Symptom Lexicon

The activity of list-making is an eclectic process that enables us to draw on varied, fragmentary sources, and simultaneously negotiate their meaning. It allows us to admire the creative potential of what is accumulated as we begin to see the items listed within historically changing conversations.[1]  It incites memories and enables us to exchange stories. The anthropologist Anna Tsing has referred to lists as harbouring “codified knowledge.” They reveal insights into sensitive historical and socio-political concerns and enable historically marginalized people to create their place in negotiations for their resources and rights.

As part of my own research about the impact of war and violence on the lives of women survivors of the Kosovo War, I began compiling lists of symptoms as they arose in conversations, situations and social interactions. I jotted them down in notebooks and on scraps of papers before ordering them by frequency of expression. [2] The emerging “inventory” was obviously fragmented consisting of what Anna Tsing refers to as “limited materials”, teased out of conversations and observations. It surely wasn’t a master list or in any way statistically representative. Yet, it was precisely because of its fragmentation (and possibly lack of representativeness in the statistical sense) that it permitted me to shift my attention to the creative interpretation and use of symptoms as something else.

I referred to the expanding list as “Symptom Lexicon.” A lexicon of feelings, bodily sensations, and social relations, which represented simultaneously painful expressions and illness narratives as well as a form of vocabulary, even a branch of knowledge about living with war in the everyday. As such, it provided me with an important avenue into hearing unusual and unexpected messages about the women’s past and present lives as well as their aspirations for the future.

Through intense listening, I learned that not all the symptoms were shared or experienced equally by the women. Put differently, not everyone mastered, or needed to master, the same range of symptomatic vocabulary to make their messages heard. Instead, their utterances were further shaped by intersecting memories of the past, social experiences, opportunities in life, and passions for social change. In such moments, bodily pains, emotions, social status, and desires came together and were visualized through bodily expressions. It was then that topics of discussion were painfully created in concrete social fields and at particular moments in time to sustain memories of the past and present. The vignettes below are illustrative.

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Edona[3] is a war widow and a mother of five children, three daughters and two sons. Her oldest daughter was married and lived in Switzerland with her husband while the other children were still at home. She lived in her brother-in-law’s house whose family resided in Germany throughout most of the year. Edona described her economic situation as “very good” due to the financial support of her in-laws. “I am doing well, I have everything that I need and I believe that it will continue to be like this.  My brother-in-law and his sons took care of me in the beginning. They were like brothers and sisters to me. They respect me very much. So, there are no problems with regards to economics.” Her most prevalent problem was the sadness that she experienced when thinking about her dead husband, “Often, I ask myself, ‘Why don’t I have a husband?  Why did he have to die in the war?’” When I asked her about what kind of health problems she has had since the war, she replied that she hasn’t had any. Yet, after reflecting on her answer, she added that she suffered from headaches. “Sometimes I get headaches, but just when I get nervous. Also, when I get nervous with the children, when I say something and they don’t obey, I get headaches. You get nervous and then you get headaches.” Her friend Lorida joined the conversation adding, “She wants to wear the jelek [vest] with golden thread. But we are not allowed to wear it [as widows] – this is when we get nervous. We want to dance at the weddings, but we have to sit and look sad.” Edona agreed telling me that when she was not allowed to dance at the wedding of her son, she became sad and developed headaches as a consequence. In addition to headaches, she feels unspecific pain in her heel and joints.

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Shukrije is a war widow who knows neither how old she is nor when she got married. She is a mother of two daughters and three sons all of whom were married except for her youngest son. Her most prevalent problem was related to her health. “We are all sick because that we had to flee from the Serbs without wearing shoes and proper clothes.” Since then, she can’t feel her right leg anymore, has asthma, cannot sleep properly, and suffers from forgetfulness. According to her, “everything has changed for the worse” since her husband’s death, as her older sons, who lived in Austria, didn’t support her and her youngest son didn’t listen to her. She complained, “I get 36 euros from social welfare. But my son spends it on cigarettes. He smokes two packages per day and doesn’t care if I have money or not.” During the interview she started massaging her right leg and when I asked whether it was hurting, she replied, “Yes, I have problems with my leg now. I have to massage it. It hurts more when I am angry and nervous. It is a result of the war. When I remember that the war separated us from our men and children, then it really hurts.” After a moment of silence she continued, “When I want to sit down to eat something, I can’t eat because I know that my husband doesn’t live anymore, like the other husbands [who died during the war]. I am sad that my family is not with me.” Upon deciding to interrupt the interview for her to get some rest, Shukrije finished in frustration with the final sentence, “The Serbs killed our cow and we didn’t have salt.”

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Jolanda is an educated woman who had a high school diploma, worked as a medical nurse in Rahovec and studied medicine for four years without finishing the final exams. She got married when she was thirty-one years old and is a mother of three teenagers, two boys and one girl. She described her economic situation as good since her brother-in-law regularly sends money from Switzerland and her husband is the director of a brickworks company. “You could classify us as middle class as my husband has a regular income that is better than incomes earned by doctors and teachers. However, if it hadn’t been for the war, we could be on a higher economic level. We had to start our lives all over again, beginning with the spoons as we had lost everything.” Although Jolanda applied for job offers for medical nurses at the family medicine centre in Rahovec and Krusha, she was not accepted with the explanation that her husband had a well-paid job and that she was, therefore, not in need of employment. When I asked her what kind of health problems she has suffered since the war, she explained that her uterus has been removed and that she suffers from osteoporosis due to the hormones that she is forced to take. When I probed by explaining that a lot of women complain that their body reacts in certain ways when they get stressed or nervous, Jolanda replied that “it is normal that war trauma leads to certain consequences. Just thinking about how we had to escape, how we had to carry our children as well as big blankets to cover them during the cold nights – whenever I think of it, I get goose bumps. At the same time, I didn’t know where my husband was hiding in the mountains. I didn’t know whether he was alive or not.” After a small pause, she explained, “I just wanted to tell you that stress exists and that consequences exist. When we were on our way to Albania we never knew whether we would be killed here or in the streets. We were distressed until we got to the border. My husband survived and also us as a family.” When Jolanda gets nervous, she doesn’t suffer from physical pains; instead, she can feel it in her “spirit.”

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Hamide went to school for only four years and got engaged to her husband at fifteen years of age to marry him two years later. Since then, she has lived together with her husband’s extended family in Pastasel and raised eight children: five daughters and three sons. Although she described her economic situation as good, she complained that there is not enough money to send her oldest son to university and that the rest of the family has difficulty making ends meet, as they have no relatives working abroad. Since the war she has suffered from chronic headaches; however, she explained that her headaches get stronger when she gets nervous or “nervous with her children.” In addition, she suffered from strong heartbeats, low blood pressure, and, related to this, dizziness. She explained that her symptoms were connected as they were related to feelings of sadness. “Maybe I got these problems from sadness. When I am sad, they become worse.” After a few moments of contemplation she concluded, “But I kind of get them from everything and the cause can be anything.”

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Women like Edona, Shukrije, Jolanda and Hamide expanded my symptom vocabulary and taught me that the experience of symptoms was context dependent, dynamic and fluctuating. Symptoms, I learned were connected to the status of widowhood, which was often experienced as oppressive leading to feelings of nervousness, worry, sadness and pain. Yet, social and economic insecurities and family conflicts could be just as triggering for symptoms to surface. Symptoms were thus able to connect inner and outer worlds. They “objectified”[4] and made visible the women’s inner states of loneliness, sadness, loss, and hurt as well as their yearning for a past associated with solidarity, wellbeing, and celebrations of life. Outwardly, in turn, women sought acknowledgement and recognition for their concerns about the education of their children, family relations, exclusion from the job market, low salaries, and impoverished living conditions while also highlighting available social support and small, but steady progress in their ordinary lives.

While pain has often been portrayed as something that destroys and defies language and communication[5], this is not what I found among women survivors of war. On the contrary, their pains themselves appeared to have the quality of a language while also enhancing the spoken word by adding vocabulary strong in expression and meaning.[6] It was a means through which women reached out to one another and were able to make claims upon their listeners for recognition of grievous inner and outer states and contexts within which they were forced to negotiate their lives. It was through such symptomatic exchanges that new framings of the past and novel ways for engaging in the present moment could be co-created with the power to reveal both uncomfortable truths concerning social inequities, lack of communal support and failing political commitment and imaginaries for a better future filled with possibilities and prosperity. Accordingly, the women’s Symptom Lexicon was not just about personal trauma and hardship, but a vehicle through which to make visible what needs changing on familial, communal and political levels so as to rebuild their country in the aftermath of war.

Author: Hanna Kienzler

[1] Anna Tsing writes in her book Friction: An Ethnography of Global Connection about her endeavor to generate lists of animal and plant species in rural Indonesia as a means to incite memories and exchange stories about the destruction of the rainforest and local attempts to resist it.

[2] For a list of symptoms see: “Utterances of Distress

[3] All names of study participants are pseudonyms to protect the women’s anonymity and privacy.

[4] Vena Das writes in her article “Language and Body: Transactions in the Construction of Pain” that women in India express their memories of gruesome experiences and events through their bodies as well as language. She explains, “grief is articulated through their bodies (…) by infliction of grievous hurt on oneself, ‘objectifying’ and making present the inner state, and is finally given a home in language” (p. 68).

[5] See for example Elaine Sarry’s seminal book “The Body in Pain

[6] I elaborate on the linguistic dimensions of pain further in my article “SymptomSpeak: SymptomSpeak: Women’s Struggle for History and Health in Kosovo” and the blog entry “Voices of Pain”.

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