This Pain in My Back: Injury, Stress, and Cohesive Personhood

– By Shaun Edmonds

Shaun Edmonds is a Ph.D. student in the Physical Cultural Studies program at the University of Maryland, College Park.

Dealing with the stressors of academia is a daily struggle. Every day is a seemingly endless attempt to prioritize a constellation of ambiguous expectations, looming deadlines, and yet still find the space to provide sufficient personal care to rise again the next day and do it all over again. It is far from unusual for disruptions in one form or another to upend a given day, but arguably we often have the agency and choice to make our prioritizations our own. We decide what is important and what can be shelved for another day. When that power is wrestled from us through injury, it can be debilitating in often unconsidered ways. In this essay I explore the ways in which chronic pain from a lower back injury created conflict between different aspects of my identity, causing my normally cohesive person to splinter into warring factions. Unlike Josh Newman’s exploration of the pain in his neck, a resultant physical manifestation of the dissonance between his social justice values and his privileged existence (2013), I instead attempt to trace the impact of the pain in my back to the creation of dissonance between body, mind, and social networks. This mapping will explore how multiple dimensions of personhood are imbricated within the body, and how those imbrications are revealed (and perhaps unraveled) through instances of injury.

Pain can be an ambiguous and simplistic term in light of its visceral impact in the moment it is felt, as well as its complex and diffuse disruption of the day-to-day. Arguably the body is frequently taken for granted by white collar workers as a vehicle for transportation or as a carrier for the intellect. During day-to-day interactions, the body becomes sublimated by the mental demands and tasks fostered in an academic environment. In the moment of injury, the body is transformed from a productive tool to a space of confinement and aggravation. Allen-Collinson and Owton argue that, “This ‘absent’ body is… brought to heightened awareness when pain or illness… reminds us of its presence” (2014, p. 3). They refer to this as “intense embodiment,” when the body becomes the central point of awareness (Allen-Collinson & Owton, 2014). Pain becomes a preoccupation that limits cognitive capacity and makes us hyper-aware of our immediate surroundings. When caught up in a ceaseless temporal current of expectations, meetings, and deadlines, pain snaps us back into the moment and prioritizes itself above all else. Wrapped up in the daily struggle to meet tasks, the body is often neglected in favor of devoting more time and energy to completing these tasks. However, as Leder posits, “…it is the discomforting or painful sensations that speak up most clearly…” (Leder, 2005, p. 336). These moments of intense embodiment remind us that the brain is part of the body, and that the body requires support to function optimally.

To understand the pervasive implications of my injury, it is important to provide context. As part of a new year’s resolution, I tasked myself with losing the ten pounds of body fat that I had recently gained, owed in no small part to the stresses of upcoming comprehensive exams and an implacable sweet tooth. My goal was to lose the ten pounds over the course of three months – a very reasonable goal. However, the start of the school year was hectic and I found myself rushing in for workouts. In a maelstrom of stressors and pressed by time constraints, I began a particular workout without properly warming up. On the second set of squats, I felt a twinge in my lower back. Not willing to give up, in an attempt to stubbornly stick to my goal, I simply did not finish squats and continued on with my other exercises. The pain worsened, but I was hard headed and continued on. When I felt I had accomplished enough, I limped out of the gym. As I later discovered at the medical center, in the process of squatting I had sprained my piriformis – a small muscle that connects the sacrum to the top of the femur. It is involved in the everyday actions of walking and sitting as well as the rotation of the leg at the hip. The strain made it incredibly painful to sit for any amount of time, and because it acts as a stabilizer during locomotion, any perturbation of the leg while standing or walking would further aggravate the injury.

The most noticeable effect of the injury, besides the pain itself, was the impact it had on my relation to my immediate environment. As a graduate student that is often tasked with sitting and reading for long periods of time, the most basic task of my existence became a source of incredible pain. The familiar comforts of my desk chair and the familiar calming commute to campus had become treacherous spaces where I was constantly alerted to my injury. I had to re-learn how my body worked and how I could move it in order to avoid pain. Daily movements as mundane as tying my shoes became an exercise in pain avoidance. If I forgot about the pain for a moment, I would be quickly reminded as soon as I transitioned from standing to sitting. In this way, my relation to the environment fundamentally changed – turning spaces of comfort to instances of agony.

This new perception of my environment as a series of hazards created a disconnection between my mind and body. Although the sublimation of my affective and material body in favor of my cognitive self had created a somewhat false cohesion, that cohesion was upended when the separation of mind and body became more pronounced. My mind felt trapped and constrained within my body as my body consistently reasserted itself to the forefront of my attention. The discomfort of sitting made it difficult to focus on reading or writing and I found myself frequently tired and frustrated.

The vigilance required to accommodate my injured body taxed my mental resources – resources already taxed by a challenging graduate program and the concomitant depression frequently associated (The Graduate Assembly, 2014). While the disorientation with the immediate environment was a new source of stress, I had not lost any of my previous sources of stress. Deadlines piled up, books needed to be read, and papers needed to be graded. Although I had been able to stay aware of and moderate my depression, the diligence required of my injury took precious resources from my limited pool of energy. As Miserandino deftly illustrates in her “spoon theory”, the chronic pain from the injury and the taxing nature of depression had left me with few cognitive and physical resources to accomplish anything beyond basic survival coping strategies (2010). I was consistently emotionally and physically drained well before the end of the day.

To provide personal care from these stressors, I had previously turned to exercise and video games. Both of these solutions had been torn from me in the injury. The gym was a site of failure not only because that was where the injury occurred, but also because hinging at the hip to sit or using my lower body were sources of pain. While playing video games would not generally be considered physically taxing, finding a position to manipulate my body to avoid the pain of sitting, constantly adjusting a heating pad, and the struggle to get on to and off of the couch made even this highly sedentary activity an elaborate event. The coping mechanisms I had relied on to combat stress had become new sources of stress, further impacting my mental and emotional state.

As the chronic pain engulfed a percentage of my working memory, destroyed my productivity, and disrupted my daily routine, it began to feel like my body had betrayed me. The amalgam of pain, depression, and both internal and external stressors coalesced and overflowed within my body. My body became a conduit for emotion and I felt perilously out of control. I became impatient and irritable, unable to channel these feelings productively and often unable to control their leakage from my body. The different aspects of my body that had feigned cohesion while I was functional revealed the pathways through which they navigated and escaped my corporeal form; fatigue, a heightened affective state, restlessness felt in my pain-free limbs, and soreness from even the most mundane actions.

I remember clearly the first day I was able to roll out of bed without pain. The daily reacquaintance with pain had become such a mainstay of my mornings that I had begun waking up thirty minutes earlier to ease myself out of bed, take some ibuprofen, and use a warm shower to relax the pain. As Leder notes, “The very absence of discomfort is tinged by a positivity” (2005, p. 338). In the moment that I realized that I was without pain, I immediately posted a status on Facebook. While I still had discomfort, the absence of pain left me elated. While things were not wholly healed, the lack of pain brought optimism that was able to begin counteracting the emotional disarray that had permeated my existence.

Nearly two months later, the training of my body to avoid pain still plagues my basic movements. While the pain is greatly reduced, there is a zone within my range of movement that remains awkward and unwieldy. There is still an expectation of pain – an uneasiness about moving in certain ways. There are still basic movements that, days later, will cause unexpected soreness. I have recently returned to the gym with some trepidation that I may, once again, transform a stress-reducer to a stress-increaser. I have also spent more time trying to provide personal care, sometimes at the expense of social commitments or embodying my role as a “good graduate student”. While there is guilt associated with this, likely it is linked to dominant discourses of personal discipline that encourage me to put productivity ahead of personal care (Foucault & Ewald, 2003).

Pain disrupts the day-to-day experience of individuals not only from the felt pain of the injury itself, but also through the mental energy redirected to the hyper vigilant awareness of potential instigations of pain as well as the loss of stress reduction coping strategies. While medical intervention remains focused on “fixing the injury”, the care of the body in its interactions with and within the world is relegated to ideas of personal responsibility and productivity regardless of the complex consequences that are resultant from the injury. These expectations and knowledges of the world are subtly embodied as part of our self-concept, and these embodied ideologies are revealed when the corporeal body fails.

References

Allen-Collinson, J., & Owton, H. (2014). Intense Embodiment Senses of Heat in Women’s Running and Boxing. Body & Society, 1357034X14538849.

Foucault, M., & Ewald, F. (2003). ” Society Must Be Defended”: Lectures at the Collège de France, 1975-1976 (Vol. 1): Macmillan.

The Graduate Assembly (2014). Graduate Student Happiness & Well-Being Report| 2014. Available from http://ga.berkeley.edu/wellbeingreport/

Leder, D. (2005). Visceral Perception. In C. Classen (Ed.), The book of touch: Berg Publishers.

Miserandino, C. (2010). The Spoon Theory written by Christine Miserandino – But You Dont Look Sick? support for those with invisible illness or chronic illness. http://www.butyoudontlooksick.com/articles/written-by-christine/the-spoon-theory/

Newman, J. I. (2013). This Pain in My Neck Living Conscientization and/as Paradox of Praxis. Qualitative Inquiry, 19(4), 247-260.

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