Kiki Smith, “Untitled,” 1990. Whitney Museum of American Art, New York.

When we are suffering (from thoughts, feelings, body sensations, or memories) it can sometimes be useful to chart the journey of others who have struggled in similar ways.

The philosopher Friedrich Nietzsche who I came to quite late in my reading life, never having studied philosophy as a subject, experiencing it for the most part a somewhat intimidating domain, struggled with health issues, both physical and mental, for much of the time he was on this planet.

If he were alive today, I suspect he might have been diagnosed with having fibromyalgia, or another issue that highly sensitive folk often struggle with.

What I find inspiring about his life is that he seems to have landed on a way, at least for a while, of finding value, meaning, and joy at the same time as being ill on a constant basis.

I think this short chapter from the novelist Stefan Zweig’s recent book on Nietzsche gets to the heart of a paradox that often arises in psychotherapy, but also in our lives in general: how to “love life, to love it even when you have no stomach for it,” as the poet Ellen Bass laments, “and everything you’ve held dear crumbles like burnt paper in your hands”?

APOLOGIA FOR ILLNESS
(from Nietszche by Stefan Zweig, 2020)

Countless are the cries of suffering issuing from the martyred body. It is an index with a hundred entries for every conceivable physical crisis, proceeding to this horrifying final statement. ‘At all stages of life, the surplus of pain has in my case been immense.’ Indeed no diabolic martyrdom is absent from this nightmarish pandemonium of malady: headaches, pounding and dizzying headaches, which for days leave him prostrate on a couch or a bed in a state of fruitless delirium; stomach cramps, along with vomiting of blood, migraines, fevers, loss of appetite, dejected mood, haemorrhoids, intestinal stagnation, fever shakes, night sweats – a gruesome vicious circle. Add to that ‘eyes three quarters lost to darkness’ which swell at the least effort or begin to weep and which allow him to enjoy the light for no more than ‘an hour and a half a day’.

But Nietzsche scorns a healthy body and remains at his writing table for ten hours at a stretch. The overheated brain takes revenge with raging headaches, nervous tension, for in the evening, when the body is exhausted the brain cannot switch off, but continues to pour forth visions and thoughts, until a narcotic must be sought in order to sleep.

But he requires ever-greater quantities (in two months, Nietzsche absorbs fifty ounces of Chloral Hydrate, just to snatch a little sleep). Then it’s the stomach’s turn to refuse to pay such a high price and it revolts. It’s a real circulus vitiosus – vomiting spasms, fresh headaches, new remedies demanded, the relentless voracious, fervid opposition of overtaxed organs in a mutual exchange with the spiky ball of sufferings.

And no respite from this play back and forth! Not the lowest margin of contentment, not the briefest month of pleasure and forgetting of the self; in twenty years, one can count only a dozen letters where a groan does not rise from one line or another. And always more furious, always more violent, becoming the wailings of one who is needled by over-sensitive nerves, too delicate and already overinflamed. ‘So make your lot more easeful; Die!’ he cries to himself; or ‘For me a pistol is now a source of the most pleasurable thoughts.’ Or ‘This horrible and unremitting martyrdom has me thirst for the end and all portents suggest, the redemptive apoplexy is close at hand.’

For a long time now he has lacked superlatives to express his sufferings; already they seem monotonous in their incessant and exasperating repetition, these wretched cries, which no longer have anything human about them, but which still ring out shrilly towards men, from the depths of this ‘dog kennel existence’. Then suddenly flames – and one can only tremble before such a monstrous contradiction – in Ecce Homo that vigorous, proud, rigid confession of faith that appears to put the lie to every lament that preceded it: ‘All in all, I have been (he speaks of the last fifteen years) in a state of quite excellent health.’

What then to believe? The thousand fold cries, or the lofty revelation? Both! Nietzsche’s body was organically strong and capable of resistance. His inner trunk was broad and stable, supporting him like a tower, his roots were sunk deep in the soil of a long line of German parsons. All in all, ‘summa summarum’, with regard to the plant, the organism, the fundamental nature of the spiritual body, Nietzsche was in truth a healthy man. Only his nerves were too delicate to withstand the violence and extreme sensations they endured and so they remained perpetually inflamed and were apt to revolt. (But a revolt that could never quite undermine his mind’s steel grip on self-domination.)

Nietzsche himself found the most charming image to paint that intermediary state between danger and security, when he speaks of ‘the little fusillade’ of his sufferings. Indeed, during this conflict, the inner walls of his life force are never breached. He exists like Gulliver in Lilliput, constantly assailed by the swarming little people of his sufferings. His nerves are always on the alert, he is continually on the lookout, keeping watch, his full attention monopolized by the debilitating and all-engrossing needs of self-defence.

But never does a genuine illness manage to break him or render him vanquished (save perhaps for that unique sickness which for twenty years sunk mineshafts beneath the citadel of his spirit and then at a particular moment blew it into the air), for a monumental spirit like that of Nietzsche cannot be felled by a brief volley of shots, only an explosion can shatter the granite of such a mind.

So, an enormous capacity for suffering opposes an enormous resistance to suffering, or rather an over-charged violence of feeling opposes an over-charged sensitive nerve in the motor system. For each nerve of the stomach, along with the heart and senses constituted for Nietzsche a highly accurate manometer, a delicate filigree-like instrument registering with tremendous amplitude the shifts and tension at the outbreak of the most painful stimulations.

Nothing remained unconscious for his body (as for his mind). The most delicate fibre which in others stays muted, in him signals immediately with a quivering and a tearing and that ‘raging irritability’ shatters, into a thousand splinters, hazardous and piercing, his naturally energetic vitality. From this come the terrible cries, when at the slightest movement, with each sudden step of his life, he happens to touch one of these open twitching nerves.

This uncanny, almost demonic, hypersensitivity of Nietzsche’s nerves, fugitive nuances that would never even cross the threshold of another’s consciousness, and which undermined him so cruelly, is the sole root of his sufferings, but equally forms the primordial cell of his genial capacity for the appreciation of values.

If his blood chances to register some physiological reaction, there does not have to be any tangible or affective cause: the atmosphere alone, with its meteorological adjustments hour by hour, is for him already the cause of infinite torments. Perhaps there has never existed a man of intellect so acutely sensitive to atmospheric conditions, so terrifyingly exposed to all the tensions and oscillations of meteorological phenomena, like a manometer, or mercury in the barometer: between his pulse and the atmospheric pressure, between his nerves and the degree of humidity, secret electrical contacts seem to exist; his nerves immediately register every metre of altitude, every change in pressure, in temperature, through a sense of discomfort in his organs, which react in accordance with each corresponding fluctuation in nature.

Rain or an overcast sky depresses his vitality: ‘A cloudy sky plunges me into a deep depression.’ He feels in his very vitals the influence of a sky heavily charged with cloud; the rain reduces his ‘potential’, humidity weakens it, dry spells enliven it, the sun brings life, but winter is for him a kind of catalepsy and death. The quivering needle of his nerve barometer swings back and forth like an April temperature which never remains constant: what he must do then is to relocate himself within a cloudless landscape, upon the high plateau of the Engadine that no wind may disturb.

And, just like the effect of the least change in cloud cover or pressure in the actual sky, his enflamed organs immediately sense the effect of all these pressure changes and atmospheric liberations upon the interior sky of the spirit. For each time a thought quivers in him, it shoots like a lightning fork across the strained knots of his nerves: the very act of thought is accomplished in Nietzsche’s case, with passionate intoxication, with a rush of electricity so that it passes over his body like a storm and at each ‘explosion of feeling, the mere blink of an eye is enough to modify the blood’s circulation’. Body and mind in the most vital of all thinkers are so intimately linked to the atmosphere that for Nietzsche interior and exterior reactions are identical. ‘I am neither body nor spirit, but rather a third element. I suffer everywhere and for everything.’

This singular disposition to discern so precisely the least stimulus was brutally exacerbated by the inactive incubating air of his life, through the fifteen years he spent in solitude.

For three hundred and sixty five days of the year, no one else comes into physical contact with his own body, neither woman nor friend, for twenty-four hours of the day are spent in discourse with his own blood, pursuing a kind of uninterrupted dialogue with his nerves. Perpetually, at the centre of this tremendous silence, he rests on his palm the compass of his sensations and, in the manner of hermits, solitary men, bachelors and eccentrics; he observes in hypochondriac excess the slightest changes that occur in the function of his body.

Others can forget because conversations and other day-to-day matters deflect their attention, as do games and general lassitude, or others may drown their feelings in wine and apathy. But Nietzsche, that genius for the diagnostic, continuously experiences the temptation to offer up himself for his own sufferings, seeking that curious pleasure of the psychologist choosing himself as subject, to be ‘his own experiment and laboratory animal’.

Again and again, with fine tweezers (at once surgeon and invalid), he dissects the suffering of his nerves and by doing so, like all natures overloaded with anxiety and imagination; he only serves to inflame his sensibility still further. Mistrusting the opinions of doctors, he takes on the role of his own doctor and ‘medicates himself’ through all stages of his life. He tries every conceivable method and cure, electric massages, dietary regimes, water therapies and medicinal baths; sometimes he blunts his excitability with bromide, then he stimulates it again with other potions.

His meteorological like sensibility forces him to search unremittingly for a particular atmosphere, a location which could be for him ‘the climate of his soul’. It might be Lugano, due to the lake air and an absence of wind, or Pfäfers and Sorrento; then he imagines the baths of Ragaz might deliver him from his malaise and that the health-giving area of St Moritz, the springs in the spa towns of Baden-Baden or Marienbad might afford him some well-being. For a whole Spring he finds the Engadine accords best with his own nature, with its ‘invigorating and ozone rich air’; then it’s a town of the south, Nice, with its ‘dry’ air, then Venice or Genoa.

Now he wants to be in the forests, now he wants to be at the coast, now on the shore of a lake, now in quiet little towns ‘with a simple and nourishing meal’. God knows how many thousands of kilometres this ‘wandering fugitive’ covers by rail, all to discover this fabled place where his nerves might be relieved of the burning and tearing and where his organs can cease being on permanent vigil.

Little by little, he distills from his pathological experiences a kind of sanitary cartography for his own personal use, studying the great works of geology to discover the region that he seeks, like an Aladdin’s ring, to finally master his body and bring peace to his soul.

No journey is too long for him: Barcelona is in his sights and he dreams too of the high mountains of Mexico, of Argentina and even Japan. Geographic position, the dietary science of the climate and food gradually become second knowledge to him. At each location he notes the temperature, the air pressure; he measures to the millimetre, with a hydroscope and hydrostatic equipment, the atmospheric rainfall and ambient humidity, so much so that his body acts like a retort or the column of mercury in a thermometer.

The same exaggeration is found in his dietary regime. There too, this ‘recording’ is to be found, a veritable medical tablature of precautions. The tea must be of a certain brand and served at a stipulated dosage so as to not do injury; a meat dish may be harmful, vegetables must be prepared in the correct manner. Little by little, this mania of medicalization, of diagnosing, becomes a pathological and egotistical trait, a tension, a hyper-awareness of the self. Nothing caused Nietzsche to suffer more than this eternal vivisection. As always, the psychologist suffers twice as much as anyone else, because he experiences the agony twice over: first in reality and then by observing himself.

But Nietzsche is a genius of violent opposites. In contrast to Goethe, who had a knack for knowing how to avoid danger, Nietzsche advances audaciously and takes the bull by the horns. The psychology, the spiritual effort  pushes the deeply impressionable man towards profound suffering and into the abyss of despair; but it is precisely the psychology, precisely the spirit which restore him to health. Like his sickness, Nietzsche’s recovery comes only from the inspired knowledge he acquires of himself.

Psychology, in a magic way, here becomes something therapeutic, a peerless application of that ‘art of alchemy’, which manages to ‘extract value from something which has no value’.

After ten years of relentless torment, he is ‘at the lowest ebb of his vitality’; already they think him lost, ruined by his nerves, by an irremediable depression, given up to pessimistic self-abandonment. Then suddenly the spiritual attitude of Nietzsche takes an about-turn through one of those meteoric and inspired recoveries, both recognition and salvation of the self, that lend the history of the spirit such intensity and drama. Suddenly he draws from himself the very malady that saps his soul and presses it hard against his heart.

Then comes the truly mysterious moment (whose date we cannot pinpoint precisely), one of those dazzling inspirations at the heart of his work, where Nietzsche ‘discovers’ his own sickness; where – surprised to find himself still breathing and to see that from the deepest depression, through the most griefstricken periods of his existence, his productivity is growing – he proclaims with the most intimate conviction that his sufferings, his privations are merely a part, for him, ‘of the cause’, the sacred cause of his existence, the only cause that is sacred to him.

At the hour when his mind has no more pity for his body and no longer participates in its trials, he sees his life for the first time with a new perspective and observes his sickness through a more profound intellect. With open arms, he knowingly accepts his destiny as a necessity, and as a fanatical ‘advocate of life’, he loves everything in his existence, even launching a hymn to his suffering in affirmation of Zarathustra, the jubilant ‘Once more! Once more, for all eternity!’

For him simple knowledge becomes a recognition and recognition a gratitude; for in this superior contemplation which lifts his gaze above his suffering and sees his own life only as a path to himself, he discovers (with that excessive joy conjured by the magic of extremes) that he owed all to his sickness and to no earthly power, that it was the mind tortures themselves that proved the greatest blessing: freedom, freedom of external existence, freedom of the spirit; for whenever he has risked settling down, delivered himself up to lassitude, released himself from the burden and abandoned his originality by becoming prematurely fossilized in some official post, a profession or a static spiritual form, it was the sickness that chased him out of it with its ruthless goad. It was the sickness that saved him from military service and returned him to science, that prevented him from being ossified in science and philology, that extricated him from the academic circles of Basel university, to enter ‘retirement’ and hence encounter the world, returning him as it were to his real self. He owed it to his afflicted eyes to have been ‘liberated from the book’, ‘the greatest service I ever did myself’.

Suffering tore him (painfully but helpfully) from all the husks that threatened to form around him, from all the relationships that began to enclose him. ‘Sickness itself liberated me’, he says of himself: it was midwife to his inwardness and the sufferings it inflicted were not unlike those of childbirth. Thanks to it, life had become in his case, not a routine, but a renewal, a discovery: ‘I discovered life, in some sense, like a novelty, myself included.’

For – and this is how the pained man now gratefully exalts his dolors in a grandiose hymn to the saint torment – only suffering leads to knowledge. Rude health is hollow and unsuspecting. It desires nothing and poses no questions and this is why there is no psychology among the healthy. All knowledge comes from suffering, ‘pain always searches to know the causes, whilst pleasure remains in a fixed position and does not look backwards’. We become ‘refined through pain’. Suffering, burrowing and scoring, breaks up the terrain of the soul and the tortuous labour of delving inwards, like the plough, turns the soil, enabling a new spiritual harvest. ‘Mighty pain is the last liberator of the spirit; she alone forces us to descend into our ultimate depths’, and he for whom it has been almost fatal has surely the right to proudly declaim these words: ‘I know life better, because I have so often been at the point of losing it.’

It is not by artifice, by a negation, by palliatives and in idealizing his bodily distress that Nietzsche manages to surmount all these sufferings, but through the primitive force of his nature, through knowledge: the sovereign ‘creator’ of values discovers himself the true value of his illness.

Martyr in reverse, he does not at first possess the faith to endure his torments; it is only from experiencing the torments themselves that he acquires this faith. But his knowledge chemistry not only discovers the value of sickness, but also its opposing pole: the value of health. Only their union can bear the accomplishment of life, that permanent tension of ordeal and ecstasy, thanks to which man rushes on into the infinite.

Both are necessary: sickness, as the means, and health as the end; sickness as the path and health as the destination. For suffering, in Nietzsche’s mind, is only the dark shore of sickness; the opposite shore is bathed in an inexpressible light: it is called recovery and only from the shore of suffering can it be reached.

Now to heal, to recover one’s health, signifies more than simply achieving a state of normal functioning life; it is not only a transformation, but something infinitely greater, an ascension, an elevation and a growth of perception: one emerges from sickness ‘with a new skin, more sensitive, with a refined taste for pleasure, with a language more appreciative of all fine things, with a more joyful sensibility and a second more dangerous innocence at the heart of happiness’, childlike and a hundred times more refined than formerly; and that second health following on the heels of illness, that health which is not blindly received, but is a treasure, sought out with great pain, bought with a hundred sighs and cries, this health ‘re-conquered with heavy losses’ is a thousand times more vital than the cursory well-being of those who are always in fine fettle.

Those who have tasted just once the quivering softness, the sparkling intoxication of this recovery, yearn always to experience the same sensation; to launch themselves again and again into the sulfurous fiery wave of burning torments, only in order to relocate that ‘captivating sensation of health’, that gilded drunkenness which, for Nietzsche, replaces and surpasses a thousand times over, all the vulgar stimulants of alcohol and nicotine.

But hardly does Nietzsche perceive the meaning of sickness and enjoys the rapturous recovery, than he wants to make of it an apostolate through the sense of the world. Like all those in the grip of the demon, he is the slave of his own passions and is unable to draw back from that dazzling interplay between pleasure and pain. He desires that the torments martyrize him ever more intensely, so as to launch himself ever higher in the jubilant sphere of recovery, where all is clarity and vigour. In this shimmering and fervent drunkenness, he gradually confuses his vehement will for recovery with the thing itself, his fever with vitality and the vertigo of his downfall with an increase in power.

Health! Health! This man so intoxicated with words brandishes them above him like a standard: it must be there the meaning of the universe, the purpose to life, the sole gauge of all values. And he who has for a dozen years groped in the shadows, from affliction to affliction, stifles his lament now in a hymn to life, the brute strength drunk on itself. With blazing colours, he unfurls the flag of the will to power, the will to live, the will to be hard and cruel and ecstatically presents this flag to coming humanity, not realizing that the strength which animates him and which allows him to raise his standard so high, is the same that will stretch the bow that sends the arrow which will kill him.

For Nietzsche, this final moment of health, which in exaltation rouses him to the dithyramb, is an autosuggestion, a ‘contrived’ health; precisely at the moment where he joyfully raises his hands to the heavens, in an outpouring of strength, vaunts (in Ecce Homo) his perfect health and swears that he has never been sick or decadent, already lightning quivers in his blood.

What sings in him and triumphs, is not his life, but already his death, this is no longer the mind informed by science, but the demon snatching its victim. What he takes for light, for the red warmth of his blood conceals the fatal germ of his malaise, and what the clinical regard of each diagnosing doctor observes so clearly in this marvellous feeling of wellbeing enveloping him during those last hours, is what is commonly known as euphoria, that peculiar moment of bliss which heralds the end.

Already the silver clarity which spreads over these last hours only projects before him the quivering sheen of another sphere, that of the demon, that of the beyond: but lost in his drunkenness he is no longer aware. He feels himself uniquely illuminated by all the splendour and gratitude of the earth.

Ideas shoot out from him like flames; language trembles with a primordial power through all the pores of his discourse, and music suffuses his soul: everywhere he turns his gaze, he sees peace reign supreme. Ordinary people in the street smile at him. Each letter is a divine message and sparkling with happiness, he writes in a final letter to his friend Peter Gast: ‘Sing me a new song. The world is transfigured and all the heavens rejoice.’ It is from this transfigured sky that the fiery ray reaches him, confusing his beatitude and suffering into one indissoluble second. The two polarities of sentiment enter his swollen breast at the same moment and on his temples the veins throb with both life and death in a single apocalyptic music.”

From Nietszche by Stefan Zweig (2020)

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