“ I am my body, my body is what I am, and it is through my body that I understand the world . . .
... how we live and experience our bodies, especially through perception, emotion, language, movement, in space, time, and sexuality.”
In our normal healthy everyday lives we tend to take our bodies and our health for granted. We do not think of them in dualistic terms. We feel and are embodied.
skin as cover
Skin is a human tapestry that embodies our sense of self, containing our kaleidoscopic imagery of our sense of self from the first embodied connections with the world. It maps not only the self, but our contact with others, and carries these memories in the way skin remembers those important attachments to significant others.
• The concept of time can be broken down into clock time, historical time, biographical time, perceived time, and the rhythm of our lives— that is, our internal clocks.
• Inhealth,spaceisnotbounded;onecanmove in and through space with relative ease.
• In illness, space can seem bounded and constrained.
Morality enters into body and health through the degree of control that one has over the body.
In health, persons do what they want with their bodies, though sometimes their activities border on body abuse.
Moral issues, such as the right to die and transplantation, are viewed from a distance, pertinent to others but not to oneself.
In illness, control over one’s body is often delegated to health professionals.
It is the aesthetics of performance or appearance that are marred by body imperfections and disabilities, bringing unwanted attention and calling for a reimaging of self
In health, persons know their body and trust the information it provides them through the senses. In turn, the self uses that information to care for and protect the body.
In illness, senses are sometimes blocked or distorted, so that any information received might be difficult to understand and interpret.
In chronic illness, technology takes on another dimension. It becomes an extension of the self, something one’s very life might depend on.
Technology refers to medications as well as to life support systems.
• After childhoodd,healthy persons are able to care for their own bodies. They are able to engage in a division of labour reflecting the roles they chose to enact. Severely debilitating illness can change all of that.
construct a perception of regaining health
• Learning to trust the body again after an acute episode of illness is important for reconstructing a healthy identity.
common illness experiences or themes
Illness as biographical disruption (Bury 1984)
Bury analysed three aspects of what Giddens (1979) had
called a ‘critical situation’
Bury highlights the complex and multi-faceted ways in which the experience of chronic illness can lead to a fundamental rethinking of a person’s biography and self-concept.
Chronic illness conceptualised as a disruptive event. Pain, suffering and death, which is normally seen at a distance, the plight of others, comes to shatter their hopes and plans
• An undesired differentness
Fear of being
discredited since headaches seen as normal ailment
How do they represent it to family, work colleagues to reduce the possibility of this
Illness & stigma
– Social fears about death
– Fear of contagion
– Abhorrence - disfigurement, pain, weakness, pallor,
loss of hair
Can lead to:
– Social isolation
– Loss of self-confidence
– Changed self-image
– Lack of trust
Stigma and shame . . . borne not just by the patient
Shame was central to interpreting the meaning both of Parkinson’s disease, as patients tended to withdraw from the ‘public domain’
Loss of Self
• Kleinman (1982:162) equates embarrassment to the shame of being different in some way, of feeling ‘ugly, marked, or not normal’.
• People may feel embarrassed. These feelings hamper them from disclosing feelings of a more personal nature.
• People tend to hide their altered bodies with clothing in an attempt to cover their differences from others.
feeling frighten and vulnerable
Fear of illness
– Pain, disability, loss of control – Social relationships
Fear of death
– Practical consciousness undermined – Existential insecurity
– Family concerns
Fear of dying
Fear of loss
social and personal