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Kieran Setiya on Infirmity

By Dr Julian Kiverstein, Philosopher, University of Amsterdam

Philosophers have tended to theorise the good life and not the bad. They have focused on pleasure and happiness, not pain and suffering; success not failure; and love, not loss. In his recent book Life is Hard Kieran Setiya invites us to turn our attention to adversity and hardship. He asks what it can mean for a persons life to go badly because of, for instance, infirmity, loneliness, grief and injustice.  

We typically ignore or even suppress reflection on hardship in pursuit of the good life. Kieran recommends a different attitude towards adversity in life – one that begins with honest reflection and acknowledgement that life, for all of us, will involve some form of suffering. He argues that reflecting on the flaws in the human condition can contribute to us living a more meaningful life. The path to living well he lays out is to live realistically in the world with all of its flaws, not in the world as we wish it could be. To live well is to accept adversity whilst nevertheless finding enough that is good and valuable to sustain us.

Chapter 1 starts from Kieran’s experiences of living for many years with chronic pelvic pain. He asks us to reflect on how to live in bodies that malfunction. Kieran begins with an important message from disability studies that although chronic pain can be physically disabling, disability is not necessarily an obstacle to living well. The life of a person living with a disability need not, because of their disability, go worse than the life of the able-bodied person. This idea can seem difficult to accept. Sight for instance is a valuable capacity for those of us that have it. If you take something good away from a life – sight – surely this must make the life of the person who is deprived of this good, a worse life compared with those that have the good feature.

Kieran patiently shows the error in this reasoning by criticising the view that there is a single way a good life must go. He argues by contrast that there are many forms a good life can take, a vast array of valuable activities that can make a life worth living. It is impossible to partake in everything that makes life good. It is therefore not necessarily harmful to be deprived of something good. So long as people with disabilities have access to education, employment, and other social opportunities, there will be enough of value in place in their lives for them to live well, and sometimes better, than the able-bodied.

What can profoundly disrupt the life of the person with disabilities is the pain they frequently endure. Kieran describes why pain is bad because it deprives the person of their ability to pursue the activities that have selected as worth doing, obstructing the person’s access to anything good. Here Kieran’s aim is to describe what the person living with chronic or persistent pain can gain from philosophical reflection. I think his answer to this question is an attitude of realism, though it will be interesting to discuss this with him.

Kieran makes two points. First philosophical reflection on a life with pain teaches us how having a body is a source of suffering. Kieran makes this argument by reflecting on how, when a person is in pain, they can want nothing more than to experience the ease of being free from their pain. When however they experience a respite from pain, the bliss they imagined they would experience is revealed to be illusory. The body recedes once again into the background of their awareness. The bliss of the relief from pain is something one can imagine only when in pain but is not something one can ever experience – it is an elusive, ultimately frustrating experience. Kieran finds solace in this

insight. The gain he suggests is a better understanding of the truth of pain. It will be interesting to discuss with him why or how he finds solace in truth. Is this solace something that is also available to all of us who do not practice philosophy?

The second point concerns the loneliness of pain. Although we can certainly empathise with another person who is in pain, in the end the pain they experience is not our pain. They must live through their pain on their own. There is a limit to what other people can share of their pain. Pain also typically isolates a person from others. We may feel, for instance, we don’t want to burden others with our suffering. Social interactions become cumbersome and require effort the person may feel they are unable to expend. Kieran argues that pain doesn’t only cut us off from other people but also from ourselves as we exist through time. When we are in pain it can feel as if the present pain we

are experiencing will endure forever. Our present experience of pain isolates us from our past and future pain-free selves. A past without pain is forgotten, a future without pain is unimaginable, even while we may long for it. We are cut-off from the past experiences we had of our bodies when pain was absent, and a future without pain may feel unattainable. Chronic pain traps us in the present. Kieran describes how when he was undergoing an experience chronic pain, he would be prepared to undergo an intensely painful but short-lived surgery that held the prospect of ending his current pain. This can seem puzzling since when we consider a choice between ending a short-lived but intense pain experience of one person or the mild headaches of many people, we will likely prefer to

end the physically intense pain of the single individual. Things seem different when we consider a single person who must choose between a single intense, short-lived pain, and many experiences of mild pain. Kieran argues this doesn’t correctly describe the situation of the person in chronic pain – they do not live through many short-lived experiences of mild pain because when they are experiencing an episode of pain they cannot think of it as short-lived, temporary episode. It seems instead like it has been going on forever and will never go away.

Kieran offers two lessons for people when they are living through an episode of chronic pain. The first is to focus on the present, treating the pain as an isolated episode in their lives, an unwanted guest to whom no special attention should be given. The second is to strive to overcome the gulf that pain introduces between ourselves in the present moment in which we are experiencing pain and our past and future selves. This gulf can be overcome by sympathising with ourselves when we are in the midst of pain in those moments when we are free from pain. While having compassion for ourselves is not the same as having compassion for others in pain, Kieran suggests that what potentially connects them is what the poet Anne Boyer has called “un-oneness”. Having sympathy

for ourselves can be the source of solidarity with the suffering of others, allowing us to see through our separateness from others, to be pained by the pain of others.

Dr Julian Kiverstein

Julian is Assistant Professor of Neurophilosophy at the University of Amsterdam. He is currently writing a monograph for Palgrave Macmillan entitled The Significance of Phenomenology, and editing a comprehensive handbook for Routledge Taylor Francis on the philosophy of the social mind. He is associate editor of Phenomenology and the Cognitive Sciences and was until recently Book Review Editor for the Journal of Consciousness Studies. 

Before his appointment at Amsterdam in 2011, Kiverstein was teaching fellow at Edinburgh University, where he played a lead role in developing and designing the Mind, Language and Embodied Cognition Masters Programme, of which he also became director. In 2006 he was one of the main architects of a successful cross disciplinary, Europe-wide project proposal on consciousness, part of the ESF Programme, Consciousness in a Natural and Cultural Context. 

He was Postdoctoral Research Fellow as part of this project, and subsequently became external partner on a cross-European follow up project on the topic of Understanding and Misunderstanding. In 2007-2009, Kiverstein was Project Leader of an interdisciplinary group investigating Subjective Time as part of the VolkswagenStiftung European Platform for Life Sciences, Mind Sciences and Humanities.

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