What does it mean to have agency over your pain?

I hear people using this word a lot these days and I'm not sure they know what it means.

I'm quite guilty of using words that I have no idea the literal meaning of (I'm also in the habit of making words up, which I think is my right as a sociologist; see, for example, "neuroscientization," which yes, is in the title of my dissertation).

But agency is a word I really care about, and spent some time thinking deeply about as it relates to pain. And since it's the week we're all supposed to be celebrating freedom, it seems like a good moment to say that I think agency is what freedom actually looks like up close. So buckle up, I'm going on a little ontological journey and I'd love you to come with me.

Here's where I've landed, after years of chewing on this: agency isn't something you have, it's something you do with conditions you didn't choose.

If you live with pain, you already know this in your body. Nobody chose the flare on the morning of the thing you'd been looking forward to. Nobody chose the doctor who didn't believe them, or the job that can't flex, or a nervous system with a long memory. Conditions you didn't choose is the water we swim in.

And yet.

The Italian theorist Antonio Gramsci had a phrase I really like: pessimism of the intellect, optimism of the will. Be clear-eyed about the constraints, including the ones so familiar they feel like your own body. Then act anyway. Not by overpowering your pain, but by trusting yourself to work with your circumstances in ways no program or protocol ever laid out for you. That's agency. That's the freedom worth celebrating this week.

One more thing, because it matters: agency is unevenly distributed. Time, resources, care, and hope are not equally available to everyone. When we forget that, we end up mistaking structural limits for personal shortcomings, and shame can take over and blunt out curiosity.