What the Body Commands: The Imperative Theory of Pain by Colin Klein (MIT, 2015)
In this book Colin Klein presents us with a rigorously constructed, well written and witty argument where he proposes that imperativism is a cogent framework for refiguring pain. He sets out his stall as an imperativist and gives a chronicle of the basic tenets of imperativism and pain: that is, imperatives are commands to action and pain in particular is a command take care. He argues that pain is a homeostatic sensation in that it is about maintaining the body, and that the primary purpose of pain is to get you to act rather than think (p. 19). Klein differentiates pain from suffering and hurt arguing that ‘[i]t is because we suffer from our pains that we dislike them, that we are motivated to get rid of them, and so on. But that is secondary to what pains are, which is imperatives to protect a particular body part’ (p. 184).
For me, the most interesting aspect of What the Body Commands is found in Klein’s propositions that imperativism enables us to understand pain as part of a cure rather than a symptom of injury (p. 10). In Klein’s argument the action that an individual will be motivated to take when pain is felt or threatened is to protect the body part that is in pain; that is, to move your hand away from a flame, to keep weight off a broken ankle, or to stop anything coming into contact with damaged skin. By constructing pain in this way, Klein makes a convincing case for pain as something that should not be seen as a negative sensation but as an aid to healing; indeed, without pain we would all do great damage to our bodies. He develops this case further in Chapters 11 and 12, where he discusses pain asymbolia – a rare condition where people feel pain but are ‘strikingly indifferent to it’ (p. 142), and Chapter 13 where he discusses masochistic pleasure. These cases might seem to run counter to Klein’s theory that pain motivates action to protect the body; however, he is able to negotiate this difficulty by pointing out deficiencies and conditions which mark asymbolia and masochism as states where the response to the motivation of pain is ignored rather than simply not felt.
Early on in the book Klein gives an example of a fire alarm as an imperative, it rings loudly in order to get one to leave a building; it is possible to ignore this imperative, to stay inside despite the clanging bells and risk of injury, but that makes it no less of an imperative (p. 19). Klein’s arguments about asymbolia and masochism are more complex but can be boiled down to something similar, the person with asymbolia feels pain but has lost the will to act to protect their body and the masochist feels pain but overrides the imperative in order to gain some other sensation which they value more. Klein’s account of first and second order imperatives adds further light to this understanding of imperatives as something which can be ignored, here pain gives the first order imperative to protect a body part and suffering gives a second order imperative to get rid of the pain. Klein’s proposes we can experience one without the other or experience both and ignore one or the other should we choose.
The book takes on the format of a lengthy argument and counter argument. Klein takes on oppositions to imperativism and discusses the benefits of imperativism in each case; for example he dismisses pain as an informant of tissue damage by countering with the suggestion that pain can be an indication of possible tissue damage such as muscle pain when running (p. 37). Here pain does not indicate damaged tissue but carries a command to stop in order to avoid damage; this variance in the content of pain, for Klein, means that pain cannot be understood as primarily representational and should therefore be considered something else, Klein addresses this by offering imperativism.
What the Body Commands continues in this vain – giving a statement about imperativism, presenting a contradictory argument, and then summing up with the reasons that imperativism is ‘right’ and the other propositions are ‘wrong’. This gives the book the feeling of a lengthy court case debating some highly technical point of law; however, it seems to me that rather a lot less is at stake here than in a courtroom and I find it difficult to really care whether imperativism works or not. Klein fails to convince me that imperativism as a way of understanding pain really matters; so what if we can present a coherent theoretical argument, what changes as a result? Even if we are able to understand pain as part of a protective process it does not change our actions or treatment when faced with real pains.
Perhaps my criticism here is unfair, from the off Klein is very clear that this book is a defence of pure imperativism as a philosophical position and at no time does he claims to be aiming for wider impacts. He states that he is pursuing this position because it is philosophically interesting (p. 9), saying ‘I take my primary charge to be to show that imperativism is a coherent picture’ (p. 9, original emphasis); Klein is very successful in presenting this coherent picture but I can’t help being left with the questions ‘why does that matter?’
Klein comes dangerously close to asserting a Cartesian duality throughout What the Body Commands. He repeatedly refers to ‘body commands’ as if they are something that is separate to the self. This is perhaps endemic in an imperative theory where we must think of pain’s primary function as to command rather to inform (p. 2). This mind/body split is one that has been effectively challenged in relation to pain by disability studies scholars (cf. Kuppers 2003; Schildrick 2009; Goodley et al 2012). Disability and a reflection on wider examples of pain including chronic pain are notably absent from Klein’s account and for this reason I find his description of pain lacking when examined in relation to my own lived experiences of pain (I have chronic lymphoedema as a result of surgery). It is notable that Klein uses a personal account of a broken ankle as a repeated reference point when discussing pain rather than thinking about pain in long term health conditions. Klein briefly acknowledges the difference between chronic pain and injury pain from which one will recover in his final chapter. Here he also considers the ways that pains are both experienced by us and as part of us and argues that this places us in battle with our own agency; however, this part of the book feels undeveloped and little more than a token nod to the wealth of work which challenges mind/body dualism.
What the Body Commands is a thorough account of a particular philosophical school of thought in relation to pain and is original and thorough in its argument. I do however wonder who the book is for, and of what consequence it is outside of its own discipline. I am left with nowhere to go. I am quite sure this book would be of great value for people who wish to explore imperativism for its own end but find it of less use for those with an interest in the medical humanities. It does not enhance our understanding of pain as understood by those who experience it (the making human that is the fundamental principal of the humanities) and does not help us change or develop medical practice. I would suggest that readers of this blog are perhaps not the intended audience for this book and would find more useful and illuminating accounts of pain elsewhere.
Reviewed by Dr Emily Underwood-Lee, a Research Fellow at the George Ewart Evans Centre for Storytelling at the University of South Wales. Her research focuses on performance, autobiographical stories and the body in a variety of contexts including feminist performance art, narratives of illness, performance and the maternal, and performance and disability.
Correspondence to Dr Emily Underwood-Lee.
Goodley, D., Hughes, B. and Davis, L. 2012. New Developments and Directions. Basingstoke: Palgrave Macmillan.
Kuppers, P. 2003. Disability and Contemporary Performance: Bodies on Edge. London: Routledge.
Shildrick, M. 2009. Dangerous Discourses of Desirability, Subjectivity and Sexuality. Basingstoke: Palgrave Macmillan.