The Passive-Active Force to Bear and to Suffer

di Rudolf Bernet

Krankheit ist jedes Mal die Antwort, wenn wir an unserem Rechte auf
unsre Aufgabe zweifeln wollen  –  wenn wir anfangen, es uns irgend wo-
rin leichter zu machen. [...] Und wollen wir hinterdrein zur Gesundheit
zurück, so bleibt uns keine Wahl: wir müssen uns schwerer belasten, als
wir je vorher belastet waren...1.

1. Introduction

Activity and passivity are not each other’s opposites. Heidegger

claims that this is an opposition belonging to an outdated metaphys-
ics. Husserl claims that most of our activities have their source in a
passive affection, that they are reactions or reactivations that sooner
or later become sedimented again in passive habits.
Already Aristotle claims that no finite substance knows of a pure
activity or a pure passivity. All finite substances act on other finites
substances and undergo the actions of other finite substances. Con-
sequently, finite substances both act and react. They are integrated
into a network of universal interaction. Aristotle calls this network
physis; phenomenologists call it ‘world’.
But what is it we name ‘passivity’? We cannot content ourselves
with the claim that what acts within the world simultaneously un-
dergoes the actions of other agents, and that this is what makes of
it a finite substance. We also cannot help but notice that Husserl
might not have taken the full measure of passivity when limiting it
to the sphere of passive syntheses, that is to say acts of constitution
that are carried out without the full involvement or awareness of the
transcendental ego. Passivity should not be restricted to the domain
of what precedes and motivates activity or to the domain of what

1
 F.W. Nietzsche, Menschliches, Allzumenschliches, Vorrede, § 4, edizione???, città???
anno???.

LA CULTURA / a. LVIII, n. 1, aprile 2020 19

Rudolf Bernet

remains of an activity when it is over. Passivity also comprehends at-

titudes and comportments such as the holding back, suspending, or
deferring an action. We commonly call these comportments attitudes
of patience. Humans are not alone in being capable of patience.
Pieces of wood that lend themselves to becoming a table, a tree that
awaits the proper season to flourish, the animal that watches its prey
are equally capable of being patient. ‘Capable’? If patience is a ca-
pacity, then it must be the expression of a potentiality, a power or,
better, a force.
The passivity of undergoing an action is thus never a pure pas-
sivity; it necessarily involves a potentiality of reaction or response
that we can aptly call a passive action. Such a passive action or ac-
tion in passivity consists in the power or the force to bear an affec-
tion arising either from outside or inside, to wait before reacting,
or even to hold back any reaction. This force to bear makes of any
matter or hulè a subject and of any human subject a subjectum. As
a responsive force or passive action, the force to bear can never be
reduced to a mechanical reflexive reaction. It allows, to the contrary,
for making choices; it is gifted with a variable degree of freedom.
The force to bear can thus also become a force to refuse to bear, or
a force to defer or suspend the choice between bearing or not bear-
ing. It is the mode of this force to bear that makes an external or
internal affection bearable or unbearable. An unbearable affection
remains related to a failing force to bear that can lead its subjectum
so far as to annihilate itself or to die. A piece of wood bent too far
splits; a traumatized human subject loses itself in pain.
It is this whole realm of activities in passivity, of positive, nega-
tive, and possibly neutral modes of the force to bear that I want to
further explore in the following reflections. I shall begin by consid-
ering how material bodies respond to the transforming power of a
human poièsis. This will then lead me to make a distinction between
the passive forces belonging to the materials of a human production
and the natural forces belonging to what Greek philosophy of na-
ture has called the cosmic ‘elements’. Consecutively, I shall turn to
the passive forces of patience that belong to plants and animals. Liv-
ing beings not only have a wider variety of responses to what they
undergo, they are also exposed to inner affections and the possi-
bility of death. It is, however, only with the complexity of human
beings composed of body and mind that those external and inter-
nal affections and the forces to bear or not bear them, gain a truly
dramatic character. In human existence, an illness of body or mind
is met with the power to reflect on one’s suffering and to regain
health. The suffering of human bodies and minds is never purely
physical or mental; it is never just a matter of organic illness or of
awareness and will. It is meaningful, and its meaning is shaped by
20
 The Passive-Active Force to Bear and to Suffer

memorial traces and symbols. Suffering human beings are also ca-
pable of expressing their sufferance by language and of address-
ing themselves to other human beings with a demand for a healing
treatment. In the administration of medication or in the payment of
fees, no less than in the verbal exchanges between the patient and
her doctor, new symbolic meanings are exchanged in the context of
imaginary projections.

2. The Passive-Active Forces of Material Bodies and of Cosmic Elements

Aristotle ascribes to the matter or hulè that is submitted to a

human process of fabrication (poièsis) the capacity or force to bear
the form that is imposed on it. He calls this its ‘dunamis tou pa-
thein’2. This inner force allows a particular matter to take a posi-
tion or stance vis-à-vis the external force of a transformative form.
It enables this matter to accept or to reject, to bear or to refuse, to
suffer or to expel a particular new form that is imposed on it. This
inner force of a particular and pre-formed matter operates from the
beginning in a double, positive and negative direction. In its nega-
tive side, the force to bear can further be directed against the force
of an external form or against its own, inner form: matter can resist
a new form, or it can burst.
This is to say that Aristotle’s physics preoccupies itself more
with forces and counter-forces than with causes and effects or with
the opposition between activity and passivity. Aristotle’s physics is
mainly concerned with events in which different and contrary indi-
vidual substantial forces meet. Aristotle doesn’t take for granted that
the outcome of these encounters between different physical forces
can be predicted by general laws. His metaphysical physics is about
what modern mechanical physics has eliminated from its field by ex-
clusively focusing on the formulation of general mathematical laws
that govern necessary and predictable causal relations between ho-
mogeneous bodies. Aristotle’s physics is both quantitative and quali-
tative; its account of movement (kinèsis) is less about transportation
in space than the transformation and qualitative alteration (alloiôsis)
of individual substances.
The success of the transformation of matter by a new form de-
pends on both the forces of the matter and the forces of the form.
The form must be powerful enough to impose itself, and the matter
must have the capacity to tolerate and bear the new form. Formu-

2
 Aristotle, Metaphysics, Theta, 1, 1046 a 11. Heidegger comments on this in M. Heideg-
ger, Aristoteles, Metaphysik Theta 1-3. Vom Wesen und Wirklichkeit der Kraft, in Id., GA, 2,
33, hrsg. von H. Hüni, Vittorio Klostermann, Frankfurt a/M 2006, pp.  87-92.

21
Rudolf Bernet

lated in Leibnizian terms, this is to say that the transformation of

a finite substance depends on a balance or an agreement between
the opposite forces of a vis activa and a vis passiva. More precisely,
Leibniz claims that all finite individual substances are already com-
posed of the active force belonging to their form and the passive
force belonging to heir matter or mass3. Consequently, it is both
the active and passive forces of the affected body, both its form
and mass, that are concerned when an active body acts on a pas-
sive body and transforms it. The movement or transformation that
a body imposes on another body is thus never a matter of mere di-
rect physical contact, because what the affecting body does to the
affected body is essentially nothing else than stimulate the inter-
nal forces of the affected body to move by itself. What an external
physical body does to another body when it puts the affected body
in movement or transforms it, is to mobilize its inner passive and
active forces.
However, the Leibnizian complication of Aristotle’s model of
physical transformation doesn’t alter anything essential about the
fact that a body can only change another body when the latter
agrees to this change. The truly new element in Leibniz’s metaphysi-
cal physics is to draw attention to the negative forces of physical in-
tolerance and resistance. To put a body in movement or to transform
it, means to overcome the ‘obstacle’ of its inner forces of inertia.
Leibniz also emphasizes the affected body’s own power of re-action.
The affected body is thus never merely passive; its transformation
by another body mobilizes both its passive and active forces. Finally,
Leibniz extends the forces of affected bodies beyond the realm of
either bearing or rejecting their transformation. The reaction of an
affected material body to an external force of transformation is not
only dynamic, it is flexible. Leibniz explicitly speaks of the vis elas-
tica of affected bodies4.
Rather than either tolerating their transformation or break-
ing under the weight of an imposed new form, a body can first let
external bodies act on it, then expel the action of these external
forces, and finally resume its initial state. Passively affected bodies
are thus not only gifted with an internal force of re-action, their
passivity becomes a matter of pathos, that is of sympathy, antipathy
or even ambivalence for the affecting body. The sympathy of a pas-
sive body for an active body that transforms it can actually go far

3
 R. Bernet, Force-Drive-Desire. A Philosophy of Psychoanalysis, Northwestern University
Press, Evanston (Ill.) 2019, pp.  36-64.
4
  G.W. Leibniz, De primae philosophiae emendatione et de notione substantiae, in Philo-
sophische Schriften, hrsg. von C.I. Gerhardt, Georg Olms Verlagsbuchhandlung, Hildesheim
1965, iv, p. 469.

22
 The Passive-Active Force to Bear and to Suffer

beyond a mere bearing and accepting of its new form. The action of
a passive body can also enhance the forces of the foreign body that
affect it and contribute to their full realization. A good example of
this is the role or function stones play in an edifice. The stones of a
building do much more than simply tolerate and sustain the weight
of the construction. They do not merely actively resist, with the pas-
sive force that binds them to the earth, the pressure they undergo.
The stones also constitute the building; they realize its form and let
it rise up towards the sky.
In their physics, Greek philosophers have always made a dis-
tinction between material bodies and the primitive elements of the
cosmos such as earth, water, fire and air. How does this distinction
affect the passive-active force to bear an alteration? There can be no
doubt that cosmic elements are gifted with passively active forces.
Earth has the elastic force to let or not let itself be ploughed, to
let or not let the seed grow, to sustain an edifice or to sink under
its weight. Water has the elastic passively active force to let or not
let itself be canalized or deviated, used to irrigate a field or be-
come a source of energy. Fire can let or not let itself be lighted,
extinguished, used to cook a meal or to heat a house. Air can be
breathed or become unbreathable, it can be compressed, or it can
swell and blow as a harsh wind. However, an element can never be
truly transformed by an active human force. All that human activity
can do to the natural forces of an element is to master or dominate
it for its own use or protection.
This is to say that the human technologies that are applied to
the elements essentially differ from the technical skills put to use
in the production or fabrication of artifacts. Contrary to the wood
that lets itself be transformed into a table, the earth that lets itself be
ploughed remains what it is, that is to say earth. The earth never be-
comes the fruits it carries and nourishes. One wonders whether Hei-
degger, despite his great affinity for Greek thought and his interest in
pre-Socratic philosophy of the elements, has been sufficiently atten-
tive, in his analysis of human technology, to this difference between
material bodies and the elements. A human skill that masters and
dominates the earth is essentially different from the human power to
use natural material bodies to produce useful artifacts or works of
art. Human imagination and human energy amplified by technolog-
ical devices can never transform the natural elements into an ergon.

3. The Passive-Active Forces of Plants and Animals

The passive forces of Aristotelian substances differ not only in

kind and quantitative intensity; they are also gifted with various de-

23
Rudolf Bernet

grees of suppleness and flexibility. To take the full measure of this

new difference we must now turn to a consideration of the pas-
sive-active forces one finds in plants and animals. It is only in the
last stage of our journey that we’ll investigate the specifically human
passive-active forces. While the passive-active forces of plants and
animals differ in degree of flexibility, human passive-active forces are
always invested with symbolic meanings and interwoven with imagi-
nary representations.
One knows how much the life of plants is affected by the quan-
tity and quality of the natural elements such as the soil, the light, the
air. The life of plants also depends on the turn of seasons. Plants can
not only secure their survival by optimally adapting their comport-
ment to changes in the environment, they can also make the best use
of natural resources in their growth and reproduction. It is only re-
cently, however, that scientists have given full credit to the ancients’
belief that plants can communicate with each other, share their
knowledge of climatic changes and threats arising from new enemies.
Making the best use of natural circumstances on which they have
no hold, adapting their behavior to the change of seasons, patiently
waiting for the proper time to transform and reproduce themselves
must be understood as an expressions of the passive-active forces of
plants, of their capacity to bear and react, to grow and to die.
Unlike the passive-active forces we have encountered in ma-
terial bodies and in the elements, the passive forces belonging to
plants are not only more flexible in their reaction to external cir-
cumstances, they are governed by an inner form. Plants react to the
changes in the form of their environment by making use of their
own, inner and dynamic form. They transform themselves to better
cope with the external form imposed on them by their surround-
ings. Their reaction is already a kind of response involving a primi-
tive kind of dialogue between an inner force of transformation and
an outer force that weighs on them. Unlike the elastic passive-active
force of bearing that we have encountered in material bodies, in
plants the force of bearing becomes a truly dynamic force that en-
ables them to change by themselves.
One can also say that the passive-active forces of plants and ma-
terial bodies differ in their relation to contingency and necessity. In
the transformation of material bodies, the necessity lies in the ex-
ternal form imposed on them; the contingency relates to how they
bear the requirements of this external form. In plants and other liv-
ing beings, the form of their external environment is only an occa-
sion or a contingent cause that mobilizes the biological necessities
of their own nature, of their inner dynamic forces of self-transfor-
mation. This is true not only for a particular, isolated living being,
but also for its species and even for the passive-active forces of life
24
 The Passive-Active Force to Bear and to Suffer

as such. Is it not true, indeed, that the evolution of life is regulated

by the necessities of an inner élan vital that meets with contingent
changes in outer circumstances? To say that these external circum-
stances are contingent is not to deny, however, that they play an
essential role in the inner evolution of life. It means only that the
evolution of life is not directly caused by external circumstances.
For Bergson external circumstances can only force life to abandon
certain branches of its development. They do not dictate where the
evolution of life should go. This leads him to say that the inner ne-
cessities that dictate the evolution of life, far from following a blind
and mechanical determinism, are compatible with a form of indeter-
mination, choice and even freedom.
In animals this freedom of choice or inner dynamic flexibility
that characterizes the passive-active forces with which they react to
their external environment is clearly greater than in plants. It re-
mains true that the manner in which an animal reacts to a situation
of danger depends on the necessities of the nature of its species or
of its inner form. However, this is not to say that the reaction of
an animal is entirely predetermined or automatic. In higher forms of
animal life, the reaction to external circumstances becomes increas-
ingly individualized. In a situation of danger, animals of the same
species can choose between different types of reaction or behavior;
they can wait or run away, avoid or attack, play dead or make them-
selves inconspicuous under a mimetic form. These different kinds of
reaction can be further perfected and even transformed by processes
of learning that can lead to entirely new types of comportment.
For animals the external circumstances to which they react with
their passively active forces and with a variety of different types of
behavior are particular events or situations that derive their mean-
ing from a specific and closed surrounding world (Umwelt). An-
imal behavior is not only more extended, more flexible and more
creative than the behavior of plants, it is not only more individu-
alized, it is expressive, and what it expresses is a specific kind of
meaning. The distance between the action of an external affection
and the passive-active reaction through an appropriate behavior, too,
has considerably grown and allows for more individualized choices.
This freedom of choice remains, however, a freedom of indetermi-
nation; it is not yet a freedom that realizes itself under the form of
a truly goal-oriented human action. It also doesn’t go so far as to
allow for the suspension of a reaction or for a time of reflection.
Equally, and unlike human beings, animals are captive to their sur-
rounding world; they cannot modify it. Animals face unforeseen sit-
uations with a variety of meaningful comportments, but they must
react to the external circumstances. They must find a solution for a
problematic situation.
25
Rudolf Bernet

Only human beings can transcend their surrounding world in or-

der to change it and interrupt the closed circle between an external
challenge and the necessity of an individual response. Only humans
are gifted with the passive-active force to bear and to suffer an un-
comfortable situation with true patience and for an extended period
of time. Only humans live a life, the center of which lies neither
in their internal form nor in the external world but in the power
to project themselves freely into the future. Only humans have a
form of consciousness that allows them to imagine and to think,
that gives them the force to suffer from their illnesses and to seek
help, that allows them to recover and to heal, and that can make
them desire to die. Only in humans does health remain irremediably
bound to illness, and life to death.

4. The Passive-Active Human Force to Bear Illness and to Combat It

We all accept that human beings have a body and a mind that
act on each other, even if we do not precisely understand how they
do so. As a phenomenologist, I shall not enter into scientific expla-
nations, but rather, inspired by Descartes’ wisdom, I shall content
myself with reference to our experience of the unity of mind and
body. I shall distinguish the affections of the body and of the mind
and investigate how each of them (or the two conjointly) responds
with their passive-active forces. I shall further limit myself to a con-
sideration of the malefic affections of the body and the mind of hu-
man beings, that is to say of the pains and illnesses to which they
are exposed, and of their power to bear and to combat them.
Beginning with the sorts of illnesses that can affect a human
body, we must first question whether they are exclusively caused
by an external agent. According to an all too physical conception,
illnesses of the body are the result of a local affection. The dis-
covery of antibiotics and the immunological system has decisively
challenged this view. It is true that antibiotics are meant to com-
bat a local affection, but they do this by appealing to the healing
forces of the entire organism. This has opened the eyes of physi-
cians to how the various organs of the body interact and coop-
erate. In consequence, their treatments have become more global
than local. Doctors try to stimulate the vital forces of the entire
organism. They have also learned to listen better to what their pa-
tients say about how they feel and experience their pain, suffering
and sickness.
The global approach to sick bodies has also thoroughly changed
our understanding of healthy bodies. Rather than an amalgam of
different organs commanded by the brain, the human body has
26
 The Passive-Active Force to Bear and to Suffer

turned out to be a system in which the different organs and even

their cells communicate with each other by exchanging information.
Doctors pay closer attention to the vital forces that allow a body to
counter, by itself, adverse affections. They have also come to under-
stand that human bodies not only have their own forces and sen-
sations, but also have memories and are invested with symbolic
meanings. If sensations, memory, and meaning are a matter of what
Descartes calls a mind, then one must conclude that a human body
has its own mind, and that all the activities we ascribe to the mind
may have a bodily component. This was the end of Descartes’ meta-
physical dualism, but certainly not of his distinction between body
and mind. It still makes sense to distinguish illnesses of the body
from those of the mind, and we can still learn from Descartes how
body and mind combat them.
For Descartes, illnesses of the mind differ from illnesses of the
body because the mind knows its illnesses much better than the
body knows its own. He concludes from this that the mind is much
better equipped to combat its sicknesses. A mind can reflect on its
diseases and it can especially distinguish between those that have
their cause in the mind itself and those that do not. For Descartes
this power of discernment constitutes already a first step towards
regaining health. When it is the world or the body that makes the
mind sick, there is little the mind can do about it. The world and
the body cannot be changed at will. But through its free will, the
mind is well equipped to fight the illnesses that depend on it, that
is to say on its passions. Since passions have their main source in
one’s imagination, the battle against mental sickness becomes a bat-
tle inside the mind itself, more precisely between its free will and its
imagination. It is true that one cannot fight the seductive power of
one’s imagination and thus get rid of one’s passions at will. The free
will needs the guidance of the intellect. It is only a human will, gov-
erned by clear and distinct ideas about the nature of the passions,
that can hope to eradicate unhealthy passions.
One should not confuse the combat of the free will and of the
intellect against unhealthy passions with the process of Freudian re-
pression. In repression the will of the ego, rather than letting itself
be guided by rational ideas, submits itself to the commands of an
irrational superego and turns directly against unhealthy desires. No
wonder that the issue of such a neurotic conflict, where two irratio-
nal agencies of the mind directly combat each other, is most uncer-
tain and most likely to generate new forms of mental (and bodily)
diseases. Descartes’ remedy for unhealthy passions seems more prom-
ising, not only because it appeals to rationality, but also because the
action of the will on the passions remains indirect, because it is me-
diated by a reflection on the nature of the sickly passions.
27
Rudolf Bernet

How does Descartes then envisage the mind’s combat against

those mental illnesses that have their origin outside of itself, es-
pecially in the body to which it is conjoined? And what about
the mental illnesses, such as sadness, grief and mourning, that are
caused by external unfortunate events? There is little the mind can
do against the loss of one’s fortune or of a loved person. What rem-
edies does Descartes then offer the unhappy princess Elisabeth5 and
the widower mourning his loved spouse6?
This is what doctor Descartes prescribes to his correspondents:
to take care of their body, to rest, and especially to rejoice in what
remains joyful in their life and in the scenery of the world. He ad-
vises them to turn their mind away from their melancholy and grief,
to distract themselves and to pay close attention to the beautiful
colors of flowers and the graceful flight of birds. Where our ratio-
nal will and sound reflection remain impotent to cure one’s mind
of the unhappy passions that are caused by events that do not de-
pend on us, only the feeling of an inner joy and self-confidence can
help.  For Descartes there exists no more secure source of joy than
to rejoice in oneself, that is, in one’s free will  –  the only good no-
body and nothing can take away from us. It is by rejoicing in it-
self that a spirit affected by the passion of sadness can regain confi-
dence. It is in ourselves, and only in ourselves, that we can find the
passive-active forces to react against the mental illnesses that have
their cause outside of ourselves. When unable to change the course
of the world and when unable to act directly on the unhappy pas-
sions and mental illnesses that do not depend on us, we can still
change ourselves.
Is Descartes’ conception of a cure for illnesses of the mind en-
tirely convincing? It seems fair to say that Descartes, unlike Spin-
oza, has a tendency to overstress the power of human consciousness
and will. The problem is not only that he ignored the large field of
unconscious passions and desires, but also that he believed that our
own reason and our own good feelings suffice to cure us from our
sickly passions. Conversely, Descartes also seems to have underrated
“what a body is capable of” (to once again use Spinoza’s expres-
sion)7. Descartes may have largely revised his metaphysical dualism
in The Passions of the mind and in his correspondence with Elisa-
beth, but he remains far removed from today’s psychosomatic med-
icine. Unlike Descartes, and even unlike Spinoza, today’s doctors

5
  R. Descartes, Correspondence with Elisabeth of Bohemia, in Id., Oeuvres de Descartes, pu-
bliées par Ch. Adam et P. Tannery, Léopold Cerf, Paris 1897-1909, iv and v.
6
  R. Descartes, Letter to Huygens, May 20th, 1637, in Id., Œuvres philosophiques, i, Gar-
nier, Paris 1963, pp.  529-531.
7
  B. Spinoza, Ethica, iii, Prop. 2, Sch.: «Etenim, quid Corpus possit, nemo huc usque de-
terminavit».

28
 The Passive-Active Force to Bear and to Suffer

have come to believe that the mind can directly act on the body
and its diverse forms of illness and, conversely, that the body can
directly cause mental illnesses.

5. The Passive-Active Human Force to Suffer and to Regain Health

A patient suffering from some kind of illness can regain her vi-
tal forces and attain a variable degree of health only when she ac-
knowledges her illness. She must be aware of her illness, and this
consciousness is what we call a human way to suffer. A demand for
healing necessarily presupposes this acknowledgment of one’s sick-
ness. Only a patient who feels ill and suffers from her illness can be
cured, and doctors do well not to treat patients who do not feel ill.
The first thing a patient demands of her physician is to recognize
her illness. This requires more than a mere diagnostic skill of the
doctor. The patient demands that the doctor listen to the story of
her illness and to take her suffering seriously. However, the percep-
tion patients and doctors have of this feeling of suffering does not
coincide. When listening to the story of a patient’s illness the doctor
also hears what his patient cannot say.
It remains true, however, that all medical treatment and every
process of regaining health begins with the story of the patient’s suf-
fering. And it remains true as well that the feeling of suffering al-
ready involves the potentiality of passive-active forces not only to
bear illness but also to get better. This is so, because suffering in-
volves a mental awareness or consciousness that allows for a first
position or stance in the face of one’s sickness. This stance is a mat-
ter of a di-stancing oneself form one’s own sickness. Even if suf-
fering does not yet involve the kind of mental reflection Descartes
has attributed to it, it already involves an interruption in the blind
mechanism of reflexive bodily comportments. The feeling of suffer-
ing is something else than the contraction or torsion of a body that
is in pain. In the feeling of suffering, the body speaks, and it speaks
to the person who is in pain. What does it speak of? It speaks of
the patient’s passive-active forces to bear and to transcend his pain,
to relate his present sensation of pain to past sensations of pain.
Conscious suffering transforms felt pain into an object that lends it-
self to a symbolic expression and to linguistic exchanges. The con-
sciousness of suffering is thus more than a mere awareness or a pas-
sive-active response to the feeling of pain, it gives rise to the desire to
regain health.
It is true that animals also suffer and are aware of their pain.
But they lack that form of conscious suffering that allows human
beings to patiently bear their pain, or to find it unbearable. Animals
29
Rudolf Bernet

blindly undergo their suffering as a fatality. Because they do not

consciously relate to their bodily pain, the desire to regain health
and to search for a healing treatment remain foreign to them. It is
only in human beings that the consciousness of suffering becomes
sufficiently detached from the sensation of pain to give rise to a pas-
sive-active force to bear sufferance, to wish to regain health, and
to search for help. This dissociation between the passive affect of
pain and the passive-active feeling of conscious suffering goes so far
that one is tempted to say that, for human beings, it is only pain
and not suffering that can become unbearable. Isn’t it true, indeed,
that human beings tend to faint, that is to say to lose consciousness
and their capacity to suffer, when the sensation of pain becomes too
strong to be borne?
It hardly seems reasonable to deny that the feeling of suffering
involves the wish to get rid of one’s pain. Positively put: the feeling
of suffering does more than allow a patient to take a stance or po-
sition in the face of their pain; it mobilizes the patient’s passive-ac-
tive forces to regain health. In the end, the treatment of a doctor
always builds on the patient’s own power to get better. According
to the famous French doctor Ambroise Paré, «le médecin pansait et
Dieu guérit». And one can already find in Aristotle the v distinction
between the power of medical art to cure (iatreusis) and the body’s
own power to regain health (hugiasis). Consequently, doctors inter-
rogate, observe, and stimulate the manner in which a sick body re-
sponds to their treatment. They have also learned not only to appeal
to the body’s passive-active powers, but to address a human person
who suffers and desires to get better.
Needless to say, in the interaction or dialogue between the re-
spective forces of the doctor and patient, language plays a central
role. In the dialogue between doctor and patient, the first true
word belongs to the patient. The doctor invites her to speak of how
she feels and from what she suffers. A true medical anamnesis ap-
peals to the patient’s own memory of the evolution of his sickness
and even to the story of his life. And the first intervention of the
doctor is again verbal. Before ordering a medical treatment he will
give the patient’s sickness a name. Calling the illness by its name is
not necessarily the same thing as a medical diagnosis. A diagnosis
belongs to the language in which doctors communicate with each
other; naming the illness is word a doctor addresses to his patient.
Informing his patient of the name of her illness is not only the doc-
tor’s first true word, it is also the first act in a medical treatment. Its
efficiency does not necessarily depend on how well the patient un-
derstands this name. It may be just the opposite, and Molière is not
the only one to think that in the act of giving the patient’s illness a
name, medical jargon may do a better job than ordinary language.
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 The Passive-Active Force to Bear and to Suffer

It is through this act of providing the patient’s story of her suf-

ferings a name that a therapeutic contract or pact is established be-
tween the patient and her doctor. However, what the act of naming
establishes, remains unnamed. It is what psychoanalysts call trans-
ference. All the words and all the objects (medication and money)
the doctor and his patient exchange, after the illness has received its
name, are invested with a meaning that depends on transference and
counter-transference. For the patient, the doctor becomes a ‘sujet
supposé savoir’ (Lacan), that is a person who knows both the cause
of the patient’s sufferings and how to cure them. For the doctor, the
patient becomes a person who is worthy of his care, a person who
engages him both passively and actively in the process of healing.
The efficiency of the medication the doctor orders for his pa-
tient is largely dependent on these relations of transference. This
shows particularly well from the fact that a placebo prescribed by
the doctor can perfectly cure his patient’s sufferings. The doctor
cannot but recognize that his medication, on top of its chemical
properties, also has an imaginary and a symbolic meaning. This will
lead him to adapt his medication to what he knows of his patient’s
history and personality. He treats a human person with imaginary
expectations, whose body carries the symbolic traces of former acts
of care and experiences of frustration. His treatment will differ de-
pending on whether the patient is a hysterical person with a strong
inclination to orality, or an obsessive, anxious person. The doctor
will order the kind of medication he thinks the sick body can toler-
ate and the patient is prepared to accept. He is attentive to both the
body’s passive-active forces to bear his treatment and the patient’s
imagination. In all this he trusts the patient and what remains of her
passive-active vital forces, of her desire to regain health, and of her
capacity to resist her death-drives.

6. Conclusion: The Desire to Be Healthy, Illness, and the Death-Drives

The path of our reflections on the passive force to bear and to

suffer has led us from the materials of a transformative human pro-
duction to the manner in which human beings can suffer from ill-
ness in their body and mind, and how they can let or not let them-
selves be cured by medical art. We have paid attention to what
we can and cannot do about the natural forces of material bodies
and the cosmic elements, and to how plants and animals resist and
adapt to the challenges imposed on them by their environment. In
all these cases we have observed how a new active force of reac-
tion and response can arise from the passive force to face the ac-
tive force of an external or internal agent. This interaction between

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Rudolf Bernet

passive and active forces, between an affection and its tolerance,

between question and response has entered a new regime in our
consideration of the human dialogue between body and mind, and
between a sick person and her doctor. We have learned that in hu-
man beings affections and responses are intertwined with imaginary
projections and symbolic meanings that go far beyond the expressive
comportments found in animals. The fundamental difference in the
way animals or plants respond to affections and interact with each
other, and the way humans do so, is mainly due, as we have seen, to
language.
In our investigation of how human beings passively bear an in-
ner or outer affection and how they actively respond to it, we have
limited ourselves to the consideration of illnesses of body and mind.
We have claimed that human consciousness and especially the feel-
ing of suffering interrupt a direct and merely reflexive reaction to
pain. Suffering, we have said, is more than feeling pain; it already
involves a first step towards regaining health. One must be aware of
one’s illness before one can desire to recover and to seek help. The
desire for health seems irremediably linked to the experience of suf-
fering and to the acknowledgement of the weakening of one’s vital
forces, that is of one’s illness.
Should we then say with Nietzsche that «Gesundheit und Krank-
heit sind nichts wesentlich Verschiedenes, wie es die alten Mediziner
und heute noch einige Praktiker glauben»?8 Must one first have been
ill to subsequently feel healthy? It seems at least true, both for the
patient and the doctor, that a person, who has no experience of pain
or the sufferings caused by illness, doesn’t truly know what health
means. It is also true, as we have seen, that both health and illness
owe their meaning to the same vital passive-active forces with which
a body and a mind react to an external or internal affection. More
precisely, health and illness are expressions of the interaction be-
tween the strength and the weakness of these forces. Already taken
in themselves, vital forces are dynamic forces, the intensity of which
is ceaselessly changing. And if this is true, then we are no longer al-
lowed to think of health as a stable state or condition. Health should
rather be understood as a fragile and ever-changing balance between
the passive-active vital forces of a body and a mind. These forces
know of no stable harmony; they forever compete with each other
for the control of a human body and mind.
Human beings are also submitted to the force of death-drives.
Death-drives are no less vital forces than the forces of self-preser-

8
  F.W. Nietzsche, Nachgelassene Fragmente, in Id., Sämtliche Werke  –  Kritische Studienaus-
gabe, 13, dtv-de Gruyter, München-Berlin/New York anno???, p.  250.

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 The Passive-Active Force to Bear and to Suffer

vation and survival. A sick person regaining health needs more than
the desire to heal her wounds and become stronger; she needs to
combat her own death-drives. Actually, human bodies and minds
are made in such a way that the battle against their death-drives is
never definitely settled. Just as health is always related to sickness,
human life is forever accompanied not only by the possibility of
death, but also by the desire to die. Desiring to be in good health
and to lead a good life means not only recovering from our illnesses
and deferring the fatal event of death, but also combating our fa-
tigue of the tiresome vicissitudes of life and our desire to put an
end to them.
We are thus led to think that the desire to be healthy is equally
a desire to be less sick and less tempted to give up in the never-end-
ing effort to stay alive. This insight seems to be in complete contra-
diction with the life of most of our contemporaries. Rather than less
sick, a great number of them desire to be more healthy  –  actually
more and more healthy. The health and especially the greater health
they seek and desire, tends to be totally severed from any relation
to their experience of the sufferings of sickness and pain. Greater
health and in particular greater health of the body has become an
idol of perfection many of our contemporaries serve with a religious
fervor. No sacrifice is too big for them, if it allows them to feel
more healthy. No food is good enough for them, no tedious bod-
ily exercises last long enough, no privations are severe enough for
them, it is as if they are willing to die in order to feel more healthy.
One is tempted to recognize, in this furious will to feel more
and more healthy, more and more alive, the mechanism of an un-
bounded and excessive death-drive. Isn’t it true that the mechanism
of death-drives, and the inertia and repetition that Freud ascribed to
them, consists in willing forever more and more of the same? It is in
their pure state, that is ‘disunited’ (entmischt) from the vital drives
of self-preservation, that death-drives show their true face. The de-
sire to put an end to the fatigue caused by the incessant effort to
stay alive, and the desire to die, make room for a purely nihilis-
tic and excessive drive that searches for nothing else than its own
self-affirmation. A pure death-drive is carried on in an accelerating
race to realize its merely immanent goal  –  at any price, and with-
out any consideration either for life or for sickness and death. A
naked death-drive shows its true face in the search for what Lacan
has called an absolute ‘enjoyment’ (jouissance)9. For death-drives to
take full control of human life, does it suffice to regard health as an
absolute and never fully possessed good or to sever its bond with

9
  R. Bernet, Force-Drive-Desire, cit., pp.  214-295.

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Rudolf Bernet

illness and death? When human life is reduced to the insane will
to be always increasingly healthy, what remains of the sane care for
life that searches for balance between health and illness? What re-
mains of the endless effort to overcome the fatigue and contrarieties
of life? What remains of the anxiety generated by the fate of death?
One can only agree with Freud, for whom the repetitive mechanism
of pure death-drives has a truly ‘demonic’ character.

Rudolf Bernet, The Passive-Active Force to Bear and to Suffer

This article is dedicated to a phenomenological exploration of the vast realm of

activities in passivity, of positive, negative, and possibly neutral modes of the force
to bear and to suffer and external or internal affection. It begins by considering
how material bodies respond to the transforming power of a human poièsis. This
leads to a distinction between the passive-active forces belonging to the materials of
human production and the natural forces belonging to the cosmic ‘elements’. Con-
secutively, the passive-active forces that belong to plants and animals are examined.
It is, however, only with human beings composed of body and mind that external
and internal affections and the forces to bear or not bear them, gain a truly dra-
matic character. In human existence, an illness of body or mind is met with the
power to consciously suffer one’s pain and to desire to regain health. Suffering hu-
man beings are also capable of expressing their pain by language and of addressing
themselves to other human beings with a demand for a healing treatment. The Con-
clusion stresses the essential and dynamic bond between health and illness, and how
death-drives take possession of a human life that is exclusively devoted to the wish
to become ever more increasingly healthy.

Keywords: Passivity and Activity; Responding to an Affection; Material Bodies,

Plants, Animals, and Human Beings; Pain and Suffering; Illness and Health; Medi-
cal Treatment; Life and Death-Drives.

Rudolf Bernet
University of Leuven (KU Leuven)
Husserl Archives, Centre for Phenomenology
and Contemporary Philosophy
Kardinaal Mercierplein 2
B-3000 Leuven
Rudolf.Bernet@kuleuven.be

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