Normalcy


I’m currently trying to get my head around the very minimal teaching that I will be doing this semester. In the Dutch system, at least where I am located, all students finish their studies with a ‘bachelortheses’. It might look a little like an Australian honours thesis, but I’m gathering it’s quite different. For one thing, everyone writes them. They’re a maximum of 6,000 words long. And you get six months in which to write it. And it’s not in a one-to-one supervisory relationship, but is supervised in groups of 5 students to one supervisor. Of which I am one.

The vast majority of these students will never have written a full academic essay. Most courses here are short, lecture-based and culminate in a multiple-choice exam. So I am suddenly realising that the key element of this project is the writing. In some ways, I’m really looking forward to this because I get to work with them over around 16 weeks. I’m thinking of suggesting that we make our meetings a little longer (they’re flexible, based on my choices, really) and include a specific, weekly session on various writing skills. Given also that many of these students will be German, this will probably be useful for ironing out some hiccups as they occur.

It’s also complicated for me, in that this is the first teaching that I’m doing, and I’m discovering that these students may not be, well, equipped to handle my comparatively random take on things. I can’t assume, for example, a critical approach to, well, knowledge. This makes me gulp a little. It makes me gulp a little more to find out that the English language program here is run mostly by Americans and that this has meant that it’s… sigh… more scientistic than other bits. Won’t that be fun? The dense normativity of such sites is a little frightening, but also exciting as a space in which to make an intervention (right?! ;-))

But my bachelortheses group topic should select somewhat:

The concept of the normal has had a profound influence on contemporary science and thus on contemporary styles of life. This group will explore both the history and the more recent function of ideas of the normal, normalcy (normality) and normalisation, particularly as they have guided medicine, psychology and the human sciences more generally, in their interaction with those categorised as ‘abnormal’. Those who are interested in the philosophical and theoretical interrogation of the concept and category of ‘normal’, and its effects on people’s lives, will enjoy participating in this group. Whereas ‘abnormality’ in a psychiatric sense is hotly debate elsewhere, I would especially encourage those students who are interested in the normalisation of those with bodies deemed to be ‘abnormal’.

So at the moment I’m trying to work out what kinds of readings I’m going to give them to get them thinking about this topic. I mentioned Ian Hacking to another staff member, who thought he would be too complicated. I’m not sure what to think about that, because I tend to think that Hacking is a very approachable writer! But so far, here’s my ‘theory’ background that I’m kicking around as I try to think this through. For the record, I’ve also got a list of different ‘normalisation’ therapies which will constitute the ‘case studies’ for the contemporary function of the normal for them; in the first session we’ll pick whichever ones they’re most interested in. So far this list includes: human growth hormone use, cosmetic surgery, circumcision (for boyfolk and girlfolk), intersex ‘corrective’ surgery, limb-lengthening surgery, pre-natal genetic diagnosis, self-demand amputation and cochlear implants. I may include trans ‘reassignment’ surgeries, but I’m a little uncertain about replicating the sense that surgery is The Trans Thing To Do, so we’ll see. I am, though, interested in the ‘wrong body’ story which seems to shape many of these practices, and also shapes the ways that trans is medicalised. Mm.

But in terms of theoretical background, I’m trying for things that will ease them into the critical approach to ideas of normality. So far I’m thinking about:

Lennard Davis’ second chapter from Enforcing Normalcy, which gives a potted history of the rise of the idea of the average, its influence on modern ideas of democracy, industry, grammar and most of all, on ideas of disability. I like this because it’s accessible, it’s fairly broad, and it raises the question of how disability is contextually situated (which students both often struggle with, and get really excited by).

Ian Hacking’s “Making Up People”, specifically the London Review of Books version. It’s useful because it discusses the ‘looping effect’ of particular normalising technologies: i.e., that we usually underestimate the effects on people of how we think, categorise, and treat them.

Ian Hacking’s Taming of Chance, chapter 1. I actually want his “Biopower and the Avalanche of Printed Numbers” but apparently this is too big an ask of the university library (?!) and has not been reprinted (sadface) since its publication in 1982 in a journal that is no longer on major subscription lists (Humanities in Society Number 5, she says, in the vain hope some kind person might have an e-copy they’re willing to bounce my way). The latter, I seem to recall, is a really neat historical and political unpacking of the development of stats, in the context of Foucault’s idea of biopower. The former is a bit drier, with all the detail of the history and fewer of the broad brush strokes that make Hacking kinda useful!

Next we hit the Foucaults: I’m thinking the final lecture from Society Must be Defended, which unpacks the way that racism (taken as the division of the social world into the subrace and superrace) fits with the development of medical concepts of health, of normalcy and of course the introduction of the biopolitical (the management of the population).

Foucault, History of Sexuality Volume 1, the bit on the Repressive Hypothesis. I want to give the students a sense of how intimately bound up together ideas of normality and the concept of an inner self needing expression are. After all, the idea of ‘becoming who I really am’ appears so neutral, but is so often enacted in normalising ways.

I’m also thinking of a bit from Discipline and Punish, because there’s some stuff on normality in there. But I have to go back to it, because it’s been a while. Also surveillance might be useful (obviously is heavily implicated in Hacking’s ‘looping effects’).

Canguilhem is probably a bit unavoidable, although I’m going to try to be selective on this one: probably the section from the end of the revised version of The Normal and the Pathological, where he explicitly tries to tie his history of medicine to politics. But I’d quite like some of his earlier points about suffering tending to produce medical consideration of the state of the patient, and thus the deeming of particular styles of being as pathological, which in turn has more to do with the mismatch between the patient and their world than about anything necessarily inherently bad (as he says a lot in that book, nature doesn’t side with humans against, say, colds and flu)

I’m considering putting in a section of Lisa Blackman’s book The Body because there’s a section that does the ‘outside-in’ thing of exploring the idea of bodies as signifying and social, and works back into the production of selves through embodiment. I don’t want to overload them with too many ideas, but this seems to be key for talking about modifying bodies like we are…

And finally I’m thinking of Nikolas Rose’s “Normality and Pathology in the Genetic Age” for a little updating of this stuff. There’s a newer ‘version’ of this paper, called “Normality and Pathology in the Neurobiological Age” but while I think there are useful things about the ‘we’re all a bit pathological!’ argument, I think it tends to efface that the hierarchies of normality and abnormality remain shockingly material in their effects.

The lovely NP of Rough Theory suggested Steven Jay Gould’s The Mismeasure of Man, for ease of access into these ideas. I’m still thinking about it: in some ways it’s useful way in, though perhaps less pithy than it might be (I get it, pop sci and all that). But it’s a bit hard to tell whether I’ll need to start from that point, and I do kind of like to avoid both ‘but the Real World!’ talk and ‘bias and objectivity’ kind of talk, because often students cling to these far more familiar ideas and use them to refuse to consider, say, the idea that objectivity is problematic, or that we need to put a question mark over the idea of the Real World, or at least over our access to it. So we’ll see!!

Any thoughts welcome, obviously! It’s hard to plan too thoroughly at this stage, because I have really no clue of the educational background of my group. Some may be ‘honours’ students (who take higher level classes all through); others may have done the science studies stuff here, and be a little familiar with some of these ideas; and of course, they may all be happily drifting along with the scientism of the English speaking program…

Advertisements

I’ve recently been reading an article by one of my colleagues (this one here, “Taking care of one’s brain: how manipulating the brain changes people’s selves” by Jonna Brenninkmeijer). She’s done some, as we call it in the biz, qualitative work with people participating in some of the edgiest of brain treatments (you know, the ones that have little or no scientific proof – sometimes because of little research – and supposedly magical results). Mostly neurofeedback machines. Her concern in the paper is not with ‘whether it works’ so much as with how it works; what effects these new technologies have on how people conceive of themselves; indeed, who they think is doing the conceiving of the self.

This is something that I’ve been intrigued by for a long time. We tend, I think, to use phrases like ‘I have depression’ or ‘I have bipolar’ rather than ‘I am depressed’ or ‘I am bipolar’. This configuration intrigues me: it suggests ownership of the mental illness, but it also makes clear a differentiation between the self and the illness. The self itself is not ill, it has an illness. Disability activists have been aware of this issue for a long time, of course. It tends to manifest along an Anglo/USAian split (though obviously not in any absolute way) where the Brits angle for ‘I’m disabled,’ as a claim of the difference of the self, and a refusal to see disability as irrelevant to the real self, whilst the USAians tend to prefer ‘having’ a disability because it’s ‘person-focused,’ not letting the subject be obscured by the disability. This in turn is the manifestation of some very different commitments, familiar from other sites of activism, to do with the (predominantly liberal) assertion of similarity and the (predominantly radical) assertion of difference. But this configuration of illness and disability, of course, has an older manifestation. Our dear old friend John Locke explicitly situated the body as property. Inalienable property — unable to be given away or sold (though this is of course coming into question with some of the new biotech… and that’s a story for another day, a nice long story!) — but property nonetheless.

This long history, of course, is part of what is challenged by certain kinds of phenomenologists, and the feminist theorists of the body that I talk about all the time. Merleau-Ponty, for example, explicitly tells us that we do not have our body, and nor are we ‘in it’, but we are it. Elizabeth Grosz focuses on the gendering of the mind/body split, saying some interesting things about how bodyliness gets allocated:

The male/female opposition has been closely allied with the mind/body opposition. Typically, femininity is represented (either explicitly or implicitly) in one of two ways in this cross-pairing of oppositions: either mind is rendered equivalent to the masculine and body equivalent to the feminine (thus ruling out women a priori as possible subjects of knowledge, or philosophers) or each sex is attributed its own form of corporeality. However, instead of granting women an autonomous and active form of corporeal specificity, at best women’s bodies are judged in terms of a ‘natural inequality,’ as if tehre were a standard or measure for the value of bodies independent of sex…. By implication, women’s bodies are presumed to be incapable of men’s achievements, being weaker, more prone to (hormonal) irregularities, intrusions, and unpredictabilities. Patriarchal oppression, in other words, justifies itself, at least in part by connecting women much more closely than men to the body and, through this identification, restricting women’s social and economic roles to (pseudo) biological terms. Volatile Bodies, p. 14.

In exploring the inadequacies of this account, the problematic politics involved, and some of the shape of an alternative account,she goes on to say

corporeality must no longer be associated with one sex (or race) which then takes on the burden of the other’s corporeality for it. Women can no longer take on the function of being the body for men while men are left free to soar to the heights of theoretical reflection and cultural production. Blacks, slaves, immigrants, indigenous peoples can no longer function as the working body for white ‘citizens,’ leaving them free to create values, morality, knowledges. Volatile Bodies, p. 22.

It is unsurprising, then, that the mind/body split continues to so inflect these supposedly new ways of talking about ourselves. Jonna’s paper is especially nice because she’s interested in how those who take part in neurofeedback understand the connection between self (mind) and brain (body). As always seems to happen when people attempt to maintain this distinction, there are (what get coded as, given the Cartesian split) confusions, incoherencies, fuzzinesses, and willfulness attributed to both brain and self in certain ways, in certain dimensions.

The self/brain split, of course, is not quite the mind/body split: the self/brain split leaves the rest of the body irrelevant, the dramatic influence of other aspects of corporeality notwithstanding (Elizabeth Wilson’s Psychosomatic does a good job of considering the influence of, for e.g, the gut on aspects of the brain). The brain gets configured, then, as slightly less bodily, slightly more modifiable, slightly closer to the mind than the body proper, fuzzing out the mind/body split into something that looks slightly less splitty but isn’t really. It’s still about the capacity for control.

There are a few consequences of this way of talking about the mind and brain and body that I want to discuss briefly. One is that turning a mental illness into a possession probably makes therapy a lot easier, in a few ways: first, it creates a self separate or separable from the illness, that can then negotiate with the illnes; second, it makes that self ‘innocent’ of the ‘badness’ or ‘wrongness’ or ‘pathology’ of the illness; third, it reorients authenticity, situating the depression-less-self as the really true self, and thus undermining the sense that one is depressed because one is realistic, and that any modification of that idea makes one inauthentic or fake. Peter Kramer, in Listening to Prozac, gives an example of a woman who feels like Prozac lets her ‘be who she really is’: socially easy, great in negotiations at work, a good manager, a cheerful daughter…. isn’t it interesting what counts as a true self, now? (My copy of the Promise of Happiness by Sara Ahmed has not yet arrived, or doubtless I’d be citing her just here!).

There are a few questions to be asked about this, of course. One is the question of responsibility: the separation of the self from the illness can be used to suggest that one cannot be held responsible for the effects of that illness on others. Again, therapeutically this can be useful in that guilt can hinder therapy, and politically, because the question of whether or not one can ‘help’ one’s illness (strange turn of phrase, that one, isn’t it?) is bound up with our ideas about the immutability of the natural being grounds for the social sphere to actually deal with difference, although with the increases in our ability to change ourselves, this is getting less strong. But it also shapes relationships in ways that can be problematic, especially in contexts of abuse, because it can make drawing lines around what one will and won’t accept difficult (why no, I’m not speaking from experience, however could you tell). After all, oughtn’t one to care for, rather than punish or reject, those who are sick? And if they aren’t their sickness, and you love who they really are, then can you stop loving/caring (etcthanksfemininityyoutellakillertale). Another, more extreme, example of this might be the inclusion of Paraphilic Coercion Disorder in the new DSM, which situates rape as not a crime but a symptom of a sickness. (My superpower (ambivalence) goes into overdrive over that one; if nothing else, it certainly makes especially clear Foucault’s argument that the psy sciences are slurping up judicial power).

Another is the way that it configures the self. The expansion of psychological abnormality–such as through the Paraphilic Coercion Disorder referred to above, or through the increasing talk about how ‘we’re all on the (autism) spectrum,’ or through questionnaires such as those for Sex Addiction (be warned that I suspect the box you tick at the top of the survey modifies your results substantially) which implicitly pathologise a range of very common, if unwanted behaviours (obviously my concern is not what is ‘real’ sex addiction or autism or anything, so much as why we want (psychology) to draw the line)–this expansion of pathology coincides with the push of the “normalizing society” (Foucault, Society Must be Defended, somewhere I can’t find just now because fuck googlebooks/the publisher/my books are still on the seas etc). This push isn’t just towards a statistical norm, it’s towards an ideal. The splitting of the self through situating all ‘abnormality’ as not-really-me functions in really fascinating ways, enabling an ideal self to become the real self, even if that self is never manifested. Which on the one hand might make some space for difference, in that I-am-really-x-but-can’t-quite-manifest-it-oh-well. On the other, though this configures the difficulty in achieving the realisation of the ideal self unfair rather than just-the-way-life-goes (an external impediment rather than, well, me) especially given that the world offers so very many means to achieve that self.

And all of this feeds into the modification of individuals (ha! ‘in-divid-ual’ indeed!) through therapeutic, pharmaceutical and other means. My concern about this (and I hope that this is obvious by now on this blog) is less to do with the number of pills people take, or the amount of therapy, or the idea that people might be changing away from some naturally-given ideal. I really couldn’t give a fuck about all of that. My concern is more with how rigorously intimate the refusal of difference is becoming through this kind of discourse. My concern is that this intimacy–it’s playing out within the self now– means that the extent to which ideas of the normal, sustained by these ‘innocuous’ phrases about having rather than being, become so thoroughly a part of our selves that they seem neutral, seem natural, seem to be about the way that things really are. Not only does this problematically continue to situate those deemed to be ‘more bodily’ than some ideal as still problems, as Elizabeth Grosz sketches above. The intimacy of these issues–this is about how I situate me, myself, I, my brain, my mind, my body, when I’m not even thinking about them/me–preclude examination of the terms by which suffering is produced and sustained by them. Or so I’m thinkin’ just now. Thoughts welcome, as ever, mes amis!

I’ve been thinking a lot about disability of late, which won’t surprise those of you who have been sharing a particular corner of the blogosphere, in which awesome and fail appear to coexist in some kind of proportion in which the latter sadly sometimes seems to be winning out. In this analysis of the “Harmonisation of Disability Parking Permit Schemes in Australia”, I argue that the shift that is being proposed is from the social model of disability, to the medical model.

The medical model suggests that there is a way that the body ought to be, and any permanent ‘loss’ of such ‘normal’ capacities constitutes disability (and that this is a natural, neutral state of affairs that is no one’s fault—except the individual body, of course). This approach is the most mainstream, and it’s constitutive of much of the discrimination that disabled people (or people with disabilities, both terminologies having a different but important political point to make) experience.

The social model, which is offered as a counter to the medical model, suggests instead that the ‘loss’ of capacity occurs not because of the impairment itself, but because of the impairment in combination with a world built for the temporarily able-bodied. (And this doesn’t only refer to the built environment, of course: models of sociality, for example, are very strongly ableist).

There’s actually another step in this little spectrum, one which doesn’t get much screen time in activism (understandably, because it’s so far from the medical model, and such a challenge to it as to appear incomprehensible or nonsensical to those committed to the medical model). This suggests that even understanding particular bodies as impaired is the result of a presumption about the body. That is, it argues that disability begins at the moment when you understand some bodies as naturally unimpaired, and others as naturally impaired: the drawing of that line is not a neutral, naturally-given one, as we like to pretend. It is a political distinction that is, in itself, is invested with the ability system, which, as Lennard Davis argues, is what constitutes particular bodies as disabled, and thus as the problem. Davis recommends that whenever we see such a problem, we ought to ask how it is that this ‘problem’ is constituted as a problem, and be careful to observe the privilege that attends that which is not considered a problem. What makes disabled bodies into ‘those bodies with problems’? The presumption, essentially, that they ought to be otherwise: normal. And this in turn maintains the privilege of the able body.

The group who potentially loses out most dramatically in the proposed parking permit scheme is those with invisible disabilities, as Lauredhel demonstrates so clearly here. In response, I began thinking about what it meant to have an invisible disability. On the one hand, it might be that we could think of those with invisible disabilities as those who can ‘pass’ as able-bodied. And sometimes this is true, at least some of the time, and there’s little doubt that this ability to pass can lead to privilege as well as the problems associate with invisibility. For example, people approaching someone in a wheelchair will often talk to their assistant pushing the chair, as if the person with a disability is incapable of thought, conversation etc, and this kind of discrimination is something those who can walk are unlikely to confront. On the other hand, we can think more carefully, and see that those who have ‘invisible’ disabilities  are those whose differences simply don’t fit into someone’s expectation of what disability ought to be. And this means that legislation is likely to discriminate against those with ‘invisible’ disabilities because it is employing the medical model of disability. What does this mean? Well, hopefully this little story of mine might help.

Years ago, now, I was stepping out (sorry, I find that phrase hilarious and had to use it) with a young man who had a visual impairment. As he was doing a PhD, this meant that he couldn’t read at quite the rate he might have liked, and sometimes working on the computer was too much. I encouraged him to make use of whatever assistance the disability office at uni could offer him, even though I understood his fairly intense ambivalence about it. They were singularly unhelpful. He felt that they treated him as if he was ‘faking it’, on the one hand, and expecting too much of them on the other. The extension of his scholarship that he was hoping to get was, they told him, simply not going to be possible. I suggested that perhaps he should look to Centrelink’s Disability Allowance to help him fund the completion of his PhD. He picked up the forms, still unhappy about this prospect, even as he knew it was probably necessary, and brought them home.

I looked over his shoulder at the forms he was trying to fill out. He had ticked the box marked ‘visual impairment’, and been sent to another section. In this section, the form asked him for some proof from an opthalmologist. He hesitated. “What’s wrong?” I asked.

“Well, I’ve seen opthalmologists,” he explained. “But the issue isn’t in my eyes. It’s in my brain.”

His visual impairment, you see, wasn’t a loss of vision due to some problem in the eye, as the form assumed. He had been prone to migraines as a kid, and at some point (I think the age of 11, but this was a while ago), he had had an incredibly severe migraine. He recounted looking downwards, and having his entire left leg disappear in his blindspot. The auras had hung around—a permanent fixture, as it turned out. He saw multiple copies of everything, more or less depending on how good a day it was. Sometimes things looked like a badly tuned TV set, sometimes there were lines, sometimes… you get the idea. But although this interfered with his vision, it didn’t fit the form’s idea of what a visual impairment was. It didn’t seem to fit into any of the other categories either, as far as either of us could tell, although he might have argued a case under ‘having suffered a stroke’ except that that category seemed to think that difficulty speaking and walking would be the primary problems he’d have then. Frustrated and embarrassed, he stepped away from the idea, away from the forms. His impairment wasn’t real, couldn’t be argued for, proven, justified. Everyone would think he was faking it. I couldn’t think of what to say.

This is part of the problem with the medical model. It has a particular image of disability, generally involving the assumption of some level of dependence on others (because of course the temporarily able-bodied are so independent[snort!]), and it institutes this, medically, legislatively. And in so doing, it requires that people with disabilities be people with particular, recognisable kinds of disabilities. Instead of testing for how one is disabled by a particular thing—by inaccessible parking, by stairs, by having to stand to be served, by the university’s expectations of a student’s reading speed—that is, instead of testing for a real problem with the way the world works, it instead requires that you fit an existing imagining of disability. And this existing imagining of disability is very limited, and thoroughly bound up with able-bodied fantasies (nightmares) about disabled bodies: as people in wheelchairs, people who are blind, people who are deaf. And indeed, it assumes that it already knows the effects of each of these impairments, a point which the Deaf community knows and battles, arguing against the idea that Deafness is a lack, or a loss, or an impairment at all. The medical model homogenises disability unnecessarily, and more than this, it renders numerous disabilities invisible because they do not match up to this fantasy of what constitutes disability.

When we legislate according to the medical model, we legislate what disability ought to be, what disability ought to look like. We legislate the visibility of disability, and we do it by rendering a whole mass of heterogeneous bodies imperceptible, invisible, ignore their capacity to be disabled by an able-bodied world. We imagine visual impairments after a singular model where vision is only located in the eye. We imagine mobility restrictions only through difficulty with walking. We imagine that the solution to PWD (and it is a solution to, not a solution for) is compensating for their recalcitrant  body, a body we assume to know all about. We reject the idea that the world might need to be reworked, rethought, rebuilt, and instead maintain disability by maintaining the world as a place which expects certain ‘normal’ things of bodies, and which privileges those bodies which can live up to this ideal as a result. When we legislate according to the medial model of disability, we maintain the disabilities of those who don’t adhere to our nightmare visions of disability, because we’re busy pretending they don’t exist, erasing them from our construction of the world. We ensure that some people remain disabled because we don’t have the imagination to allow the category of ‘disability’ to be shaped by the heterogeneity of real bodies, the heterogeneity of real needs, the heterogeneity of the real ways that people live their lives. We refuse to produce legislation which tests not for ‘the impairment itself’, but for disability, because that might implicate the able-bodied, our standards of normalcy, might trouble the extraordinary privilege maintained only at the disadvantage of those who don’t live up to our standards. We render bodies which might trouble our limited imagining of difference invisible, and then shrug, and raise our hands in the air, and ask how we could possibly have known that such people even existed, and how we could possibly be expected to ‘cater to’ such exorbitant, excessive difference. The perceptibility of bodies is a key stake in the politics of disability, because disabilities aren’t invisible. They’re invisibilised.

P.S We’ve done a whole lot of the work of being active for you! Beppie, Lauredhel and I have given you some quick and easy ways to respond to the supposed “Harmonisation Scheme”: a form letter, and a letter encouraging organisations to submit a response.

In opening this thesis, I situated suffering in relation to the imagining of the body politic. Suffering, I suggested there, is positioned as the uprising of the chaotic ‘state of nature’ into the rational, civilised calm of the structure of the state. As we have seen, however, it is, in fact, that suffering is constitutive of the state: it plays a key role in the techniques of biopower, ensuring that contemporary forms of subjectivity are invested, viscerally, in the reproduction of normalcy, and thus in both the reproduction of both a “proper” individual body, and the reiteration of the particular image of the body politic. Suffering, I have argued, is not a natural occurrence but bound up with the subject’s production as subject. It is thoroughly contextual, a result of the bodily tolerances engendered by contemporary styles of being-in-the-world, and the tacit knowledges—knowledges particularly about the value of different bodies—they bear with them. These bodily tolerances are never merely individual. They shape and are shaped not only by what I have called the incarnatory context, but by one of the key ways that this context is imagined: in, through and as the body politic.

Moira Gatens’ discussion of Hobbes’ Leviathan, which I alluded to in the introduction, suggests that the imagining of the body politic as a literal body is not an innocent metaphor (Gatens , 21-28). Rather, she suggests that it is in and through the metonymic and metaphorical construction of the body politic as male that the worth of women is so undermined. I would add to this that in fact Hobbes’ imagining of the body politic is far more specific than this: it is white, male and thoroughly able-bodied; more, it is envisaged as a sovereign, rational individual. It is maintained through the echoes of this model of subjectivity and sovereignty in the individuals which makes it up: the body politic’s sinews, according to Hobbes, are the contracts binding (male) citizen to (male) citizen. In imagining sociality in the image of the contract, and in the maintenance of the ideal body (politic), the devaluation of particular bodies is both essential and concealed. It is, as Diprose has so eloquently drawn to our attention, the memorialising of the generosity of some, and the forgetting of others that structures this body, what is valuable to it, what can count as property, proper bodies and proper subjectivities. The memorialising of the value ascribed to particular bodies thus functions to reiterate the privilege—the standard, the norm-ideal—of the white, male, heterosexual and able-bodied male. It is also, as Gatens suggests, what enables the forgotten incorporation—the ‘swallowing’—of the gifts and generosity of all those whose ‘corporeal specificity marks them as inapprorpriate analogues to the political body’: women, immigrants, those racialised as other than white, those of classes other than middle class, and of course, those whose bodies are considered not ‘able’ (Gatens , 23).

The meaningfulness of these bodies—these “too-specific” bodies—is produced through the extraordinary discursive strength of medicine, also equipped to render them less specific, better ‘analogues’. The body that Hobbes envisaged did, indeed, risk sickness: civil war was the disease he sought to inoculate Leviathan against (Hobbes 1998, 19), the breaking of the social contract. But in fact our discussion here has shown us that this body politic, for all its apparent impermeability, all its apparent invulnerability, is a dream wispy and frail, threatened by the inevitable presence of all that it must constitute as disavowed: bodies ‘disabled’, of colour, female, transitioning, intersexed, ‘disfigured’, working class and so on. Medicine, a technique of biopower, as Foucault has noted, plays its part in this economy of bodies in the reproduction of normal citizens; thereby also maintaining (the value of) the white, able-bodied body politic, in whose image all value is medically, legally and economically calculated. Medicine is not, of course, a monolith, and nor is it to be thought of as an evil: it offers us the means for recovery when we sick, heals us when we have accidents, gives us capacities we might never have had, and gives us a way of understanding all these transformations, the world, and ourselves. Yet the extraordinary legitimacy of science means that truth-effects attach to these constructions, be they the constructions in the appearance and experience of flesh as made by knife, needle and thread, or pharmaceuticals; or in those less recognised but no less significant ways: in the construction of perception, comportment and styles of being-in-the-world more generally. Thoroughly imbricated in the liberal humanist individualism which grounds Hobbes’ imagining of the Leviathan, medical science plays a, perhaps even the, key role in the modification and (re)production of proper subjects, proper desires, proper bodies: it constructs and reconstructs normalcy as natural so that these bodies—and the body politic in whose image they are made—may remain unremarked and unremarkable. Suffering, then, has a dual effect: anatamopolitically, it produces subjects who suffer their “abnormalcy,” experiencing the (medically assisted) achievement of normalcy as a home-coming, as an achievement of who they “really” are; and biopolitically, it reproduces the normal body of the population, the ideal of the body (politic) as free from suffering.

It is, as we have seen, in the (im)possibility of aneconomic generosity that this unjust and economic imagining of the body politic is troubled, shaken and undone. Hobbes’ imagining of the bodies’ sinews as lying in the various ‘pacts and covenants’ (Hobbes 1998, 19) of its citizens—of some kind of social contract—is laughably simplistic in the context of the complex and unpredictable generosity of embodied, intercorporeal and intersubjective subjectivity and sociality. These gifts, the gifts that constitute us as inevitably intertwined with others are bonds that we cannot recognise without simply appropriating these gifts, thieving them into a careful re-membering of the Leviathan, its articulation as a body whose ties lie only within: joints, ligaments, nerves, muscles.

Yet even this destruction of the gift can never be total: the giftness can never be completely swallowed into the calculation of economy. The gift may always be foreign to the circle of economics, but it is nonetheless essential to it. And as I have described in the final chapter of this thesis, the embodied subject is always more than the perfect citizen: she is both rational and irrational, cognitive and corporeal, calculating and responsible. This means that whilst the subject cannot recognise the gift (for to do so is to render it not a gift), responsibility is nonetheless possible: there are means of engagement with the gift which allow it to remain aneconomic. In this responsibility, I have suggested, lies the possibility of a tacit, corporeal acknowledgement of the generosity of others—of the intertwining of the subject with the generous other, an intertwining that always exceeds the contractual, the rational, the calculated. This ‘acknowledgement’ means that the very tolerances that constitute not only “individual” subjects, but the body politic itself, are troubled, shifted, the sediment of entire histories stirred, altered and recast. Thus Leviathan is revealed to be not singular and contained, made impermeable as if by the selvage edge of a piece of fabric, where the weft binds it only back to itself. Rather, responsible styles of being-in-the-world not only testify to the gifts of others but also to the knotty mass that Leviathan already is—a Leviathan indeed, made not in the reductive image of a man, but as something unimaginable—monstrous, unfinished, messy, uncontainable and never entirely present. It is this that bears out the promise of another time, one never simply present, and the promise of that which Lévinas dreamt of: an anarchic moment of ethical justice. A justice born in those alterations to come.

…[gulp]…

ND still more… sorry for lack of updates, people. The writing-up is slow, and I am behind yet again, so once again, you get a chunk o’ theory that at this stage I’m crossing fingers isn’t going to preclude publication. (Robert, if you’re still reading, this section might demonstrate some of the ambiguity of trying to work with Levinas’ approach to ethics and politics in relation to suffering…) Can anyone definitively tell me if I’m risking not getting published by putting this up here? Oh, and send me good writing vibes, won’t you please? 🙂
… we pick up from the last Chapter 1 post…

The word “suffering” occurs a lot in Levinas’ writings. This is, perhaps, unsurprising, given that he writes, at least partially, to negotiate with the memory of the Shoah (also known as the Holocaust). The call of the other, which demands response, is characterised in various ways-through the face, the expression of mortality, height, destitution, to name only a few-but suffering, perhaps, remains the characteristic that subtends all of these. It is the suffering of the other to which the subject responds, prior to will, assessment or knowledge. I cannot be, Levinas argues, but that I respond to the suffering other.

It is the vulnerability of the other, then, that calls to me, and brings me into being. Yet Levinas also, primarily in the “mature” text Otherwise than Being, characterises the experience of the call for the subject as one of suffering. The deprivation of the ego’s self-satisfied enjoyment through the call of the other to query his or her own presumption is, in some sense, a source of suffering. Yet Levinas distinguishes between these two types of suffering, partially because his ethics is never about symmetrical reciprocity:

there is a radical difference between the suffering in the other, where it is unforgivable to me, solicits me and calls me, and suffering in me, my own experience of suffering, whose constitutional or congenital uselessness can take on a meaning, the only one of which suffering is capable, in becoming  suffering for the suffering (inexorable though it may be) of someone else (Levinas 1998, 94).

The other’s suffering is purest ‘evil’ (Levinas 1998, 93), in other words, whilst my own suffering can be fundamentally ethical; is, indeed, the very expression of the ethical. This contrast, then, offers us both sides of the story, and as intertwined-the experience of suffering itself, and the response it engenders which is also suffering but of a different modality. Although the centrality of suffering to ethics means that his discussions of suffering are spread throughout his work, it is ‘Useless Suffering’ that constitutes, perhaps, Levinas’ most explicitly discussion of it, and particularly in relation to theodicy, which is a theological term for the justification of belief in God in the face of suffering. As we shall see, this is of surprising relevance to a discussion of the role played by suffering in contemporary discourse, most particularly because it queries the privileged status of the “cure” as the superlative response.

Levinas describes the phenomenology of suffering in terms of how it functions within a consciousness accustomed to grasping the world, accustomed to perceiving, knowing and thus having the world be meaningful: to this consciousness, suffering is fundamentally contradictory.

Suffering is, of course, a datum in consciousness, a certain “psychological content,” similar to the lived experience of color, sound, contact, or any other sensation. But in this very “content” it is an in-spite-of-consciousness, the unassumable. The unassumable and “unassumability.” “Unassumability” that does not result from the excessive intensity of a sensation, from just some quantitative “too much,” surpassing the measure of our sensibility and our means of grasping and holding; but an excess, an unwelcome superfluity, that is inscribed in a sensorial content, penetrating, as suffering, the dimensions of meaning that seem to open themselves to it, or become grafted onto it (Levinas 1998, 91).

Suffering, then, occurs within consciousness, but as thoroughly ungraspable. Indeed, it also penetrates all possible sensorial content, and thereby renders everything unassumable. This does not simply designate the kind of content that is overwhelming because I cannot take it all in at once, but rather content that is not content, that I could never grasp. Thus suffering strips out all the dimensions of meaning that the subject might deploy in attempting to grapple with it, and infiltrates all meaning, including the already-established.

It is as if suffering were not just a datum, refractory of the synthesis of the Kantian “I think”-which is capable of reuniting and embracing the most heterogeneous and disparate data into order and meaning in its a priori forms-but the way in which the refusal, opposing the assemblage of data into a meaningful whole, rejects it; at once what disturbs order and this disturbance itself. It is not only the consciousness of rejection, or a symptom of rejection, but this rejection itself: a backward consciousness, “operating” not as “grasp” but as revulsion… The denial, the refusal of meaning, thrusting itself forward as a sensible quality: that is, in the guise of “experienced” content, the way in which, within a consciousness, the unbearable is precisely not borne, the manner of this not-being-borne; which, paradoxically, is itself a sensation or a datum… Contradiction qua sensation: the ache of pain-woe‘ (Levinas 1998, 91-2).

Suffering, then, is the lived experience of contradiction, of the inability to experience what one nonetheless experiences. Suffering cannot be grasped, but revolts against such a grasping, disturbing not only this particular moment of the subject, but troubling all meaning, all order.

Indeed, Levinas invokes this experience of the ungraspable as engendering a unique form of passivity as the fundamental factor in the experience of suffering:

[t]he passivity of suffering, in its pure phenomenology… is not the other side of any activity… [it] is more profoundly passive than the receptivity of our senses… sensibility is a vulnerability, more passive than receptivity; an encounter more passive than experience. It is precisely an evil… Suffering is a pure undergoing (Levinas 1998, 92).

This is not simply passivity that could at any moment be turned into activity, then, but a passivity far more fundamental, prior to the possibility of activity. In this moment, then, Levinas is pointing out that it is not simply my inability to act that is at stake here: ‘[i]t is not a matter of a passivity that would degrade human beings by affecting their freedom’ (Levinas 1998, 92). It is not that I am denied my existing capacity to be an agent, to enact an existing freedom. The “no” of suffering is so thorough-going that it unpicks the very possibility of acting.

The humanity of those who suffer is overwhelmed by the evil that rends it, otherwise than by non-freedom: violently and cruelly, more irremissibly than the negation that dominates or paralyses in non-freedom. What counts in… the submission of suffering is the concreteness of the not, looming as an evil more negative than any apophantic not… The not of evil, a negativity extending as far as to the realm of unmeaning… It is the impasse of life and of being-their absurdity-in (new page) which pain does not somehow innocently just happen to “color” consciousness with affectivity. The evil of pain, the deleterious per se, is the outburst and deepest expression, so to speak, of absurdity. Thus the least one can say about suffering is that, in its own phenomenality, intrinsically, it is useless: “for nothing” (Levinas 1998, 92-3).

How precisely this nothingness works is clarified by recalling the priority of the ethical. It is the ethical relation of the subject’s response to the other’s call that alters the ontological, shifting being-for-itself and being-in-itself into a being-for-the-other. It is the ethical relation of subject to other that opens up the possibility knowledge, and to the possibility of justice. As Levinas describes,

this depth of meaninglessness that the analysis seems to suggest is confirmed by empirical situations of pain, in which pain remains undiluted, so to speak, and isolates itself in consciousness, or absorbs the rest of consciousness (Levinas 1998, 93).

In this sense, then, suffering is a mode of being that breaks apart the ethical relation, isolating the individual in his or her individual being, radically turned in on him or herself, in a state of ‘extreme passivity, helplessness, abandonment and solitude’ a thorough-going, ontological and precisely unethical solitude which is ‘condemned to itself with no way out’ (Levinas 1998, 93). There is no way to move beyond, outside, or through the experience precisely because such a movement requires the relation with the other in order to make meaning. The suffering subject becomes:

psychologically deprived, retarded, impoverished in their social life and impaired in their relation to the other person-that relation in which suffering, without losing anything of its savage malignancy, no longer eclipses the totality of the mental and moves into a new light, within new horizons… For pure suffering, which is intrinsically senseless and condemned to itself with no way out, a beyond appears in the form of the interhuman (Levinas 1998, 93-4).

In being drawn out of the closed-down state of being that the subject is in when s/he suffers, the ‘beyond’ that is offered is precisely one that troubles the meaninglessness of suffering: ‘the order of meaning… is precisely what comes to us from the interhuman relationship, so that the Face… is the beginning of intelligibility’ (Levinas 1998, 103). Without it, I cannot resist suffering’s dismantling of my capacity to enact the ‘assemblage of data into a meaningful whole.’

In many respects, I would suggest that Levinas’ description of suffering echoes Cassell’s. Indeed, Cassell positions meaning as at the heart of his challenge to the Cartesian split, and the querying of the radical distinction between self and other, between self and community (Cassell 2004, 230-237). The difficulty that Cassell expresses in grappling with the very idea of meaning (see for example Cassell 2004, 241) is, I would suggest, specifically engaged with by Levinas’ ethical theory. Levinas argues that the relation between subject and other generates meaning specifically because it is required of the subject as responsible: intelligibility, as we saw above, begins with the Face. More striking in the similarities between the accounts of suffering provided by the ethical philosopher and the physician is the idea that suffering causes the break-down of meaning. The intactness of the person requires the relation with the other-the meaning-making relation of responsibility. The loss of this relation through the solipsistic turning-inward identified by Levinas produces a threat to the intactness of the person, a threat to their capacity to make the world make sense.  They are not alone in this; Elaine Scarry argues that  ‘[p]hysical pain does not merely resist language but actively destroys it, bringing about an immediate reversion to a state anterior to language’ (Scarry 1984, 4). Cassell and Scarry both provide remarkably detailed engagements with the physicality of suffering, and of the extent to which meaning is bound up with the intactness of the self. In the following chapter, I will examine Merleau-Ponty’s theory of bodily being-in-the-world to help us understand how and why bodily being is bound up both with meaning-making and thus with the trauma of suffering in the next chapter.

To this point, however, Levinas has given us a way of understanding, as far as possible, the enigma that is suffering for consciousness; or more to the point, Levinas makes it clear that the enigma is caused by the breaking of the meaning-making ethical relation. The subject’s capacity to grasp his or her suffering is undermined by the (un)ethical isolation from the other. Yet whilst these broad brush strokes may give us a sense of what suffering is, it is important that for Levinas, the call is precisely the call of alterity; here we turn to the question of the subject’s responsibility to the other. Alterity, to recall, is the radical otherness of the other, which remains not simply ungraspable, but ungraspability. The ‘the original call for aid, for curative help… [comes] from the other… whose alterity, whose exteriority promises salvation.’ (Levinas 1998, 93) In this sense, then, the suffering of the suffering other is an expression of precisely that alterity, and thus cannot be fully grasped by the subject. If an attempt is made to thematise the other and their suffering, to suppose the radical uniqueness of this particular other’s experience to be comprehensible, then a violence has been done to that other.  This is not an ethical response.

A chunk of thesis, from about half way through the first chapter, soon to be followed by a chunk of Levinas-in-thesis… for your interest (or not!):

What does the reduction of suffering to disease allow in the cultural negotiation with it? What power relations are concealed in this reduction of suffering to the natural? How is ‘intactness’ produced as the nature of subjectivity such that particular experiences are experienced naturally as threat? In other words, what ‘material subjection’ is concealed in constitution of subjects who suffer, and in the reduction of suffering to the natural, neutral response to a wrong? What might it mean to, instead, to think suffering itself not simply as a natural response to either disease or oppression (as therefore naturally bad things), but rather as a technique of power?

To begin to explore these questions, we need to examine what kind of political significance suffering has. Given that I have, thus far, been engaging with suffering as it is understood in a medical setting, I now turn to Arthur Frank’s consideration of the medical treatment of suffering in the context of a capitalist, consumerist culture in his article, ‘Emily’s Scars: Surgical Shapings, Technoluxe and Bioethics.’ (2004) He is concerned less with what suffering itself is and how it is caused, and more with the status of demands for ‘cure’ articulated through suffering. As a result, he often problematically blurs the lines between pain and suffering; or rather more specifically, attempts to circumscribe his use of the word “suffering” to those experiences marked as, in some way, legitimate.

Frank observes that the ethical imperative to relieve suffering (or as he frames it, ‘”to alleviate pain,”‘) has historically formed medicine’s ‘original and still pre-dominant purpose.’ (Frank 2004, 22) It is this purpose that has functioned to legitimise (to varying degrees) a range of interventions, including the surgical ones Frank focuses on in this article-limb-lengthening surgery, cranio-facial reconstructive surgery, intersex “corrective” surgery and of course cosmetic surgeries. Using philosopher Alisdair McIntyre’s theory about the eighteenth century invention of the notion of selfhood, he observes that the marriage between this strong sense of a self which ought (morally speaking) to be fulfilled and the consumerism of current culture has a very specific effect. This has resulted in surgical methods being used for what Vogue magazine calls ‘”technoluxe,”‘ (cited in Frank 2004, 21); that is, medical expertise has become, he suggests, a commodity, consumed towards the fulfilment of self, a practice particularly evident in what is usually referred to as cosmetic surgery. This is far from a new complaint against cosmetic surgery: Sander Gilman demonstrates that the concern about authenticity, passing and the “unnatural” achievement of status otherwise unattainable (such as the position of Gentile through the modification of the “Jewish nose” (Gilman 1999, 124-137) or the “reproduction” of a foreskin (Gilman 1999, 137-144) has long troubled the industry. (Gilman 1999, 3-36) Indeed, the questionable position of cosmetic surgery has historically led much of the medical profession to distance themselves from the practice. But Frank’s concern is specific: it is not a concern, at least at first glance, about the authenticity, but rather that ‘technoluxe medicine distorts the allocation of medical services and distracts medicine from its original… purpose,’ (Frank 2004, 22) which is, of course, the relief of suffering. Cosmetic surgery, in other words, distracts medicine from its proper business.

He struggles, however, to make this argument, precisely because suffering is so often claimed in relation to cosmetic surgery. (see also Davis 1995 for a qualitative analysis and discussion of suffering in cosmetic surgery.) Frank interrogates an example of such suffering which is specifically drawn from the same Vogue article from which he draws the rather laden term ‘technoluxe.’ A woman had surgery performed on her feet, because she ‘”grew tired of burying [her] toes in the sand when [she] went to the beach. It was humiliating.”‘ (Frank 2004, 21) This humiliation (probably, to be fair, only one aspect of the experience that led her to have surgery performed on her feet) is not simply observed by Frank, but assessed:

Pain is not what it used to be, and here I return to the moral justification of the satisfied medical consumer who says going to the beach pre-treatment was “humiliating.” I react to this statement as an inflation in the language of pain: if having unfashionable toes counts as humiliating, in what words can we describe the lives of people living with massive facial deformities? (Frank 2004, 22)

This is a fascinating stand for Frank to take, as we shall see. The implicit understanding of language here is essentially equivalent to the Wittgensteinian notion we saw Edwards utilise: “humiliation” here is considered to be a term separate to the experience itself, which operates to pick it-a specific, known and knowable experience-out of the mass of other experience. Frank thus represents this woman’s claim to pain as being somewhat bogus; she has merely identified her experience wrongly, or failed to understand the language-game as it ought to be understood (a position I do not think that Wittgenstein would have much sympathy with).

He goes so far as to compare her suffering with that of someone with a form of suffering whose recognition has long been legitimised: that of a person with massive facial deformities. Part of Frank’s difficulty with accepting this woman’s pain to be real is that he sees terms such as “pain,” and “suffering,” and “humiliation” as referring to a single experience. He cannot recognise this woman as suffering, for to do so would be to claim that it is equivalent to other forms of suffering, such as someone with massive cranio-facial deformities. This equation may well be deeply troubling. However, it also adopts the medical framework Cassell critiques, in which a particular experience is reduced to its ‘truth’: there can be, it supposes, only one true experience of suffering, one in which all bodies partake, regardless of their differences. In this respect, he assesses her experience against what he has already identified as “real suffering.” In so doing, he seems to fall into precisely the trap he warns against:

Research places whatever cannot be operationalized, objectified, and rewritten within the stylistics of universality among “all the things [that] do not fit”. Whatever cannot be reinscribed as an instance of some extralocal category must be rejected and censored. (Frank 2001, 359)

Thus the problem lies not in the experience of suffering itself, but medicine’s (and ‘research’s’ as Frank identifies above) unwillingness and inability to respond to the specificity of different experiences of suffering. As we have already seen with Cassell, suffering is always different because subjects are differently consituted. It is important to acknowledge this difference, not simply in order to be ethical, but because it also shifts the focus back onto the cultural elements that contribute to different kinds of suffering. Frank’s response to this, however, is not to challenge medicine’s conception, but rather to eliminate certain claims to suffering. If we simply deny some forms, cultural constructions which play into the production of suffering go uninterrogated.
Yet perhaps this is not entirely fair: he does acknowledge that the woman’s experience is significant, just not as suffering. Rather, the woman’s claim to humiliation becomes not an expression of her suffering but simply an articulation of a social problem, ‘as troubling as I find the usage of humiliating in this instance, it is important to hear the very real problem that this woman is working to express.’ (Frank 2004, 22) On the one hand, this gives the woman’s claim some weight, but on the other, it strips her claim of its ethical imperative, the imperative which Frank has already suggested directs medicine. In the end, according to Frank, the problem that this woman is articulating is actually that suffering, within a Western capitalist culture, has been made into a kind of currency, such that many will (implicitly inauthentically) inflate their experience such that it becomes an exchange value which legitimises the use of medical resources on ‘technoluxe.’

Yet this is a dangerous claim to make, given, as we have seen, suffering is contextually defined. The problem the woman with ugly feet is working to express does not have to do with what kind of experience is regarded as legitimate for surgery by the medical profession: it is, rather, her suffering. It is this woman’s experience that needs to be heard, not merely the way or the fact that she expresses it. More than this, a subject’s experience of suffering does not occur in isolation from the culture in which he or she occurs. Suffering is not linearly felt, known and named in that order, as Frank seems to assume, but operates in the inescapable context of a subjectivity constructed in the entangling of representation and experience, of culture and embodiment. The construction of subjectivity here is not the creation of an ‘ideology’ overlaying a “true, free self,” for which Foucault critiques Marxism (although Frank may well agree with this). Rather, suffering is constructed, where construction takes the dual meaning of the building of a subject, and also the construal of them: suffering is not safely ensconced in a prior ‘taken-for-granted ontology,’ and as such, this construction is not something the subject can shake off. It is part of what makes them a subject in the first place. The point is, in the end, that because subjects are discursively constructed, the use of the words “pain” or “suffering” in the context of technoluxe surgeries ought not to be reduced or dismissed as merely an ‘inflation in the language of pain’ but as an inflation in suffering itself.

Alongside this, we need to consider the question of ethics, as Frank reveals. In the end – and despite his problematic dismissal of “inflated” pain – he claims that,

trying to compare forms of suffering – comparing the woman humiliated by her toes with a young person deformed by a facial hemangioma – is not useful. The attraction of such a comparison is that it promises apparently clear-cut medical guidelines for practice. Unfortunately, practice will have to confront a reality that is not clearly divisible into categories. The issue may be better thought of not in terms of what suffering we allow as legitimately in need of fixing, but rather, what form of decision-making we respect. (Frank 2004, 26)

In shifting the focus from suffering to forms of decision-making, Frank is attempting to introduce the ethical element into guidelines about who ought to be permitted to undergo surgery. His concern with ethics is admirable, and well-grounded: ‘the personal is communal,’ (Frank 2004, 26) he argues, and since norms about bodies are created communally, the personal choice to undergo surgery must be understood to contribute to those norms. He echoes Canguilhem here, who argues that ‘[t]he normal is then at once the extension and the exhibition of the norm. It increases the rule at the same time that it points it out.’ (Canguilhem 1991, 239) It is worth recalling, however, that his primary concern is the distribution of medical resources.
Frank suggests that by focusing on decision-making in a communal context-a Socratic, dialogical model is his favoured method-individuals may come to understand ‘how their particular trouble relates to others’ troubles, and how their proposed solutions might cause others more trouble.'(Frank 2004, 26) Frank’s turn to decision-making in place of suffering in order to assess which claims to surgery are to be legitimate is understandable but problematic: effectively, it is the attempt to shift from the subjective space of suffering to the supposedly objective (or objectively assessable) space of dialogue and decision-making. This assumes a number of things, but perhaps most problematically, it presumes that the decision about whether to have surgery can be understood purely and simply as a rational one. Yet if this were the case, given that all the surgeries he discusses are normalising and thus as the creation of the normal confirm the norms which in turn create problems for others, the rational, ethical (if selfless) response to them would probably be never to have surgery. However, I do not think that Frank sees this as ideal; rather, he does seem to perceive some surgeries as legitimate. The confirmation of some norms is, it would seem, rationally justifiable; it is norms related to the appearance of feet that are a particular problem.

The problem is rationality: here we return to the question of what can figure as truth. He has already demonstrated that, rationally speaking, the woman with ugly toes cannot truly be understood as suffering, but he fails to ask why. The attempt to shift the focus from suffering to the rational process of decision-making is problematic because it assumes that rationality gives us some way of transcending that experience, or rendering it irrelevant – a reiteration of the liberal humanist mind/body split and perhaps more significantly, existing systems of discursive truth. It assumes we respect and respond to rationality, because it exists beyond the influence of cultural norms, and permits an “outside” perspective from which to adjudicate. This is a deeply problematic stance, and fails to take into account the normative function of marking particular discourses as “rational,” a label which has all too readily been attributed to the systems developed out of the ways that white men have thought, historically. (Lloyd 1984) It also once again denies the importance of the body in the way that we exist-always as embodied subjects. The very norms he is concerned that surgery further legitimates do not simply float about outside subjects, but are part and parcel of the subject’s embodied construction within our culture. Knowing the ethical, rational response cannot unbind the subject from that culture. The choice to not have surgery does not mean that the subject’s experience of themselves (as suffering) is altered. To presume that this is, or could be, or even should be the case is once again to suppose that the mind can transcend the body, that the two are separable.

Returning to the woman who suffered because of her ugly feet, another more disturbing problem arises: it is difficult to see the ethics of Frank’s argument that we should move away from responding to suffering to responding to someone’s capacity for rationality. In the rational, dialogical assessment of forms of decision-making, suffering may be rendered irrelevant, precisely because it is subjective, and possibly irrational. This does not, however, make the suffering not true: the individual still experiences it. Yet this is precisely the problem: whilst the rational, dialogical debate is always public, suffering is made to be only ever individual. In this respect, responsibility for suffering is (rationally) made solely the responsibility of the individual who experiences it.

However, if subjects are culturally constructed, an individual’s suffering is an articulation of broader – and communal – constructions of normalcy, abnormalcy, deviancy and suffering. The experience of the woman with “ugly” feet may be read to reveal the increasing intolerance of corporeal difference, for example, if her suffering is taken to be actually experienced rather than merely mis-named. Thus the individualising on the grounds of suffering leaves uninterrogated the way that the experience of suffering functions to dovetail with occurrences of “deviancy;” that is, it ignores the way that suffering tends to function to enforce normalcy in subjects. The danger of individualising the experience of the woman with “ugly” feet is that it fails to place responsibility where it belongs – with the communal. As van Hooft puts it, ‘If neither the gods, the cosmos, providence, nor a faith in human progress rob suffering of its tragedy, then we are left just with the brute fact that we and others suffer. And in this there is community.’ (van Hooft 1998, 20) Here, we can recognise the biggest problem with Frank’s proposed ethics. It risks rendering the ethical imperative of responding to suffering irrelevant except that which it is rationally explicated, and thus leaves us with the question: why is it ethically necessary to respond to the suffering other, and how does that imperative come about? Is it ever going to be possible to develop a rational ethical framework that does justice to that imperative?

References available on request (what, I’m feeling lazy… oh, alright). The main ones are:

Canguilhem 1991 The Normal and the Pathological Zone Books

Frank 2004 ‘Emily’s Scars: Surgical Shapings, Technoluxe and Bioethics’ Hastings Center Report 34(2), pp. 18-29

Gilman 1999 Making the Body Beautiful: A Cultural History of Aesthetic Surgery Princeton Uni Press

van Hooft 1998 ‘The Meanings of Suffering Hastings Center Report’ 28(5), pp. 13-19

If you want any others, let me know

wlettrine3.jpgELL, my supervisor has asked me to write an abstract of my thesis. Which makes me kinda breathless and not in a good way… but I thought I’d try writing some of it out here to see if anyone had any thoughts for lack of clarity, or similar, and because you know, I expect the world to be fascinated by my horribly dense work. Ah yes 😉 Actually, this isn’t going to be the final abstract, which apparently needs to be 300 words long. But it’s an attempt to lay out the argument of the thesis so that my supervisor can (ahem) find me examiners… Apologies for the weighty formal language—you can tell it means I’m anxious!

This thesis takes as its first provocation the centrality of the concept and the term ‘suffering’ in contemporary discourse, and most particularly in relation to technologies that are used to change the appearance or function of the body. Suffering has, in many ways, become a defining part of contemporary life. Political positions are regularly parsed in terms of their potential to reduce suffering, and it is used regularly to prompt ‘proper’ ethical engagement with difficulties faced by a particular group or individual. Liberalism deploys the term ‘harm’ to get at some sense of suffering that is to be avoided, whilst ‘exploitation’ is a favoured term of Marxists. When racism, sexism, homophobia or other kinds of exclusions are marked as problematic, it is often articulated through reference to the suffering caused. Indeed, one could be excused for thinking that injustice simply is equivalent to suffering, for this equation is regularly made, sometimes implicitly and sometimes explicitly, such that these two are intriguingly constructed together: suffering is taken to indicate an injustice, and injustice is to be avoided because it causes suffering. In the contemporary Western context, however, and there is a regime of power/knowledge deeply concerned with suffering, in ways that are, supposedly, not primarily about politics, or injustice, or even ethics (though this last is more swiftly brought into play in its defence). This regime is medicine.

The first chapter, then, unpicks the medical engagement with suffering. Medicine regularly takes its treatment of suffering as a justification of its existence and operation. Yet I argue that it also regularly naturalises suffering, equating it simply with pathology: if one is suffering, it is because there is something wrong with one’s body, a wrongness over which medicine claims expertise and control. I suggest that this naturalisation has numerous problematic effects. First, as Eric Cassell demonstrates, it means that clinical engagement with the suffering body tends to actually miss suffering altogether in reducing it to pathology, and thus never actually treats it. Second, the reduction to pathology means that medicine often cannot engage with the specificity of the suffering subject, and with the way that their suffering is unique. I argue that this uniqueness arises not from some essence, but rather from the unique situation of each subject. Third, the naturalisation of suffering precludes the space of denaturalisation, thereby concealing the role that suffering plays in the production and reproduction of normalisation. As such, it conceals the function of suffering in normalisation (by which I mean to include the depiction of ‘deviance’ as a source of suffering), and particularly its role in the construction of (normalised) embodied subjects in contemporary culture.

In the second chapter, then, I turn to Merleau-Ponty, whose phenomenological concerns have been taken up by feminists, critical race theorists and critical disability scholars. Their reconfiguration of Merleau-Ponty helps us get at the production of embodied subjects in and through their context, and more particularly, through their adoption and adaptation of the styles of being in the world with which they are surrounded. Merleau-Ponty argues that it is through syncretic sociability—the intercorporeal intertwining of the subject’s embodiment and the embodiment of others—that the subject is produced. Through the work of Gail Weiss and Linda Alcoff, I argue the particular styles of being in the world carry tacit body knowledges given to them by the discursive, institutional, capitalist and embodied world around them. These tacit adoptions (and adaptations) of existing styles of being, I argue, produce, through sedimentation, what Rosalyn Diprose calls ‘bodily tolerances.’ In effect, the habituation of particular styles of being in the world produces bodily tolerances which, if transgressed, may result in the subject experiencing suffering.

The third chapter argues that normalcy has become a, or perhaps the, dominant logic embodied in this way. In this way, the subject comes to experience their ‘normalcy’ as their ‘essence’ or inner ‘truth’, and the body’s recalcitrance in ‘matching,’ or more accurately projecting this truth can thus become a source of suffering. I examine this dynamic in some detail, particularly demonstrating the effect that the possibility of normalisation (through surgery or through pharmaceutical use, for example) has on the constitution of an intolerance to the ab/normal, both a subject’s own abnormalcy and the abnormalcy of those thereby marked as other. I focus on the way that a world constructed in and through normalcy, as critical disability studies especially demonstrates, tends to reiterate and confirm the experience of marked corporeal difference as a source of suffering. The naturalness of the body marked as normal is thereby protected from critique. In this respect, then, I turn to a more thorough-going and reflexive question: what role does the concept of the norm play in the construction of embodiment, according to Merleau-Ponty? I argue that even when his work has been taken up with a cautionary eye for the constitution of difference, the notion of ‘sedimentation’ as a core structure of embodiment (even as the ‘content’ that is sedimented is acknowledged to vary and thus produce difference) thereby naturalises a particular construction of embodiment (and time). As a result, the role that the norm plays in the concept of ‘sedimentation’ is not interrogated. I argue that embodiment in the contemporary context may, to a large degree, be produced through sedimentation, but that acknowledging the contextual specificity of this production is significant because it allows recognition of when and how this it is challenged (a point that will be raised again in more detail in chapter 5).

The fourth chapter explores the political significance of corporeal difference and the technologies related to their normalisation (or otherwise). It deploys Diprose’s concept of corporeal generosity, a critical appropriation of Derrida’s ‘gift,’ to demonstrate the asymmetries of ‘memorialisng’ and ‘forgetting’ of the gifts of others functions to reproduce privilege and disadvantage. It is through the generosity of various others that the embodied subject is formed, yet in the context of contemporary bodi I argue that in contemporary body projects, the body is constructed as a site of memorialising and forgetting. The embodied subject may be a produced as a palimpsest of gifts, yet only some of these are memorialised in their flesh. I argue that modifications of the body and embodiment gain their significance in this context, such that the normalisation of bodies marked as abnormal is a memorialising of the gifts of normal others—gifts which already work to inform the subject’s style of being in the world. Memorialising is thus always bound up with forgetting, such that the normalisation of the subject forgets, viscerally, the generosity of othered others. What becomes clear in such an analysis is the extent to which the embodiment of the individual subject is shaped and in turn shapes the political constitution of and engagement with corporeal generosity.

In the fifth chapter, I build on this analysis with a greater focus on what Derrida calls the impossibility of the gift, and the ethical (in contrast, though not necessarily opposition) to the political. The forgotten gift may be unrecognised, and thus not permitted to be part of the political domain, but it also escapes its ‘destruction,’ and more to the point, I argue that even in being forgotten, it still matters. Alcoff’s rearticulation of Merleau-Ponty’s theory of embodiment, which suggests that there is a tacit level at which the gift may be acknowledged, or more precisely, testified to without being subject to the cognitive processes required for recognition. Styles of being in the world which are shaped by the tacit acknowledgement that they do not occur without others, are thus open to a similarly tacit acknowledgement of the gift of others in a way that permits their alteration. Indeed, such bodies are not bound by the sedimentation of the personal history of their being in the world; rather the other’s gift affects troubles the sedimentation and offers a responsible comportment a way to respond to the other as other. In this way, we can see that the modification of ‘wrong’ bodies through particular technologies as a resolution to suffering is fundamentally bound up with the irresponsibility of dominant modes of comportment. The ethics of bodily change thus demonstrate two (always intertwined) forms: modifications seek to memorialise the subject’s self-presence, and thematise the corporeality of the other; alterations, on the other hand, are changes made to bodily being in responding to the other qua other. Thus it becomes clear that the ethics of a particular change lies not naturalness (and the concurrent distrust of change), or in the challenge to naturalness (and the concurrent distrust of the already-existing), as so many ethical frameworks of body modification have supposed; but rather in responsibility. Further, the ethical, responsible style of being in the world with others, sketched here, has political import; this lies not least in that corporeal generosity allows for ethics to be given corporeally, such that it resonates and amplifies through the incarnatory context and challenges the normative, sedimentary and normalised comportments through which power maintains the sovereign, self-present individual.

Apologies for the tail end of that one; it’s 3 am and at this time yesterday, I was drunk. Any suggestions for examiners gratefully received (we’re trying to formulate a list at the moment). I’m also trying to work out a title for this little baby; apparently I need to officially rename it well before I submit, which means I’m running out of time (for everything, really). I’m thinking perhaps Suffering Difference with the usual colon and explanatory phrase/list of three keywords to follow. Any thoughts much appreciated. I’d run a competition to win an island holiday or something for the title I wind up using, but I’m so pov I can’t even make it (sob!) to TransSomatechnics. So my undying gratitude is about the most I can afford, but hey, it’s something, right? ;-P

Next Page »