Tender Points

by Amy Berkowitz

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.).

Teaching Guide (or Book Club Guide) here: bit.ly/2aqJV2X

Genres: Poetry, Memoir, Nonfiction, Essays, Disability, Feminism, Biography Memoir

136 pages, Paperback

First published June 20, 2015

About the author

Amy Berkowitz is the author of Gravitas (Éditions du Noroît / Total Joy, 2023) and Tender Points (Nightboat, 2019). Her writing and conversations have appeared in publications including BOMB, Bitch, The Believer, and Jewish Currents. She lives in San Francisco, where she’s working on a novel and a nonfiction thing.

Reviews

[Mike · Rating 5 out of 5]

On Friday I went to Skylight Books to see Maggie Nelson read from her masterpiece (edit: one of her masterpieces) The Argonauts, and she gave a sterling endorsement for the writer that was following her, a young woman named Amy Berkowitz. I didn't gather that Maggie Nelson was the opener to a headlining act, but was thrilled to see that her blurb was also on this book's back cover. Also written in a format akin to The Argonauts and Citizen, Tender Points is an immensely American lyric as well. I picked up a copy and followed along as she read. A searing document of a true eternal recurrence - rape trauma - and an informative treatise on the origins of fibromyalgia, the implications of the root pains in hysteria, a defense of the BOB in Twin Peaks, and a list of great noise music recommendations aside, it is a collage of disparate elements wholly connected through the communication of pain. The reading triggered the hell out of me and there was some collateral damage incurred by that - oftentimes those around me suffer when I fall into the "infinite action replay" spell - but I digress. At the signing, I told her I was working on my own piece about my sexual assault. (This is true.) I felt like I had hit a lull, but was invigorated by her ability to connect these elements together into a unified whole: seeing her pull off the feat gave me something to "rise" to. She wrote in my copy, "To Mike, tenderly: Write the thing!"

All I want is to show it to her when it is finished. If it's remotely something she can behold to the degree that I did for her work, it'd be a hallmark victory for all that I have deigned to create. A short virtuosic work.

[Leslie · Rating 5 out of 5]

A beautiful and plainly written book-length essay about living with and writing about fibromyalgia, trauma, being a survivor, and more. Side note: I can't help but feel a kinship with any writer who mentions riot grrrl in a book on any topic.

Many passages stood out to me, and made me see the world in new ways, but here's one that I reached for a pencil to underline:

"Brautigan's style of misogyny--call it gentle misogyny, subtle misogyny, or microaggresive misogyny--is woven deep throughout the fabric of our culture. Tight little stitches you can barely see. Woven so deep you could love one of his stories so much that a phrase from it is the first thing you think of when you describe your pain--pain caused by a quiet act of violence permitted by this pervasive misogyny."

[Pauline · Rating 4 out of 5]

Prêté par une amie, ce recueil rassemble des textes sur la douleur chronique, le viol, le trauma. Tisser des liens entre tout cela, c'est précieux et important. Résolument féministe, l'autrice y pointe également cette manie de la société, d'hystérie en fibromyalgie, de laisser dans le noir les femmes qui souffrent sans qu'on comprenne pourquoi.

À lire si, comme moi, vous avez dans votre entourage des femmes qui ont des douleurs chroniques.

[Sonia · Rating 5 out of 5]

This was quite possibly the best and most resonant book I’ve ever read about chronic illness. I have a lot of thoughts about it but I’m not sure I can articulate them right now, but I will just say: it was very empowering, as someone who’s struggled with chronic illness that has enormously impacted my life and what I’m capable of, to see many of the things I’ve found myself thinking about written out this way. Just because you deal with a condition or illness that medicine doesn’t understand or know how to treat yet doesn’t mean it isn’t real. Your pain is real. Your struggle matters. Your story matters.

[Bobbieshiann · Rating 5 out of 5]

"i'm 31 but i feel like i'm 60. people in my life may think i am exaggerating but i am always in pain. every morning i wake up feeling like i was run over by a truck. i feel like i've been hit by a bus. i wake up stiff like a coyote with rheumatism. i wake up in the woods on a bed of dried moss. i have a doctor i have a wolf i have an ex. interrupting me, stepping out from behind the same tree to block my path. invisible, impossible to prove. whether or not you believe me. imagine it repeating like a gif".

this is the story about a woman who has fibromyalgia. it is a common and complex chronic pain disorder that causes widespread pain and tenderness to touch that may occur body wide or migrate over the body. amy talks about her experience with this disorder and her life struggles. it is said that this disorder is a excuse for women to be lazy, and most people do not take it serious. this disorder links back to her being raped by a doctor as a kid. i did think at once maybe her being in constant pain is a mental thing and is way to cope with her trauma, but what do i know? as i read her book i believe her words and she makes valid points. since this disorder affects women more then men, it is unknown and disregarded by people and doctors. it is sad to hear these such things but we do come from a world that made it so that women can always be behind men. men are trusted while women have to jump through hoops to be heard.

i cannot judge her from reading her story. i could only get better informed and see the word through her eyes. i am glad she decided to share her life and make people more aware. i have a certain soft spot for this book.

[Rosamund Taylor · Rating 5 out of 5]

I reread this while I had a migraine, and found it so compelling I changed my rating from three stars to five. I found the short pieces moving, and while I was in a place of pain, reading them was very cathartic. This time round, I appreciated Berkowitz's brevity and her clarity.


In 2018 I said:
This is written in the style I think of as "poetry-essays". These pieces, rarely longer than 200 words, sometimes read like short pieces of prose, sometimes more like prose-poetry or sometimes a spoken word piece. This style works very well for Maggie Nelson and is exceptional in the work of Claudia Rankine, but Berkowitz doesn't have the same control as they do. Sections, here, can feel repetitive or badly worded -- but my main criticism is the brevity of this book. Berkowitz raises so many interesting topics, from the sexism inherent in the diagnosis of fibromyalgia, to the history of hysteria in medicine, to the meaning of psychosomatic illness and how we view illness in a capitalist society. I'm fascinated by all of this, but each section was so short that none of these pieces felt adequately explored, and I was left unsatisfied. That being said, I do recommend this book -- there are some extremely strong pieces about medicine and sexism, and some very moving writing about living with fibromyalgia. As I also have this diagnosis, I found these particularly moving, and it's very rare for me to see my lived experienced explored like this.

[Carmelo Valone · Rating 5 out of 5]

A poetic and meaningful interpretation of the culture of living with chronic pain, ptsd, and fibromyalgia. As a sufferer myself, it's a beautifully written memoir as the world has been flooded with how-to-deal-with books, it's just lovely to read that someone, somewhere elese in this world is being honest about the disease and it's origins, which is never a pretty place.

[malou]

Sometimes, you find a book in a shop and you read it in a day and it's the exact thing you needed to read in that moment? This was one of those

[Madeleine · Rating 4 out of 5]

berkowitz's background as a music writer radiates through the medium of this engrossing and sharp work of creative nonfiction/poet's lyric — concern with sound, expression, legibility, and bite. i appreciated this book's well-honed archive: anne carson, wojnarowicz, sontag, despentes, rankine, and the smart way that it breaks down the tight prose poems at the beginning. some of the metaphors did less for me (such as one, repeated in the text: "imagine it repeating like a GIF"), and while berkowitz talks in the afterward about being influenced by the disability justice movement, i didn't so much see that movement's analysis or community reflected within the text. for what it is, a beautifully written feminist prose poem.

[Kiralleta · Rating 5 out of 5]

Моя подруга прислала мне эту книгу со своими пометками на полях и со словами «прочти, оставь свои заметки, и отправь мне книгу обратно». Так и вышло. Я прочла откровения Эми Берковиц и заметки моей подруги на полях, а также оставила свои впечатления и мысли на этих же полях. Такой вот своеобразный обмен травмами, опытом и попытка понять других людей и разделить их переживания.

Нежные точки - про саму Эми, которой поставлен диагноз фибромиалгия. Она пытается понять отчего на ее теле столько нежных точек, которые причиняют ей хроническую боль. Эми заявляет о болезни, рассказывает о ней через свою книгу и показывает, что женщины, которым были нанесены травмы, не одни.

Эми рассказывает про опыт насилия в ее жизни, как ее изнасиловал врач, к которому она пришла на прием и про то, как она живет с этим, доверяет другим людям, и старается, чтобы голос женщин, которые столкнулись с насилием, был услышан. Книга издана таким образом, что большую часть страниц занимает пустота. Не знаю намеренно это было сделано или нет, но эффект для читателя оказывается таким, что ты сразу берешь ручку / карандаш и начинаешь копаться в своих чувствах, переживаниях, описывать свой опыт, реагировать на строки и искать те самые «Нежные точки» в своей жизни.

[no · Rating 3 out of 5]

very 2015

[Brianna · Rating 5 out of 5]

"People in my life may think I am exaggerating but I am always in pain. Every morning I wake up feeling like I was run over by a truck. I feel like I've been hit by a bus. I wake up stiff like a coyote with rheumatism. I wake up in the woods on a bed of dried moss. I have a doctor I have a wolf I have an ex. Interrupting me, stepping out from behind the same tree to block my path. Invisible, impossible to prove. Whether or not you believe me. Imagine it repeating like a GIF"

This book was so good, I can't stop thinking about it. Tender Points stands on its own but formally & thematically it reminds me of Sarah Manguso's The Two Kinds of Decay and a little bit of Claudia Rankine's Don't Let Me Be Lonely. This book is a wonderful meditation on illness & pain & the idea of gendered pain specifically. There's such a dearth of those narratives & women who usually do talk about their pain are often ridiculed or dismissed which can be so dehumanizing. For me the most powerful parts of her book was when she transcribed comments left on articles about Fibromyalgia: "They're just whiney people who love to be 'sick'" , "They're just nasty fat women who want to collect disability checks" , "I knew a woman with it; she was miserable and had a whole Myspace dedicated to the constant pain." Even though this is specifically about Fibromyalgia I think this is what a lot of women who suffer from chronic pain and chronic illness have to deal with and why talking about it outside of message boards and support groups is so hard and why books like this are so incredibly important. This book really meant everything to me, I loved it.

[Allison · Rating 5 out of 5]

So well-written. Anyone interested in fibromyalgia, rape culture and lyric essays should read this.

[Natalie Marlin · Rating 4 out of 5]

One of the rare books where I just found myself overcome with immense, vivid teary recognition from the first page. Overwhelming, necessary.

[Leah Rachel von Essen · Rating 3 out of 5]

Tender Points by Amy Berkowitz is a really poetic reflection on the author's fibromyalgia, chronic pain, and experience of trauma. It is richly emotional and delves into the issues around rape culture, medical dismissal, and medical trauma. I really enjoyed so much about this read. As person with fibro, I related strongly to much of what she wrote about, and I thought it was a really good book about sexual assault and trauma.

However, my reading experience was ruined by Berkowitz's argument against the "cute-ing of illness." She argues that the Spoon Theory "does little to alter certain peoples' misogynist misperceptions of fibromyalgia as a fake disease invented by middle-aged women because they're lazy." She then argues that we use "cuddly vernacular" such as "flare-up" or "fibro fog" and that "fibromyalgia patients are going to have an easier time being taken seriously by the system if they choose to code switch and talk about their illness in precise, clinical terms."

I wildly disagreed with this point. First, I truly fail to understand what is cute about the term "fibro fog" or "flare-up." There is nothing inherently "domestically feminine" about the term "Spoonies." I'm sorry. It's a reach. Second, some of these terms fill a gap where traditional Western medicine has no words to explain the symptoms, which have been historically ignored and dismissed. Third, speaking to doctors in "clinical" terms does not do anything if they're going to dismiss our conditions. We've all gone into appointments with lists of symptoms and detailed research, only to be sent home, dismissed, or misdiagnosed anyway.

These terms were created by a community coming together, creating a new language around disability that allows us to articulate our specific struggles to each other and to non-disabled or ill people. As my partner brought up when I was ranting about this chapter, communities don't need to be in constant battle. Our chronically ill lives do not need to be in constant utilitarian fight against the doctors who dismiss us. There is power simply in us coming together and sharing our experiences. It lets us know we are not alone, and it creates a space for new ideas to bloom.

Content warnings for misogyny, fatphobia, sexual assault/rape depiction and discussion, trauma.

[Hannah Ingber · Rating 3 out of 5]

“But you really would love to go: You, too were once a little kid who thrilled at swooping around rinks to Groove Is in the Heart and Turn the Beat Around. It’s just that’s not your reality now. But the tyranny of mandatory fun is bearing down. Everyone’s eyes are on your ankles, and they won’t be satisfied until they see scars or bandages or blood.”

“How the fuck am I ever going to support myself. And my boyfriend says, “Well, don’t wallow in it. That’s not going to help. Just pick yourself up and get back out there.” These are the words of a little league coach but I am not a little league team. I am a grown person with a disability.” 62

read this for my research paper. it’s hard to read someone write about how their life is defined by pain and trauma and social isolation. She writes about how peers resent her because her body will not allow her to do certain things, but that no one can tell. She writes about how doctors don’t take her pain seriously because of her gender. She writes about how she can’t perform to her potential at work. It was wierd because i’ve never read soemthing that i can so directly relate to, and i guess that’s comforting. but it’s still kinda just sad cus relating to soemthing doesn’t make it better. didn’t love the prose of it all tbh but ive never read this style before so that was cool. but idk it’s scary to read something when it feels like a chronicle of my future. but also it’s nice to see mt own experiences reflected. made me ponder how frustrating treatment is and such and such and such

[Catherine Bond · Rating 5 out of 5]

Une fin de soirée à parcourir les passages émouvants, frustrants, éclairants d'Any Berkowitz sans arriver à lâcher le livre. D'une importance capitale, vous m'entendrez en parler probablement autant que de Peau de Dorothy Allison. À garder près de sa table de chevet pour consultation fréquente et prêts à des ami.e.s!

[Marian · Rating 5 out of 5]

Stellar. One of the rare books I want to immediately reread.

[Katie Kelsey · Rating 5 out of 5]

This is a quick read, I personally read it in two sittings.
Very powerful, and I loved the overarching symbols and how they all came together in the end!

[Jacob Massa · Rating 5 out of 5]

Great, timely rec from Monica.
Medicine is, often, a mess. Glad to have met this author before my job starts.

[Daria Manzhura · Rating 5 out of 5]

Одновременное чувство узнавания и радости от этого и злости, смешанной с печалью, от того, что плиту патриархата всё ещё не удаётся сломать, только быть вместе под ней.

[andreea. · Rating 4 out of 5]

.

[Amy · Rating 4 out of 5]

A quick read about fibromyalgia, trauma, misogyny, and a little Twin Peaks. I remember being in my early 20s and declaring that "fibromyalgia isn't real" and while I still wouldn't be alone in that sentiment, who did I think I was? Certainly not a doctor, and more likely just not a fan of the young woman I knew who vocalized that diagnosis (which is still a complicated diagnosis given the variety of symptoms). However, I have now read a few books like this one, have had relatives that have faced the frustration with the medical profession -particularly with the lack of understanding about ambiguities in women's health, and have been a person that experiences my own psychosomatic ailments at times, I hope to keep increasing empathy in this area, and anger when women aren't taken seriously about pain.

[Alexis · Rating 5 out of 5]

Whenever my life gets or feels too disconnected, books like this pull me back. Someone else exists and they view themselves compassionately even while in pain? They also find mysogyny painful and angering? I love this book.

[Michelle · Rating 5 out of 5]

This is a very intense, poetic (short) memoir. The author has fibromaylgia and I picked it up because I’m intrigued and perplexed by some of these diseases that are “hidden” as she calls them. I’ll admit I grapple with thoughts related to something like “Chronic Fatigue Syndrome”...fighting the urge to dismiss it as “not a real illness.” And then I of course hate myself for thinking it (easy to be dismissive when you’re in good health). I really want to understand and have better sympathy for those suffering from these types of illnesses (also plays a role in one of my upcoming novels). I do wish this was longer and explored certain topics more (her background, and even the history of “hysteria” and the link with sexual trauma). But overall gorgeously written and affecting and even the "research" parts incredibly salient. Well-done.

[Avery Guess · Rating 5 out of 5]

Tender Points is a story about pain. About fibromyalgia, specifically. About rape, specifically. About being a woman in pain. About being a woman diagnosed with fibromyalgia. About being a woman who was raped. Berkowitz explores the twin presence of pain and trauma, of a rape that boomerangs back through the body and becomes fibromyalgia, and what it means to be a woman who is not believed (because she is a woman) - not about the rape, not about the pain, and how she goes on living with the pain. I believe my body took this book in as much as my brain; saying "Yes, yes, yes, this is how it is. Thank you."

[Hannah]

This book is everything. I wanted to cry while reading it, and it put me in pain thinking about how I have been in this pain and how this diagnosis is everything and it saves you but it's also frustratingly belittling and unsettling and unhelpful. So much to say that I can't even organize my thoughts right now.

Everyone should read this for about 100 different reasons, but especially if you have chronic pain or if you're a medical professional. This is one of those texts that will help make you less the asshole that your medical school is trying desperately to turn you into.

[Emily · Rating 5 out of 5]

In the weeks since I read this, I've encountered several women with fibromyalgia in the mental health clinic where I work. I'm grateful to this beautiful, emotional volume for helping me tune into the frustration and pain of the disease, so I don't inadvertently become another skeptical health professional questioning their experience.

[Jessica · Rating 5 out of 5]

A powerful memoir bursting with sadness and anger and pain. Berkowitz has been diagnosed with fibromyalgia and in this book she explores the emotions of chronic pain, the path to diagnosis, invisible illness, and trauma. Her prose is withering and she manages to pack so much into so few words. And those words, they linger. I look forward to more from Berkowitz.

Highly recommend.

[Carolee Wheeler · Rating 4 out of 5]

Meaningful musings on chronic pain. Might trigger some, due to rape trauma.