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Blog Post: Nietzsche and Pain
🕑 Added 2025-09-04 10:06:55 +0000 UTCI will put this up on Substack at some point, but wanted to put it here first :). It is a bit of a work in progress re: an area of Nietzsche I sometimes think goes a bit unnoticed.
I am writing this post, having spent most of the day lying on my sofa, trying in vain to focus on my copy of Turgenev’s Fathers and Sons, which I am re-reading for a video (though, between you and me, I’m finding that I read it so poorly the first time around that “re-reading” feels like a generous way to put it).
My day has taken this rather frustrating turn because I suffer from chronic pain. On an average day, I probably spend around 12-14 hours in some kind of low-level, nagging pain. Luckily, I have had this for years and most of the time it does not affect my moods too much, nor does it hamper my work. But occasionally there will be a day like today, where the pain becomes so much that I have to write the day off as a waste of time, and retreat back into bed to feel sorry for myself like the true pasty Englishman I am.
But it is also times like these that I realise just how much of my life is dictated by my pain. One of the reasons I manage to keep my pain to a reasonable level is because I have, over many years, tested the exact kinds of routines that minimise the flare-ups, and I stick to them almost religiously. The pain is digestive in nature so this largely consists in carefully timing when I eat and what I eat, but there are a whole host of other tiny moving parts that just keep the pain at bay.
I don’t say all of this to complain. I deeply enjoy my life and would not trade it for anyone else’s. But I do say it to illustrate one thing: this chronic pain condition is probably the most important single factor in how I live my life. It forms a plurality in the parliament of my decision-making process. It does not dictate my life, but it often has the deciding vote. It means I travel as little as possible (since when I travel I tend to have to take some cocktail of medication in order to make the experience go smoothly). It often leaves me too exhausted to do much of anything after work. And it means I am often incredibly anxious about breaking from my routines.
But what does this all have to do with Nietzsche. Well, something that I feel is almost always overlooked in discussions on Nietzsche, both in popular discourse and even in a lot of academic literature, is that Nietzsche suffered from a really quite debilitating chronic pain condition. To quote from Ecce Homo:
“In the same year that [my father’s] life declined mine also declined : in my six-and-thirtieth year I reached the lowest point in my vitality, I still lived, but my eyes could distinguish nothing that lay three paces away from me. At that time - it was the year 1879 - I resigned my professorship at Bale, lived through the summer like a shadow in St. Moritz, and spent the following winter, the most sunless of my life, like a shadow in Naumburg. This was my lowest ebb. During this period I wrote The Wanderer and His Shtadow. Without a doubt I was conversant with shadows then. The winter that followed, my first winter in Genoa, brought forth that sweetness and spirituality which is almost inseparable from extreme poverty of blood and muscle, in the shape of The Dawn of Day. The perfect lucidity and cheerfulness, the intellectual exuberance even, that this work reflects, coincides, in my case, not only with the most profound physiological weakness, but also with an excess of suffering. In the midst of the agony of a headache which lasted three days, accompanied by violent nausea, I was possessed of most singular dialectical clearness, and in absolutely cold blood I then thought out things for which, in my more healthy moments, I am not enough of a climber, not sufficiently subtle, not sufficiently cold.”
I apologise for the long quote, but I promise it is all relevant. The points this section establishes (as well as the others in which Nietzsche mentions his pain in Ecce Homo) are the following:
Nietzsche suffered from chronic headaches and a frustratingly variable deterioration in sight for much of his adult life, including when he wrote many of his most well known works.
There is a direct connection between the suffering he felt, and the contents of those works.
Remember, this is Ecce Homo, which is explicitly Nietzsche’s attempt to write his own philosophical autobiography. He wants, at least partly, to explain the drives, instincts, as well as the physiological and psychological markers, that are behind his writing. As if this were not enough, Nietzsche explicitly links his health to the development of his philosophy, saying:
“For this should be thoroughly understood ; it was during those years in which my vitality reached its lowest point that I ceased from being a pessimist: the instinct of self-recovery forbade my holding to a philosophy of poverty and desperation.”
Now, I obviously have not read every piece of secondary scholarship on Nietzsche out there, but I have read quite a lot. And it is always striking to me how little attention tends to be paid to this link Nietzsche himself draws between his own suffering, and the need to abandon the prior pessimistic bent in his own philosophy.
For example, I am a huge fan of Bernard Reginster’s interpretation of Nietzsche’s own project as geared around nihilism. And a big part of Reginster’s analysis stems from the notion that life contains a lot of suffering, and that the kind of ideas that Nietzsche overturns (such as the existence of God, or Heaven, or even just the existence of a state of calm, satisfied being) are part of the conceptual apparatus that has allowed people to deal with this suffering. For Reginster, the “nihilism of despair” that people might feel in response to these ideas being overturned is because they no longer have an ideal that can justify all of this suffering. He thus places many of Nietzsche’s key ideas (most notably the will to power) as ways of dealing with suffering. To quote Reginster directly:
“Nietzsche explicitly emphasizes the idea of overcoming resistance, which he presents as their common defining feature: “But all expansion, incorporation, growth is striving against something that resists; movement is essentially tied up with states of displeasure; that which is here the driving force must in any event desire something else [than happiness] if it desires displeasure in this way and continually looks for it.—”(WP 704). “Expansion, incorporation, growth,” Nietzsche suggests, “is striving against something that resists.” The will to power is therefore the will to “striving against something that resists.” Since striving against is an effort to overcome, we might say that the will to power is the will to overcoming resistance.” (Reginster, The Affirmation of Life, p. 126)
And again:
“It is quite explicitly by virtue of his will to power, as I have characterized it in the previous chapter, that the “human of the future” will be able to revaluate the ideal out of which nihilism inevitably grows: “this human of the future who will redeem us from the previous ideal as much as from that which had to grow out of it, from the great disgust, from the will to nothingness” must be strong, and therefore “a different kind of spirit than likely to appear in this present age: spirits strengthened by wars and victories, for whom conquering, adventure, danger, pain have become a need” (GM, II 24).” (ibid. p.148)
Here Reginster draws the connection explicitly, by arguing that part of Nietzsche’s future aspiration for the “human of the future” is that they will be able to see pain as a need. That is, it is explicitly part of Nietzsche’s project of overcoming nihilism that we learn to reconceptualise pain.
As I said, I am an enormous fan of Reginster’s interpretation (I am not alone here - Jared Henderson from @commonplacephilosophy is similarly a fan, and it has even garnered praise from Brian Leiter, so we are talking about a heavyweight scholar here). And I cannot help but make a connection between Nietzsche’s own chronic pain, and his need to revaluate aspects of life such as suffering. Nietzsche and my shared predicament re: pain was actually one of the reasons I was so drawn to reading him in the first place, and why I go back to his works again and again and again.
If you’ll permit me to get a bit speculative and subjective here, an awful lot of the themes in Nietzsche’s writings: from the need for self-overcoming, inner strength, reevaluating pain, transmuting tragedy into something valuable, and even observations about thwarted drives leading to ressentiment and a kind of inner gnawing, all seem almost tailor-made for someone who is in pain for much of the time. Ideas about physiology influencing (and in some cases even dictating) valuation also hits very close to home for someone who is often at the mercy of their own body in a very literal way. I obviously cannot possibly claim that this is how Nietzsche came up with these ideas. I am just suggesting that, from the perspective of someone who does suffer from chronic pain, albeit in a different form than Nietzsche did, they resonate intensely with the kind of vague musings I have had in some of my moments of “lowest vitality”. It’s just that, you know, they’re put into words by one of the greatest geniuses of the 19th century, rather than scrawled into my £7.99 notebook in between immodium tablets.
I can understand why people might be reluctant to examine this sort of thing in detail. In a lot of cases I am pretty opposed to mining a philosopher’s personal life to interpret their works. For many philosophers, their arguments stand alone. I am not sure interpreting the Tractatus through the lens of Wittgenstein’s temper, or Russell’s On Denoting through his many marriages would be all that helpful. However, when it comes to Nietzsche and pain, I would make an exception for a few reasons.
The first is that his writings often concern the effects of pain and suffering, and specifically transmuting pain, resistance, and other seemingly “oppositional” forces as something decidedly anti-pessimistic.
The second is that Nietzsche seems insistent that his pain has influenced his writings, and that he in fact transmuted his own suffering in a way that mirrors his philosophy. Not only this, but a big theme in this philosophy more generally is just how great an effect physiology has on philosophy and psychology. From Nietzsche’s posthumously published notebooks:
“A dangerous distinction between ‘theoretical’ and ‘practical’ can be found, e.g. in Kant, but also in the ancient philosophers; they act as if pure intellect presented them with the problems of knowledge and metaphysics; they act as if practice should be judged by its own measure of value, whatever answer theory may give. Against the first, I pit my psychology of philosophers; their most detached calculations and ‘intellectuality’ remain but the faintest impression of a physiological fact;” (Section 458)
It is clear that, for Nietzsche, the physical condition and the philosophical output of a thinker are inseparable.
And thirdly, much more subjectively, I know from first-hand experience just how much being in pain most of the time affects how you see the world. Couple this with the fact that Nietzsche's illness was one reason he had to cut his academic career short (something he later looked upon as a blessing in disguise), and I think we really do have a strong case for treating this as an essential influence on his thought.
I don’t want to overstate my case here. I am neither an academic nor an expert, and Nietzsche’s illness does not by any means go totally ignored in scholarship. I just wanted to give one reason why, when I read Nietzsche, the spectre of his pain always seems to loom large on the horizon. And that this also has the potential to serve as evidence for some of my favourite interpretations of such a unique thinker.
Comments
Shirley Noble
I am beginning to think that chronic pain is much more prevalent than our societies would like to admit. Thirteen years ago I developed fibromyalgia after an agonizing pinched nerve in my back that took 3 months to heal. They say that an extended episode of extreme pain can trigger
Lizelle Van Wyk
Hey Joe, I read your post whilst in the UK, visiting a friend of mine (with 'A Short History of Decay' as my travel companion - brilliant!). I couldn't respond because I forgot my password. But I discussed your post with my friend. I am truly sorry for what I am about to write; I know you have a very low tolerance for woo (based on ideas you've introduced with 'I'm sorry if this sounds woo' - ideas I consider quite mundane). Naturally, as my friend is a previous Coven sister (I left the Coven), my mind went to possible spiritual causes. She Googled and saw that indeed, many of the very heady philosophers (a.o. Kant, Schopenhauer and also Nietzsche) had gut problems. We thought that it might be that darn denied brain-gut relationship, you know. We are quite sure that you need a spiritual practice and/or a good wife. I'm sorry if I'm making this sound flippant. It's not my intention. I even developed some gut pains whilst there (the same day, just after we discussed it) (they are vegan and some vegan food has that effect on me) and tried solving it spiritually. I went outside, lay on the grass and rubbed my belly. It worked, but only until dinner. I needed a good night's sleep (which is what I usually need) and did not eat any processed food the next day. I know it is a terrible pain! Thank you for sharing. And I really do wish you the best of health.
