Suffering


This is a small, rough something I put together while I was at BIOS (LSE) during June. It’s really half a paper, kind of – and quite rough along with it – and part of where I want to go next is to ask about the, well, unhappy recipients of US military violence, and why, exactly, they don’t quite show up on the radars of those writing articles about therapeutic forgetting. And about the role propranolol could play in exacerbating the asymmetry of trauma produced in wars with Western countries who have easy access to pharmaceuticals.

The rise of happiness discourse in the last few decades has been remarkable. Although the Declaration of Independence codified the pursuit of happiness as a key element of freedom for US politics, happiness talk has spread far and wide. There are mildly critical public and popular discourses – such as Alain de Botton’s Affluenza – but these mostly critique assumptions about what it is that will make us happy. The goal of happiness remains a pervasive influence, especially on contemporary understandings of freedom. Indeed, as more and more is ‘discovered’ about happiness, it has become less a lucky accident, as Sara Ahmed points out the word’s etymological root in ‘hap’ might suggest, and more something earned through labour, something worked towards, a telos which shapes lives.

As Carl Elliott has shown, however, happiness is increasingly both over-determined and difficult to know: a Wittgensteinian beetle-in-the-box, he claims. Wittgenstein writes “Suppose everyone had a box with something in it: we call it a ‘beetle’… No one can look into anyone else’s box, and everyone says he knows what a beetle is by looking only at his beetle” (Wittgenstein, cited in Elliott, 2004, p. 301). Elliott suggests that it is this radical internality to happiness which makes it so susceptible to the production of anxiety and uncertainty which is leveraged by pharmaceutical companies, particularly in the US’s context of aggressive marketing. Elliott writes:

Wittgenstein’s beetle box game makes an important point about the words we use to describe our inner lives – words such as ‘pain,’ ‘depression,’ ‘anxiety,’ ‘fulfilment,’ and so on… Because nobody can look into the box of another player, nobody has any way to compare his or her ‘beetle’ to that of another player…. So they begin to worry. How does my ‘beetle’ measure up. Is my ‘beetle’ healthy? Would I be happier with a different ‘beetle’…. And this is precisely the reason it is possible to market successfully so many ways of improving psychic well-being, from psychoactive drugs and cosmetic surgery to self-help books and advice columns. If I never know for certain whether the quality of my experience matches up to yours, I am always susceptible to the suggestion that it could be improved (Elliott, 2004, pp. 301-302).

Of course, this idea of the radical internality of psychic states is already suspect from a Foucauldian perspective. This sense of a concealed inner self is, for him, a fiction produced by the recurrence of the repressive hypothesis. It grants legitimising truth effects to individuality and individualism, in turn concealing processes of subjectivation, and the implication of those radically internal experiences in much larger political structures. Although Foucault’s distrust of existential and phenomenological concepts of subjectivity led him to avoid discussion of ‘how people feel,’ numerous scholars working with even a partially Foucauldian frame are concerned with precisely this: the politics of how individuals feel.

The subjectivating technology of being ‘obliged to be free,’ (Rose, 1999, p. 87) as Nikolas Rose calls it, which brings with it both biopolitical (population administration) and anatomopolitical (individual discipline) effects, is modulated through ideas, ideals, and experiences of happiness. Elliott cites a French surrealist painter, Phillipe Soupault, who claimed, ‘one is always in danger of entrapment by what appears on the surface to be a happy civilisation. There is a sort of obligation to be happy’ (Soupault, cited in Elliott, 2004, p. 303). Even as happiness is not straightforwardly equivalent with freedom – the persistence of ideas of ‘false consciousness,’ ‘happy slaves,’ and perhaps even ‘happy housewives,’ demonstrates this – freedom is predominantly oriented toward, and justified by, happiness. As Lauren Berlant argues, commenting on contemporary American political culture, the shared fantasy about politics is that ‘[t]he object of the nation and the law… is to eradicate systemic social pain, the absence of which becomes the definition of freedom’ (Berlant, 2000, p. 35). In eradicating social pain, freedom is achieved, and the pursuit of happiness made possible. Foucault’s account of the ‘normalizing society’ (Foucault, 2003, p. 252)  where freedom is a key dimension of power, cannot be unbound from the experiences of happiness and suffering in contemporary neoliberalism. Where Foucault argued that ‘there is one element that will circulate between the disciplinary and the regulatory… [:] the norm’ (Foucault, 2003, pp. 252-253), Sara Ahmed’s account in The Promise of Happiness manages both to share his concern to demonstrate the relation between ‘macro’ and ‘micro’ technologies of power, yet demonstrate the normative significance of feelings:

[H]appiness involves a way of being aligned with others, of facing the right way. The points of alignment become points of happiness. The family, for example, is a happy object, one that binds and is binding. We hear the term ‘happy families’ and we register the connection of these words in the familiarity of their affective resonance. Happy families: a card game, a title of a children’s book, a government discourse; a promise, a hope, a dream, an aspiration. The happy family is both a myth of happiness, of where and how happiness takes place, and a powerful legislative device, a way of distributing time, energy and resources. The family is also an inheritance. To inherit the family can be to acquire an orientation toward some things and not others as the cause of happiness. In other words, it is not just that groups cohere around happy objects; we are asked to reproduce what we inherit by being affected in the right way by the right things (Ahmed, 2010, p. 45).

The pursuit of happiness, then, for all that it is fantasised by liberalism as the site of free, individual creativity, is profoundly political. The teleological orientation towards happiness is not simply about achieving the right emotional state, but also about feeling the right feelings in relation to the correct objects: a form of individual, communal, national and international alignment through which the alignment is maintained.

Therapeutic Forgetting

It is in this context, then, that I want to think through the politics of recent developments in the use of propranolol in terms of happiness and suffering. Propranolol is a remarkably efficient drug. It is used to reduce anxiety, to regularise heartbeats, to reduce the tissue damage in burn victims, amongst a range of other uses and the many new ones in development (including as an aid to quitting smoking, and perhaps even for enhancing cosmetic surgery patient’s satisfaction with the results of their surgery). Recently, however, it has been found that propranolol has an unusual effect on memories of trauma. In reducing the release of stress hormones in response to trauma, propranolol modulates three elements of memory, according to Elise Donovan:

[the] formation, acquisition, and encoding of the memory; emotional response to and consolidation of the memory; and reconsolidation, reinstatement, and retrieval of the memory, which includes recall and the emotional responses triggered by later stimuli. (Elise Donovan, 2010, p. 63)

Much of the discussion of propranolol as a tool for ‘therapeutic forgetting’ has been about its effect on the second element, the consolidation of the memory (). If administered within 6 hours after a traumatic incident, propranolol affects the consolidation of the memory. Rather than being ‘overconsolidated,’ as some commentators describe the ‘pathological’ memories that produce PTSD, the memories are consolidated in a ‘normal’ fashion (Bell, 2007; Henry, Fishman, & Youngner, 2007). There is, however, probably currently more scientific research on the effect of propranolol on the final element of memory, in the recall and reconsolidation, because, if as effective as it is hoped, this will enable the treatment of those already living with PTSD. In both cases, however, the benefit here is meant to be that the ‘emotional’ or ‘affective’ part of the memory is stripped out, whilst the ‘facts’ remain, although there is some uncertainty about whether stress hormones also assist in producing particularly clear or detailed ‘factual’ memory (Kolber, 2006).

The usefulness of the capacity of propranolol in ‘therapeutic forgetting’ was already explicitly tied to questions of happiness in one of the earliest sources of commentary on it, the US President’s Council on Bioethics’ report, Beyond Therapy: Biotechnology and the Pursuit of Happiness, released in 2003. This may, in fact, be where the somewhat misleading name ‘therapeutic forgetting’ arose. Although numerous anxieties about the effects of therapeutic forgetting were given in this report (which was widely acknowledged to be quite conservative!), the majority of the concerns expressed had to do with ‘authentic’ personhood, with the (especially moral) value of diverse experiences of happiness and suffering, and, somewhat awkwardly, the social and political importance of memories of suffering. They end with this claim about a propranolol-using future:

Nothing would trouble us, but we would probably be shallow people, never falling to the depths of despair because we have little interest in the heights of human happiness or in the complicated lives of those around us. In the end, to have only happy memories is not to be happy in a truly human way. It is simply to be free of misery—an understandable desire given the many troubles of life, but a low aspiration for those who seek a truly human happiness. (President’s Council on Bioethics, 2003, p. 264)

The resistance expressed in this report is grounded fairly clearly in a commitment to ideas about normal human being, ideas which those from the ‘transhumanist’ side of the tracks suggest indulge in a naturalistic fallacy, assuming that what (already) is is all that ought to be. However, whilst much academic and bioethical commentary in the aftermath of the report resisted this conservatism (especially in the American Journal of Bioethics target article and set of responses published in 2007), I want to suggest that there remains an implicit commitment to particular ‘alignments’ towards suffering and happiness. It is this commitment to the apparent dovetailing of happiness, an absence of pain, and individual freedom which has produced both the numerous positive arguments for propranolol, and a neglect of larger concerns.

Ethics, Politics, and Suffering

Propranolol is hard to argue against. The reduction of suffering is an important ethical imperative, one which crosses, I would suggest, both the rigorously systematised conceptions of ethics that bioethics is committed to, and other more critical frameworks such as those offered by Emmanuel Levinas, or Jacques Derrida. The reduction of suffering is imagined as core not only to political structures, as the Berlant quote I cited above indicates, but also to medicine; even if and where we might critique that image of such institutions, at least some aspect of their legitimacy and significance may be said to arise from it. Liberating individuals from their suffering so that they may pursue happiness is such a simple good.

Yet the consequences of liberating individuals through the use of propranolol also reveals that suffering plays a key motivating role in producing normal, happy, free people: people oriented correctly towards their own optimisation, towards a happiness that is not merely their own end, but also others. There is an example given by Elise Donovan of a case in which she believes propranolol could not and should not be denied:

Take… the case of a 30-year-old veteran who has completed a tour in Kosovo in addition to three tours in Iraq. Upon walking past a cemetery on the way to a 4th of July BBQ, he is overtaken by grief at the sight of veterans’ graves decorated for the holiday. The grief, guilt, and memories triggered by this sight result in his spending over an hour sobbing uncontrollably in the cemetery on the grave of a deceased veteran, while sounds of civilians enjoying their holiday can be heard in the distance (Elise Donovan, 2010, p. 72).

Without minimising one iota the suffering experienced by this young veteran, it is also interesting that Donovan selects an event – Independence Day – which is meant to be taken as a site of happiness. The decorations, the promise of the BBQ and the sounds of civilians, are all proper alignments to happiness: they render Independence Day and the creation of the United States as happy objects, sites around which happiness is supposed to coalesce.

I have suggested that happiness is attributed to certain objects that circulate as social goods. When we feel pleasure from such objects, we are aligned; we are facing the right way. We become alienated – out of line with an affective community – when we do not experience pleasure from proximity to objects that are attributed as being good. The gap between the affective value of an object and how we experience an object can involve a range of affects, which are directed by the modes of explanation we offer to fill this gap (Ahmed, 2010, p. 41).

The weeping veteran’s suffering, then, is explicitly situated as a misalignment: a failure to be made happy by what ought to make one happy, and thus a failure to participate in recreating the object of the nation as a happy one. Ahmed elsewhere discusses the ways that alienated subjects, such as unhappy migrants, can become ‘bad objects’ for social projects, such as multiculturalism, because the alienated subject’s unhappiness is supposed to result from an individual misalignment with the happy social project, rather than from, for example, the implicit racism that can characterise much multiculturalism. Yet the case of the unhappy veteran produces a more complex and troubling dynamic for this politics of happiness than the unhappy migrant. In this case, PTSD becomes the unhappy object, not the individual, partly because the willingness to fight ‘for one’s country’ is so clearly a happy orientation towards a happy object. The suffering is thus understood as an injustice, because it is assumed that the veteran would and will be happily aligned, given that this suffering is the result of his or her commitment to the military protection of the happiness of this happy object of the nation. The happiness of the military veteran – who is the go-to example throughout many of the papers on propranolol – appears as good, and right, and properly aligned: a straightforward good thing.

There is, of course, a continual problem with suffering veterans in this politics of happiness. The evidence of his or her participation in the happy alignment to the happy object of the nation is given by suffering, a paradox in this fantasy about good political institutions. This is where the politics of propranolol becomes particularly problematic. “Treating trauma” like this inevitably produces it as a pathology. Arguably the creation of PTSD already did this but as sociologists such as Peter Conrad has underlined, the capacity to treat is part of what produces a particular state of being as pathological (Conrad, 2005). It renders the problem of PTSD a medical problem, and, more than this, a medical problem experienced by the survivor. This narrows the clinical and societal focus to the survivor, and the aftermath, responsibilising her or him as an individual. As with other examples of neoliberal responsibilisation, this functions to obscure the situation that produced the suffering that is now being ameliorated (Kelly, 2010). Whilst this tendency may be slightly less in the case of veterans because in such robust evidence of their “happy alignments,” holding them entirely responsible for their suffering is clearly problematic, the approach to their ‘PTSD’ means it is, nonetheless, present.

The problem here is that the veteran’s PTSD is one of the few sites of trouble for the happy object of the nation. The suffering of those on “the other side” of whatever conflict the veteran was involved in not only does not trouble the state, but affirms it: these people who suffer suffer because they are/were incorrectly aligned (they were terrorists, is perhaps one of the more familiar examples) and thus their suffering works only to affirm the happiness of the happy object. Thus, the problem in the case of propranolol is that what is being obscured is what Ahmed calls the ‘scene of wounding’ (Ahmed, 2004, p. 33), a scene and a wounding in which the happy object of the nation is implicated. After all, it is the nation that sends soldiers off into combat, knowing they will probably experience trauma. The nation, this happy object, supposed to guarantee freedom, sends soldiers to kill others. In fact, in military training, the capacity to resist the trauma attached to killing is bound to achievement, such that succumbing to it is coded as failure. Similarly, military training encourages the development of incredibly close ties between soldiers, which both enhance safety in combat zones, and increase the likelihood of trauma arising from watching friends die.

In this sense, the suffering of veterans is testimony to the failures of the happy object of the nation. In this context, then, the politics of propranolol is intensely problematic: it covers over the scenes of wounding, enabling realignment. That realignment might be a happy one, for the individual – indeed, according to Ahmed’s argument, it is no accident that that alignment toward the happy object is happy – but it is happy, too, for the legitimating fantasies of those political structures which are meant to guarantee happiness. Given that the vast majority of major political changes have arisen in and through the insistent testifying to suffering – whether that suffering arises from colonisation, racism, war, sexism, homophobia, ableism or any one of a range of responses to ‘bad objects’ – the forgetting of that suffering, even when it does not obscure the ‘facts’ of the memory, has ramifications for progressive social change.

Conclusion

In this context, I think that it is premature to jump to a ‘yes’ or ‘no’ about propranolol, despite the number of academics willing to do so. I would suggest, instead, that this kind of critical appraisal of the politics of propranolol underscores that such biomedical developments have a politics which arises not straightforwardly from the drug itself, nor from the solution it offers to a particular form of suffering. Rather, the politics of propranolol arises from the political significance of memory, suffering, happiness and freedom, such that attending solely to the veteran suffering from PTSD can obscure far larger problems, problems which are implicated in the reproduction of suffering. The extreme antagonism between the ethical imperative to reduce this individual person’s suffering, and the political means to address the occurrence of suffering in the first place, indicates a profound problem with contemporary political structures that requires thorough consideration. As Erik Parens puts it,

[w]ork on our bodies instead of our environments may incline us to ignore the complex social roots of the suffering of individuals. And the easier it is to change our bodies to relieve our suffering, the less inclined we may be to try to change the complex social conditions that produce that suffering (Parens, 1998, S7).

Without such a negotiation, the ethical imperative to relieve suffering becomes part of biopower in a way that continues to conceal the violence that lies in the gap between legitimating fiction and experiential reality, a gap that biopower produces and sustains.

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I’ve just been reading a paper called “The Problem of Suffering and the Sociological Task of Theodicy,” written by David Morgan and Iain Wilkinson, at the same time as re-reading Levinas’ “Useless Suffering“, mostly to find juicy quotes (Levinas has to be one of the least quotable philosophers I know of – well, that’ s not quite right. He’s very quotable, but only at length. It’s an issue). I guess I’m back to thinking about suffering. I suspect I’ll never escape it!

But the paper from Morgan and Wilkinson I found a bit troubling. First of all, there’s a bit of a lack of clarity in the way that they differentiate ‘theodicy’ and ‘sociodicy’ and ‘inverted sociodicies’ (?). They claim that the first is, as we might be familiar with already, the justification for the belief in god despite the existence of suffering. The second, they suggest, is kind of like the same, only it’s about the belief in, y’know, progress. As Levinas puts it in “Useless Suffering,” this is mostly about the faith in a ‘kingdom of transcendent ends’, which of course for me evokes the Nietzschean critique of the ‘two worlds’ in Platonic Christianity. And the final, ‘inverted sociodicies’, is “brings from obscurity the ‘hidden hurts, fears and desperate cravings’ without which the ‘real story’ of the twentieth century cannot be told (Graubard)”. (Morgan and Wilkinson, p. 205). This would be the one that Morgan and Wilkinson see their own project as part of. I have a lot of sympathy with their position on this, really I do, although there’s a bit of carrying-on about how no one else (except a select inner circle) has been doing these ‘inverted sociodicies’ before which I think is indicative of a real failure to grasp what precisely is going on here. I am not convinced that no one else in academia has, at the centre of the drive for their work, a desire to name sufferings that have not been named, or a desire to alleviate those sufferings in some way. Maybe I’m just hopeful, but I honestly find it very difficult to believe. I think that one of the things that’s interesting about a lot of academic work is the various manifestations of that ethical impulse, and the ways that institutions so commonly fail to sustain it. Anyway.

What’s interesting to me, though, about their desire to participate in these ‘inverted sociodicies’ (which, to be upfront here, I’m going to argue are less ‘inverted’ as failing to grasp how thorough-going theodicy/sociodicy are in the commitment to the grand narratives) is that it hangs on a very particular conception of knowledge and language.

Despite numerous well-respected claims to the contrary – from Levinas, from Elaine Scarry, from Schopenhauer, amongst others – they argue that suffering can and should be articulated, be made meaningful, be made, specifically, the object of knowledge. Not knowledge of where and how suffering occurs, but knowledge of what suffering is like. The experience of it. In one of the bits that made me particularly indignant, they suggest first that suffering ‘lies in our “capacity for knowledge”, and then declare that “there is a paradox here, for whilst suffering appears to depend on the need to impose meaning on our lives, suffering is often at its most unbearable when meaning is the very thing it negates.’ (Morgan and Wilkinson, p. 203).  They then refer to Levinas, whose description of the phenomenology of suffering contains this (as I’ll show) erroneous quote:  “Taken as an experienced content, the denial and refusal of meaning which is imposed as a sensible quality is the way in which the unbearable is precisely borne by consciosuness, the way this not-being-borne is, paradoxically, itself a sensation or a given.” In this quote, they leave out a key word: “the way in which the unbearable is precisely not borne.” This is not about stocism, and nor is it about an underlying subject who is capable of bearing the unbearable sensation, who will always persist. This is about the sensation of the complete decimation of the subject. This is, as I’ve described it elsewhere, about the breaking apart of a world (which is meaningful, though not in the way that Wilkinson and Morgan argue it is (rationalish) but in the way that Levinas describes – a world opened to the other).

But Levinas also makes a distinction between suffering-in-me-for-the-suffering-other (which has as its meaning compassion, according to him: ethics, in some sense), whilst the suffering other is an outrage, a useless, meaningless evil which cannot be given meaning without doing (more) violence.  But Wilkinson and Morgan go on to suggest that the problem is that we just haven’t yet come up with the proper, adequate language yet. And when we do, we will be able to really progress forward, according to them. This, I think, is a complete failure to grasp what’s going on, but more than this, it subjects suffering to precisely the same modernist endeavour that has shaped the ideals of progress that they are apparently so wary of. KNOW EVERYTHING.

Suffering hasn’t arisen as the dark-but-expungable underside of modernist progressive drives. In fact, most of those modernist progressive drives take as their justification the relief of suffering. Look at Lyotard’s two grand narratives: the March to Freedom (thanks Marx!) and the Progress of the Spirit (shout out to (not) my boy, Hegel!). These are not motivated by a selfish desire to ‘enhance’ the world, not really. They are motivated, at least in part, precisely by the desire to alleviate suffering. Let’s make no mistake: the reason that Nazism, source of such suffering, became comprehensible to everyday Germans wasn’t through simple irrationality, through a straightforward failure to be concerned with suffering. It was precisely because it was made rational. As Foucault put it, what we saw in the 19th and 20th centuries was the development of a very particular kind of racism, supported by the ‘avalanche of numbers’ (Hacking). This racism divided the world into the subracial and the superracial. We can see where this is going. But the point here is that the genocide of the subracial was precisely justified as a strengthening  of the population, as a future-focussed, utopian drive towards a world in which no one suffered, in which everyone was strong, and able-bodied, and strong of mind, and fertile, and strong. A world in which none would have to suffer, and indeed, in which one may be maximally free. Foucault has some really nice ways of describing it in Society Must Be Defended – something about how the ‘vital principle’ was sustained through the excision of the subracial. And these stories, which were never delimited to Nazi Germany anyway, Western Nurembergian protests notwithstanding,  go on and on and on, now! The story we tell now is that you wouldn’t suffer if you’d just be whiter, more masculine, more able-bodied, more neurotypical, more more more ideal, more normal.

The point here is that I really do sympathise with Morgan and Wilkinson’s attempt to try and shed some light on the mucky and often-obscured underside of the shiny story of progress. But to do this in the name of that progress, to claim that progress and suffering are here simply in “an irreconcilable and destabilizing tension between the civilizing ideals of reason and the record of exploitation, violence and suffering which has been inflicted upon nations, ethinic communities and globally vulnerable groups” (p. 210), well, that seems to me to be a complete failure to grasp precisely what is at stake here. This shiny story of progress is earned on the backs of that suffering, because the shiny story of progress has no time, nor space, for difference, as Lyotard was so at pains to point out. It plays a key role in producing, manifesting, concealing and, yes, justifying, that suffering.

I don’t have the answers here. These are not simple matters. Part of why they are not simple is because it is so very easy to get so caught up in the commitment to the ethical alleviation of suffering that one puts faith in whatever brings that alleviation closer quicker, without really engaging fully with the genealogy of the complex structures within which we’re operating.  But the seductive ease of the equation of knowing more with progress in negotiating suffering… we need, desparately, to remain critical about that. Because theodicy structures our cultural logics, promising utopias (if we could all just become one, become equal, become same) and sustaining anguish and suffering in the here and now…

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 today about the relationship between liberalism and neoliberalism, specifically in relation to harm (this is as I’m filling-out the paper on rape below).

The Millsian (is that even a word?) version of liberalism says, basically, that we should let everyone do whatever they want to do (to maximise their chances of living the good life) so long as they don’t harm others. In this imagining of liberalism, then, the State’s legitimacy is (at least partly) the result of protecting the (ideal) subject of the State from (ideal) harms (Gatens, in Imaginary Bodies makes a nice version of this argument).This kinda screws anyone who falls away from that ideal in some way—as I’ve argued elsewhere, it is increasingly configuring any suffering experienced beyond those vulnerabilities legitimised by the State’s protection as pathological, or unnatural. Okay.

But in the shift to neoliberalism, the reasoning starts to be that we should determine the risks of harm to the (ideal) subject, and through increasing State control, minimise the chances of that risk coming about. But again the specificity of that ideal subject come to shape which risks count as risks the State ought to be responsible for, and which are the responsibility of the individual.

Neoliberalism, in the legitimising stories told about it, is more responsive, more attuned to the different vulnerabilities of different spaces, of different subjects, more methodical in tracking risk, through probabilities and norms. But of course this isn’t really the case. Rather, only certain risks can be tracked. Only certain normative risks can be carefully avoided through increasing control; and those risks are always about the protection of good, ideal individuals through the management of those populations which are deemed abnormal. This concept of risk itself does all the work—with statistics an’ everythin’!—of legitimising the deeming of certain populations to be risky.

It’s not surprising, then, that it is only in relation to certain populations that the continual gesturing towards harm that takes place under neoliberalism actually works as a corrective to the liberal requirement that someone suffer before the State will intervene. Correctiveschmorrective, in other words, I guess.

Apologies for a not very interesting post – just squooshing some thoughts together…

So it’s been a while since I’ve been back here to update you all on where things are at, and now here I am on the third day of my new postdoc, feeling guilty for letting you all be misled for all this time! I’m actually not in Austria. Around August or September last year, I applied for a postdoc in a Psychology department (I know, whut?) at a university in the Netherlands. After a far swifter process than I’ve encountered with any other postdoctoral position, I was offered a two year position, with a teensy bit of teaching, to work on the therapeutic forgetting project.

So here I am, having uprooted myself from the easy spaces of Sydney and, more lately, Canberra, and transplanted myself into a small Dutch town with an abundance of bikes and (comparatively) cold weather. I have a new house, with stairs so steep they barely deserve the name, and French doors which at the moment are mostly used for watching something fall from the sky while I try to decide if it’s snow or sleet or hail or rain. I have an office, which is ridiculously exciting for me, who didn’t even have a dedicated university computer during my PhD.  I have some new colleagues who, even if they think I’m a trifle odd for having the diverse interests I do, have been remarkably, and unusually, welcoming. We had a dinner in my honour. Everyone has lunch together each day. It’s collegiality gone wild! 😉

But I’m also hovering at the beginning of a new project, with all the future-taming that seems to entail (I love the way that futures hover, unmanageably big, beautiful and slightly out of reach, like a kite, but inevitably there’s the process of trying to catch at it, to tug down a string to let it become at least mildly real). Of course there’s the reading (I’m trying to work out whether my new colleagues will hold it against me if I do what I always did in my PhD years, which is go to a cafe and read for hours, instead of sitting in my office in front of a computer), and there’s the thinking about a new set of papers, but it always feels like there’s something more I should be doing to prepare myself for, y’know, actually doing it. This could be a delaying tactic (which has worked sadly too well for the book-of-the-thesis, which I’m still trying to grapple with, getting sadder as I go) or it could be the perfectly reasonable marinating stage. We’ll see.

So far, I’ve been copying files to my office computer, printing out things and signing myself into Dutch bureaucracy. I have printed out CFPs and stuck them on the wall, applied for the Feminist Theory Workshop at Duke (now that I have an institution to cover some of the funding, everything feels a lot more within reach, not to mention certain geographical proximities which seem to hold such promise just now) and I pulled out a notebook and pen to do my usual beginning-thing of handwriting a plan with numbers and cross-outs and lines that lead to ‘minor’ thoughts that scrawl into importance as they head for the margin. And then I thought of my fallow-lying blog, and thought I’d share some of this process with you…

So, would you like to see what I promised I’d try and do? This is an excerpt from the ‘Letter of Motivation’ (I’d never written one before and really had no idea what I was doing!) that I sent to my new colleagues…

My project is entitled ‘Therapeutic Forgetting: Happiness, Suffering and the Politics of Medical Innovation.’ It seeks to provide a critical engagement with the developing pharmaceutical practice of ‘memory dampening’, particularly the potentials of the betablocker propranolol. I will explore the issue of therapeutic forgetting in ways that intervene in or critique ‘common sense’ or dominant understandings of it, specifically by considering the often-neglected intersections between embodied subjectivity, memory, suffering and happiness. Using the methodological tools of feminist theories of the body, queer theory, critical race and whiteness studies, critical disability studies, phenomenology, bioethics and poststructuralism (which one can see at work in my doctoral thesis, attached), I will offer a postconventional analysis of the ethical and political issues around therapeutic forgetting, as well as consider the way that propranolol is likely to affect individual subjects, given contemporary structures of subjectivity and embodiment. I propose to analyse the following key issues:

  • the role of memory in the construction of the contemporary embodied subject, and the subject’s vulnerabilities to suffering;
  • the contemporary imagining of medical innovation in relation to the happiness/suffering distinction, and conceptions of ‘enhancement’;
  • the issue of how propranolol is both differentiated from and related to other ‘treatments’ for trauma, in terms of both the lived experience of them, and their ethical, social and legal significance;
  • the way that ‘memory dampening’ interacts with contemporary forms of subjectivity—such as the lived experience of a mind/body or brain/body split—and current constructions of suffering, for example as damaging, as enabling, or as useless;
  • the effect of ‘memory dampening’ on contemporary conceptions of ethics, politics and justice, given their reliance on the liberal humanist understanding of the subject, of trauma, and of memory.

Also, just as an aside, I’m thinking about using that paper (the one in the post below) as a way of kick-starting my thinking about this. And I think I want to spend a bit more time considering the likely military use of propranolol, and the way that it exacerbates the question of whose trauma can be forgotten, and for whom…

Oh, and I’ve been using the word ‘trauma’ because it’s used a lot in the stuff on propranolol, but I’m not sure I really want to go there. Does anyone have any thoughts about the use of the T word? It feels awfully freighted with the weight of the psy sciences, with that whole PTSD thing (which is a troubling enough ‘disorder’ in itself), and with the attempt, then, to make-expert the knowledge of suffering, to swipe it out of the everyday land of suffering and into, well, a whole grid of intelligibility more invested in knowing than in, well, ethics. Sorry, my psy-invested kids, is that mean??

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]…

To suggest that suffering-or, rather, the desire to avoid it-lies at the heart of contemporary Western conceptions of politics, sociality and subjectivity may at first seem extreme or excessive. Yet political positions are frequently parsed in terms of their potential to reduce suffering, and when racism, sexism, homophobia or other kinds of minority exclusions and exploitations are marked as problematic, this is often articulated through reference to the suffering caused. Indeed, when those envisioning the modern democratic state turned to tales of origins, the state garnered its virtue, its raison d’etre, its superiority, from its capacity to shift lives from being ‘nasty, brutish and short’ (Hobbes 1998, 84). In this imagining, the natural state, against which the body politic defends those within it, is one of suffering.

The centrality of suffering to the conception of the state, albeit as disavowed, is not restricted to the past. If liberalism enshrined respect for the individual, transgression against him-and it was, all of Mill’s protestations to the contrary notwithstanding, a him (Mill 2006)-was conceived as suffering’s less subjective face, harm. The issue of harm has been carefully laid out-somewhat problematically, as theorists such as Wendy Brown have suggested (Brown 1995), for those “most vulnerable”-in and through the development of detailed systems of law and legislation designed to adjudicate and prevent harm. Indeed, central to the recurrent and politically powerful idea of a “failed state” is that state’s inability to “protect” its people from the allegedly natural state of suffering and chaos (according to this image, the two inevitably wedded), imagined as always pawing predatorily at the state’s borders.

This imagining of the body politic is not restricted specifically to politics. Rather, the liberal humanist vision of the strong but inevitably endangered state, standing against the chaos and suffering of nature, inflects the entirety of contemporary life. It shapes sociality and subjectivity, and the key institutions of economics, law and medicine. The subject is constructed as thoroughly, radically individual, arising out of some naturally occurring essence. This subject, as liberalism so often reminds us, is naturally free and sovereign, and this freedom and sovereignty ought to be given expansive range, and indeed sustained as far as is possible, limited only by the state’s prohibitions of transgression upon- the causing of harm to-another. It is this that is construed as an echo of the predatory nature against which the state is pitted. The subject may extend this sphere of freedom and protection to all his property. Property, here, marks all objects the subject possesses, and as such, Cartesian dualism, with its insistence on the status of the body as an object, raises its head. According to this logic, the sensible, passionate body is untrustworthy, bearing the traces of nature’s chaos within it, and must be divided off from the perfectly civilised, perfectly rational mind which is thus the site of freedom. The body becomes the mind’s ownmost property, according to Locke, inalienable but nonetheless fundamentally separate from who and what the subject really and essentially is-free (Locke 2003, 111).

The second element shaped by this liberal humanist conception of the body politic is sociality. Proper modes of sociality, as Hobbes reminds us, are those which strengthen the body politic-the covenants which bind the Leviathan into the image of man (Hobbes 1998, 19). These covenants, of course, must be democratic-they presume an equality between all members of a social world on the basis of an essential humanity. As Moira Gatens so incisively notes, however, this “humanity” upon which equality is premised is made in the image of the body politic itself, such that full membership of the body politic requires the subject’s body to be constructed in its image: as white, male, able-bodied, heterosexual body (Gatens Chapter 2, 1995). Contract is understood as free and unduressed on the presumption of this equality, and as such, this essentially civilising mode of being social requires two equal but fundamentally radically distinct parties exchanging property of equivalent value. This neat and contained image of economy as the core structure of social and political life, married with the hallowed image of the individual and the body politic as made in his image, informs and provides the strength of the liberal state’s battle against suffering.

Yet suffering does occur. The central and extraordinarily legitimised position of medicine, medical science and medical technology in contemporary culture constitutes the means by which the state may be understood as innocent of the suffering that occurs within its borders, without conceding failure: it allows medicine to position it as a natural wrong. Medicine, if all the stories told of it are true, seeks to relieve suffering. As we shall see in the first chapter, however, medical discourse configures this suffering as simply and utterly the product of the body-or more precisely, of a pathology within the body: the body’s order gone wrong. Thus the body-always treated as fundamentally separate from the subject who inhabits it, an individual also taken to be radically distinct from the setting within which he, or she, perhaps, is situated-is, according to medicine, the true site of suffering. The body politic remains, then, never responsible for this individualised suffering. Relief of suffering, according to this model of medicine, entails the ‘return’ of the body to equality with others-it must be modified to be made normal. The model of the body remains singular-the male, white, able-bodied image through which the state itself is structured-and normalcy, then, remains deeply specific.

Feminist theorists have long challenged the centrality of liberal humanist ideals to contemporary life. Contemporary feminist theorists of the body have focussed upon corporeal difference as a key provocation, and the grounds for troubling the apparently totalising tendencies of liberal humanism as they play through ideas of subjectivity, sociality, politics and ethics. This focus on embodiment has enabled the cross-pollination of this branch of feminist thought with other forms of theory: with critical race studies, critical whiteness studies, critical disability theory, queer theory and many others.
Situated in the context of such challenges to liberal humanist thought and politics, then, this thesis takes corporeal difference, and particularly the often normalising modification of the body as a technique for relieving suffering, as its central concern. Deliberately spanning an enormous variety of modificatory technologies, namely human growth hormone use, limb-lengthening surgery, cosmetic surgery, intersex “corrective” surgery, self-demand amputation and Modern Primitivism, and contrasting these with other bodily alterations constructed as neutral, I seek to demonstrate that the the increase in modifying bodies-with all the ambiguity that phrase evokes-(in)forms the ethical, political, social and economic domains of contemporary life. Suffering and the normalcy which is always thought to be its cure, I will argue, ought not to be presumed to be simply the uprising of the state of nature into our civilised, liberal and humanist world. Instead, I will demonstrate that suffering is precisely a product of it, a central element in the maintenance of the norm (and thus the body politic itself) and of the forms of embodiment, subjectivity, valuation, tolerance and sociality, that subtend and support it.

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, I turn to Merleau-Ponty’s work, 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 by 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 that 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. The embodied subject thereby produced 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 bodily being (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 is challenged (a point that will be raised again in more detail in Chapter Five).

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 in the ‘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 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-recognised-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 corporeality 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 demonstrates that there is a tacit level of being-in-the-world, at which, I argue, 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. Fundamentally, the other’s gift troubles the sedimentation through which the subject is embodied and this is, in fact, the response to the other qua other rather that an intentional (agentic) act. This allows us to see that it is the irresponsibility of dominant modes of comportment which bring about the suffering supposedly ‘cured’ by the modification of ‘wrong’ bodies. 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. The ethics of a particular change lies not, as has been supposed by various ethical frameworks, in either its adherence to naturalness (and the concurrent distrust of change), or in its challenge to naturalness (and the concurrent distrust of the already-existing). Rather, the ethics of a particular bodily transformation (and this includes non-deliberate changes) lies in its responsiveness to the other. Further, the ethical, responsible style of being-in-the-world with others 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 as the dominant mode of embodiment.

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