Tuesday, February 2, 2021

"Hierarchy of Suffering"

This is a tricky one, so bear with me. 

These are just my initial thoughts on a complex sensitive issue. I stand to be corrected if I'm missing some nuance here (and to correct myself if I later have additional thoughts).

A common saying these days is "There is no hierarchy of suffering." I agree with it. There's something important in this. Everyone's suffering is absolutely valid. No one gets to tell someone else that the suffering they're experiencing doesn't count. No one's suffering should be discounted on the basis that someone else has it worse. I also hope no one will feel a need to dismiss their own suffering this way (which is a common feeling many trauma survivors have--mine doesn't count because it wasn't as bad as others who had it "worse"). 

It is a critical starting point from which we should never stray.

But like other platitudes, it has an icky side: when used as a means to silence those who've been through severe trauma and/or have obstacles in the way of their healing that others don't. When it's used to keep them from speaking about what makes their experiences different from others who may be speaking. To erase all suffering that occurs outside the margins of what is typically visible on the basis that it's all the same. 

Of course, there's such a thing as different degrees, complexity, treatability of suffering. We don't even need to compare our suffering to others to know this. We've all suffered in a variety of different ways in our lives, some of which had a greater impact on us than others. Some which resolved more readily. We certainly would never say all physical injuries/conditions are the same. A tension headache that comes on periodically but is relieved with advil is not the same as a brain tumour that causes constant severe suffering and a dramatically shortened life. (note: I have no lived experience of either of these conditions so I apologize if I've missed some nuance here)

So what's really happening here? What are we getting at? Everyone's pain matters. And we know our own pain best. If something hurts you, no one else gets to invalidate it by saying it's disproportionate to whatever its apparent causes are or whatever your current circumstances are. Pain is pain. And there won't always be an obvious source. The pain doesn't need to "fit" a cause. It is valid all on its own. 

But of course there can be differences. Repeated severe trauma (especially in childhood) can have profound effects that can substantially increase our risk for all kinds of other types of illness and suffering, including early death. And we deserve to have the reality of it taken seriously. We deserve to have people available to treat it who are competent to address its complexity and severity--who understand what makes it different. Not just dismissed as unnecessary to hear about or specifically address because "it's all the same." 

That said, it's not something to be enforced by silencing other people's pain. It's about listening to people and validating what's actually happened to them and what they in fact experienced as a result. If someone says, "my suffering is immense" then we don't look to what happened to them and say "that's not a good enough cause." The causal relationship is not always straightforward. Nor is there any reason why it should have to be. Pain is pain. It doesn't require further justification. It deserves compassion, regardless of how it may have been caused, or whether a cause can even be ascertained. 

But the problem with insisting that there are generally no differing degrees/types/severity, is (1) It's an absurd and invalidating form of erasure when it dispenses with the need to listen to what people actually endured; (2) It conceals actual hierarchies that otherwise operate. 

When used to conceal and reinforce existing hierarchies, this type of approach says "Well, we all have trauma and there's no hierarchy of trauma, so you need to buck up like the rest of us, and recover through the things that work for us." It erases critical differences which isn't okay either. It says "You are not allowed to share the aspects of your suffering that are unique and different--the fact that for you suffering was a constant theme rather than an occasional experience, the fact that it's exacerbated by ongoing injury from systemic racism, ableism, homophobia, transphobia, etc. to which others aren't exposed." It's all just the same; therefore, we don't need to listen to people's experiences. And in fact when they try to tell us, we silence them and say no you may not speak about the ways in which your experience of suffering isn't reflected by the prevailing discourse because "there is no hierarchy of suffering."

So then whose pain becomes the norm? And whose becomes invisible? When there's "no hierarchy of suffering" what gets to be visible? IMO, all too often it's the experiences and realities that otherwise are dominant. The ones that are already promoted as 'normal" by existing hierarchies.

There are in fact vastly different ways in which people can suffer, all of which matter and count, but of course they can be different. Repeated trauma from which there is no escape tends to have different effects beyond single incident trauma. This is something we know and will hear if we listen to people who have been through it (as well as to science). That said, other forms of suffering (including single incident trauma) can also have enormous effects all on their own, which we know both from listening to people who've endured it and listening to science that listens to those people. 

So the only way to know the type, degree and severity of suffering is to listen to people and believe them. My suffering is immense. I've been through a lot, but I'll (1) never silence someone who has been through "less" but experiences the same degree of suffering from it; and yet at the same time, I'll (2) never silence someone who has been through things I haven't--e.g., repeated trauma in addition to ongoing systemic racism--by saying it's "all the same." 

The answer is to hear it all and be prepared to have nuanced validating discussions about it. And no we don't have to "grade it," but we don't get to silence it either or absurdly pretend that it's all the same and that all kinds of vulnerabilities and inequalities don't play a role. If we silence it, we won't be able to redress it. And there are indeed inequalities that need to be redressed. We can't use a language of "sameness" to wave those away. There are things happening we need to stop. 

We can be open to both similarities and differences, without a pre-determined "hierarchy" but also without a dismissive erasure that says "well it's all the same--so who needs to hear from you--we can just extrapolate from our own experiences"(in a way that reinforces existing hierarchies and absolves those in the mainstream discourse from having to hear from those whose experiences tend to be marginalized/ignored).

The answer in my view: listen carefully and attentively to lived experience (and whatever science flows from genuinely taking it into account in an inclusive way). Don't silence it in either direction by declaring it "too little" "too much" or "all the same." Just listen.

As a survivor of repeated trauma, for whom an experience of safety was often the exception not the rule at critical points in my life, my experiences are indeed different in some crucial ways from what I hear many others sharing. I don't expect there to be a grading system and I would never silence someone or discount their suffering just because what they've been through is different from what I have, but I expect to be heard about the impact that has had on me even if I have to use strong terms to adequately convey it, even if I have to say that my experiences aren't reflected in what I hear others saying (not as a matter of judgment or comparison, but as a matter of fact). At the same time, there are many ways in which my suffering was lessened by the way the world accommodated me, as it may not have done for others (e.g., it wasn't compounded by experiencing the racism minoritized people have to endure on an ongoing basis), so I don't assume that people who've experienced something different than I have are all in "the same" place. My complex trauma doesn't relieve me of the responsibility of listening to and learning from the complex trauma of a residential school survivor, for instance. I have trauma too, but it's not "the same." It doesn't relieve me from the responsibility of learning about what others have had to endure and the impact it's had on them.

I listen. And I try to learn. From both similarities and differences. With an openness and non-defensiveness about both (as a goal, though none of us can ever be perfect at this).

In my view, we can benefit from the recognition of both the "sameness" (our "common humanity") and the differences (arising from our own experiences). We need to stop erasing these in the name of some platitude in either direction. If we don't acknowledge the ways in which we are similar, then we miss out on connection and solidarity. If we don't acknowledge the ways in which our suffering can be different, then we miss out on validation, accommodation and inclusion.

We can do both. It's all valid. It's all very real and very human, but it's not all "the same."
 


As always, please note that I am a lawyer, not a mental health professional of any kind. I have no expertise in trauma or mental health. Also, please note that any opinions and views expressed in this blog are solely my own and are not intended to represent the views or opinions of my employer in any way. 

I am very grateful to have received a 2019 "Clawbie" Award for this blog (which reflects the importance of this topic): https://www.clawbies.ca/2019-clawbies-canadian-law-blog-awards/ 

For some of my external writing on this topic, see: 




3 comments:

  1. Thank you for sharing this. I am only now, in my fifties, confronting a lot of stuff that went down in my early childhood and teens and just learning how to name what happened and contextualize my present circumstance as it relates to my childhood and adolescent experiences. I understand your point as it regards not minimizing others' trauma or pain because it does not match one's own experience, but there is a lot to be said for the support found in groups who can identify with the pain and aid in healing, even if the kind of trauma or degree of pain differs. But openheartedness and openmindedness, as you say above, should be non-negotiable baseline conditions.

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    1. Yes I absolutely agree and apologize that I didn’t see this comment before. Thank you so much

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    2. Yes I absolutely agree and apologize that I didn’t see this comment before. Thank you so much

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