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This won't hurt a bit: the cultural history of pain

Speculation about the degree to which human beings and animals experienced pain has a long history.

Jack the ripper: three plates from Jacques Fabien Gautier d’Agoty’s Myologie (1746-48), the first full-colour anatomical atlas. Taken from the sick rose by Richard Barnett (Thames & Hudson, £19.95)

On 16 April 1872, a woman signing herself “An Earnest Eng­lishwoman” published a letter in the Times. It was entitled “Are Women Animals?”.

She was clearly very angry. Her fury had been fuelled by recent court cases in which a man who had “coolly knocked out” the eye of his mistress and another man who had killed his wife were imprisoned for just a few months each. In contrast, a man who had stolen a watch was punished severely, sentenced to not only seven years’ penal servitude, but also 40 lashes of the “cat”. She noted that although some people might believe that a watch was an “object of greater value than the eye of a mistress or the life of a wife”, she was asking readers to remember that “the inanimate watch does not suffer”. It must cause acute agony for any “living creature, endowed with nerves and muscles, to be blinded or crushed to death”.

Indeed, she continued, she had “read of heavier sentences being inflicted for cruelty towards that – may I venture to say? – lower creation”. She pleaded for women to be subsumed under legislation forbidding cruelty to animals, because that would improve their position in law.

Speculation about the degree to which human beings and animals experienced pain has a long history, but “An Earnest Englishwoman” was writing at a very important time in these debates. Charles Darwin’s Descent of Man had been published the year before her letter, and his Expression of the Emotions in Man and Animals appeared in 1872. Both Darwin and “An Earnest Englishwoman” were addressing a central question that had intrigued theologians, scientists, philosophers, psychologists and other social commentators for centuries: how can we know how other people feel?

The reason this question was so important was that many people didn’t believe that all human beings (let alone non-human animals) were equally capable of suffering. Scientists and philosophers pointed to the existence of a hierarchy of sentience. Belief in a great “Chain of Being”, according to which everything in the universe was ranked from the highest to the lowest, is a fundamental tenet of western philosophy. One aspect of this Chain of Being involved the perception of sensation. There was a parallel great Chain of Feeling, which placed male Europeans at one end and slaves and animals at the other.

Of course, “An Earnest Englishwoman” was using satire to argue for greater rights for women. She was not accusing men of failing to acknowledge that women were capable of experiencing pain. Indeed, that much-maligned group of Victorian women – hysterics – was believed to be exquisitely sensitive to noxious stimuli. Rather, she was drawing attention to the way a lack of respect for the suffering of some people had a profound impact on their status in society. If the suffering of women were treated as seriously as the suffering of animals, she insisted, women’s lives would be better.

Although she does not discuss it in her short letter, the relationship between social status and perceptions of sentience was much more fraught for other groups within British and American societies. In particular, people who had been placed at the “lower” end of the Chain of Feeling paid an extremely high price for prejudices about their “inability” to feel. In many white middle-class and upper-class circles, slaves and “savages”, for instance, were routinely depicted as possessing a limited capacity to experience pain, a biological “fact” that conveniently diminished any culpability among their so-called superiors for acts of abuse inflicted on them. Although the author of Practical Rules for the Management and Medical Treatment of Negro Slaves, in the Sugar Colonies (1811) conceded that “the knife of the anatomist . . . has never been able to detect” anatomical differences between slaves and their white masters, he nevertheless contended that slaves were better “able to endure, with few expressions of pain, the accidents of nature”. This was providential indeed, given that they were subjected to so many “accidents of nature” while labouring on sugar-cane plantations.

Such beliefs were an important factor in imperial conquests. With voyeuristic curiosity, travellers and explorers often commented on what they regarded as exotic responses to pain by indigenous peoples. In Australia, newly arrived colonisers breathlessly maintained that Native Australians’ “endurance of pain” was “something marvellous”. Others used the theme as an excuse for mockery. For instance, the ability of New Zealand Maoris to bear pain was ascribed to their “vanity”. They were said to be so enamoured with European shoes that “when one of them was happy enough to become the possessor of a pair, and found that they were too small, he would not hesitate to chop off a toe or two, stanch the bleeding by covering the stump with a little hemp, and then force the feet [sic] into the boots”.

But what was it about the non-European body that allegedly rendered it less suscep­tible to painful stimuli? Racial sciences placed great emphasis on the development and complexity of the brain and nerves. As the author of Pain and Sympathy (1907) concluded, attempting to explain why the “savage” could “bear physical torture without shrinking”: the “higher the life, the keener is the sense of pain”.

There was also speculation that the civilising process itself had rendered European peoples more sensitive to pain. The cele­brated American neurologist Silas Weir Mitchell stated in 1892 that in the “process of being civilised we have won . . . intensified capacity to suffer”. After all, “the savage does not feel pain as we do: nor as we examine the descending scale of life do animals seem to have the acuteness of pain-sense at which we have arrived”.

Some speculated whether the availability of anaesthetics and analgesics had an effect on people’s ability (as well as willingness) to cope with acute affliction. Writing in the 1930s, the distinguished pain surgeon René Leriche argued fervently that Europeans had become more sensitive to pain. Unlike earlier in the century, he claimed, modern patients “would not have allowed us to cut even a centimetre . . . without administering an anaesthetic”. This was not due to any decline of moral fibre, Leriche added: rather, it was a sign of a “nervous system differently developed, and more sensitive”.

Other physicians and scientists of the 19th and early 20th centuries wanted to complicate the picture by making a distinction between pain perception and pain reaction. But this distinction was used to denigrate “outsider” groups even further. Their alleged insensitivity to pain was proof of their humble status – yet when they did exhibit pain reactions, their sensitivity was called “exaggerated” or “hysterical” and therefore seen as more evidence of their inferiority. Such confused judgements surfaced even in clinical literature that purported to repudiate value judgements. For instance, John Finney was the first president of the American College of Surgeons. In his influential book The Significance and Effect of Pain (1914), he amiably claimed:

It does not always follow that because a patient bears what appears to be a great amount of pain with remarkable fortitude, that that individual is more deserving of credit or shows greater self-control than the one who does not; for it is a well-established fact that pain is not felt to the same degree by all individuals alike.

However, in the very same section, Finney made pejorative statements about people with a low pain threshold (they possessed a “yellow streak”, he said) and insisted that patients capable of bearing pain showed “wonderful fortitude”.

In other words, civilised, white, professional men might be exquisitely sensitive to pain but, through acts of willpower, they were capable of masking their reaction. In contrast, Finney said, the dark-skinned and the uneducated might bear “a great amount of pain with remarkable fortitude” but they did not necessarily deserve credit for it.

It was acknowledged that feeling pain was influenced by emotional and psychological states. The influence of “mental factors” on the perception of pain had been observed for centuries, especially in the context of religious torture. Agitation, ecstasy and ideological fervour were known to diminish (or even eliminate) suffering.

This peculiar aspect of pain had been explored most thoroughly in war. Military lore held that the “high excitement” of combat lessened the pain of being wounded. Even Lucretius described how when

the scythed chariots, reeking with indiscriminate slaughter, suddenly chop off the limbs . . . such is the quickness of the injury and the eagerness of the man’s mind that he cannot feel the pain; and because his mind is given over to the zest of battle, maimed though he be, he plunges afresh into the fray and the slaughter.

Time and again, military observers have noted how, in the heat of battle, wounded men might not feel even severe wounds. These anecdotal observations were confirmed by a systematic study carried out during the Second World War. The American physician Henry K Beecher served in combat zones on the Venafro and Cassino fronts in Italy. He was struck by how there was no necessary correlation between the seriousness of any specific wound and the men’s expressions of suffering: perhaps, he concluded, the strong emotions aroused in combat were responsible for the absence of acute pain – or the pain might also be alleviated by the knowledge that wartime wounding would release a soldier from an exceedingly dangerous environment.

Beecher’s findings were profoundly influential. As the pain researchers Harold Wolff and Stewart Wolf found in the 1950s, most people perceived pain at roughly similar intensities, but their threshold for reaction varied widely: it “depends in part upon what the sensation means to the individual in the light of his past experiences”.

Away from the battlefield, debates about the relative sensitivity of various people were not merely academic. The seriousness of suffering was calibrated according to such characterisations. Sympathy was rationed unevenly.

Myths about the lower susceptibility of certain patients to painful stimuli justified physicians prescribing fewer and less effective analgesics and anaesthetics. This was demonstrated by the historian Martin Pernick in his work on mid-19th-century hospitals. In A Calculus of Suffering (1985), Pernick showed that one-third of all major limb amputations at the Pennsylvania Hospital between 1853 and 1862 had been done without any anaesthetic, even though it was available. Distinguished surgeons such as Frank Hamilton carried out more than one-sixth of all non-military amputations on fully conscious patients.

This is not simply peculiar to earlier centuries. For instance, the belief that infants were not especially liable to experiencing pain (or that indications of suffering were merely reflexes) was prominent for much of the 20th century and had profound effects on their treatment. Painful procedures were routinely carried out with little, if any, anaesthetic or analgesic. Max Thorek, the author of Modern Surgical Technique (1938), claimed that “often no anaesthetic is required”, when operating on young infants: indeed, “a sucker consisting of a sponge dipped in some sugar water will often suffice to calm the baby”.

As “An Earnest Englishwoman” recognised, beliefs about sentience were linked to ideas of who was considered fully human. Slaves, minority groups, the poor and others in society could also be dispossessed politically, economically and socially on the grounds that they did not feel as much as others. The “Earnest Englishwoman’s” appeal – which drew from a tradition of respect and consideration that lays emphasis on the capacity to suffer – is one that has been echoed by the oppressed and their supporters throughout the centuries.

Joanna Bourke is a professor of history at Birkbeck, University of London, and the author of “The Story of Pain: From Prayer to Painkillers” (Oxford University Press, £20)

This article first appeared in the 11 June 2014 issue of the New Statesman, The last World Cup

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The West can never hope to understand Islamic State

Graeme Wood's The Way of the Strangers: Encounters with the Islamic State reminds us of something that ought to be obvious: Islamic State is very Islamic.

The venue for the declaration of the “Islamic State” had been carefully chosen. The Great Mosque of al-Nuri in Mosul was a fitting location for the restoration of a “caliphate” pledged to the destruction of its enemies. It was built in 1172 by Nur al-Din al-Zengi, a warrior famed for his victories over the Crusaders. When Abu Bakr al-Baghdadi ascended the pulpit in July 2014 and proclaimed his followers to be “the backbone of the camp of faith and the spearhead of its trench”, he was consciously following in Nur al-Din’s footsteps. The message could not have been clearer. The Crusaders were back and needed defeating.

Time present and time past are both perhaps present in time future. In Islamic State’s propaganda, they certainly are. Sayings attributed to Muhammad that foretold how the armies of Islam would defeat the armies of the Cross serve their ideologues as a hall of mirrors. What happened in the Crusades is happening now; and what happens now foreshadows what is to come.

The Parisian concert-goers murdered at the Bataclan theatre in 2015 were as much Crusaders as those defeated by Nur al-Din in the 12th century – and those slaughters prefigure a final slaughter at the end of days. When the propagandists of Islamic State named their English-language magazine Dabiq, they were alluding to a small town in Syria that – so they proclaim – will at last bring the Crusades to an end. Every issue is headed with the same exultant vaunt. “The spark has been lit here in Iraq, and its heat will continue to intensify – by Allah’s permission – until it burns the Crusader armies in Dabiq.”

How much does Islamic State actually believe this stuff? The assumption that it is a proxy for other concerns – born of US foreign policy, or social deprivation, or Islamophobia – comes naturally to commentators in the West. Partly this is because their instincts are often secular and liberal; partly it reflects a proper concern not to tar mainstream Islam with the brush of terrorism.

Unsurprisingly, the first detailed attempt to take Islamic State at its word ruffled a lot of feathers. Graeme Wood’s article “What Isis really wants” ran in the Atlantic two years ago and turned on its head the reassuring notion that the organisation’s motivation was anything that Western policy­makers could readily comprehend.

“The reality is,” Wood wrote, “that the Islamic State is Islamic. Very Islamic.” The strain of the religion that it was channelling derived “from coherent and even learned interpretations of Islam” and was fixated on two distinct moments of time: the age of Muhammad and the end of days long promised in Muslim apocalyptic writings. Members of Islamic State, citing the Quran and sayings attributed to the Prophet in their support, believe themselves charged by God with expediting the end of days. It is their mandate utterly to annihilate kufr: disbelief. The world must be washed in blood, so that the divine purpose may be fulfilled. The options for negotiating this around a table at Geneva are, to put it mildly, limited.

In The Way of the Strangers, Wood continues his journey into the mindset of Islamic State’s enthusiasts. As he did in the Atlantic, he scorns “the belief that when a jihadist tells you he wants to kill you and billions of others to bring about the end of the world, he is just speaking for effect”. Although not a report from the “caliphate”, it still comes from front lines: the restaurants of Melbourne, the suburbs of Dallas, the cafés of Ilford. Wood’s concern is less with the circumstances in Syria and Iraq that gave birth to Islamic State than with those cocooned inside stable and prosperous societies who have travelled to join it. What persuades them to abandon the relative comforts of the West for a war zone? How can they possibly justify acts of grotesque violence? Is killing, for them, something
incidental, or a source of deep fulfilment?

These are questions that sociologists, psychologists and security experts have all sought to answer. Wood, by asking Islamic State’s sympathisers to explain their motivation, demonstrates how Western society has become woefully unqualified to recognise the ecstatic highs that can derive from apocalyptic certitude. “The notion that religious belief is a minor factor in the rise of the Islamic State,” he observes, “is belied by a crushing weight of evidence that religion matters deeply to the vast majority of those who have travelled to fight.”

Anyone who has studied the literature of the First Crusade will recognise the sentiment. The conviction, popular since at least the Enlightenment, that crusading was to be explained in terms of almost anything except religion has increasingly been put
to bed. Crusaders may indeed have travelled to Syria out of a lust for adventure, or loot, or prospects denied to them at home; but that even such worldly motivations were saturated in apocalyptic expectations is a perspective now widely accepted. “Men went on the First Crusade,” as Marcus Bull put it, “for reasons that were overwhelmingly ideological.”

The irony is glaring. The young men who travel from western Europe to fight in Syria for Islamic State – and thereby to gain paradise for themselves – are following in the footsteps less of Nur al-Din than of the foes they are pledged to destroy: the Crusaders.

Jonathan Riley-Smith, who revolutionised the study of the Crusades as a penitential movement, once wrote an essay titled “Crusading as an Act of Love”. Wood, in his attempt to understand the sanguinary idealism of Islamic State sympathisers, frequently echoes its phrasing. In Alexandria, taken under the wing of Islamists and pressed to convert, he recognises in their importunities an urgent longing to spare him hellfire, to win him paradise. “Their conversion efforts could still be described, for all their intolerance and hate, as a mission of love.”

Later, in Norway, he meets with a white-haired Islamist to whom the signs of the impending Day of Judgement are so palpable that he almost sobs with frustration at Wood’s failure to open his eyes to them. “To Abu Aisha, my stubbornness would have been funny if it were not tragic. He looked ready to grab me with both hands to try to shake me awake. Were these signs – to say nothing of the perfection of the Quran, and the example of the Prophet – not enough to rouse me from the hypnosis of kufr?”

Wood does not, as Shiraz Maher did in his recent study Salafi-Jihadism, attempt to provide a scholarly survey of the intellectual underpinnings of Islamic State; but as an articulation of the visceral quality of the movement’s appeal and the sheer colour and excitement with which, for true believers, it succeeds in endowing the world, his book is unrivalled. When he compares its utopianism to that of the kibbutzim movement, the analogy is drawn not to cause offence but to shed light on why so many people from across the world might choose to embrace such an austere form of communal living. When he listens to British enthusiasts of Islamic State, he recognises in their descriptions of it a projection of “their idealised roseate vision of Britain”. Most suggestively, by immersing himself in the feverish but spectacular visions bred of his interviewees’ apocalypticism, he cannot help but occasionally feel “the rip tide of belief”.

The Way of the Strangers, though, is no apologetic. The time that Wood spends with Islamic State sympathisers, no matter how smart or well mannered he may find some of them, does not lead him to extenuate the menace of their beliefs. One chapter in particular – a profile of an American convert to Islam whose intelligence, learning and charisma enabled him to emerge as the principal ideologue behind Dabiq – is worthy of Joseph Conrad.

Elsewhere, however, Wood deploys a lighter touch. In a field where there has admittedly been little competition, his book ranks as the funniest yet written on Islamic State. As in many a British sitcom, the comedy mostly emerges from the disequilibrium between the scale of his characters’ pretensions and ambitions and the banality of their day-to-day lives. “He can be – to use a term he’d surely hate – a ham.” So the British Islamist Anjem Choudary is summarised and dismissed.

Most entertaining is Wood’s portrait of Musa Cerantonio, whose status as Australia’s highest-profile Islamic State sympathiser is balanced by his enthusiasm for Monty Python and Stephen Fry. His longing to leave for the “caliphate” and his repeated failure to progress beyond the Melbourne suburb where he lives with his mother create an air of dark comedy. Visiting Cerantonio, Wood finds their conversation about Islamic State ideology constantly being intruded on by domestic demands. “His mother was about ten feet away during the first part of the conversation, but once she lost interest in the magazines she walked off to another part of the house. Musa, meanwhile, was discussing theoretically the Islamic views on immolation as a method of execution.”

The scene is as terrifying as it is comic. Were Cerantonio merely a solitary eccentric, he would hardly merit the attention but, as The Way of the Strangers makes amply clear, his views are shared by large numbers of Muslims across the world. Just as Protestant radicals, during the 16th-century Reformation, scorned the traditions of the Catholic Church and sought a return to the age of the Apostles, so today do admirers of Islamic State dread that the wellsprings of God’s final revelation to mankind have been poisoned. What, then, are they to do?

That their enthusiasm for, say, slavery or the discriminatory taxation of religious minorities causes such offence to contemporary morality only confirms to them that there is a desperately pressing task of purification to perform. As Wood observes, “These practices may be rejected by mainstream Muslim scholars today, but for most of Islamic history, it barely occurred to Muslims to doubt that their religion permitted them.” Verses in the Quran, sayings of the Prophet, the example of the early caliphate: all can be used to justify them. Why, then, should Islamic State not reintroduce them, in the cause of making Islam great again?

Perhaps the most dispiriting section of Wood’s book describes his attempt to find an answer to this question by consulting eminent Muslim intellectuals in the US. Scholars whose understanding of Islam derives from a long chain of teachers (and who have framed documents on their walls to prove it) angrily condemn Islamic State for ignoring centuries’ worth of legal rulings. It is a valid point – but only if one accepts, as Islamic State does not, that scholarship can legitimately be used to supplement the Quran and the sayings of Muhammad.

When Wood asks Hamza Yusuf, an eminent Berkeley Sufi, to demonstrate the group’s errors by relying only on the texts revealed to the Prophet, he struggles to do so: “Yusuf could not point to an instance where the Islamic State was flat-out, verifiably wrong.” This does not mean that it is right but it does suggest – despite what most Muslims desperately and understandably want to believe – that it is no less authentically Islamic than any other manifestation of Islam. The achievement of Wood’s gripping, sobering and revelatory book is to open our eyes to what the implications of that for all of us may be.

Tom Holland’s books include “In the Shadow of the Sword: the Battle for Global Empire and the End of the Ancient World” (Abacus)

The Way of the Strangers: Encounters with the Islamic State by Graeme Wood is published by Allen Lane (317pp, £20​)

This article first appeared in the 19 January 2017 issue of the New Statesman, The Trump era