[Paleopsych] spiked-health: Our unhealthy obsession with sickness
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Thu Apr 7 16:45:09 UTC 2005
Our unhealthy obsession with sickness
[Foucault was indeed prescient.]
Why is being ill now embraced as a positive part of the human
by Frank Furedi
We live in a world where illnesses are on the increase. The
distinguishing feature of the twenty-first century is that health has
become a dominant issue, both in our personal lives and in public
life. It has become a highly politicised issue, too, and an
increasingly important site of government intervention and
policymaking. With every year that passes, we seem to spend more and
more time and resources thinking about health and sickness. I think
there are four possible reasons for this.
First, there is the imperative of medicalisation. When the concept of
medicalisation was first formulated, in the late 1960s and early
1970s, it referred to a far narrower range of phenomena than is the
case today - and it was linked to the actions of a small number of
professionals rather than having the all-pervasive character that it
Essentially, the term medicalisation means that problems we encounter
in everyday life are reinterpreted as medical ones. So problems that
might traditionally have been defined as existential - that is, the
problems of existence - have a medical label attached to them. Today,
it is difficult to think of any kind of human experience that doesn't
come with a health warning or some kind of medical explanation.
It is not only the experience of pain or distress or disappointment or
engagement with adversity that is medicalised and seen as potentially
traumatic and stress-inducing; even human characteristics are
medicalised now. Consider shyness. It is quite normal to be shy; there
are many circumstances where many of us feel shy and awkward. Yet
shyness is now referred to as 'social phobia'. And, of course, when a
medical label is attached to shyness, it is only a matter of time
before a pharmaceutical company comes up with a 'shyness pill'. Pop
these pills, and you too can become the life and soul of the party!
One of my hobbies is to read press releases informing us of the
existence of a new illness, the 'illness of the week', if you like.
Recently I received one that said: 'Psychologists say that love
sickness is a genuine disease and needs more awareness and diagnoses.
Those little actions that are normally seen as the symptoms of the
first flush of love - buying presents, waiting by the phone, or making
an effort before a date - may actually be signs of a deep-rooted
problem to come. Many people who suffer from love sickness cannot cope
with the intensity of love and have been destabilised by falling in
love or suffer on account of their love being unrequited.'
Of course, an intense passion can and does have an impact upon our
bodies. But when even love can be seen as the harbinger of illness,
what aspect of our lives can be said to be illness-free? What can we
possibly do that will not apparently induce some sickness or syndrome?
Medicalisation no longer knows any limits. It is so intrusive that it
can impact on virtually any of our experiences, creating a situation
where illness is increasingly perceived as normal.
This leads to my second point - there is now a presupposition that
illness is as normal as health. Earlier theories of medicalisation
still considered illness to be the exception; now, being ill is seen
as a normal state, possibly even more normal than being healthy. We
are all now seen as being potentially ill; that is the default state
we live in today.
This can be glimpsed in the increasing use of the term 'wellness',
with well men's clinics and well women's clinics. 'Wellness', another
relatively recent concept, is a peculiar term. It presupposes that
being well is not a natural or normal state. After all, there are no
such things as 'sunshine clinics' or 'evening clincs'; such normal
things do not normally need an institution attached to them. And why
would you have to visit a wellness clinic if you were well, anyway? It
makes little sense.
Wellness has become something you have to work on, something to aspire
to and achieve. This reinforces the presupposition that not being well
- or being ill - is the normal state. That is what our culture says to
us now: you are not okay, you are not fine; you are potentially ill.
The message seems to be that if you do not subscribe to this project
of keeping well, you will revert to being ill.
In supermarkets, especially in middle-class neighbourhoods, buying
food has become like conducting a scientific experiment. Individuals
spend hours looking at how many carbohydrates there are, whether it's
organic, natural, holistic. Spending time reading labels is one way of
doing your bit to keep well.
Being potentially ill is now so prevalent that we have reached a
situation where illness becomes a part of our identity, part of the
Some of us might not flaunt it, walking around saying, 'I've got a gum
disease' or 'I've got a bad case of athlete's foot'. That doesn't
sound very sexy, and is unlikely to go down well at the dinner table.
But it has become acceptable to talk openly about other illnesses - to
declare that you are a cancer survivor, or to flaunt a disability. As
we normalise illness, our identity becomes inextricably linked to
illness. So it is normal to be ill, and to be ill is normal.
The nature of illness changes when it becomes part of our identity.
When we invest so much emotion in an illness, when it becomes such a
large aspect of our lives through the illness metaphor, we start to
embrace it - and it can be very difficult to let go of that part of
our identity. This is why illness tends to become more durable and
last longer. Sickness is no longer a temporary episode: it is
something that, increasingly, afflicts one for life. You are scarred
for life, with an indelible stamp on your personality. This can be
seen in the idea of being a cancer survivor or some other kind of
survivor; we are always, it seems, in remission. The illness remains
part of us, and shapes our personality.
As this happens, illnesses start to acquire features that are no
longer negative. In the past, illness was seen as a bad thing. Today
you can read illness diaries in the Guardian and other newspapers and
magazines. We often hear the phrase: 'I've learned so much about
myself through my illness.' It becomes a pedagogic experience: 'I may
have lost a leg and half my brain cells, but I'm learning so much from
this extremely unique experience.' It's almost like going to
university, something positive, to be embraced, with hundreds of books
telling us how to make the most of the experience of sickness.
We are not simply making a virtue out of a necessity; rather we are
consciously valuing illness. From a theoretical standpoint, we might
view illness as the first order concept, and wellness as the second
order concept. Wellness is subordinate, methodologically, to the state
of being ill.
The third influence is today's cultural script, the cultural narrative
that impacts on our lives, which increasingly uses health to make
sense of the human experience. The more uncertainty we face, the more
difficult we find it to make statements of moral purpose, the more
ambiguous we feel about what is right and wrong, then the more
comfortable we feel using the language of health to make sense of our
lives. At a time of moral and existential uncertainty, health has
become an important idiom through which to provide guidance to
This is now so prevalent that we no longer even notice when we are
doing it. For example, we no longer tell teenagers that pre-marital
sex is good or bad or sinful. Instead we say that pre-marital sex is a
health risk. Sex education programmes teach that you will be
emotionally traumatised if pressured into having sex and will be
generally healthier if you stay at home and watch TV instead.
There are few clear moral guidelines that can direct our behaviour
today; but we have become very good at using health to regulate
people's lives in an intrusive and systematic fashion.
Even medicine and food have acquired moral connotations. So some drugs
are said to be bad for the environment, while others, especially those
made with a natural herb, are seen as being morally superior. Organic
food is seen as 'good', not only in nutritional terms, but in moral
terms. Junk food, on the other hand, is seen as evil.
If you look at the language that is used to discuss health and
medicine, or obese people and their body shapes, it isn't just about
health: we are making moral statements. A fat person is considered to
have a serious moral problem, rather than simply a health one. As we
become morally illiterate, we turn to health to save us from
circumstances where we face a degree of moral or spiritual
The fourth influence is the politicisation of health. Health has
become a focus of incessant political activity. Politicians who have
little by way of beliefs or passions, and don't know what to say to
the public, are guaranteed a response if they say something
health-related. Some also make a lot of money from the health issue,
from pharmaceutical companies to alternative health shops to
individual quacks selling their wares - all are in the business,
essentially, of living of today's health-obsessed cultural sentiment.
Governments today do two things that I object to in particular. First
they encourage introspection, telling us that unless men examine their
testicles, unless we keep a check on our cholesterol level, then we
are not being responsible citizens. You are letting down yourself,
your wife, your kids, everybody. We are encouraged continually to
worry about our health. As a consequence, public health initiatives
have become, as far as I can tell, a threat to public health.
Secondly, governments promote the value of health seeking. We are
meant always to be seeking health for this or that condition. The
primary effect of this, I believe, is to make us all feel more ill.
Here's a prediction - Western societies are not going to overcome the
crisis of healthcare; it is beyond the realms of possibility. No
matter what policies government pursue, or how much money they throw
at the problem, even if they increase health expenditure fourfold, the
problem will not go away. As long as the normalisation of illness
remains culturally affirmed, more and more of us are likely to
identify ourselves as sick, and will identify ourselves as sick for a
growing period of time. The solution to this problem lies not in the
area of policymaking, or even medicine, but in the cultural sphere.
Frank Furedi is professor of sociology at the University of Kent, and
author of Where Have All the Intellectuals Gone?: Confronting
Twenty-First Century Philistinism (buy this book from Amazon (UK)
or Amazon (USA)). This is an edited version of a speech he gave at
Health: An Unhealthy Obsession, a conference hosted by the Institute
of Ideas in London on 12 February 2005. Visit his website here.
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