Experiencing Illness

Experiencing Illness (Its Uncanny Liminality)

            Perhaps the most pressing impingement on the will to life as lived is the experience of illness. Health, as Hans-Georg Gadamer aptly put it, is an enigma. We are unsure of exactly what it is without due recourse to understanding its absence. As if it were a singularly focused sense of the social, wherein we only feel the weight of society as a set of rubrics, roles and rules when we resist its presence or openly rebel against it, similarly, illness speaks to us in irruptive tones, interrupting the generally unthought experience of health. Illness, no matter how slight, is always something of a shock. ‘I felt fine, just a moment ago’, we might tell ourselves. ‘What could possibly have gone wrong in that time?’ of course, we are told that many illnesses have incubation periods, genetic markers might manifest themselves over a brief and sudden period, or injury might have resulted from being at the wrong place at the wrong time, or through a freak accident, or yet a calculated risk gone awry. Our health, the most precious thing we can be said to ‘possess’ – the love of another is a gift and not a possession, for instance – is, in one sense, constantly at risk of being lost.

            And it is not that illness is ever-present for most of us. If so, we would have no true experience of what it means to be healthy at all. Sickness and health would be subjectively interchangeable. No, it is rather the sometimes-stark contrast between them that allows us the perspective to compare and contrast such seemingly opposing states. Illness confronts us in the manner of all things irruptive. The visionary was confronted by his vision, the saint by her mission, the pilgrim by the end-times, and the artist by their muse. In all such cases, there is a ‘reality to the unseen’, which William James specifically states is a hallmark of religious experience, also irruptive when radically present, though much less so when presented through institutional lenses. This generally invisible yet real plenum, the space from which uncanny things emanate is by its character unidirectional. We, for instance, at least in our mortal and fragile form, cannot transgress its boundaries, oblique and occluded as they are when made contiguous with the everyday world. To do so would be risking all, as if we had deliberately made ourselves sick, or if we had attempted suicide.

            The irreal sphere speaks to us, but it hears us not. We too might close our ears to its glossolalia, turn our eyes from its hieroglyphics. But what we cannot do is control it from without. This at least, from the tradition that claims such a realm even exists at all. It is medicine that makes the first attempt to open up the irreal in the name of rationality and through the use of empiricising methods. The mystery of ill-health itself was to be solved, even if specific conditions remained unresolved. What medicine does is to reframe illness as a departure from a set of experienced conditions that betray their ‘normal’ state through their functional status. That the doctor often begins his hermeneutic by asking ‘How do you feel? Where is the pain? What kind of pain is it? How strong?’ and so on, betrays both its kindred nature with the investigation of any mystery, including the criminal type at perhaps one end of the spectrum – after all, the criminal role is merely a socially defined career that itself is ‘ill’ and Abnormative – and cosmology at the other; what is the nature of the universe, how did it come to be? The diagnostic criteria are themselves arranged on a spectrum of their own, gradually departing from the cut and dried as we experience the shift from physical ailments to those deemed ‘mental’. If we can say that the mechanics of proprioceptive function seem to take on their own uncanny presence – functioning in health ‘normally’ and yet also somehow miraculously – they thus exude a certain tacit charisma, as if they are the resonance of Being in creation. On the other hand, mental illness is both the truer mystery due to its ability to fraudulently present itself as if it were a kind of charismatic presence, but also and at once due to the fact that while charm can be faked, as anyone who has been on a first date can attest, authentic charisma cannot. The emotionally compromised can maintain their charm, at least for certain hours of the day, but physical illness is simply, and at best, unpleasant.

            For modern physical medicine, the discursive dues have been paid. Even if the root cause remains unknown, this idiopathy is never an epistemological problem. One always can identify the effects and perhaps also treat them. ‘Managing one’s illness’, from addiction to diabetes to pancreatic breakdown and a host of others, has become a commonplace phrase in daily life. It may be diet, it may be drugs, exercise or even meditation, but such management clearly takes the place of any outright cure. It is of interest, from the perspective of witnessing the shift from illness being sourced wholly within the irreal no matter its material effects to it being itself fully material and empirical, that illness management can claim to have the only remaining pedigree that harks back to traditional diagnostics. That is, the shaman, in countering the sorcerer, tells the victim that she must ‘live with the curse’ as there is no cure for it. But there are countermeasures, which must taken even daily, that ameliorate the curse’s effects or indeed force it into dormancy, as if in remission. For in traditional cosmology, there is no such thing as an accident; nothing occurs by chance alone.

            Nothing truly is altered by the upshifting of both magic and sorcery – the one patrolling the sunny side of the existential street, the other skulking along the shady side – into the sole purview of a god. If such a deity is given to evaluation, it issues forth its own curses and blessings, and only time will tell which is which in the end. The sourcing of the irruptive in the irreal, giving it is uncanny force and perhaps also a kind of soteriological suasion, is unchanged. It is only with the advent of medicine that illness is both brought down to earth but at once denuded of its earthy roots. Even so, such knowledge is clearly also a work in progress; everything about the subjective volatility of mental illness underscores the incomplete character of medical discourse. More than this, its own history, especially that of psychopathology itself, lends credence to the belief that applied science may have its limitations, if not in principle its limits, when confronted with a state which rests part of its status in premodern metaphysics. Like ultimate questions which only religion presumes to answer – indeed, it must do so if it is to be worth our consideration at all – mental illness proffers to the doctor a kind of abject faith, if only in itself.

            Though the medical specialist is also human and thus also can suffer ill-health, medical discourse is an objectivating space deliberately set over against the irreal, just as is modern evolutionary cosmology a bastion against creation ex nihilo. Not that the discourses of anti-transcendental metaphysics can answer to ultimate cosmogonical questions. In this, the absence of understanding precisely what health is, in its essence, is made choate only by being able to tell what it is not. Sanity thus is best framed as a practiced knowing of social customs and the presentation of self in daily living-on. Any other definition risks sliding sideways from this normative practice and becomes immediately subjective or, at the very least, introduces a ‘subjectionable’ element by having to undertake the interrogative journey of ascertaining how the patient ‘feels’ about her emotions and thoughts. The person who suffers from illness of any kind is subjected to it simply by retaining their status as a subject. I feel my illness in a manner no one else can, and so it goes for everyone else. Even the dislocation between pain receptors and pain processors in the brain is not enough to resolve this subjection of the subject to illness. Yes, some persons appear more ‘stoic’ than others, another factor amongst a myriad that the doctor must try to take into account. Some patients ‘present’ well, other badly. Some presentations little resemble clinical data, while in other cases, the data speak to relatively good health though the patient still feels badly. In a word, illness is the most salient way by which we identify health.

            One early deontological departure from the traditional sensibility that illness and therefore also mortality are functions of either evil acts or primeval fates comes to us from the Greek physician Alkmaion, who stated that humans are in fact mortal because ‘they have not learned to connect the beginning and the end’ in the way that the rest of nature has been evolved to do. I am not a perennial being, and even though my being is completed in mine ownmost death, this completion differs utterly from that which is completed by beginning once again, over and over. Insofar as the experience of illness is like a rehearsal for dying, its theatrical power emanating from a representation of both the uncanny and the charismatic in the guise of a journey from the healthy place of magic to the unhealthy space of sorcery, it alerts us to the fragility of our shared human lot. But illness is no mere metaphor, a point to which Sontag as emphatically has alerted us. However irreal it may feel, its reality rests in the material change in function and variance that often can even be measured, sometimes indirectly but always with a sense that illness’ sources, however obscure some of them may yet be to medicine, cannot be taken literally as either curse or cure.

            Thus, the experience of illness is as much something that distracts us from pursuing the most objective course while at once offering a very personal glimpse into the very ontology of health, its history and its discursive career. For mental illness, this glance may become a manner of life, though never a way of living. For in being forced into the darker reaches of mortal being, we should not think to rest there let alone remain. Illness is the lesser sibling of anxiety, which rests within us as part of our Dasein. Even so, illness as experienced allows us to more gently understand that dying has its own ethic, and that the disconnect between our origins and our ends is not so fatal to absolve us of willing a return to an enigmatic health. Only through accomplishing this return do we then also glimpse the wider miracle of nature’s self-connected being, that which our consciousness cannot so far grasp in any other manner.

            G. V. Loewen is the author of 56 books in ethics, education, health, social theory and aesthetics, as well as fiction. He was professor of the interdisciplinary human sciences for over two decades.

Sentiment and Sentimentality

Sentiment and Sentimentality

            If we want to abandon our daydreams, we must look at the other thing these ornaments are hiding and put ourselves in a state of methodical doubt in regard to them. (Merleau-Ponty, 1955:225, italics the text’s).

            The third of William James’ legendary set of Gifford Lectures is entitled ‘The Reality of the Unseen’. In it, he reminds us that reality is matched in human consciousness by ‘unreality’, or at the very least, a set of realities is balanced by a similar set of unrealities. Such a term, ‘unreal’, during the fin de siécle period meant less the uncanny or surreal and more simply the sense that it lacked agreement and rationality. The first due to its generally unobservable character, the second due to its resistance to being subject to reason. Yet James did not find the idea of unreality to be in itself unreasonable or even unempirical. Regions of the brain, separated only by ‘the filmiest of screens’, were either occlusive in their contiguities or were yet unexplored in their potential. Mapping the brain, as Broca had accomplished in James’ own time, was not the same thing as understanding exactly how these different regions managed their internal affairs. Consciousness itself was thus constructed by apparatuses and architectures unseen yet real.

            The reaction to Enlightenment transparency, the ideas of the individual, of free will, of sovereignty of thought, and their belated early Victorian offspring, progress, democracy, positivism, feminism, shared one powerful leitmotif. Evolution moved through unseen means. Phenotypes could be observed – even in our own time, when the genome is itself observable, the dynamic between genes and environment as well as mutation, genetic drift and so on, are not to be directly ‘seen’ – as the outcomes of a process the reality of which eluded Darwin though not, of course, Mendel. Consciousness, now radically remade as a ‘social product’ in Marx and Engels 1846 work – not published until 1932, mind you – also contained, or was yet contained by, an unseen reality. When Janet first proposed the idea of the unconscious he did so quite unconsciously, if you will, with none of the glaring threat and radically primordial overtones of Freud’s later reworking. Perhaps it is better to describe Janet’s efforts as ‘unself-conscious’, given the latter’s deeply self-reflective and philosophical construct. For our present purposes, however, we want to merely note that whether it is evolution, consciousness, empiricity as phenomenologically inclined, or structuralism in linguistics and later the social sciences, it is the ‘reality of the unseen’ that dominates post-enlightenment discourses.

            Now is this the same unseen as James had in mind? Not at all, or at least, not entirely. If the Enlightenment, in its brash rationalism and its common-sense empiricism, had made the old idea of unreality flee into the cultic or rustic mindsets alone, it ran the tables for only a scant three generations before it itself began to be displaced. Like any revolution, the old regime – in this case, of thought in general and not specifically politics, though these seismic shifts are related – while defeated and in flight, doubles back upon the victors. It does so not by a pure counteroffensive, but by altering its self-conception. The old must displace itself from its own customary sentiments in order to reappear, through the back door, as it were, in a new set of guises but with the same basic principle in hand. What the unseen was to the religious worldview, James’ ultimate topic, became the unseen within that scientific. Science, that paragon of Enlightenment practice, its ‘application’ of both reason and observation as redefined and reminted by the eighteenth century becomes, by the end of the nineteenth, a fertile field of occlusive discourses. From organismic evolution to psychology to phenomenology to structuralism, the conception of the unseen, of ‘unreality’, ensconces itself perhaps even more deeply than it had ever found itself to be in religion alone. For after all,  however mysterious was the invisible hand of the divine, all would ultimately be revealed to human consciousness. There would be, in truth, no truth untold.

            Can one say the same for the unseen that animates many of our most profound conceptions of modernity? Certainly, the race has been on, following the second world war, to both provide a ‘grand unified theory’ in cosmology but also a unity of scientific understanding – sometimes referred to as ‘levels theory’ – regarding all human and non-human existence. Pike’s 1957 opus attests to the reach of such a sentiment; that science can only overtake its predecessors by explaining as much as did these older forms of thought. In a word, science must both become the new religion and the end of religion. And it would do so by finally uncovering the conception of the unseen within its own novel discourses.

            Yet this sentiment is a self-conception. If religion had its primal mover in unreality, its symptom in the uncanny but with the foreknowledge that the hand of God was ultimately a canny one – ‘everything happens for a reason’ becomes the mantra of the believer; the phrase is itself at best trivially true but the acolyte transforms such ‘reason’ into a connected plan – then science has the same in the surreality of cosmological evolution. It is, to our sensibility, just as unbelievable that the entire known universe should be as a point of light, that for eons nothing but cosmic background radiation should exist, that no other explanation need be given for existence entire, as it was to believe that a superior being with unexplained provenience and the more so, origin, should have simply created existence out of inexistence. At some level of reflection one is bound to ask, ‘what’s the difference?’.

            And yet there is a difference, stark, stolid, and still as stunning as it must have been in 1859 or would have been in 1846; and that is, science presents a cosmos that is non-teleological; it has no final purpose. This differs in as radical a manner as possible from the previous metaphysics, wherein a final goal was assumed. And while Hegel attempted to preserve the telos of history, of spirit, in his phenomenology – such a dynamic was also unseen in its primacy, one can note – by the 1840s this had been rejected by the entire swath of younger thinkers, from Mill to Marx to Martineau to Darwin himself. In art, the difference between Beethoven and Wagner might be cast along similar lines, the difference between Goethe and Dickens perhaps as well. But most importantly, it was the concept of evolution – in spite of its own ultimately unexplained origins; what sets the serial universe in motion? – that departed from the sentiment that existence entire should have a purpose beyond itself.

            In this, we are confronted by the whole question of the difference between sentiment and sentimentality. The one is customary, assumed, unseen. It is part of the social stock of knowledge at hand and is a lynchpin of contents for any phenomenology of culture or even of consciousness ‘itself’. But the second is contrived, fashionable, observable and indeed, desires itself to be observed at all times and in all places by as many as possible. Sentimentality is as much a flaneur as is sentiment retiring. The one lives to see and be seen, the other would die before giving up its unseen reality to either science or religion. With the overturning of telos as reason, sentimentality overtakes sentiment as the compelling force animating human consciousness in its self-refracting lens.

            Travelling alongside the conception of nothingness, a concept aberrant like no other to Western consciousness, ‘atelos’ provides a perverse reassurance that our worst selves need not concern themselves with the final ends given impetus by our egregious acts. The world could end, yes, but by our own hand. We own the end, we ourselves are the end entire. Perverse, yes, but such a term hardly begins to describe such a sentimentality as this. While it is mostly the case that mere sentiment cannot provide for either human freedom or authentic being, let alone thought – the ‘sacrifice of the intellect’, another one of James’ famous phrases, is demanded by any set of traditions, customs, doctrines or doxa, not only those religious in character – it is rarely the case that traditions alone provoke the apocalypse. In our fear that revealed religion might self-construct self-destruction for all, believers and non-believers alike, have we not stepped too far away from the equally customary sensibility that a culture must simply be reproduced at all costs? We have, in our Enlightenment liberation, excised divinity and its teleological children from our sentiments only to be faced with a gnawing sense that without ultimate purpose, meaning too disappears.

            Does this then also suggest that meaningfulness is no longer extant at all, or is it only hidden from us, a final effect of the transfigured conception of the unseen in our new reality? Merleau-Ponty asks us to consider this ‘other thing’, this otherness that now can only be other to us by maintaining itself ‘underneath the ornament’ of none other than sentimentality. I want to suggest that meaning does not necessarily have to be hitched up to purpose, and that just because we now live within a non-teleological modernity and live through and by an ateological consciousness, this does not demand either the reality of the unseen or the sacrifice of the intellect. Indeed, reality is all the more meaningful if it has a depth which is at first occluded, and the intellect is all the more real if its meanings emanate from both a fully conscious sensibility and an equally real unconscious sensitivity. If anything, the liberation of human freedom of the will frees up not so much humanity as a whole – perhaps each one of us tends in her own direction on this point; we each of us are thrown upon the pathless landscape of the purposeless truth and this is the meaning of ultimate freedom – but rather the ability for meaning to come to its own fulfillment freed up from final purposes and ends alike.

            G.V. Loewen is the author of over fifty books on ethics, education, social theory, aesthetic and health, and more recently, fiction. He was professor of the interdisciplinary human sciences for over two decades.