Amy Berkowitz on the Rebirth of “Tender Points”

Amy Berkowitz

Sometime in February, Alexandra Naughton met up with Amy Berkowitz at a cafe in San Francisco to talk about the re-release of Berkowitz’s book Tender Points (an incredible and extremely readable lyric essay on the topic of trauma and chronic pain) by Nightboat Books. 

The pair sat at an outside picnic table in San Francisco, before the reality of the pandemic hit the United States, and discussed what’s changed since Tender Points was first published in 2015, zines, the roles of trauma and disability in literature, what Berkowitz and Naughton are working on these days, and the birds in their immediate surroundings.

We’re recording, we’re ready, a pigeon just cocked their head up and looked at me as I said that.

They’re ready.

So let’s just jump into it. How many years has it been since Tender Points was originally released?

Five years! That’s half a decade.



It just occurred to me that we should probably test this to make sure it’s recording.

That’s a good idea.

Okay this is recording number 2.



I’m just flipping through your most recent book, a place a feelings something he said to you, which you just gave me a copy of. I love the cover and the back cover. I just realized how they relate to each other.

I’m really into true crime, and got inspired to design the book cover this way by this case where a woman allegedly painted a mysterious note onto a door that said “she saved him, can you save her?” and then died under suspicious circumstances.

When I look at the front and the back of the book I have a really immediate interpretation of what they mean. Like erasing, literally destroying a place a feeling something he said to you.

Oh that’s true, too. That’s a great observation. Thanks for coming up with the title, by the way.

Well I mean, you wrote it. I just talked you into using it as the title.

Let’s talk about you. This book came out five years ago. What has changed in your life since this book came out.

Did you read the afterword?

(laughing) No! I didn’t know there was one.

I was talking to Stephen from Nightboat and both of us thought it would be good to add some new content. I didn’t think I had something to say, but as I started writing it I realized that what I had to say is the story of where the book brought me in the four years since it was published. And what really happened was writing the book and publishing and promoting it helped me find community that I didn’t have before, in terms of connecting me to other sick and disabled people and other survivors, and there’s a part where I talk about feeling so alone in my pain, and through making this book and touring with it and talking about it I realized there was a community I could identify with, and that felt really empowering.

How did the community that you found respond to the book?

One thing that was really lovely and gratifying was I’ve had a number of interactions with people who said “your book is the first time I saw my experience reflected, and reading your book made me realize that I’m not alone,” and it’s funny because that is the experience I’ve had, and like meeting them made me feel like I wasn’t.

I think that’s the best thing about writing about a difficult personal topic and putting it out into the world is getting responses from people like, wow I’m not alone. Helping others who have been through something similar feel seen.

Has that been your experience?

Yeah. I’m like bringing out my shame, and exposing that, so that we can feel less ashamed and just live. How long did Tender Points take you to write?

About two years.

What was your process like? Was writing Tender Points, like did you feel compelled? How did it compare to writing your previous works?

I did feel compelled. The connection between my chronic pain and the trauma I experienced as a child is something that I’ve been trying to understand ever since I woke up with chronic pain the morning after I recovered that memory, and Tender Points was an investigation of that. I was in a really unsupportive graduate program that sort of apologized for and did nothing about this abusive professor, so that was not a place where I felt comfortable talking about or writing about these experiences. I didn’t feel like my experiences as a survivor would be believed or honored there, so it took me some time. I was writing a lot of poetry in grad school and after grad school. Occasionally I would write a poem that I liked, but none of it felt very urgent to me. It wasn’t like flowing out of me. 

What was it about?

It was like Frank O’Hara: I do this, I do that poems. Friendship. Dating. Just my daily life as a young woman. I’m writing a long poem right now called “Gravitas” about how much I hated grad school. One reason I hated grad school is that no one would ever do anything about this serial predator professor, and the other reason is that the only feedback I ever got on my poems was “umm, your poems lack gravitas.”


You know, and I was just trying to write my truth as a young woman. And it was pretty sexist, as a friend would later point out, because there were young men in my classes writing poems about eating hamburgers on Amtrak and they weren’t getting that feedback. I think I internalized that criticism and thought my poems lacked gravitas and were frivolous and it wasn’t until I felt ready to start writing Tender Points and start this project that I did feel this urgency, like oh I have to unravel this mystery. Like obviously, sexual trauma, chronic pain, disbelief of women’s pain, patriarchy, these are all very weighty topics, they certainly have gravitas. That was exciting for me, not because I wanted to please these professors but now I felt motivated, because I felt alone but I knew I wasn’t alone, this topic just wasn’t being written about enough yet. 

Was it this criticism of your professors that influenced you to write in this sort of masculine, non-fictiony voice that you talk about in the book?

I think that was more of a reaction to female patients not being taken seriously by doctors, but I think it’s possible that me losing faith in the lyric form, in poetry, as a place where I could say something and be listened to, may have been related to my experience in grad school. Also, nobody reads poetry. You have to already be a poet to read poetry.

It kinda is poetry though.

That’s a point of contention. I’ve seen it in many different departments of bookstores, though I requested that “Lyric Essay” be printed on the back.

I didn’t know what label to apply to my book, I think I want to call it a novella now. But it’s basically poetry, even when it’s not.

It’s the kind of poetry I like the most, because it’s so readable.

It’s readable!

It’s got these long paragraphs of prose and it’s like someone is talking to me. It feels so real and immediate. That’s why I liked it so much.

Your book is really easy to read, too.

I think that’s so important.

Tender Points is extremely accessible and I agree that super important, especially for what it’s about.

I value that a lot in books. I have a preference for books where it just feels like a friend is talking to you, which is why Frank O’Hara is such a touchstone. 

What do you think is a good reading companion to Tender Points?

If you have read Tender Points, it’s somewhat obvious that it was inspired by Maggie Nelson’s Bluets, so formally that’s definitely a sibling to it.

I didn’t know that, but I never read Bluets.

Oh, it’s really good I’ll let you borrow it. So that’s a relation. Also, not formally similar, but a book that deals really beautifully with the connection to chronic pain and trauma is Leah Lakshmi Piepzna-Samarasinha’s Dirty River, it’s a memoir that has been very inspiring to me.

(looking at the bird under the next table) Aww, I like how they’re just eating that bread.

(to the bird) You got your bread, bud. No one is even trying to get it. Eat your bread!

Aw, they’re getting the crumbs.

I had a pigeon fly very close to my face on Market street the other day.

Ha, that’s pretty gross.

Yeah, but I felt chosen.

If you were gonna be on an AWP panel to talk about Tender Points, who would you want to be talking to?

You have such good questions, this is making me want to go to AWP.

Really? I’m kinda just pulling these out of my butt.

You have such a good butt collection of questions. I feel like I should think about this. Off the top of my head I’d say definitely Leah Lakshmi Piepzna-Samarasinha, Diana Arterian who doesn’t write about chronic pain but writes about trauma. Sonya Huber, who wrote Pain Woman Takes Your Keys. There’s been what feels like an explosion of books about chronic pain since around the time Tender Points came out, and I’m really happy to see more people talking about it. 

Did you have to do a lot of self promotion?

I had some friends ask to interview me, and we did a good job of sending out review copies. I set up a tour on my own, which was a lot of fun, with fellow Timeless writer Paul Ebenkamp. That was fun. I think that was right after the book came out.

Where did you go on tour with Paul?

I’m trying to remember. We went to New York, Philly, Baltimore, DC, Western Mass, and Boston. Six cities in seven days.

Do you want to talk about the new book you’re working on?

Yeah we can talk about it.

What’s your process been like for this book?

It’s been really funny. Like, you’ve written a novel but I’d never written a novel, and after this I want to ask about your process. It took me fully six or seven months to learn that, at least for me, in order to write a long book of prose I just need to write and I can go back and edit later. I kept writing and rewriting the first four chapters again and again and again before I realized I should write several thousand words at a time and then go back and go over it. The other thing I needed to learn is that there’s a reason people think about word count. As someone who is trained as a poet it never occurred to me to have discipline, I would just write a poem when I thought of one. And Tender Points was a collage method, like I would just write something and then put it together later. But with a novel I realized, oh I should sit and try to write 2,000 or 1,000 words or 3,000 words, and that’s how to move forward. So that took me a long time to learn that; once I learned that, then I knew how to write a novel. It’s been so much fun to learn a new skill and create a world. Can I ask you about your process of writing a novel?

Well, with American Mary I didn’t know what I was doing when I was writing it. I didn’t think it was going to be a novel. I was just trying to write stories about partying and see if I could connect them together. Look at that crow, so pretty.

Aww. Did you teach yourself, I don’t want to use the word “discipline” necessarily, but like, oh I have to write so many words?

Yeah, I had never done anything like that before. I would just make myself write it and work on it. Trying to put it together in such a way that it felt cohesive and made sense. I still like it, I’m still proud of it, and I wish it got more attention but I guess I also don’t really care. How many words can you write in a sitting?

I’ve been doing some writing residencies so if I’m at a residency and I’m away from my partner and my home and my work I feel like the most I ever wrote in a day was 4,000 words. That’s a high though. At a residency I would aim for 2,000 or 3,000 words. At home maybe 1,000 or 2,000. Now that my manuscript is pretty long I’m not paying as much attention to how many words as much, it’s not about adding more words, it’s more about revision.

That crow just stole that toast. And now the pigeons are like, where’s my bread?

I told you to eat it while you still had the chance!

I like pigeons. I don’t know why people have a problem with them.

Has your book been described as autofiction?

No, but people are always asking me “did this really happen,” or “whoa I can’t believe you did that,” and maybe I did do that but it’s fiction.

I think you’re allowed to say it’s fiction.

Yeah! And that’s what I usually say.

And people should respect that. But I also understand that it’s hard to ignore the similarities as a reader that you might think that you see. I want to talk for a second about How Should a Person Be, because I forget where I read this, but I came across the idea of a ghost book, which was defined as the book you had in mind when you started conceiving of your book. Not really inspired by it, but you have this book in mind and when you sit down to write your book you want it to be the same shape as your ghost book. And for me, for my novel, my ghost book is definitely How Should A Person Be, because I like how it’s so narrative and personal and conversational and how thoughtfully the growing friendship between the two characters is described and I definitely steal the plot point of having the best friends go on a trip together  to intensify the conflict they’re having.

I read that book and I barely remember anything about that book, the only thing I can kind of remember is when she goes to sleep with that guy, and he lives in a dirty apartment.

(laughing) Israel!

Yeah that’s the only thing I remember. And there’s that part in the beginning where they’re having a painting contest, and that reminds me of something you would write to be honest.

Cool. Thank you. Yeah, Israel winds up being a jerk.


And there’s that part where he makes her go to a cafe and write him a letter while wearing a dress with no underwear.

Right! And like, a 12 year old boy ends up seeing her.

Right, I forgot about that.


And her description of giving Israel a blowjob is very good. And I love how she describes kind of falling in love with her best friend. Like how they meet, and she doesn’t like her at first, and there’s this growing intimacy. And then they have a fight over a dress when they go on a trip to Florida.

I don’t remember that part.

For my novel I was trying to figure out how to raise the tension at a certain point, and I was like oh they go on a trip together!

Hell yeah.

And they go on a poetry tour.

That’s funny.


I like the idea of a ghost book. I’m not sure if I had one when I was writing American Mary, but for this new one I think I was trying to recapture the energy of American Mary, but like in a totally different way. 

It’s interesting to have a ghost book be one of your own books. I think American Mary and your new book have similar energy. My experience as a reader, your new book captures that energy from American Mary but it feels so much more cohesive. That intense urgent energy.  

Thank you. Do you have to go to a quiet place to write, or do you go to cafes?

Yeah, I go to cafes a lot. And I’m lucky to have a room in my apartment where I can write. I’ve had the same desk since I was 17, and it was from Target, and it was never very comfortable to sit at so three months ago I just put it on the curb and bought a new desk. So now I actually, that’s all I needed to do, so I actually use that room.

Where did you get the new desk from?

I got it on Facebook Marketplace for $40. It folds. I can put it in my car.


Yes, it’s a great desk. 

Is it a desk or a table?

It’s a table, but that’s what I like. I can move my legs under it. And I angled it so it’s facing the window, but not totally facing the window so my back is to the door because that’s weird.

Yeah I don’t like that either.

Where do you like to write?

In bed. Although, that’s not a good place for me I guess. I have a really hard time focusing on anything for too long. Even when I feel determined to do something, I just can’t. I’ll do anything else. It’s really a struggle for me, every time. But in bed is where I usually write. I like to write at nighttime. I like to spend the morning and afternoon cleaning my apartment so I feel comfortable enough to write. The novel that I’ve not been writing, the one I started years ago and put in a drawer two years ago…

I think I just realized that you’re working on a novel now.

Yeah, it’s been a while. I stopped working on it to write a place a feeling something he said to you. Like I couldn’t do anything, I needed…

It really does seem like this needed to come out.

Yeah, it needed to come out. I think about it the way Tony Soprano described his experience in therapy. It was like a hot dump that just needed to be pushed out.

It’s so good!

Thank you. Do you think in a way your work in progress is responding to anything from Tender Points? Are the two books communicating with each other? What role does disability play in your work?

Tender Points is about chronic pain and its connection to the trauma of sexual violence. I think the novel I’m working on now is about the more subtle ways people hurt each other around rape. So not rape and not rape apologists, but the well-meaning friend who tells everybody about her friend’s assault, even though her friend isn’t ready to talk about it. I haven’t really seen that represented in literature. I’ve seen it in zines, I’ve done a ton of research with zines which has been amazing. I think it’s something that’s real and happens a lot and could be helpful to write about in a book. And so I thought I was just writing about that. On a funny note, I was at a friend’s wedding a couple of years ago and this random guy asked me what I was writing about, so I told him and he actually started physically backing away from me. Like I don’t even know if he was aware he was doing it, but he just started walking backwards.

Oh my god.

So anyway, then I started writing and I was like, wait a minute. My protagonist should be disabled, because there’s not enough literature about disabled people by disabled people. I don’t want to miss this opportunity to write a protagonist with chronic pain. I’m really glad I did that, I think it’s added a layer of complexity to the book. And I like that it’s not a book about disability, the character just happens to be disabled. It’s also kind of exciting to me to also give her bipolar disorder, which is a diagnosis I share with her, which I left out of Tender Points because I worried it would be one step too far in terms of me not being believed and being too unreliable of a narrator. I’m kind of excited to write a bipolar character who doesn’t have any mood episodes during the book, her bipolar is really well-managed, it just happens to be a part of who she is and readers don’t get to go on the wild ride of her emotional rollercoaster with her, which is something I think of as a gross desire for readers to have.

No, for sure. It’s voyeurism. It’s trauma-porn or disability porn. It’s important for characters to have something that makes them different without that thing that makes them different being their entire personality.

It feels fun to be doing that with my main character. And you know, ableism, things like that show up in her life but it’s not what the book is about. She actually winds up having this journey of starting to recognize herself as part of a disabled community, it becomes this rich awakening for her that she’s not alone. She starts making, and this is probably because I was doing so much zine research—

What does that mean?

Oh, just reading zines. I visited the zine archive at Barnard, which is an amazing resource and open to the public, which is not made clear on their website. I also ordered a lot of zines online. Like I said, there’s not a lot of literature about the subtler points of hurt feelings about sexual assault, but there’s a lot of zines about that topic. So probably because I was doing so much research I had my main character experience her awakening of being part of a community of sick and disabled people by making a zine out of it, and meeting people by finding contributors for the zine, which is called Sick Thoughts.

Nice. Have you read other books where the main character is bipolar, but that’s not the focal point of the book?

It feels like a rarity. I don’t want to say I haven’t, but nothing comes to mind. Can you think of one?

No. I’m trying to think of any book where the main character has a mental illness and that’s not the focus of the book. Like, Catcher in the Rye.

There’s books about depression, My Year of Rest and Relaxation. But yeah. I like it just being an incidental theme.

Tell me more about the zine research.

One of the first zines I found was called Scorched Cunt. And I found it when I was visiting Minneapolis a few years ago, and it made me, it’s a very generous and thoughtful zine.

It’s a one-off?

Yeah, by a person who was raped and they just chronicle their thoughts and the demands that they made on the person who assaulted them, just how things went down and their feelings throughout the whole process. It’s a very good read and provides a lot of insight into that experience. After I read that I thought, oh there’s probably a whole lot of great zines about this, and I found a lot online. Just google “sexual assault zine,” you can find PDFs, and there’s a couple distros I ordered things from. 

And then I saw this blog post, which has since been taken down from the Barnard University Library website, that was like “it’s sexual assault awareness month, and the Barnard Zine Archive has selected a number of titles about sexual assault,” and I was like, these are amazing. So next time I visited New York, which is where I’m from, I made an appointment to go and it’s an amazing collection from the 1990s to today, and I just saw so many different perspectives on the experience of sexual assault and so much creativity with the visual presentation.

Was it difficult, reading all the sexual assault zines?

Yeah, it was. It was very hard to make myself sit down and do it, but also kind of, I don’t know if healing is the right word. There’s so much heart in them, and they all feel like labors of love, like they must have been really hard to write but their authors really cared about connecting with people and letting them know that they’re not alone. They all made me feel like I wasn’t alone. So it’s a very beautiful experience reading them, but yeah when you have a stack of them it feels like a lot.

I can see that.

What about your book, is it technically out?

It’s out. Yeah, it was published by Spooky Girlfriend Press in January 2020.

Have you heard from people yet the reactions to it? Has it gotten reviews yet?

Um it has not been reviewed yet, but Kimi Sugioka recently told me that she read it and she couldn’t put it down, that it’s quick to read, like the material being discussed has the potential to bang you over head but it doesn’t do that, like she didn’t feel like was being accosted by this heavy material because of the way it unfolds. 

What kind of promotion are you doing for the book?

Well, I got a few pieces published right when the pre-sale for the book started. So that was something. I also wrote a press release. It’s a lot of work and I don’t really know what I’m doing, but I like to think about things in terms of the music industry. Like picking good singles, picking the right time to release the album. I think you can learn a lot from albums that flop.

There’s a lot of similarities.

I think I picked some good singles to release.

I think you’ve always seen the literary world through the metaphor of the music world.

I really, really love music. I wish I was in a band. 

I’m pretty sure, now I wanna say did you say this, but I’m pretty sure Zoe Tuck said, “Every poet wants to be the lead singer of a band.” 

I don’t think I said that, but I think it’s true. I did karaoke last week after my reading with Cassandra Dallett, I sang “Possum Kingdom” by the Toadies, and Cassandra Dallett was like, “Girl why are you not the lead singer of a band?” I mean, I want to be!

You should just make some beats or something, get a synthesizer. 

I’ve recorded myself performing this piece I wrote over a Jason Molina song, and people seem to really like when I perform that live, with the music. I recorded it with a friend last year and I just need to release it. But yeah, I really want to be in a band.

I don’t want to be in a band anymore, but I get that. I love your book by the way.

Oh thank you. I love your book.

I really think your book is going to reach people, help people. That’s the kind of book it is, it’s somebody telling you their story. I mean, I had that reaction to it. Like, oh, this is what it means to be in an abusive relationship. It’s the feeling of someone trying to control you and in the moment not really knowing how to escape that dynamic. It’s so real, and you put it into words so well. I think a lot of people will read it and really resonate with it.

Thank you so much. And Tender Points I think achieves the same goal, it feels really real and personal and also gives a lot of information about chronic pain and its link to trauma. It’s powerful, and I think you did something that helped other people come out and talk about their experiences. No one is alone.



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