amy berkowitz with cat on shoulder

I feel particularly passionate about this interview, which I conducted with poet Amy Berkowitz about her forthcoming book, Tender Points (pub. date June 20, 2015). Amy and I met one another in graduate school, where I spent many an afternoon in her kitchen—Amy is an extraordinary cook—while sharing stories about our lives. As described by her publisher: Tender Points is a narrative fractured by trauma. Named after the diagnostic criteria for fibromyalgia, the book-length lyric essay explores sexual violence, gendered illness, chronic pain, and patriarchy through the lenses of lived experience and pop culture (Twin Peaks, Teenage Mutant Ninja Turtles, noise music, etc.).

Basically, her book, which I was fortunate enough to read a review copy of, is about many of the things I care about. It’s also devastatingly and beautifully written. You can pre-order it here.

Also! You’ll have a chance to win a copy of the book at the end of this interview. Stay tuned.

tender points book cover

Q: Reading this book was very exciting for me. To indulge in our history together for a moment—you were actually the first person I ever knew who was diagnosed with fibromyalgia, as well as being the first person who affirmed my suspicions about some of my own traumatic experiences when we were in graduate school together. I was diagnosed with fibromyalgia later—and then late-stage Lyme and PTSD—but I feel as though those early conversations in your small kitchen were formative for me.

A: Yes! It’s great to connect with you about this. More conversations between people with fibromyalgia diagnoses, please. We don’t have to include this next bit in the interview, but I have to admit that I don’t have a clear memory of your telling me about your own traumatic experiences. I have a really poor memory in general and I think I tend to often block out things that are disturbing/trauma-related. So if you want to remind me about that, you’re welcome to. You’re also absolutely welcome to talk about something else.

Q: You were the one who told me that my own doctor experience had been one of sexual assault.

A: Oof.

Q: Which was interesting to me, because I had a certain kind of trauma narrative going for myself at the time that primarily centered around a specific rape. But this does remind me of a part of your book about imaginary paintings of women talking about rape, which I saw a form of elsewhere and loved.

A: Yes, there’s an essay in the book called “Paintings I Won’t Paint,” that was previously published in VIDA’s Reports from the Field series, which is a wonderful series in general. In short, it’s basically an examination of all the time I’ve spent throughout my life talking about rape with my female friends, describing our rapes, helping each other through PTSD, strategizing [about] how to make safer communities, complaining about Law & Order SVU. Raising up that unpaid labor of talking about rape to honor its importance, but at the same time to criticize the fact that we spend so much of our time obligated to it. Now we find ourselves in a meta-moment, we find ourselves as people in the essay. Talking about talking about rape.

Regarding multiple strands of trauma narratives: I’m not sure if you’ve had this experience, but for me, it’s interesting to think about how multiple violations/rapes/traumas can all kind of fold together in a person’s mind. There’s a part in the book where I realize that each doctor visit I had in my early 20s, experiences where I let an uncaring male doctor treat me disrespectfully, were more traumatic because they layered upon this older experience of being raped by a doctor. And then calling MetLife to sort out my disability claim felt incredibly traumatic, because it was effectively another abuse by the medical system.

“Tender points” are the famously vague diagnostic criteria for fibromyalgia, and I also thought of the book as being a series of tender points; it’s made up of fragments, and many of them—being about difficult/sensitive subjects like rape and chronic pain—are, well, tender.

Q: Oh my God, I just had a terrible call about disability benefits two days ago that made me cry. But that’s a whole other conversation, too—the trauma of having to explain one’s issues to a generally uncaring system, a system that’s overwhelmed and centered around binaries and checklists.

Now that we’ve kind of segued into talking about the medical side of trauma, I want to talk about the title of the book, which is this great, great title. I think it’s absolutely perfect. So, to ask a very boring question—how did the title come about? I’m shit at titles, so I always wonder.

doctor performing tender points exam

A: This may be a side note, but this [related] video is fucked up, and I think very indicative of the white male doctor /female fibromyalgia patient dynamic. [The video is a demonstration of how tender points are assessed.] Basically, this literally listless woman named Deb is swiveled around as the doctor pokes her 18 tender points. Just the lack of agency there is stunning.

The title felt very obvious. “Tender points” are the famously vague diagnostic criteria for fibromyalgia, and I also thought of the book as being a series of tender points; it’s made up of fragments, and many of them—being about difficult/sensitive subjects like rape and chronic pain—are, well, tender. I liked reclaiming the phrase “tender points,” and using it to signify my own ideas about fibromyalgia, instead of this odd diagnostic tool.

baby carrots

Q: When did you first begin to see the link between trauma and the fibromyalgia diagnosis, and how did that inform the writing of this book? A question that I think your book brings up quite well is how the body/mind divide isn’t very helpful when it comes to these kinds of diagnoses.

A: The link was there from the start: I was lying in bed one night–after an unpleasant visit with a doctor who talked to me in a disrespectful way–and something about the way this doctor talked to me shook something loose inside of me. And, lying there, I suddenly remembered being raped by my pediatrician as a kid. I fell asleep, and then woke up with pain all over my body, which was diagnosed as fibromyalgia.

So to me, the connection was obvious. Given my experience, it’s hard for me to understand why other people would have to be persuaded that the mind and body are one, and that trauma and other emotional/psychological experiences can manifest themselves physically. And other people’s unwillingness to see this connection–especially doctors’ unwillingness–is limiting our understanding of the body and how to heal it.

Q: There’s also a conversation to be had about skepticism, and about not believing women in general; you exhibit this painfully in the book with what I’m assuming are quotes from forums and the like, from people who claim “fat women” who are “lazy” are the people who claim the fibromyalgia diagnosis. Which is to say, There is no pain, and also, There is no trauma. It’s hard to be a woman and to be believed.

A: What I’m doing how is this loud howling/groaning combo, which is my gut reaction to this kind of thinking. Something I wonder about is the identity of these people (they mostly seem to identify as men) who are skeptical of and angry at women who have fibromyalgia. Where is this anger coming from? It’s so powerful. What are these men afraid of? What are they reacting to?

As women, we aren’t trusted as reliable narrators of our own experience, or as authorities on anything, really. But also, I don’t think there’s a ton of awareness around the link between fibromyalgia and rape/trauma.

Q: I think it IS different from the anger and skepticism that comes in general about 1.) rape and trauma alone 2.) claiming illness—and perhaps subsequent assistance, such as disability benefits—alone.

A: As women, we aren’t trusted as reliable narrators of our own experience, or as authorities on anything, really. But also, I don’t think there’s a ton of awareness around the link between fibromyalgia and rape/trauma. More awareness around that would probably be a good thing.

Q: I actually think people are afraid to make that link, because that link seems to inherently feel like… an attack on the “legitimacy” of the physical pain and other consequences of things such as fibromyalgia.

A: That’s a good point. Because who’s a bigger liar than a rape victim? If she lied about being raped, she’s lying about the pain, too. And another thing I mention in the book is that I’ve found that some fibromyalgia patients themselves refuse to believe the mind-body connection because they don’t want to think “it’s all in their head.”

brain dust

Q: There’s a lot of research in the book. There are a lot of quotes from theory and literature, and things like the awful comments we were just talking about. What was that research process like?

A: The research process was fun. The more I talked to people, the more books were recommended to me. Books led me to other books, the Internet is full of angry skeptics on message boards AND useful information, I live near a public library, etc. The research felt like exploring a few different rabbit holes. I just followed whatever trains of thought felt interesting and learned as I wrote.

Q: There was something else I wanted to bring up—about circling around talking about trauma—in real life, but in literature, too. You talk about your primary trauma directly in the book. It made me think about—I don’t know if you followed this, but Roxane Gay received some flak for not speaking explicitly about her childhood assault in Bad Feminist, which later led to her writing a separate piece about it. Did you always know that you were going to specify what happened to you when you were working on the book?

A: I haven’t read Bad Feminist yet. And I didn’t hear about this, but why did people criticize her for that? Isn’t that her choice? Did it feel like a big hole was left in the book by its omission?

Q: I’m trying to remember what exactly happened—it had to do with an essay in the book in which she was criticizing the act of eliding rape in media, as opposed to showing the brutality of it. And people were saying: Well, you didn’t show the brutality of your own experience in these essays.

A: That’s a stupid fight to pick, in my opinion.

Q: People generally pick stupid fights with Roxane Gay, I have noticed. What was your decision process like, in terms of deciding how much to say about your own history of trauma?

A: I think I knew I was going to mention it, but I didn’t know what that mention would look like. I wrote the book in a Google Doc, which was useful for writing about trauma, because if I wrote something that felt difficult or triggering, I could just scroll down and move on. When I was ready to print out the whole document, I looked at the places I described the rape, and decided what I was comfortable saying publicly.

Q: I’m interested in the fact that you wrote the book in a google doc, because [the book] has a fragmentary quality to it. How did you approach its structure?

A: I knew I wanted it to be in fragments from the beginning, because the story itself is fragmented: a repressed memory that connects to a trauma that causes an illness and so on. So from the Google Doc, I put together fragments that ranged from one paragraph to a couple of pages in length. When I was invited to do a reading, I’d collage 10 or 15 minutes of fragments together. When it came time to assemble the book, I organized all the notes into polished fragments, and then, with the help of poet Stephanie Young, sat on my living room floor and literally cut the fragments apart and taped them together.

Q: I love hearing about stuff like that. And I think I’m going to start wrapping up here, too. First, thank you so much for doing this interview with me. It’s been a treat and an honor. Finally, I want to ask—in terms of your work, where do you think resilience fits in with your path as a writer?

A: Thank you so much! It’s great talking to you, and I appreciate you taking the time to do it. [About resilience], that’s a good question. I think I’ve grown to become a pretty resilient person, given all the shit I’ve had to deal with, and part of the way I’ve coped is by staying interested in my problems and where they fit into bigger-picture problems, and finding satisfaction in writing about that.

Q: I love that.

To be entered in the giveaway for a copy of Amy Berkowitz’s book, Tender Pointsleave a comment here with a part of the interview that particularly struck you as important and/or interesting, and why.

BIO: Amy Berkowitz is the author of Tender Points, forthcoming from Oakland small press Timeless, Infinite Light in June. Her writing has appeared in 580 Split, Dusie, and Where Eagles Dare, and on the VIDA blog. In 2014, she was a writer in residence at Alley Cat Bookstore & Gallery. She lives in a rent-controlled apartment in San Francisco, which serves as the headquarters of her small press, Mondo Bummer Books, as well as the venue for the Amy’s Kitchen Organics reading series.