During the last two weeks of her life, Laura stayed in bed, sleeping most of the time. Fentanyl and morphine may have dulled her pain, but she was still aware.   In the evening, if she did not hear Anne Mei practicing her violin, or did not like what she heard, Laura would cry out, “Ken!”  If I wasn’t already with her, I would come running to assure her that Anne Mei would practice soon, or that I would speak with her about doing better. I would not describe Laura’s reaction to Anne Mei’s practice or lack thereof as “pain” in any of the senses we have been talking about. I think it is a better example of disturbance, taraché, the second of Aristotle’s three facets of fear and shame (pain, disturbance, and “bad things,”), to which we now turn.

In classical Greek literature, Aristotle’s word taraché often refers to political upheaval or tumult like the confusion of battle, even rebellion and civil war.   See Aristotle’s Politics (1257a5, 1262b25) and Plato’s Republic (415a).  The year before Laura’s diagnosis the majority party in the town where I was manager went through a civil war over elements of an affordable housing plan I had been instrumental in creating.  First, the party leader was deposed and then in the following two elections for municipal council all those members who had supported the most controversial element of the plan were replaced.  As mentioned in the post about the read-and-scribble argument with Laura, fear of losing my job added to the turmoil we both felt during this period.

Aristotle uses taraché to refer to the turmoil that fear and shame unleash. C.S. Lewis gives more graphic details of this turmoil at the opening of his memoir about the loss of his wife.  He writes that he had never been told that grief felt so much like fear:

The same fluttering in the stomach, the same restlessness, the yawning.  I keep on swallowing.  At other times it feels like being mildly drunk, or concussed.  There is a sort of invisible blanket between the world and me.  (Lewis [1961] 3)

Simone Weil also describes the “irreducible part” of grief in terms of bodily tumult:

a difficulty in breathing, a constriction of the heart, an unsatisfied need, hunger, or the almost biological disorder caused by the brutal liberation of some energy, hitherto directed by an attachment and now left without a guide.  (Weil  [1973] 117-118)

Aristotle does not expand on what he means by disturbance as part of the experience of fear. Later when talking about shame working like a passion (páthei), Aristotle points out that shame has an effect on the body similar to the effect of fear of danger.  He also notes that we blush when we are disgraced, and become pale when fearing death. (R. 1128b10-15)  Aquinas says that tristitia causes “a certain flight of the appetite (fuga appetitus).”  And if we can’t flee, anxiety weighs us down to the point of not being able to move, or even speak. (S.T.  I-IIae, q. 35, a. 8 co.)

Walter Cannon is widely credited with coining the phrase “fight or flight” in his classic study Bodily Changes in Pain, Hunger, Fear, and Rage: An Account of Recent Researches Into the Function of Emotional Excitement, e.g., Goldstein and Kopin (scientific), www.gentle-stress-relief.com/walter-cannon.html (popular).  The exact phrase “fight or flight” does not appear in his book, and Cannon quotes other previous studies on the same subject using similar language.  More than for coining a popular phrase, however, the book remains useful for its descriptions of research findings on what goes on inside our bodies when we feel fear, pain or anger.

Cannon’s descriptions flesh out (pun intended) Aristotle’s reference to disturbance as something not quite the same as pain when we experience shame or fear. Cannon summarizes the “visceral changes” involved with these “emotional disturbances” as follows:

  1. hormones and nerves stop digestion to free up energy for use elsewhere in the body;
  2. blood shifts from the organs in the abdomen to the organs needed for action (heart, lungs, central nervous system);
  3. the heart starts beating more strongly and more rapidly;
  4. hormones dilate the blood vessels and the bronchioles in the lungs, both to prepare to move (fight or flee), but also to mitigate the effects of muscle fatigue once in motion;
  5. circulation of “energy-giving sugar” increases.

Each and every one of these changes works to increase the body’s effectiveness in the “violent display of energy” involved in fear or anger. (Cannon (1915) 215-216)

The bodily turmoil unleashed in these situations anticipates the responses that will be needed in order to survive.  Cannon quotes a number of previous analyses of fear, which are relevant here for directing attention to disturbance.  Spencer talks about how muscles tense, teeth gnash, claws stick out (in animals), the eyes and nostrils dilate.  In sum, he views the body as it palpitates, trembles, hides, and escapes.  McDougall specifically associates fear with flight, and anger with fight.  For Crile, fear foreshadows potential injury.

For Cannon these bodily reactions are “typical organic responses … evoked through inherent automatisms.”  These “pattern reactions” resemble “inborn reflexes of low order,” such as sneezing.  As such, they “flash through … neurone groups,” suddenly and unexpectedly.  They are automatic because time is of the essence.  These reactions have evolved so that we don’t have to think about them or will them to start or keep going.  The main work of these reactions is to increase the production and distribution of sugar and adrenaline and to redistribute them through the blood to the muscles required to fight or flee.  (185-6, 198 ff.)  The effects of the muscle exertion fed by sugar and adrenaline, such as oxygen deprivation, actually stimulate production of more adrenaline and sugar.  These bodily “disturbances” also promote rapid coagulation of the blood which will likely flow in a fight.  (204 ff., 210-12)

Cannon notes interaction among blood pressure, pain, and “the psychic disturbance that is simultaneously aroused.”  He doesn’t say so, but I see imagining as contributing to the process by which blood pressure increases if we see an escape.  When we don’t see any definite way out, blood pressure drops and we can become paralyzed with fear.  (187) If the excess adrenaline and sugar produced in response to fear, anger, or pain is not “worked off,” it can have pathological consequences for the body.  (194n.) If “fear, worries and anxieties” are allowed “to disturb the digestive processes when there is nothing to be done,” one’s body has been put on “war footing” with no war going on.  (267n.)



One Comment

  1. Dear Ken,
    Thank you for this wonderful site. I am saving this one to refer to in my work as a bereavement volunteer with Gilchrist Hospice Care in Baltimore. And I enjoyed to one about the opera singer as well: I had heard the same interview while I was driving through a rainstorm to a meeting outside of Washington at rush hour . . . that was the only interview I’ve ever heard where Terry Gross was somewhat nonplussed. Keep up the good work. Pat Podufaly Schultheis

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