Das unheimliche – Towards a phenomenology of illness (original) (raw)
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Illness as unhomelike being-in-the-world: Heidegger and the phenomenology of medicine
Medicine, Health Care and Philosophy
In this paper, an attempt is made to develop an understanding of the essence of illness based on a reading of Martin Heidegger's pivotal work Being and Time. The hypothesis put forward is that a phenomenology of illness can be carried out through highlighting the concept of otherness in relation to meaningfulness. Otherness is to be understood here as a foreignness that permeates the ill life when the lived body takes on alien qualities. A further specification of this kind of otherness can be found with the concept of unhomelike being-in-the-world. Health, in contrast to this frustrating unhomelikeness, is a homelike being-in-the-world in which the lived body in most cases has a transparent quality as the point of access to the world in understanding activities. The paper then proposes that the temporal structure of illness can be conceptualised as an alienation of past and future, whereby one's past and future appear alien, compared with what was the case before the onset of illness. The remainder of the paper follows two paths as regards the temporality of illness. The first path explores the temporality of the body in relation to the temporality of the being-in-the-world of the self. One way of understanding the alienating character of illness is that nature, as the temporality of our bodies, ceases to obey our attempts to make sense of phenomena: the time of the body no longer fits into the time of the self. The second path explored in the paper is that of narrativity. When we make sense of the present, in relation to our future and past, we do so in a special manner, namely, by structuring our experiences in the form of stories. Illness breaks in on us as a rift in these stories, necessitating a retelling of the past and a re-envisioning of the future in an effort to address and change their alienated character. These stories, however , never allow us to leave the silent otherness of our bodies behind. They are stories nurtured by the time of nature at the heart of our existence. It is then claimed that the idea of life's being a story must be understood in a metaphorical sense, and an exploration of how phenome-nology addresses the metaphoric quality of its conceptu-ality is ushered in. It is pointed out that metaphors can be systematically related to each other and that they always have a founding ground in the orientation and basic activities of the lived body. Therefore, if the concepts used in working out a phenomenological theory of health and illness are, to a certain extent, metaphorical, one could, nevertheless, claim that the metaphoric qualities of the phenomenological concepts are primary in referring back to the lived body and the way it inhabits the world.
The body uncanny – Further steps towards a phenomenology of illness
Medicine, Health Care, and Philosophy
This article is an attempt to analyse the experience of embodiment in illness. Drawing upon Heideg-ger's phenomenology and the suggestion that illness can be understood as unhomelike being-in-the-world, I try to show how the way we live our own bodies in illness is experienced precisely as unhomelike. The body is alien, yet, at the same time, myself. It involves biological processes beyond my control, but these processes still belong to me as lived by me. This a priori otherness of the body presents itself in illness in an uncanny and merciless way. The unhomelike breakdown of our everyday being-in-the-world suffered in illness is explored through Heidegger's notion of the world being a " totality of relevance " , a pattern of meaning played out between different " tools ". The lived body is compared to a broken tool that alters and obstructs our way of being " thrown " and " projecting " ourselves in the meaning patterns of the world through feelings, thoughts and actions. The similarities and differences between this unhomelikeness of illness and the specific unhomelikeness of authentic understanding, reached according to Heidegger in existential anxiety, are discussed. In order to illustrate how the lived body can present itself as " broken " and " other " to its owner, and in what way this unhomelike experience calls for help from health-care professionals, I make use of a clinical example of a severe and common disease: stroke.
The Uncanny of the Illness Experience: Can Phenomenology Help?
Psychopathology, 2019
The illness experience encompasses not only several changes in bodily processes but also the very feeling of becoming ill. This seemingly non-scientific aspect of being sick is characterized by forms of uncanny body experiences and an unhomelike being-in-the-world. Both include disconcerting phenomena, feelings of fear, restlessness, and inexplicability. In this paper we discuss some contributions aiming to understand the illness experience, focusing on the concept of the uncanny. This life event brings changes in the familiarity of our world, revelation of what previously was and should have remained hidden, loss of control, and the certainty of mortality. The experience of uncanniness is here conceptualized as a psychopathological phenomenon that should be regarded as a general symptom of diseases and should be identified and approached. We discuss the impact of these considerations on medical practice, focusing on the role of physicians and ultimately on the purpose of medicine.
Illness and two meanings of phenomenology
Journal of Evaluation in Clinical Practice, 2020
Background: When approaching medicine, phenomenology has at least two meanings that need to be distinguished in order to become relevant in its application to medical practice. Up to now, these two meanings have been overlapped by most of the scholarly literature. Therefore, the purpose of the article is to differentiate between them, thus endorsing their potential use in medical practice. Methods: The first meaning was instituted by Edmund Husserl and views phenomenology as transcendental, ie, as a transcendental rigorous science based on the unravelling of transcendental subjectivity/intersubjectivity. The second takes it more as a narrative enterprise, ie, as a description of personal subjective experience, thus seeming closer to other approaches to disease which can be found both in philosophy and other fields. Nevertheless, both provide advantages and disadvantages when it comes to approaching illness. Results: Neither of the two meanings can supersede the other and, consequently, neither of the two analogue forms of phenomenology can impose itself as the phenomenology of medicine. Conclusion: It is important to clarify the consequences of applying each of the two understandings of phenomenology to medicine in the context of its current development. Our present inquiry concerns not merely the disentanglement of the status of what today's scholarly literature calls phenomenology of medicine in relation to meanings of phenomenology, but also the limits of applying phenomenology to the field of medicine.
Fredrik Svenaeus has applied Heidegger’s concept of ‘being-in-the-world’ to health and illness. Health, Svenaeus contends, is a state of ‘homelike being-in-the-world’ characterised by being ‘balanced’ and ‘in-tune’ with the world. Illness, on the other hand, is a state of ‘unhomelike being-in-the-world’ characterised by being ‘off-balance’ and alienated from our own bodies. This paper applies the phenomenological concepts presented by Svenaeus to cases from a study of depression. In doing so, we show that while they can certainly enrich our understanding of depression, they can also reveal a clash between some societal definitions of illness and the individual’s definition. Phenomenological analysis may thus cause us to question what we mean, or think should be meant, by the terms ‘health’ and ‘illness’.
Phenomenology of Illness H.Carel, 2016 Oxford, Oxford University Press xi + 248 pp, $50.00 (hb)
Journal of Applied Philosophy, 2018
Havi Carel's new book is the culmination of over a decade of thinking about illness. Her engagement with the subject is both academic and personal. After being diagnosed with a life-limiting lung disease, Carel published a powerful reflection of her own experiences of illness in Illness: The Cry of the Flesh (Durham: Acumen Publishing, 2008), and has written a number of academic articles developing a phenomenology of illness since. The Phenomenology of Illness contains the best of both these approaches, blending together personal anecdote and rigorous philosophical analysis to deepen our understanding of what it means to be ill. Written for an academic audience, the book has two aims: 'to contribute to the understanding of illness through the use of philosophy, and to demonstrate the importance of illness for philosophy' (p. 2). What motivates a phenomenological approach to illness? Carel offers three rationales: as the study of lived experience, phenomenology is a natural approach to understanding the variety of illness experiences; it provides a non-prescriptive framework free of conceptual restrictions; and it underscores the centrality of the body to understanding human experience (p. 7). The structure of the book can be divided into roughly two sections. The first five chapters develop the general framework for a phenomenology of illness, with the final chapter in this half applying the framework to respiratory illness. The second section of the book explores the relationship between illness and other key philosophical topics, namely, wellbeing, death, and epistemic injustice. Thus, the structure aptly mirrors the two-part aim of her project, leveraging the conceptual tools of phenomenology to examine illness, and conversely, exploring how illness may illuminate traditional debates in philosophy. A brief note: many of our thoughts in this review developed during a term-long seminar on Carel's book. This was attended by philosophers (both analytic and continental), social scientists and clinical practitioners, among others. The value of Carel's project was evident throughout the discussions. The book not only reframed issues traditionally viewed under the scope of Anglo-American philosophy; it also offered a shared language and perspective for engagement between the social sciences, humanities, and the medical sciences. Carel's approach is based on a definition of illness as 'serious, chronic, and lifechanging ill health, as opposed to a cold or a bout of tonsillitis' (p. 2). Illness is something which changes the subject's way of being, in a way that a simple cold does not. Following others, Carel contrasts this with disease, whereby disease is seen as physiological dysfunction. The book makes great use of this distinction and it no doubt
Illness as the saturated phenomenon: the contribution of Jean-Luc Marion
Medicine, Health Care and Philosophy, 2019
During the last few decades, many thinkers have advocated for the importance of the phenomenological approach in developing the understanding of the lived experience of illness. In their attempts, they have referred to ideas found in the history of phenomenology, most notably, in the works of Edmund Husserl, Martin Heidegger, Maurice Merleau-Ponty and Jean-Paul Sartre. The aim of this paper is to sketch out an interpretation of illness based on a yet unexplored conceptual framework of the phenomenology of French thinker Jean-Luc Marion. Focusing on concepts of the saturated phenomenon and flesh, the paper develops an interpretation of illness as the saturated phenomenon, which highlights a variety of dimensions of illness already elaborated within the phenomenology of medicine, such as the affective dimension of illness, the disruptive dimension of illness, the transformed perception of the self in illness, mineness of flesh in illness and the inexpressible and hermeneutical dimension of illness. In addition to that, the paper explores some of the consequences the proposed interpretation of illness offers regarding the nature of illness and health. It is argued that illness in its essence is very similar to the experience of other saturated phenomena, suggesting that the difference between them does not lie within the character of the affective givenness, but rather within the dynamic relationship between the affective givenness and its conceptualization. It is also shown that the experience of health is compatible with the experience of saturation and thus is not limited to the tacit and harmonious background state.
A Defence of the Phenomenological Account of Health and Illness
Journal of Medicine and Philosophy, 2019
A large slice of contemporary phenomenology of medicine has been devoted to developing an account of health and illness that pro- ceeds from the first-person perspective when attempting to under- stand the ill person in contrast and connection to the third-person perspective on his/her diseased body. A proof that this phenom- enological account of health and illness, represented by philo- sophers, such as Drew Leder, Kay Toombs, Havi Carel, Hans-Georg Gadamer, Kevin Aho, and Fredrik Svenaeus, is becoming increas- ingly influential in philosophy of medicine and medical ethics is the criticism of it that has been voiced in some recent studies. In this article, two such critical contributions, proceeding from radic- ally different premises and backgrounds, are discussed: Jonathan Sholl’s naturalistic critique and Talia Welsh’s Nietzschean critique. The aim is to defend the phenomenological account and clear up misunderstandings about what it amounts to and what we should be able to expect from it.
Health and illness as enacted phenomena
Topoi, 2021
In this paper I explore health and illness through the lens of enactivism, which is understood and developed as a bodily-based worldly-engaged phenomenology. Various health theories-biomedical, ability-based, biopsychosocial-are introduced and scrutinized from the point of view of enactivism and phenomenology. Health is ultimately argued to consist in a central world-disclosing aspect of what is called existential feelings, experienced by way of transparency and ease in carrying out important life projects. Health, in such a phenomenologically enacted understanding, is an important and in many cases necessary part of leading a good life. Illness, on the other hand, by such a phenomenological view, consist in finding oneself at mercy of unhomelike existential feelings, such as bodily pains, nausea, extreme unmotivated tiredness, depression, chronic anxiety and delusion, which make it harder and, in some cases, impossible to flourish. In illness suffering the lived body hurts, resists, or, in other ways, alienates the activities of the ill person.