We are even less aware of our internal organs and the physiological processes that keep us alive. In this fascinating work, Drew Leder examines all the ways in which the body is absent—forgotten, alien, uncontrollable, obscured.
Bodily pain and distress come in many forms. They can well up from within at times of serious illness, but the body can also be subjected to harsh treatment from outside. The medical system is often cold and depersonalized, and much worse are conditions experienced by prisoners in our age of mass incarceration, and by animals trapped in our factory farms. In this pioneering book, Drew Leder offers bold new ways to rethink how we create and treat distress, clearing the (...) way for more humane social practices. Leder draws on literary examples, clinical and philosophical sources, his medical training, and his own struggle with chronic pain. He levies a challenge to the capitalist and Cartesian models that rule modern medicine. Similarly, he looks at the root paradigms of our penitentiary and factory farm systems and the way these produce distressed bodies, asking how such institutions can be reformed. Writing with coauthors ranging from a prominent cardiologist to long-term inmates, he explores alternative environments that can better humanize—even spiritualize—the way we treat one another, offering a very different vision of medical, criminal justice, and food systems. Ultimately Leder proposes not just new answers to important bioethical questions but new ways of questioning accepted concepts and practices. (shrink)
This is the first volume to systematically explore the range of contemporary thought concerning the body and draw out its crucial implications for medicine.
Pain is far more than an aversive sensation. Chronic pain, in particular, involves the sufferer in a complex experience filled with ambiguity and paradox. The tensions thereby established, the unknowns, pressures, and oscillations, form a significant part of the painfulness of pain. This paper uses a phenomenological method to examine nine such paradoxes. For example, pain can be both immediate sensation and mediated by complex interpretations. It is a certainty for the experiencer, yet highly uncertain in character. It pulls one (...) to the present but also projects one outward to a feared or desired future. Chronic pain can seem located in the body and/or mind; interior to the self, or an alien other; confined to a particular point and/or radiating everywhere. Such fundamental paradoxes, existential and epistemological, can challenge those living with long-term pain. (shrink)
This article proposes the benefits to be had from an unusual conversation: that between those suffering from chronic pain/illness and from long-term incarceration. Taking a phenomenological approach, a series of experiential commonalities are outlined: pain and illness, like incarceration, can cause a constriction of lived space and the range of possible action; a disruption of lived time, such that one is trapped in an aversive ‘now’, or ever trying to escape it; isolation, as meaningful social contacts diminish or are ripped (...) away; and disempowerment and depersonalisation, especially when the ill person feels caught within a medical system that can be dehumanising in ways that echo prison life. Drawing on pathographies, and my published conversations from teaching philosophy classes in prison, I outline some of the strategies whereby creative individuals help relieve these modes of disruption. These include adaptability, as individuals learn to live differently, but well, within the limits imposed by pain/illness or incarceration; appreciative presence, the ability to find joy in, and richly utilise, the ‘now’; mental freedom, which includes the capacity to choose emotional responses, and to expand the intellect and spirit even when the body is confined; and community, surmounting isolation through empathic relation with others. I suggest a conversation between these groups can bring mutual benefit, and teach us all how to live well in extreme circumstances, which we may encounter some time in our life. (shrink)
This paper suggests that the paradigm of the lived-body developed by Straus, Merleau-Ponty and others has important implications for medical practice and theory. Certain recognized flaws in modern medicine, such as its reductionist tendencies and lack of emphasis on preventive measures are shown to be related to the exclusive use of a Cartesian notion of embodiment. Increased attention to the paradigm of the lived-body emphasizing its unity, purposiveness and "enworldment" could help to beneficially reorient practice. Moreover, this portrayal of the (...) body as an intentional entity may provide a better tool than the traditional view for conceptualizing the psychological and psychosocial components of disease etiology, as well as some newly developed modes of treatment. CiteULike Connotea Del.icio.us What's this? (shrink)
I argue that clinical medicine can best be understood not as a purified science but as a hermeneutical enterprise: that is, as involved with the interpretation of texts. The literary critic reading a novel, the judge asked to apply a law, must arrive at a coherent reading of their respective texts. Similarly, the physician interprets the text of the ill person: clinical signs and symptoms are read to ferret out their meaning, the underlying disease. However, I suggest that the hermeneutics (...) of medicine is rendered uniquely complex by its wide variety of textual forms. I discuss four in turn: the experiential text of illness as lived out by the patient; the narrative text constituted during history-taking; the physical text of the patient's body as objectively examined; the instrumental text constructed by diagnostic technologies. I further suggest that certain flaws in modern medicine arise from its refusal of a hermeneutic self-understanding. In seeking to escape all interpretive subjectivity, medicine has threatened to expunge its primary subject — the living, experiencing patient. (shrink)
Encounters with illness, impairment, and aging can disrupt one’s experiential relationship with self, body, others, and world. “Healing” takes place when the individual is able to re-integrate his or her world, even if the condition is not medically curable. Drawing on work in the phenomenology of the body, this article examines a series of eight “healing strategies” individuals employ, each representing a different way of orienting toward the painful or impaired body. One may lean into freeing oneself from the body, (...) through strategies of “refusing,” “ignoring,” “objectifying,” or “transcending” its problems. Conversely, one may choose to embrace the body, through strategies such as “accepting,” “listening,” “befriending,” or “witnessing.” It can be beneficial to have a good number of such coping strategies at one’s disposal, enhancing flexible response to chronic challenges. They also are often used in synergistic or complementary combinations. (shrink)
The thesis of "token identity" or "token physicalism" advanced by fodor and others attempts to reconcile materialism with a non-Reductionist view of the special sciences. However, I argue that since the individual events or "tokens" of any science are only designated according to its general types, The former cannot be specified physicalistically while the latter are not. Though attempting to combat a positivistic view of the sciences, Fodor's thesis rests on a positivistic opposition of token and type.
The lived body has structures of ability built up over time through habit. Serious illness, injury, and incapacity can disrupt these capacities, and thereby, one’s relationship to the body, and to time itself. This paper focuses attention on a series of healing strategies individuals then employ on the “chessboard” of possibilities intrinsic to lived embodiment. This can include restoring past abilities ; and/or transforming one’s bodily structure or use-patterns, or the external environment, to compensate. With many conditions, including progressive aging, (...) no full rehabilitation is possible. Nevertheless, one can also seek consolation, richness, or hope by remembering the past; anticipating the future; or presencing, that is, living fully in the now. Insofar as past, present, and future are interwoven in one’s life experience, many also meet adversity by a life-story revision, constructing a new narrative to render events meaningful. Some also access a sense of transpersonal timelessness, whether through anticipation of an afterlife, or a sense of the eternal present. There is a literature on the adaptive coping mechanism used by the chronically ill, but with its diverse patient populations, methodologies, and categories, it has proved difficult to systematize. This article suggests that the structures of lived embodiment, as explored by phenomenology, provide a way to understand the modes of wholeness individuals access over time, and in relation to time—what is here termed chronic healing. (shrink)
Lucy Osler's piece, "Controlling the noise: A phenomenological account of Anorexia Nervosa and the threatening body," lays out an important new interpretation of anorexia. Anorexia Nervosa is no longer viewed as primarily a perceptual distortion of body-image, an obsession with thinness, or an attempt to dematerialize—to free the subject from its inert thing-like body. Rather, the body itself, and the visceral body in particular, takes on a "voice" which the anorexic experiences as demanding and threatening. Anorexic monitoring and self-starvation beckons (...) as a way to regain power over this renegade viscerality. Unfortunately, this strategy of self-empowerment is doomed to backfire; hunger, illness, and body/food... (shrink)
This article explores the cultural and philosophical foundations of factory farming. Modes of capitalist production play a role: Marx’s analysis of the fourfold alienation of labor can be applied to animal-laborers. However, the harshness with which animals are treated exceeds the harshness directed toward human workers. At root is a cultural anthropocentrism that prohibits viewing animals as moral subjects, removing ethical restraints. Ultimately, the modernist ways in which animals are treated as both like and unlike human workers are related to (...) the rise of Cartesian mechanism. The categories of “human” and “animal” are reconfigured by the image of the “machine.”. (shrink)
This paper explores the ability and desire of the embodied self to “shape-shift”—to experience from within the capacities of animals, or natural phenomena like trees and mountains. Shape-shifting is discussed insofar as it manifests in a broad range of cultural domains, including children’s play, mythico-religious iconography, spiritual practice, sports, the performing arts, and so on. This potential for shape-shifting is grounded not simply in our evolutionary history and biological kinships, but in the phenomenology of the lived-body. Our own powers are (...) explored, expanded, and transformed through our communion with the non-human world. (shrink)
This paper explores the ability and desire of the embodied self to “shape-shift”—to experience from within the capacities of animals, or natural phenomena like trees and mountains. Shape-shifting is discussed insofar as it manifests in a broad range of cultural domains, including children’s play, mythico-religious iconography, spiritual practice, sports, the performing arts, and so on. This potential for shape-shifting is grounded not simply in our evolutionary history and biological kinships, but in the phenomenology of the lived-body. Our own powers are (...) explored, expanded, and transformed through our communion with the non-human world. (shrink)
Western philosophy’s relationship with prisons stretches from Plato’s own incarceration to the modern era of mass incarceration. Philosophy Imprisoned: The Love of Wisdom in the Age of Mass Incarceration draws together a broad range of philosophical thinkers, from both inside and outside prison walls, in the United States and beyond, who draw on a variety of critical perspectives (including phenomenology, deconstruction, and feminist theory) and historical and contemporary figures in philosophy (including Kant, Hegel, Foucault, and Angela Davis) to think about (...) prisons in this new historical era. All of these contributors have experiences within prison walls: some are or have been incarcerated, some have taught or are teaching in prisons, and all have been students of both philosophy and the carceral system. The powerful testimonials and theoretical arguments are appropriate reading not only for philosophers and prison theorists generally, but also for prison reformers and abolitionists. (shrink)
Case examples are studied in order to ascertain what best characterizes the work of consultation-liaison (C-L) psychiatrists. Such practitioners play the role of "inter-interpreter": they are able and called upon to mediate between different conceptual worlds. In certain instances this may involve reconciling or choosing between physicalistic and mentalistic interpretations of the case. At other times it is the opposing world-views of patient and staff that must be reconciled. The mediating position of the C-L psychiatrist is thus found to be (...) clinically valuable, and illustrative of the differing discourses that characterize modern medicine. Keywords: hermeneutics, mind-body relations, clinical interpretation CiteULike Connotea Del.icio.us What's this? (shrink)
