Neurasthenia, no longer diagnosed today, was an illness that was commonly diagnosed in the late nineteenth and early twentieth centuries. It was an umbrella category that encompassed all manner of somatic and psychosomatic ailments. In order to make this disease more palatable to the American public, Dr. George Miller Beard constructed an economic metaphor, in which people had a certain amount of "nerve-force" that could be saved or spent and, when overspent, could result in "nervous bankruptcy" (Beard 9). My essay analyzes The Diary of Alice James from a disability studies perspective in order to illustrate how Alice James uses this economic discourse rhetorically to reclaim her subjectivity, to characterize disability as central to identity, to disrupt the narrative of disability as global incapacity, and to configure pain (rather than illness itself) as work.
"How well one has to be, to be ill!" Alice James wrote in her diary after one of her particularly traumatic "physical collapses," the seriousness of which she downplayed as "rather excessive and comic in its combination, consisting of one of my usual attacks of rheumatic gout in that dissipated organ known in the family as 'Alice's tum,' in conjunction with an ulcerated tooth, and a very bad crick in my neck" (129). James had suffered with a painful disability for much of her adult life, which since her youth had been vaguely described, as Leon Edel explains, as a problem of the "nerves" (8). After her first "breakdown," at age nineteen, James was diagnosed with a host of nervous conditions, including neurasthenia, 1 which was a "popular" medical diagnosis in late nineteenth-century America (Kellogg 15-16). Published nearly half a century after her death, The Diary of Alice James provides insight into the difficulties of living with a diagnosis of neurasthenia and might be understood as an early form of what G. Thomas Couser has termed "life writing" (603). In what follows, I analyze James's diary through a disability studies lens to illustrate the ways in which James views disability as central to her identity and uses the medical discourse of her day rhetorically to illustrate her subjectivity and agency in a culture that insisted on women's (especially disabled women's) submission and passivity. I argue that, through her writing, James challenges assumptions about and attitudes toward women with disabilities, disrupts the accepted narrative of disability as global incapacity, and offers a unique response to the traditional view of women with disabilities (or invalid women) as in-valid. Using Elaine Scarry's concept of work as a synonym for pain, I examine the associations between these terms in the diary and demonstrate how James's deploys the discourse of neurasthenia to configure pain as a task of work.
Scholars have often read James's disability metaphorically as social malaise, as a rebellion against or resistance to her feminine role, as a performance or enactment of the role of an invalid woman, or as her work. In his introduction to The Diary of Alice James, Edel speculates that "at least some part of her condition was the common one of Victorian restrictions on women" and cites Henry James as saying that her "'tragic health was, in a manner, the only solution for her of the practical problem of life'" (8). Echoing Edel and Henry James, Elizabeth Bronfren argues that James's "nervous ailment was intimately connected both with the feminine role her culture ascribed to her and with her resistance to the lethal boredom of enforced uselessness, the stifling of her active nature, the frustration of her youthful hopes that went along with being a young woman in mid-nineteenth-century New England" (385). Additionally, Lisa M. Koch argues that Charlotte Forten Grimkés and Alice James portray "sickliness as performative" in their diaries, highlighting "the drama often associated with female invalidism in the latter half of the nineteenth century" (59). The view of James's "tragic health" as resistance to constraints placed on nineteenth-century women has persisted, as has the view that James's invalidism was her work. For example, in The Death and Letters of Alice James, Ruth Bernard Yeazell argues that James viewed invalidism as her career and dying as her life's work. Furthermore, James's biographer Jean Strouse argues that rather than becoming "a historian, or a writer of politics, a pioneer in women's education, or the leader of a radical movement, she became an invalid . . . registering social change and personal conflict in the dramatic wars that raged through her body and mind" (ix and xv). Her "miserable health," Strouse later argues, "was her career": "The intelligence and energy Alice might have used in some productive way went into the intricate work of being sick" (291). Instead of reading James's disability as a metaphor for something else, as a performance, or as her work, I focus on how she uses the discourse of neurasthenia to write about her experience of living with a diagnosis of neurasthenia. I argue that the "work of being sick" was not a career choice but represented the difficult work James had to do to resist the totalizing category of neurasthenia and to manage the chronic emotional strain and bodily pain that plagued her for much of her adult life.
Neurasthenia was a disabling disease that took many late-nineteenth century men and women off their feet and away from their work. In 1869, Dr. George Miller Beard, a prominent neurologist at the time, identified neurasthenia as a new disease affecting Americans (Beard). According to Beard and his colleagues, neurasthenia was a disease of the nervous system characterized by a wide variety of somatic and psychosomatic symptoms, including exhaustion, neuralgia, headaches, dyspepsia, and insomnia. With the publication of Beard's American Nervousness: Its Causes and Consequences in 1881, neurasthenia began receiving increasing attention from the medical community such that, by the late nineteenth century, it was a commonly diagnosed disease. In his text, Beard attributes the increase of nervousness, another name for neurasthenia, to the following five developments: "steam power, the periodical press, the telegraph, the sciences, and the mental activity of women" (iv). Individuals from the upper echelons of American society, "brain-workers" rather than "muscle-workers," were considered particularly vulnerable to developing neurasthenia for their involvement in intellectual endeavors and the processes of cultural modernization (Beard 97). Women were especially prone to disease because of their presumed inherent weaknesses as well as their increasing involvement in intellectual and educational activities. As an avid reader, writer, and educator, 2 Alice James would have been considered highly susceptible to developing neurasthenia.
In order to explain how neurasthenia affected the human body, Beard developed an economic metaphor, in which individuals had a certain amount of "nerve-force" or nerve-energy in the bank that could be saved or spent, and when overspent, improperly invested, or wasted, could result in "nervous bankruptcy" (9). This body-as-a-bank metaphor took hold in late nineteenth-century American society and became the primary means of understanding the human body as well as the economy. As scholar Tom Lutz has argued, "The image of economic 'collapse,' in relation to the stock market, is itself preceded culturally by the idea of a brain-collapse, a name for nervous breakdown" (12). The economic discourse of neurasthenia not only allowed medical practitioners to describe neurasthenia to patients in ways they could easily understand and use to characterize their ailments but also provided a useful mechanism for making rhetorical arguments connecting bodily health to economic health and stressing the importance of individual health to societal health. Many popular writers of the time, including Theodore Dreiser, Edith Wharton, and Kate Chopin featured neurasthenic themes and characters in their works, and William James and Theodore Roosevelt used neurasthenic discourse to make philosophical and political arguments. While a large body of scholarship has been devoted to discussing fictive works that incorporate the themes and imagery of neurasthenia, there remains a gap in the scholarship about the use of neurasthenic discourse in women's nonfiction texts.
[M]y glorious rôle: Writing the Self
The discourse of neurasthenia, with its connections to the labor force through the language of economics, provided James with an "available means" by which to estimate her value in an economy that largely valued either men's productive or women's reproductive labor (Roberts 8). As Natalie A. Dykstra has argued, "Alice itemized her somatic and psychosomatic ailments using the lingua franca of value production in the nineteenth century: the nouns and verbs of capitalism and industry" (122). While Dykstra argues that James viewed her illness as "her work," I am suggesting that the discourse of neurasthenia may have enabled James to illustrate that managing pain (rather than illness itself) required work (125). While the privilege of acting as a productive citizen was historically reserved for the able-bodied rather than the disabled, James employs the commonplaces of neurasthenic discourse—notions of bodily energy, force, spending, and waste— to resist the ways in which the dominant culture classified women with disabilities as in-valid, thereby situating herself as socially and culturally viable.
In her first diary entry, James provides a sense of her purpose for keeping a diary, which is to "lose a little of the sense of loneliness and desolation which abides with me." She cites emotional strain, "that geyser of emotions, sensations, speculations and reflections," headaches, stomach troubles, fainting spells, and bodily pain as the problems plaguing her throughout her diary (25). Within the context of the diary, James positions herself, in some ways, as a stereotypical neurasthenic, as delicate, 'sensitive,' and prone to prostration, and she uses the discourse of neurasthenia in order to account for her overly emotional reactions and painful bodily sensations (47). In other moments, she subverts this discourse in order to assert a particular subjectivity in which disability becomes central to identity. Using the economic metaphor—a banking concept of the body—James constructs an economy of self with which to characterize the difficulties of living with a disability and to view her writing and her ability to manage emotional strain and bodily pain as valuable.
In a diary entry written in October of 1890, James recalls the time in "'67 or '68" when "I broke down first, acutely, and had violent turns of hysteria." In this entry, James takes up the discourse of neurasthenia to describe the complex blend of mental turmoil and physical pain she experienced and implies the difficulties involved in living with the further restrictions (in addition to those placed upon nineteenth-century women) that living with a diagnosis of neurasthenia imposed on her. Referring to her brother William James's paper on the 'Hidden Self,' and the idea that "the nervous victim 'abandons' certain portions of his consciousness," James explains that, "Owing to some physical weakness, excess of nervous susceptibility, the moral power pauses, as it were for a moment, and refuses to maintain muscular sanity, worn out with the strain of its constabulary functions" (148-149). In combining William James's theory with neurasthenic discourse, James reveals a kind of tug-of-war taking place between her body and her mind and reflects a neurasthenic economy of morality, in which one might be suffering from "either moral laxity or extreme moral sensitivity" (Lutz 4). While she claims she has "never been able to abandon my consciousness and get five minutes rest," she explains that an "excess of nervous susceptibility" could lead to a shortage of "moral power;" therefore, she considers killing her father. But, she does not kill her father because she is not "insane." She has all the "horrors and suffering of insanity," but, perhaps because she has been so unsuccessfully treated by the medical profession, 3 she has to be her own "doctor, nurse, and straight-jacket" (149). As the same entry continues, James develops her own theory about the connection between disability and morality: "When all one's moral and natural stock in trade is a temperament forbidding the abandonment of an inch or the relaxation of a muscle, 'tis a never-ending fight" (149). While James reveals a belief in moral sensitivity as a potential cause of nervousness, she also indicates the ways in which she was forced to resist neurasthenia and how that resulted in "fight" or war against her own body. James's use of the discourse of neurasthenia in this entry allows her to express the difficulty of living with a disability that demanded her immobility in a culture in which women were always already immobilized.
As a result of a number of social, cultural, economic, and political factors, the nineteenth century was a particularly turbulent time for people with disabilities. Such factors include the publication of Charles Darwin's "On the Origin of Species" (1859), the Eugenics Movement (1880s-1930s), P.T. Barnum's "freak shows," (1830s-1940s), the "Ugly Laws" (1860s-1970s), and the Immigration Act of 1882. 4 In a diary entry penned in December of 1889, James refers specifically to P.T. Barnum's practice of displaying disabled bodies as so-called "freaks" in his circus. After entertaining a handful of visitors over a three-day period, James laments, "There are some half a dozen people who have come to see me once and who have never come again, causing me to feel like a Barnum Monstrosity which had missed fire" (63). In comparing herself to one of Barnum's monstrosities, James recognizes the extent to which her disability caused her to be viewed as a spectacle, a curiosity, or even a freak. In late nineteenth-century America, James and other people with disabilities were regarded as objects in eyes of the scientific and medical professionals and by the larger culture engaged in practices of viewing what were considered "disfigured" or "abnormal" bodies in "freak shows" designed to amaze and amuse. Given her status as an invalid and her history of being viewed by her doctors as a medical curiosity, James perceives these one-time visits as a personal failure to entertain her audience.
In a seemingly related entry, written in July of 1889, James contemplates her role as an invalid woman when she recognizes the "deadness" of her nurse's "expression" in contrast to "the tide of speculation that was coursing thro' my brain" and exclaims, "'Oh! Nurse, don't you wish you were inside of me!'" Dismayed, her nurse vehemently replies: "Inside of you, Miss, when you have just had a sick-headache for five days!'" (48). Taken aback by her nurse's remarks, "at this sublime moment when I was feeling within me the potency of a Bismarck," James is left feeling that "my glorious rôle was to stand for Sick headache to mankind! What a grotesque being I am to be sure!" (48). As Elizabeth Duquette has argued, "her satirical entry lambastes narrative norms for the representation of the sickroom, the aesthetic dimension of nineteenth-century domestic ideology, and the seemingly common belief that invalids themselves represented the illness that afflicted them" (728). While the "role" of the invalid woman in the late nineteenth century was to swoon in the privacy of the sickroom, the "role" of people with disabilities was to amuse a much larger public audience. However, this entry testifies to her resistance to both standing for illness and performing as a "Monstrosity."
As this entry continues, James engages the economic discourse of neurasthenia and reveals a sense of frustration with living with a diagnosis of neurasthenia: "Lying in this room, with the resistance of a thistle-down, having illusory moments of throbbing with the pulse of the Race, the Mystery to be solved at the next breath and the fountain of all Happiness within me—the sense of vitality, in short, simply proportionate to the excess of weakness!" (48-49). In this slightly erotic formulation, in which her "illusory moments of throbbing" might be read as code for sex or masturbation, James reiterates her annoyance about being disabled by a "Mystery" illness that has evaded her doctors for years. Furthermore, James makes a clear reference to neurasthenic discourse by representing an economy of illness, in which not having enough "resistance" (perhaps of nerve-force) results in an "excess of weakness." The discourse of neurasthenia not only offered James a means by which to write about her ailments but also to argue for the work involved in constructing a sense of self. In constructing a sense of self, or a sense of her self as a subject, James presented an economy of selfhood by which she could determine her "productive worth" (207).
"[F]orm given to what was vague": Constructing the Subject
In order to construct herself as a subject, James often compared her self to other people with access to a larger portion of the world than she had access to as a disabled woman. When comparing her self to others, James remarked on what her limited perspective could offer her. Additionally, she sought to provide an explanation for what may have been viewed by others as overly emotional behavior. In an entry written in June of 1889, James explains,
I went out again today, and behaved like a lunatic, 'sobbed,' à la Kingsley, over a farmhouse, a meadow, some trees and cawing rooks. Nurse says that there are some people downstairs who drive everywhere and admire nothing. How grateful I am that I actually do see, to my own consciousness, the quarter of an inch that my eyes fall upon; truly, the subject is all that counts! (31).
While James refers to herself as a "lunatic" for "sobbing" over something so ordinary, she explains her overly emotional reactions by comparing herself to the "people downstairs who drive everywhere," and presumably see extraordinary things, but "admire nothing." Unlike these other people, James can "see" the beauty of the landscape because "the subject"—the person looking, rather that what is being looked at—"is all that counts." The "quarter of an inch" that she is able to see represents a point of contrast that tends to emphasize her superior mode of seeing. Even seeing very little, she sees more than her neighbors do. While James is usually the one being looked at, in this case, she is the one doing the looking. As Rosemarie Garland-Thomson points out, "Feminism prompts the gaze; disability prompts the stare. Feminization increases a woman's cultural capital; disability reduces it" (28). By returning the "stare," James reverses the accepted relationship between people with disabilities and the non-disabled and presents an economy of selfhood in which "the [disabled] subject" becomes someone that "counts." By challenging cultural assumptions about what might be considered as lunacy and what might instead be read as insight, she regains a sense of her own subjectivity and agency.
This subtle use of the economic metaphor to construct an economy of self and to assert her subjectivity in some entries lends itself to more direct applications of neurasthenic dogma in other entries. For example, in several instances, James applies neurasthenic ideology—notions of frailty, sensitivity, and artistic intelligence—to represent her self as perceptive and intelligent as well as to argue that women's art (and writing) has productive value. Recounting one day in the summer of 1873 when she visited an art gallery and saw a "Botticelli," James explains that she felt blissful because, unlike "poor Mrs. Ogle," who did "not know what to do with pictures," she discovered that she "was a 'sensitive,' and that I was not only 'mute before a Botticelli,' but that a Botticelli said an infinity of things to me" (47; emphasis added). As this entry continues, James relates another story about a "portrait painter" named "Porter" who, upon seeing the work of "an old master" for the time, simply "sauntered about glancing casually here and there with no more ripple of emotion than if he were at Doll and Richards'. How cheap the quality of his personality stood out!" (47; emphasis added). Taken together, these separate narratives, appearing as part of the same story, reveal the extent to which James had internalized an economic view of herself in relationship to the world around her. More specifically, in this entry, James takes up the discourse of neurasthenia in order to estimate her own worth and wealth of emotion and "personality" against Mrs. Ogle and Porter's poverty. It is no coincidence that she makes this distinction in relation to her ability to appreciate art. Indeed, she reiterates here her sense of herself as an artist-writer as well as her deep conviction that art should be of some use, rather than merely for passive absorption. The metaphors used to describe how neurasthenia operated in the human body, including one that compared the human body to a battery without much charge and one to a bank without much money may have promoted a view of the disabled body as run-down and/or equated disability with poverty or failure. In Claiming Disability: Knowledge and Identity, Simi Linton points out that "figures of speech further objectify and alienate people with disabilities and perpetuate inaccurate information about disabled people's experience" (128). Perhaps, then, James saw her art (her writing) as a means to achieve productive value or at least to disassociate her from intellectual poverty and/or personal failure.
In an entry written March of 1891, roughly one year before her death, James makes an explicit reference to the economic discourse of neurasthenia: "Through complete physical bankruptcy I have attained my 'ideel,' as Nurse calls it, and we are happily established since March 12th in a little house on Campden Hill" (181). This clear reference to the economic metaphor reveals the extent to which James ascribed to an economic view of disability. In this passage, James connects "physical bankruptcy" to an achievement of an ideal and suggests that there is an inverse relationship between bodily value and aesthetic/mental value. In the remainder of the entry, James describes the reasons—"I could not go out of town, or become the prey of the landlady"—that made getting a house a "necessity" (181). Thus, James's "physical bankruptcy" necessitates getting a house because she is presumably no longer physically able to "go out of town" and she fears that her weakness would allow her to become a landlady's "prey." Her view of what being physically bankrupt could mean, in this instance, includes the ways the weak were at risk of becoming "prey" to the strong. To be physically bankrupt, in other words, made it necessary for James to retreat to the safety of the home, a necessity that exposes the historical tendency to isolate people with disabilities in their homes and relegate them to the fringes of society.
James's use of the discourse of neurasthenia allows her not only to view herself as a subject but also to challenge the historical inclination to medicalize people with disabilities and to view them as objects. As Couser argues, "In the case of illness and disability often the foremost motive of life writing is to recover variously dysfunctional bodies from domination by others' authority and discourse, to convert the passive object into an active subject" (291). With this view in mind, James's engagement with and subtle challenges to the discourse of neurasthenia might be interpreted as a method for recovering her body from "domination" and viewing herself as an "active subject" in the face of always being looked at as a "passive object."
Throughout her diary, James recalls a number of situations in which she has been viewed as an object.. In one instance, she recalls a conversation between her nurse and an individual interested in renting her "rooms":
Some one who wants these rooms asked Miss Clarke if she had 'got rid of the fidgetty old lady in the drawing-room.' It is so comic to hear oneself called old, even at 90, I suppose! What one reads, or rather all that comes to us is surely only if [sic] interest and value in proportion as we find ourselves therein, form given to what was vague, what slumbered stirred to life (27).
While James accepts the view of herself as "fidgetty" and finds it "comic[al]" to hear herself referred to as "old," she also recognizes that she is being objectified—viewed as an obstacle—by the individual interested in renting her "rooms." Here, as elsewhere in the diary, James employs the discourse of neurasthenia in order to combat the view of herself as an object or obstacle and to place a "value" on her ability to "find" herself through her experiences. In so doing, James suggests an economy of self in which disability might be read as central to identity.
In an entry written only a few days later, James relates a similar experience of being objectified, this time by her "next door" neighbor: "Miss Percy from next door came in to see me, she is the most good-natured being, and evidently looks upon me, funny as it seems, as a pitiable object. She asked me with the greatest conviction, if I didn't get 'awfully tired of reading!'" (35). James, of course, does not view herself as a "pitiable object" but as an intelligent and intelligible subject with a more fulfilling life on the couch with her books than her neighbors have going "in and out all over the place 20 times a day" (35). In subtly challenging Dr. S. Weir Mitchell's "rest cure" and the medical establishment's ban on books 5 as a means toward recovery, James recovers some sense of her own subjectivity. The "'fidgetty old lady'" ceases to exist as the passive object to be removed from the "drawing-room" and takes shape, "form given to what was vague," if even in only her own mind, as an active subject.
In her diary, James uses the discourse of neurasthenia to position herself as a subject with agency rather than as an object of pity. Her diagnosis of neurasthenia and her status as an invalid woman effectively disqualified her from obtaining a career or doing any kind of sustained creative or intellectual work, as these endeavors were thought to cause nervousness (Mitchell 47-48). Her disability worked, in some ways, to disbar her from full participation and citizenship in American society. However, the discourse of neurasthenia offered James a means to write about her experience of living with a diagnosis of neurasthenia, to estimate her "worth" in relation to those around her, to reclaim a sense of her identity, and to view herself as an active subject rather than as a passive object.
"[P]hysical pain is forgotten": Configuring Work as Pain
In an 1876 letter to a "friend," James points to the value in women's artistic (and perhaps written) productions. She writes, "Feminine art as long as it remains a resource is very good but when it is an end its [sic] rather a broken reed. Matrimony seems the only successful occupation that a woman can undertake" (quoted in Strouse 88). In James's formulation, women's artistic productions were useful if they were a "resource" but not if they were an "end." In other words, women's art and writing is valuable when it is of some use or when it serves some purpose. But, what purpose did James think women's art and writing could serve? She supplies an answer to this question in a diary entry written many years later. After reading George Eliot's letters, she exclaims,
What an abject coward she seems to have been about physical pain, as if it weren't degrading eno[ugh] to have head-aches, without jotting them down in a row to stare at one for all time, thereby defeating the beneficent law which provides that physical pain is forgotten" (41).
As she criticizes Eliot, she expresses a sense of self-pride in her ability to tolerate "physical pain." She represents headaches as "degrading" because they often put her out of commission and relegated her to a hyper-feminine role. As Dykstra has argued, "Alice excoriates Eliot because she does not want herself to be seen as only sick—a risk not as pressing for Eliot, given her public writing career" (124). Inscribing illness and bodily pain within the history of one's life without a mechanism for coping apparently defeats the "beneficent law which provides that pain is forgotten." As the entry continues, James explains that writing about pain, however, is "good" when it is accompanied by some sense of how to combat it:
If she related her diseases and her 'depressions' and told for the good of others what armour she had forged against them, it would be conceivable, but they seem simply cherished as the vehicule [sic] for a moan...What a contrast to George Sand who whatever her failings never committed that unpardonable sin; it even makes her greasy men of the moment less repulsive (41-42).
There is a lot at stake for James in these remarks. She was concerned, for example, that her own diary might be interpreted in terms of "a vehicule [sic] for a moan," which was something she considered an "unpardonable sin" and one that she presumably did not want to commit. But, the letter and the diary entry suggest that women's art and writing (especially about pain) is resourceful when it serves to help others (probably women) to develop coping strategies for managing bodily pain, which may have been particularly important given James's negative experiences with the male medical establishment and their treatment of women's nervous illnesses.
In a particularly frustrated moment, in December of 1889, James characterizes the "work" of "an invalid" as managing her discomfort: "One day when my shawls were falling off to the left, my cushions falling out to the right and the duvet off my knees, one of those crises of misery in short, which are all in the day's work for an invalid Kath. 6 exclaimed, "What an awful pity it is that you can't say damn." (66). In "Disability in Theory," Tobin Siebers explains that, "The great challenge every day [for people with disabilities] is to manage the body's pain, to get out of bed in the morning, to overcome the well of pain that rises in the evening, to meet the hundred daily obstacles that are not merely inconveniences but occasions for physical suffering" (177). In the above passage, James reveals the sense of her disability as work, but it is the work of living in and through physical pain and discomfort to accomplish "the hundred daily obstacles that are not merely inconveniences but occasions for physical suffering."
In The Body in Pain: The Making and Unmaking of the World, Elaine Scarry argues that physical pain is almost impossible to represent because it has no "object." "This objectlessness, the complete absence of referential content, almost prevents it from being rendered in language: objectless, it cannot easily be objectified in any form, material or verbal" (Scarry 162). However, Scarry explains, while pain is often unrepresentable in language, "a near synonym for pain...is the word 'work'" (Scarry 169).
Far more than any other intentional state, work approximates the framing events of pain and the imagination, for it consists of both an extremely embodied physical act (an act which, even in nonphysical labor, engages the whole psyche) and of an object that was not previously in the world...It does, however, under all circumstance, and regardless of whether it is primarily physical or mental labor, entail the much more moderate (and now willed, directed, and controlled) embodied aversiveness of exertion, prolonged effort, and exhaustion...Thus, the wholly passive and acute suffering of physical pain becomes the self-regulated and modest suffering of work. Work is, then, a diminution of pain: the aversive intensity of pain becomes in work controlled discomfort (170-1)
Scarry recognizes that mental and physical pain cannot be separated out, which is something James relates in her diary. Furthermore, Scarry provides a way of understanding why pain, which nearly evades representation, is often represented as work. Because both pain and work involve "exertion, prolonged effort, and exhaustion," which is especially true in the case of chronic illnesses, "pain becomes in work controlled discomfort." In other words, the regulatory processes used in working through pain are similar, if not the same, as those used in doing work.
Throughout her diary, James recognizes that her disability, in particular, her physical pain, separates her from others who are not in pain and cannot know the nature of her pain. In an entry written in January of 1890, James explains, "A while back I was greatly enjoying a friend from home who went far back and in whose presence the past revived for a bit, when suddenly she removed herself to the planet Mars by asking me whether I was in pain anywhere at that moment.". James could not blame her friend for her inability to perceive the physical pain that "was the essence of the Universe to [her] consciousness," but she was unwilling or, more likely, unable to express it. Her pain, at the time of this meeting with her friend, was such that James could not describe it in words—except in her diary as "a palpable substance between us" (77). This entry suggests the extent to which people with disabilities arouse fear in the non-disabled and illustrates the reasons why James felt lonely and desolate when she started keeping a diary. As Susan Wendell explains, "The fear of pain is also expressed or displaced as a fear of people in pain, which often isolates those with painful disabilities" (109). Since James cannot represent her pain to her friend in a meaningful way, she "[bluffs] off her investigations" widening the gap between them (77). In writing about this experience in her diary, even without the language to adequately express pain, James is able to convey both her chronic pain and the resulting emotional distress for her readerly audience. Writing about pain was, for James, also a mechanism for managing it.
In the diary entry with which I title and begin this essay—"How well one has to be, to be ill!"—James reveals the necessity of managing her bodily pain and uses the discourse of neurasthenia to characterize the management of her pain as a kind of work.
By taking a very small dose of morphia, the first in three years, I was able to steady my nerves, and experience pain without distraction, for there is something very exhilarating in shivering whacks of crude pain which seem to lift you out of the present and its sophistications (great Men unable to have a tooth out without gas!) and ally you to long gone generations rent and torn with tooth-ache such as we can't dream of (129).
While James relies on a neurasthenic understanding of her disability, she also presents subtle challenges to the male medical establishment by taking charge of her own cure. By taking morphine, she is able "steady [her] nerves," or perhaps to balance her fund of nerve-force, and "experience pain without distraction," unlike "(great Men unable to have a tooth out without gas!)"—possibly a gentle rebuttal to the cultural attitude toward pain that suggests women cannot bear pain like men—in order to manage her bodily pain without also experiencing nervous bankruptcy. In some ways, James is seeking a spiritual connection to pain here, in which being a neurasthenic is a bridge to other people experiencing similar kinds of pain, a connection that may have made her feel less alone. But, this entry is also a critique of the medicalization and objectification of people with disabilities. In particular, James's desire to "experience pain" might be read in terms of a struggle to regain a subjective experience of pain. In the last line of this entry, James implies mental strength in spite of physical weakness by revealing that she does not "succumb and send for [her] Primrose Knight," her doctor, but waits patiently to recover. While she reiterates her acceptance of neurasthenic doctrine by suggesting that her "recovery" depended on a version of the rest cure, James implies that she has "no faith" in doctors. While she insists on "patience" and the "simple ingredients of refraining from muscular contractions and vocal exclamations," 7 her recipe for recovery does not involve a direct interaction with a doctor or a more formal rest cure, which would have taken place under a doctor's supervision (129). In using the discourse of neurasthenia—the language of the nerves—to frame this passage, James translates otherwise empty metaphorical meanings into a meaningful personal experience. In taking charge of her own pain and her own recovery, James subverts the neurasthenic understanding of women as weak and incompetent and translates the experience of pain into the work of controlling her discomfort. In so doing, she gains a sense of agency over her body and asserts herself as a subject rather than as an object.
In some ways, the lack of a single diagnosis (until a few months before her death) prompted James to find a way to talk about her disability. 8 The discourse of neurasthenia provided a means for James to understand, experience, and write about her disability. To be sure, one of the things this discourse allowed James to illustrate was that her disability was painful. In her final diary entry, written in March of 1892, James writes:
I am being ground slowly on the grim grindstone of physical pain, and on two nights I had almost asked for K.'s lethal dose, but one steps hesitantly along such unaccustomed ways and endures from second to second...however this may be, physical pain however great ends in itself and falls away like dry husks from the mind, whilst moral discords and nervous horrors sear the soul (232).
On dying, then, James describes physical pain as temporary and as confined to her body. While physical pain was forgettable, the "nervous horrors" she experienced were not. Instead, they are somehow emblazoned on her "soul." While James realized that readers of her text would not experience her physical pain, they would understand her "nervous horrors." As Alice Golomb Hoffman has argued, "the diary moves outside the body, but it does so only on condition of preserving intimate connection to the felt materiality of the body" (417). Her soul, then, in this last entry, becomes a metaphor for her text.
Alice James's work was not invalidism. This was just a circumstance of her life. Her work was to build up resistance to bodily pain and to show others how this was possible. Viewing James's work as managing pain does not deny her actual experience of living with chronic bodily pain. It does not see James's disability in terms of a choice that she makes to resist certain social conventions. It understands that part of the work of living with bodily pain involves controlling discomfort. Living with chronic bodily pain meant not only managing pain in order to perform daily tasks in order to take some amount of enjoyment out of life but also interacting with others in ways that sometimes necessitated hiding or masking her pain for others' comfort. In other words, controlling her own discomfort meant controlling others' discomfort when viewing her disabled body. For all James's "work," The Diary of Alice James succeeds in showing how it is possible to exist in the world with a body that others could not seem to understand and wanted to classify and categorize with received cultural meanings, empty of any understanding of the her life. Using the discourse of neurasthenia allowed James to represent the work of living with pain in her diary, and the work of writing the diary channels that pain and disability into value.
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In Alice James: A Biography, Jean Strouse indicates that James was diagnosed with "neurasthenia, hysteria, rheumatic gout, suppressed gout, cardiac complication, spinal neurosis, nervous hyperaesthesia, and spiritual crisis" (ix-x).
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James was involved in several charitable and educational organizations, including the Female Humane Society of Cambridge and the Society to Encourage Studies at Home (Strouse 136).
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In an entry written on in September of 1890, James writes: "And then these doctors tell you that you will die, or recover! But you don't recover. I have been at these alternations since I was nineteen and I am neither dead nor recovered—as I am now forty-two there has surely been time for either process. I suppose one has greater sense of intellectual degradation after an interview with a doctor than from any human experience" (142).
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As Douglas C. Baynton points out, the Immigration Act "prohibited entry to any 'lunatic, idiot, or any person unable to take care of himself or herself without becoming a public charge" (45).
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Famously criticized in Charlotte Perkins Gilman's "The Yellow Wall-Paper," Dr. S. Weir Mitchell's rest cure required women to remain in bed for six to eight weeks and refrain from engaging in intellectual activities, such as reading and writing.
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Katharine Peabody Loring was Alice James's longtime friend and caretaker.
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In her 1891 self-help book, Power Through Repose, Annie Payson Call recommends a that "a nervous invalid, or with anyone who suffers at all from overstrained nerves," speak in a "quiet, mellow voice" in order to rebalance "poorly balanced nerves" (40).
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As James recalls in her diary, she was diagnosed with breast cancer in May of 1891.
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