A Rant on Pathology

Or how I think the world would be a better place if we got to know our neighbors and stopped thinking so much about our pain

Confession: I’m a wee bit of a hypochondriac. I’ve also been a sickly person my whole life, spending much of my childhood in bed with sicknesses that would kill a Victorian child. Perhaps because I grew up in an environment unsafe for the vocalization of my anxieties, my depression has learned to manifest itself through somatic derangements. Because of various unnoteworthy illnesses, I’m in pain constantly, but I don’t usually let this get in the way of living. When I’m wallowing in depression, though, the physical pain deepens and I become fixated on explaining it away with whatever diagnosis TikTok eagerly slips into my mind. There is power in a diagnosis—it’s what gives way to a prognosis!— and TikTok is so good at diagnosing.

I fucking love TikTok. I love following with grotesque curiosity how this gargantuan tech company sways behavior, from making it impossible to get a reservation at some mediocre New York City restaurant that has gone viral to telling women they probably have some trendy new autoimmune disorder. A couple weeks ago I made dinner for a friend and the topic of female pain came up, she said, “What’s that illness everyone has now?” and I knew exactly what she was talking about. It’s true, an Ehlers-Danlos Syndrome diagnosis is the new female autism diagnosis! About a year ago, out of absolutely nowhere, the videos on my feed stopped being about Autism or Narcissistic abuse and started being about EDS. Fuck, I even considered the possibility of having it!

I know many women who have gotten diagnosed with autism recently. All are high-functioning, productive members of society with full lives, but the diagnosis has been very important to them. One told me it freed her from feeling the need to perform normalcy in certain ways but also further alienated her, making her fully feel her abnormality. Over-identification is a danger of diagnosis recently turned to virtue. People become patients and clients willingly, explaining away their behavior in terms of their abnormalities, which are always terminal. I must say now that this is a tricky subject to discuss, because female pain has often gone unnoticed by the medical apparatus of the State, and it’s important women feel empowered to advocate for themselves and take their pain seriously but also, as Jemima Kirke famously said in an IG Q&A, I think we think about ourselves too much sometimes.

When I studied philosophy, I’d frequently have talks with my mother about my distaste for the overarching theme of the violence of negation. It all seemed very macho to me: Hegel’s account of the creation of self-consciousness vis-a-vis a “struggle to the death” between two consciousnesses, the idea of desire being caused by a lack, the Kantian idea that through critique (ie a negation of the here/now) we experience transcendental freedom. It just didn’t feel right to me, still doesn’t. I’m not quite sure I even am a woman, but maybe being a woman is being stuffed and wanting more. Love begets love is my personal motto. The ideology of negation is everywhere, though, and its apotheosis lies in the imperative to— instead of building the self— brand the self by distinguishing the self from others. In this way, we conflate abnormality with personhood. The abnormal, Foucault tells us in his lectures from the 70s, is rendered by the State to medicalize and eradicate sexual freedom. So why is everyone now so eager to be abnormal, pathologized?

My thoughts are that, just as BP popularized the term “carbon footprint” in order to shirk blame for climate change by placing it on individual consumers, tech companies are blaming the alienation they cause by telling the consumer there’s something wrong with them. We are constantly being told to work on ourselves by taking creatine or figuring out the source of an emotional scab that has healed over just fine. Just as the division of labor alienates us from our labor, the division of social groups in favor of online ones alienates us from our real-life communities. This alienation is what makes the conditions of capital possible. Just a couple weeks ago I saw a healthy person DoorDash themselves a coffee from a Dunkin that was 50 feet from their house. Therapy is so normalized that if a man hasn’t been in therapy women will consider it a red flag. BetterHelp (remember in 2023 when they faced charges for sharing client data to Meta and Snapchat for advertising purposes?) is valued at over $1 billion. (Don’t even get me started on people using ChatGPT as therapy!) The internet eradicated monoculture, now it seems the only sense of normalcy is to feed into neuroticism about our abnormalities.

I have a friend who is much older than me and incredibly successful in his field. One night, over sushi, we talked about how he doesn’t feel traumatized by anything that has happened in his life. This made him feel like a bizarre anomaly. His father drank and sometimes things would get a little scary, but he didn’t describe any resentment toward his father and seemed to integrate this story beautifully into his own. “Is it possible I’m not traumatized like everyone else?” he asked me. I must admit that I did find the challenge of trying to decipher what his baggage was to be interesting, but eventually I concluded with him that he was, in fact, fine. Just because something bad happens to you doesn’t make it traumatic, trauma happens when the event creates a fissure in your understanding of yourself. Psychologists have hypothesized that when the event happens, if we have a support network that makes us feel cared for and seen, the event will not have a rupturing effect. It’s the compounding nature of our isolation, fear, and abandon that is preventing us from integrating events and making us feel sick…

I’ve always said that, when talking to a stranger, there’s more to agree on than disagree on. The Sun is up there in the blue sky, the streets are busy, the wind is tousling my hair. That we can all see. So why not take a note from the lens grinder Spinoza and acknowledge ourselves as modes of God? A distinction is important for political representation, but I think we should all have a healthy skepticism about any institutional practice that makes us feel completely different from the person standing next to us on the subway.