himself
and to every other. Indeed, patience is that which allows for the experience of
the “holy” in the midst of a life that has reached the very nadir of profanity,
banality, and decadent masochistic egoism. Patience, time, hope: the Desire of
the will for Goodness limited by nothing.