Going from Alpha to Beta because of Chronic Pain, Stress, and Decision Fatigue

Gertrude Highland

“Your characters need agency,” my professor said to me. We were sitting at a U-shaped table in rural Ohio, discussing the merits of my short story that featured Old Testament harbingers of doom.

“What?” I said.

“Agency. Agency.” His accent thickened with his own urgency. “Why do the characters do what they do? Take my novel, for instance. It’s the classic love story between a man, a woman, and a whale.” His expression was deadly serious.

I couldn’t focus on his words. I couldn’t think. My entire body hurt, and sitting in a hard plastic chair wasn’t helping.

“Right, agency.” All the while I’m thinking, Wait, did he say whales?

I used to be assertive.

I had dreams, and I chased them with relentless, single-minded intent. Most importantly, I knew what I wanted. Goals were set and pursued and, crucially, met. I could sit for hours and bang out a novel. I could exercise until my muscles quivered from exhaustion. When I looked in the mirror, I was proud of what I saw.

I could make my own goddamn decisions.

After my first car accident, I was more than happy to surrender all medical- and health-related decision-making to my parents. I was only seventeen and grievously injured, enough that learning how to live with limitations would take up most of my time. I couldn’t handle anything beyond the immediate and necessary. Anything else became superfluous.

Decisions went from a solo task to choices-by-committee.

I needed input. Opinions. Advice was weighed, positions sought. Taking on major decisions exhausted me. What if I was wrong? What if I messed up simply because I was so tired?

It took me years to realize this was a symptom of decision fatigue. Too many decisions to make? Shut the body down.

This happens whether you’re tired or hungry or in pain.

Side note: Someone decided that “panger,” like “hanger,” shows how you’re just not you when you’re hurting.

(Eat a Snickers.)

Willem Dafoe and his goddamn glorious legs. Source.

Anyway, the second car accident shattered whatever agency I had left. Decisions were relegated to my husband. Even tiny ones, like what I wanted for dinner, felt consequential. What if I was wrong?

Stagnation felt easier than making the wrong decision. A wrong decision might leave me feeling worse than I already felt, and could I handle that?


On a related note, I can determine my husband’s current focus with his therapist based on how he tries new conversational gambits.

I noticed that upon surrendering a decision, he’d gently lob it back over the net.

“I don’t know,” he’d say with a shrug and a calculated gleam in his eye. “What do you want to do?”

No idea. Sheer paralysis rendered me mute as I considered the weighty differences between macaroni and burritos. I’d choose in desperation, using whatever context clues were available to discern my husband’s preferences.

Detective work is easier than just bearing the weight of my own bad decisions.


My third car accident, the third before age 33, pulled a tired and defeated sigh from my worn-out body.

Chronic pain and stress dull the mind. It occupies a part of the brain at all times, splitting my attention and ruining my focus. The more physically damaged I become, the less likely I am to take risks because of the potential cost.

Assistant Professor Stephen Cowen at the University of Arizona noted the following in his own research:

If you’re suffering from chronic pain, your ability to make good decisions or adapt to new information might be compromised. You might not realize it, but your friends and others might notice that you’re sticking to what you know. You’re not venturing out, you’re not trying new things, you’re not learning new information. You’re kind of on autopilot.

This plays into the Spoon Theory a bit — you know, a woman was at lunch with her friend, yadda yadda yadda, and the friend asked what it’s like to live with chronic illness. The woman cast about for inspiration before landing on a cluster of spoons. Each spoon represented a discrete task, and once they were used, they were gone. Even if that meant not showering, not eating, or not going to work. You only had so many spoons.

Decisions take energy, even if they’re as small as what to wear or how to style your hair. Sheer exhaustion made me take a backseat years ago.

The older I get, the more I realize just how tired I really am. It’s easier not to shower. Not to style my hair. Not to get dressed. Not to go outside. It’s easier and it doesn’t hurt as much.

It’s easier to stay put and not get hurt.

“If I’d just listened to you,” I said to my husband, “if I’d stayed working from home, I wouldn’t have gotten into this third car accident.”

He didn’t say anything.

Then I got angry, positively glowing with fury — not at him, not really. Instead, I was mad at the whole world. Why should I have to stay home? Why should I have to put my life on hold just because other people can’t drive? Why can’t I have agency over my decisions?

My life doesn’t stop even if I stay inside. Even if I were to live in a bubble like Adam Sandler in that stupid, stupid movie, I would still somehow be damaged.

Wait, it was Jake Gyllenhaal!? Source

These days, I remind myself constantly to pull my shoulders back. Stand up tall. Head straight, not forward like a pelican.

Remember to have agency. Remember the “why.”

Gertrude Highland

Written by

*Shrug.* www.gertrudehighland.com

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