( A book from the home page at: http://www.midrivers.com/~wds)
By:
WADE SIKORSKI, Ph.D.
Box 202
Willard, MT 59354
Copyright 1998, Wade Sikorski
This book may not be reproduced without the express written consent of the author.
Contact wds@midrivers.com for permission.
ACKNOWLEDGMENTS
CONTENTS
CHAPTER 1:
The Politics of the Immune SystemCHAPTER 2:
Dis/ease: The Challenge to EcopolityCHAPTER 3:
PsychoneuroimmunologyCHAPTER 4:
Dis/ease as a Politics of IdentityCHAPTER 5:
Dis/ease as Society and PoliticsCHAPTER 6:
Healing the EarthCHAPTER 7:
Causing Dis/easeCHAPTER 8:
Responsibility for Dis/easeCHAPTER 9:
Healing Dis/easeBack to Home Page
Acknowledgments
Sometimes a few words of encouragement go a long way. Without the encouragement of Jane
Bennett, this project would have never been started, finished, or done as well as it is. She
convinced me I could do it when I didn't feel like it, assured me it was good when I doubted it,
and told me it wasn't good enough when it wasn't. I will always be indebted to her. I am also indebted to Sally Moran, Elias Zungia, and Doren Valentine for proofreading my
manuscript and giving me many helpful suggestions. The staff at the Fallon County Library in
Montana was very helpful when I needed assistance collecting information. My aunt, Kathy
Sikorski, was supportive throughout the whole project. And other people, too many to mention,
provided me with information, read portions of my manuscript, and did other small favors that
helped greatly. I am grateful to the following presses for permission to republish their material: Chapter 7 in this
book is a revised version of an essay I had published earlier in New Political Science, under the
title, "Toleration and Shamanism," number 26 (Fall 1993), pp. 3-20. I used part of a poem from
Gary Snyder's Turtle Island, Copyright 1972 by Gary Snyder, reprinted by permission of New
Directions Publishing. And, by permission of the publisher, I quoted extensively from Dean
Ornish's essay, "Opening Your Heart Anatomically, Emotionally, Spiritually," Noetic Sciences
Review, number 28 (Winter, 1993), pp. 5-9. According to modern medicine, disease is an accident, an effect of bacteria, viruses, toxins,
trauma, and genes. The result of material force meeting material force, it exists independently of
observation, consciousness, or identity. This book argues, in contrast, that "nature," itself, is a
building, a fabrication imposed by modernity on the earth's mystery and that disease can be
meaningful interpreted as an expression of the self's entanglement in systems of power, exclusion,
and hierarchy. Disease is not an objective reality independent of the observer, the rules of
discursive formation, and temporal situation; it is an eruption of truth, a dis/ease with the way the
world is happening. As a result, disease can be healed not just by intervening in the body's
physiology, but also--and perhaps more completely--by healing the world the self is implicated in.
By addressing the needs of a dis/easing identity. Conventional medicine conceals how identity can be dis/easing because it separates the awareness
of nature from nature and analyzes the two separately. However, just as modern physics has
established that the observer cannot be separated from the observed, the new science of
psychoneuroimmunology has established that the mind cannot be separated from the body. Both
mind and body, as we will show throughout this book, interact to provide a dense and complex
situation from which disease emerges. Because of this complexity, disease can never be reduced
to a simple, merely physical, cause. While bacteria, viruses, toxins, trauma, or genes invariably
have something to do with the eruption of disease, they do not, by themselves, ever provide a full
account of it. Instead, disease can be more accurately described as something that emerges from
a complex nexus of embodiment, environment, culture, language, power, and alterity. From an
ecopolitics of situation. This book is divided into two parts. The first part interprets recent discoveries in biology,
immunology, psychoneuroimmunology, and epidemiology. The first couple of chapters interpret
the mindbody at the cellular level, the next chapters proceed to the psychological level, and we
end Part I with a discussion of the health of nations. Throughout this progression from the micro
to the macro levels of analysis, the new science of psychoneuroimmunology, which deals with the
intimate relationship between thoughts and the body's neural and immune biochemistry, provides
an underlying basis for interpreting the eruption of disease. As we shall see, not just the brain but
the immune system and all the rest of the body "thinks," processes the world. Immune cells are
surprisingly sophisticated at sensing the world, interpreting it, and communicating their responses
to the rest of the body. Given the way immune cells function, disease cannot be just an invasion
from the outer world, but an interpretation the body makes of the world. Given this framework,
social and political reality cannot be separated from the body's physiology. Part II deals with the political and philosophical implications of Part I. If psychoneuroimmunology
is right about claiming that mind and body are not two different entities but one, a unified
mindbody, then the study of whatever is dis/easing the self should not be limited to the
psychology of the individual but must be extended to the individual's family, community, and
polity. The images, metaphors, thoughts, and feelings that constitute and enable the immune
system's response to the world are not just personal (or physiological and environmental), but
intersubjective and transpersonal, an effect of language, culture, tradition, and systems of power. Where Part I deals with the new sciences of disease, Part II interprets the ontology of dis/ease.
The eruption of disease, it will argue, is not merely an illness, it says something about the way we
are in the world. If the individual's body is diseased, there is something dis/easing about the world
it is in, and so, the whole world must be called into question, politicized, before the individual can
be healed. Since disease is no longer an accident but a meaningful response to our situation, the
existence of disease means that there perhaps is something dis/easing about the technology we
use, our relation to the earth, the hierarchies we organize ourselves into. If disease is caused by dis/ease, a meaningful response to the world we live in, healing the body
means healing the whole world. Once the conventional scientific interpretation of what causes
disease fails, and we begin to interpret disease as something emerging out of our existential
situation, a lot of very interesting philosophical issues emerge--the responsibility for dis/ease, the
nature of good and evil, and the need to tolerate difference. Modernity has left us with a very impoverished story of what life is. According to it, nature is but
a coherence of forces, sometimes randomly distributed, sometimes systematically organized, but
always without meaning, purpose, or goal. And so, the only meaning our lives can have is the
meaning we impose on the world. However, when we begin thinking of disease as dis/ease, an
ontological eruption that has meaning, we are called to reflect on our lives in a way that has been
impossible for a very long time. While some will no doubt find the interpretation of disease this books offers disturbing, if not
threatening, it nevertheless, I believe, has considerable power to heal the nihilism implicit in our
age. My deepest hope is that this book will become a way for the reader heal the dis/ease of the
modern world.
Introduction
Chapter 1
The Politics of the Immune System
We are walking communities. Ten percent or more of our body weight is bacterial [in its evolutionary origins], and it's just foolish to ignore that.(1)
Lynn Margulis
Territorial democracy will become a late-modern anachronism unless it is compromised and exceeded by a new pluralization of democratic spaces, energies, and allegiances.(2)
William Connolly
According to modernity's rules of discursive formation, political theory should have nothing to do
with the body's immune system. Immunity, health, disease, and healing are topics best left to
medical science. That's the conventional wisdom, the conventional demarcation of intellectual
territory. Nevertheless, as conventional medical science is increasingly discovering, the body's immune
system is intimately related to personal identity, what is self and other--what I call an ecopolitics
of alterity. Caught up in a ecopolitics of identity and difference, the body's immune system does
not end at the skin's boundary, but, by internalizing external demarcations of self and other,
extends beyond it to the culture, land, and ecosystem in which it is situated. The world in which it
happens. Interpreting the world outside itself, the immune system is but an eco/political strategy
for maintaining identity in a world revealed by difference. Seeking to exclude the other, to
identify difference, and to protect the territory of self, the immune system establishes boundaries,
defends them, balances powers, settles disputes, learns tolerance, and retains the past--just as a
political system does. As a site for building and maintaining identity, the body is not just a simple unity, not just a system
of harmonious function, but also a dispersed and decentralized economy of strategies, differences,
and purposes that are, depending on the balance of powers shaping them, sometimes in contest,
sometimes negotiated, and always subject to change. Within its boundaries, and because of its
environmental "foreign relations," it is an ecosystem made up of different roles, niches, and
strategies for survival. Living with each other, the denizens of this ecosystem, without
consciously understanding the intent of the whole, are caught up in dynamic and shifting
interrelationships with each other--their population numbers fluctuate, their niches evolve, and
their survival strategies change. However, while each may have their own purposes and aims, none of these different entities can
pursue their aims without entanglement in the others, without, to some extent, taking up their
cause. Mimicking, duplicating, and repeating the behavior of larger organisms in the ecosystem,
cells in the most remote parts of the body, for example, must learn, either through adaptation or
coevolution, to regulate their behavior--just the right amount of energy use, just the right amount
of mitosis--so as to not disrupt the function of any other part of the body. The body, then, is a
community built by adaptation, coevolution, and interwoven purpose, not of consent or intent,
just as almost every human community in the history of the world has been. In other words, all
the boundaries separating micro and macro, body and soul, cell and organism, individual and
ecosystem, humanity and nature, self and other, and signifier and signified are shifting, contingent,
and unstable. Not fixed or absolute. As the biologist, Lynn Margulis, points out in epigraph above, much of the body--and perhaps, if
we go back far enough in evolutionary time, virtually all of it--is not the body, but something
other, something exterior that has taken up a place in its interior. As a fact of evolutionary
history, the boundaries of our body's identity shift, are frequently transgressed, violated, invaded,
and taken over by an exterior world. Because inside cannot so easily be separated from outside,
the body has a dynamic and shifting foreign policy that is not easily gathered into a single identity.
As Lewis Thomas has written: A good case can be made for our nonexistence as entities. We are not made up, as we had
always supposed, of successively enriched packets of our own parts. We are shared, rented,
occupied.(3) The whole length of our digestive tract, for example, a wide assortment of bacteria, yeast, fungi,
and perhaps a parasite or two, live happily within us, digesting our food, making it possible for us
to absorb it. Without these many "foreigners" within us, we would surely die. They are just the
beginning. Much of what passes as "us" is simply a variety of cells cooperatively going about
their business in these ecopolities we call ourselves, eating, reproducing, surviving. According to Margulis, these organisms within ourselves might even be conscious about what
they are doing.(4) Confounding the differences we use to build our identity, they can, she insists,
create, remember, recall, and use representations of themselves and their environment--to think
and respond to their context. For Margulis, consciousness may not be something limited to
humans, or even highly evolved mammals, like monkeys and dolphins, but is something that we
share in common with the simplest of bacteria. Indeed, the differences between bacterial
consciousness and our own are problematic enough that anyone who would dispute her needs to
identify just what the differences are. Just what is it that makes us different, conscious when
everything else lacks it? Some sort of quantitative threshold, where number somehow connects
together, combines in unity, and becomes singular? Perhaps. Whatever consciousness is, the mammalian brain shows signs of having originally been just a mass
of microbes that somehow started resonating with each other, negotiated their unity, and took up
common cause. The firing of synapses may be nothing more than a contemporary modification of
primordial efforts to swim. Only because these primordial efforts are situated in an evolved
mammalian brain, a community of cells, are "we" able to learn, think, and be aware. If this is so,
our consciousness is a lot more like grass growing together than a tree growing by itself. The
brain is not one entity, but many, a diverse, multiple, nonhierarchical polity. As Deleuze and
Guattari put it: Thought is not arborescent, and the brain is not a rooted or ramified matter. What are wrongly
called "dendrites" do not assure the connection of neurons in a continuous fabric. The
discontinuity between cells, the role of the axons, the functioning of the synapses, the existence
of synaptic micro fissures, the leap each message makes across these fissures, make the brain a
multiplicity immersed in its plane of consistency or neuroglia, a whole uncertain, probabilistic
system ("the uncertain nervous system"). Many people have a tree growing in their heads, but
the brain itself is much more like a grass than a tree.(5) According to Margulis, even "our" lymphocytes, which are cells in our immune system essential
to sorting out identity and difference, evolved independently of our distant relatives. But then,
like any invading antigen, they got into the bodies of our evolutionary predecessors and sort of
took things over, using our bodies as sites to "graze" on invading "antigens." In pursuing their
own autonomous identity, these foreigners evolved to take over our identity, making us into what
we are by attacking anything "they" did not identify as "self." They produced our bodily identity
by insisting on a distinction of otherness beneficial to themselves. Or, better, finding common
cause, we co-evolved together to produce a single identity, a symbiotic relationship. Whatever
the initial contest over identity may have been, the symbiosis became a happy, mutually supported
and integrated one, for the most part. (Unless autoimmune dis/eases like allergies, lupus, and
diabetes strike.) As a result of a common identity forming, the differences between inside and
outside stabilized and took on the appearance of an immutable difference separating self and
other. However, the idea that we, as human agents, have an identity may be an delusion. From the
vantage point of our "foreign" immune system cells, the body may be just a convenient place to
live, since it attracts bacteria, fungi, and viruses--and from time to time cancerous cells--for them
to live on.(6) So, our claim to identity--and to the otherness of "antigens"--may be more a strategic
claim by a successfully colonizing other than in any singular or transcendent truth of our identity.
Maybe "we," as we like to think of ourselves, are just an epiphenomenon, unimportant to the
process that built the body's polity. Maybe our consciousness of ourselves has very little to do
with what we are. Perhaps we should qualify this as an extreme interpretation, one not quite right. But for now, lest
we get lost in issues of consciousness that aren't that relevant here, let's pursue the image of the
body as an ecosystem of many tiny little cellular creatures. These cellular creatures are crawling
around, eating, reproducing, and dying, blissfully unaware that we, the larger ecopolity, even
exist, or matter. Lewis Thomas continues: At the interior of our cells, driving them, providing them the oxidative energy that sends us out
for the improvement of each shining day, are the mitochondria, and in a strict sense they are not
ours. They turn out to be little separate creatures, the colonial posterity of migrant
prokaryocytes, probably primitive bacteria that swam into ancestral precursors of our eukaryotic
cells and stayed there. Ever since, they have maintained themselves and their ways, replicating
in their own fashion, privately, with their own DNA and RNA quite different from ours. They are
as much symbionts as the rhizobial bacteria in the roots of beans. Without them, we would not
move a muscle, drum a finger, think a thought. Mitochondria are stable and responsible lodgers, and I choose to trust them. But what of the
other little animals, similarly established in my cells, sorting and balancing me, clustering
together? My centrioles, basal bodies, and probably a good many other more obscure tiny
beings at work inside my cells, each with its own special genome, are as foreign, and as
essential, as aphids in anthills.(7) As it is within the cell, so is it without, and nowhere is this more evident than the many different
creatures that make up the immune system. The human body's immune system is a wonderfully
vast and complex ecosystem of interacting cells--about 10 12 in number, two orders of magnitude
more cells than the nervous system has.(8) Claiming the body's territory as its own, seeking to keep
its ecopolity separate from the rest of the world, to put a boundary around self and make the
inside a community, the immune system circulates throughout the whole body, keeping watch
over every tissue, organ, and cell. The cells that compose it are developed and maintained by a
variety of different tissues and organs--the thymus, bone marrow, spleen, liver, and lymph nodes.
Many cells of the immune system are spread throughout the blood and lymph circulatory systems,
where they are poised to enter all of the body's fluids and spaces. Within the immune system there are two major branches of little organisms. The first are the
T-cells, which come to maturity in the thymus (so the "T"), and includes a variety of cells
described as helpers, suppressors, killers, and so on. The other group of little organisms is the
B-cells, which originate in bone marrow (so the "B"), and are responsible for a vast array of
antibodies, the chemicals that in one way or another destroy things identified as foreign, not self.
Together, T and B-cells have ways of recognizing, interpreting, and differentiating any molecular
structure that can ever exist. The thymus gland has been described as the soul of the immune system.(9) The thymus sits right on
top of the heart, where it can easily interact with the circulatory system. Using a variety of
hormones, the thymus attracts pluripotential cells from the liver, otherwise called "stem" cells.
These cells are undeveloped, undifferentiated, neophyte cells. They go to the bone marrow,
where they develop some more, then they move on to the thymus. Once inside the thymus, their
capability for being a T-cell is activated through an endlessly complex variety of hormonal
messages. The hormones enter the neophyte T-cell and interact with certain genetic programs in
the nucleus, bringing out certain characteristics, suppressing others. The process is long and
dangerous for the maturing T-cells--95% of them will die.(10) The first lesson these budding T-cells learn, the one essential to policing the ecopolity, is how to
read self. Each cell in our body has a unique protein signature that it displays on its outer
membrane, a sign that very specifically differentiates it from the outer world, telling the rest of the
body that it belongs to it, that it is self. Not only does each cell in the body have this universally
available mark of identity, but some T-cells can also recognize the unique signs of a cell being a
heart cell, a brain cell, a stomach cell and so on. T-cells develop complementary protein
structures on the surface of their cells, mirroring the body's various signatures of self. When they
bump into, or, as some immunologists describe it, "kiss" another cell that belongs in the body, the
structures fit together, interlock, and the T-cells recognize "self." This recognition is essential for
maintaining harmony within the body; otherwise the T-cell might start activating the body's
immune response inappropriately, and the body's ecopolity would erupt in civil disorder. The body puts a considerable investment in T-cells--information, energy, and development--and
so, unlike many other cells in the body that will live only weeks or months, T-cells will live much
longer, often more than 60 years. This is necessary because the body's identity is at stake. To
maintain its continuity, it needs a memory to police it, to remember what it was, what it is, so that
it can keep it the same. Keep the community a community. While it is inside the thymus, learning to recognize self, the T-cell is also taught to recognize one
antigen, one thing that is not self. The variety of antigens that the immune system can recognize
numbers in the millions, every molecular structure in the world. Every virus and germ, every kind
pollen, every inorganic and organic chemical that has ever existed on earth. Even, some say, the
life forms that may exist on Mars. Everything. Apparently, through some sort of internal
generator of diversity that spews out every sort of possibility, the immune system builds molecular
structures to mirror everything that exists. Because of this internal generator of diversity, everything can be recognized as other to the body,
including every part of the self, ironically enough. Along with T-cells taught to recognize the
AIDS virus, the Polio virus, and streptococcal bacteria, the immune system includes T-cells that
will recognize every kind of tissue or cell in the body--heart, kidneys, muscle, bone, and so on--as
other. A T-cell that identifies these tissues and organs as antigens, as something not self, has the
same urge to attack them as other T-cells programmed to recognize diseasing agents, like
measles. Because the immune system can read every part of the body as something that is not
self, the body is susceptible to a variety of what are called autoimmune diseases, things like
rheumatoid arthritis, pernicious anemia, diabetes, thyroid disease, and so on. These are diseases
where the immune system, lost in dis/ease, misreading its identity, starts attacking self. The reason everyone's body is not tearing itself apart, dissolving its boundaries, and losing its
difference with the world, is because these readings of the self as other are selectively repressed.
That is how the body's ecopolity is maintained--a selective reading of the otherness of self. The
T-cells that would like to, say, attack the bone joint, causing inflammation and arthritis, are
actively "told" not to by other, more politically correct, T-cells that can impose their reading of
these tissues and organs as self over the other T-cells readings of them as antigens. In spite of all
these autoreactive, identity destroying T-cells circulating in the body, the body is only
occasionally afflicted with autoimmune diseases. This is because there is a sharp division of labor
among T-cells. Diversity is necessary to stabilize the whole ecology of the immune system. (The proteins on their
surface identify what kind of cell the T-cell is, which the numbers one through eleven
designate--thus names like T-4 or T-8.) If one kind of cell is deranged or destabilized, other cells
can, at least partially, compensate. If control over the immune system is decentralized, dispersed,
and duplicated, then, with each control system limiting the others, it is less likely that any single
antigen can disrupt the body's identity. Each different kind of cell, by being different, having
varying functions, and limited purposes, stabilizes and balances the whole network.(11) Though
immune functioning can be said to be controlled, the specific sites of control are widely dispersed
and duplicated, spread over an integrated network. According to Niels Jerne, a Nobel Prize winning immunologist, the immune system is
self-maintaining, capable of regulating itself using only itself.(12) Jerne calls this the network
theory. According to Jerne's network theory, the immune system is not a hierarchy of control or a
constant and consistently identifiable entity, but rather a rapidly shifting strategic deployment,
governed by a self-limiting grammar of identity. Within this system, even the very genetics of the
cells, with their high rates of mutation, gene splicings, and rearrangings, are being shaped by the
network to form surface receptors and antibodies made necessary by the network's own strategic
deployments. In the same way that language gives meaning to different words by means of their
grammatical context, the network, as a whole, rules the immune response, not isolated genes of
individual cells. Jerne writes: Looking at languages, we find that all of them make do with a vocabulary of roughly a hundred
thousand words, or less. These vocabulary sizes are a hundred times smaller than the estimates
of the size of the antibody repertoire available to our immune system. But if we consider that the
variable region that characterizes an antibody molecule is made up of two polypeptides, each
about 100 amino acid residues long, and that its three-dimensional structure displays a set of
several combining sites, we may find a more reasonable analogy between language and the
immune system by regarding the variable region of a given antibody molecule not as a word but
as a sentence or a phrase. The immense repertoire of the immune system then becomes a
vocabulary comprised not of words but of sentences that is capable of responding to any
sentence expressed by the multitude of antigens that the immune system may encounter.(13) According to Jerne, this network language has rules, and according to them, every antibody the
body clones acts to limit itself. Or, to say it another way, every antibody is also its own antigen,
each self its other. Seeking to exclude otherness, the antigen it is made to identify, every
antibody can identify itself as other and can limit its own reproduction. . . . (I)n its dynamic state, our immune system is mainly self-centered, generating anti-idiotypic
antibodies to its own antibodies, which constitute the overwhelming majority of antigens present
in the body. The system somehow maintains a precarious equilibrium with the other normal
self-constituents of our body, while reacting vigorously to invasions into our body of foreign
particles, proteins, viruses, or bacteria, which incidentally disturb the dynamic harmony of the
system.(14) Dwyer likens this process to throwing a stone in a pond of water: Shock waves race to shore,
then rebound off it, racing back to where the stone was thrown in, though weaker, but still
interfering with--and canceling out--the primary waves.(15) Every antigen dropped in the body
does the same thing, provoking a dramatic response, but also a response to that response, that,
given the appropriate context, neutralizes it. And so we have an anti-antibody, and after that an
anti-anti-antibody, and after that an anti-anti-anti-antibody, expanding endlessly, until the response
is either dampened or amplified, depending on what is necessary. Always reacting to itself,
mirroring its own responses back and forth, the immune system is always in a state of dynamic
internal responding, rippling with its own responses to itself. Even when the immune system is not threatened, populations of immune cells are fluctuating
dynamically, much the same way that populations of rabbits and foxes will fluctuate in relation to
each other in a closed ecosystem--the rabbits multiplying when there are few predators to limit
them, but as they reproduce feeding the foxes, who multiply until they cause the population of
rabbits to plummet, eventually starving their own numbers down, making it possible for the
rabbits to reproduce faster again than they are eaten. The immune system is much more complex
than this heuristic struggle between foxes and rabbits, though, and many populations of immune
cells are in flux at any one time. These fluctuations are kept from being dis/easing, from getting
out of hand and provoking an escalating immune response, because of their chaotic properties.
Though the population fluctuations seem random, unpredictable, and unrestrained, they in fact
fluctuate around "attractors."(16) These attractors stabilize the fluctuations, keeping them from
becoming diseasing. The new science of chaos, which is being increasingly used to understand what is sometimes
called "turbulence," is not exactly what it appears to be. It is not merely a science of random
distributions; rather, it is the discovery that although events in a dynamically interactive system
may be unpredictable, they can have emergent properties, patterns of sometimes haunting beauty.
Chaos happens when a system crosses a threshold, and the rules that had made the system's
behavior predictable and linear shift to a new level of nonlinear flux. Though the results are
complex and unpredictable, the system shows patterns of incidence centered around an
attractor.(17) Unlike other systems, and in particular mechanical systems, the immune system
begins in chaos, and chaotic behavior is essential to its stability. Each such component agent operates strictly on the basis of its local environment but, because of
the system's network constitution, there is global cooperation which spontaneously emerges as
the states of all participating components become mutually satisfactory. In such a system there is
no need for a central processing unit to guide the entire operation, and the external impacts do not
turn the system's axle. External stimuli modify only the local environment of individual
components (which will behave according to conventional stimulus-response patterns), but the
system's operation and properties will always emerge from global co-operativity. This passage
from local rules to a new emergent property of the entire system, which cannot be reduced to the
quality or performance of single components, is the very heart of network mechanisms.(18) The immune system is not just an ecosystem of different biological types of cells playing out their
properties but a dispersed polity caught up in a non-hierarchical network of relationships that,
overall, result in the body assuming an identity, a history, a memory, and an ability to interpret
itself and the world. It does this by endlessly reflecting itself back to itself. According to Donna
Haraway, because of this "mirroring" going on within the immune system, there can be "no
exterior antigenic structure, no 'invader', that the immune system had not already 'seen' and
mirrored internally."(19) Nothing can happen to the immune system that it has not already mirrored,
read, anticipated, and responded to. And so "self" and "other" lose their oppositional quality,
becoming "subtle plays of partially mirrored readings and responses," each created, shaped, and
formed by the other. There is no "outside" to the immune system, really, because every antigen
that it can read is already within it, waiting to be activated. Self is always the other. Though it
forms a boundary that separates it from the outside, the immune system has an internal image of
the outside world, and responds to it, and it alone. And this internal mirroring of "self" and
"other," this reflecting on identity and difference, is what is crucial to immune systems' function,
not the outer world invading the inner world. So the metaphor of the "body at war," commonly used to describe immune functioning, is not
entirely accurate because the body is not repulsing an invader so much as it is cultivating self.
Perhaps the imagery of a gardener weeding her garden would be a better metaphor, partly
because the body's response to otherness is rarely so frantic as war, but mostly because the entire
terrain of the contest between identity and difference is a cultivated one. According to Haraway, Jerne's theory subverts the boundaries that the rationalist theory of
recognition or representation put up. Identity and difference are not separated by boundaries
marking out representation and represented, but rather by an internal strategy for maintaining
identity. There is no outside or inside, no self or other, only strategic deployments within a
dynamic network of identity and difference. Because of this, the boundary between individual and
organism, the identity that separates part and whole, is extremely problematic because each
'individual', or organism, is made up of other individuals and organisms, a nested hierarchy of
identities. Different levels, different strategies, different identities. Often these different identities,
having coevolved with each other, harmonize, cooperate, work in symbiosis with each other, but
not always. Dis/ease is a conflict of identities within the body's ecopolity. Since every construct
of individuality is in fact a product of multiplicity, contingency, and dynamic strategy, the body is
not one but many, an ecopolity built of different identities. The body is, as William Connolly might describe it, a rhizomatic plurality.(20) As such, as we
should not liken the body to a tree, as political theory has long likened the body politic, but to a
rhizome, a dispersed, largely underground, mutually supporting, network of connections.
Drawing sustenance from deep in the earth, rising up through a single trunk, and reaching upward
toward heaven, trees are well suited to carry the hierarchical, unitary, and metaphysical imagery
that the West has long used to govern itself. While trees are wonderful, and deserve to be hugged
by all right thinking people, the political imagery that they have taken on, and legitimated, is
oppressive and false to the body's heterogeneous reality. As Deleuze and Guattari put it: "We're
tired of trees. They've made us suffer too much."(21) As images of what the body politic is, trees cause suffering by supporting a politics of
fundamentals, absolutes, hierarchies, and exclusion--all of which eventually ends in efforts to
eliminate alterity. In arboreal imagery, the other is other, an enemy that, threatening the security
of a singular reality, must be destroyed. Hence, the image of the body at war. . . . While not
nearly as glorious as trees, rhizomes are not nearly so easy to threaten or provoke. With only a
single trunk to transmit nourishment, information, and energy from below to the top and back
again, trees are vulnerable. Cut a ring in the bark around a tree, as beavers and porcupines are
notorious for doing, and the whole tree dies. The body politic, imagined as a tree, can support only diversity in the branches, and that diversity,
as more than a few theorists of the body politic have pointed out, all depends upon a singular
trunk.(22) However, rhizomes are different. Nourishment and energy are not transmitted through a
single trunk but through a network of roots, a network that regenerates itself whenever it is
disturbed. Cut the leaves and stems of a rhizome off, tear the roots up into many pieces, and the
network reestablishes itself. (Just as the immune system does.) Without a center organizing their
functions, rhizomes are notoriously hard to kill. In fact, tillage often makes them healthier. If we are to understand the body's dispersed, yet interconnected, qualities and more effectively
heal its dis/eases, we must set aside the arboreal dream of health, a dream that builds identity with
hierarchical fundamentals, and replace it with a more dispersed, decentralized and interconnected
one--an imagery, perhaps of rhizomes, that accepts the contingency of difference, the alterity
within identity, and the possibility of connection despite dispersion. And so, while the identity of
the body's ecopolity is ambiguous, complex, and dispersed, it does have a certain, very solid, kind
of unity, if only because of the differences that sustain it. And they are maintained by a rhizomatic
network of many different kinds of organisms that police it, creating the boundary that separates
self from other. Unfortunately, the metaphor of a "body at war" has long been used to interpret, and thus, name,
the functioning of the immune system. We have "killer" cells, for example--cells which attack
otherness. Other cells, like inducer cells, warn of the approaching enemy, like sentinels. And then
there are chemicals to poison the invaders. The names and metaphors used to describe the
functioning of the immune system are hardly innocent. Revealing the world as a war against
otherness, these metaphors implicate us in systems of power that I contend are, of themselves,
dis/easing. Knowing our identity through the metaphors of war, we limit and constrain the
functioning of the immune system to the pathology of war--to images of conquest, defeat, and
subjection. Inevitably, the metaphors that we use to interpret reality end up constituting it. By
interpreting the body as a being at war, we make it that way, dis/easing ourselves with the alterity
of physiological enemies. Just as the boundary separating mind and body is a strategic fabrication, built by modern systems
of power, the differences separating metaphor and reality are shifting and contingent, a fabrication
of discursive formations, not of an independent or objective reality. Metaphor becomes reality in
the immune system, as we shall see in the next couple of chapters, and in the end it is hard to tell
which is which. And so, unfortunately, the metaphors of war that science has used to interpret
the functioning of the immune system have become reality. Our bodies have become beings at
war with the world. This does not mean that this imagery of war cannot be subverted with more
peaceful images; it only means that there is not just metaphorical and discursive resistance to this
effort but physiological resistance as well. Because of the imagery that has structured our
discourse, our bodies are beings at war. Despite ourselves, we must, tentatively, interpret it that
way. For now, at least. In what follows I will try to subvert the imagery of war by deploying the imagery of ecosystems
and political relationships, but my interpretive efforts can only go so far. Science names the
various functions of the immune system using the metaphors of war. And so, if we are to have
any access to the discoveries science has made of the immune system, we must use the names it
has given things. And then submit to that reality. Otherwise, we would be unable to
communicate. To tell you what science has discovered, I cannot rename everything as I would
like it to be. Though I can contest the dis/easing effects of various scientific metaphors used to
constitute our bodies, I cannot completely dispense with them. And so, in what follows I may
sound like a general explaining troop movements, but, please be assured, I do not rest easy in that
role. Wherever possible I will try to substitute the imagery of war with the imagery of ecosystems
and politics. Eventually, if you join me in this effort, we may build a world that is not possessed
by the metaphors of war. Inducer, or alarm sounding T-4 cells, have the special role of alerting a variety of other immune
system cells by releasing chemicals that both bring them in and release their attack mechanisms.
When they read the presence of otherness, they release a chemical called interleukin. Interleukin
is a hormone-like chemical that communicates between (inter) leukocytes, which is the name of
the family of cells to which all T-cells belong. Killer cells, otherwise known as T-8 lymphocytes, circulate throughout the body, looking for their
specific antigen, whatever it is. Once they find it and interlock with it, they get ready to attack,
but they must wait for an interleukin message from an inducer cell before they actually do it. If
the message arrives, they select from an assortment of more than a hundred different poisons in
their cytoplasm, and they release the ones that will kill their antigen. Typically they dissolve the
target cell's wall, leaving it to bleed to death. Targets of killer cells include bacteria, cells of
transplanted organs, or the body's own cells if they are cancerous, virus infected, or in some other
way trigger an auto-immune respone. Though they are not, themselves, T-cells, macrophages (from the Greek words for "big" and
"swallow") do much the same thing as killer cells, just differently. As their name suggests, they
are larger than T-cells, and they accumulate in tissues that are injured or inflamed, where they
seek out infectious agents. When they find them, they send out lobes or tentacles, like an amoeba,
and simply swallow their prey, digesting it. Macrophages typically eat bacteria, fungis, or even a
large clump of viruses cross-linked by antibodies. A multipurpose carnivore, the macrophage is
incapable of recognizing individual viruses, leaving that task to other cells. After a macrophage swallows something and begins digesting it, it interprets it using its
constituent molecular components, and then sends out chemical alarms that resemble parts of the
invading agent.(23) Other cells in the immune system, reading these messages, gather and respond
in their own way. Sometimes macrophages don't swallow the antigen, they just release a chemical
that damages it. Not only do they alert other cells, but the enzymes that some T-cells release also
attract macrophages when they are attacking otherness. So control of the immune response goes
back and forth between macrophages and T-cells. (T-cells can also suppress the activity of
macrophages.) Macrophages are formed in the bone marrow, the soft hollow inside bones, along with red blood
cells, and they are released from the bone marrow in a somewhat immature form, called
monocytes. Wandering about in the blood system in this form, they are attracted to traumatized
tissues, where, upon recognizing an antigen, they rapidly mature and become macrophages. Another kind of control is necessary to keep the immune system in balance, and this is supplied by
another kind of T-cell, the immunoregulator, or suppressor T-cell.(24) This cell has the function of
interpreting the appropriateness of the immune response. If the immune response is not regulated,
limited, and isolated, considerable damage, if not death, can happen. Powerful and toxic
chemicals are released when the immune system identifies otherness, and to keep the immune
system from damaging the identity it would protect, it must suppress its response. Suppressor
T-cells also keep killer T-cells that would identify some part of self as an antigen from attacking
and destroying self. Suppressor T-cells play an important role in the development of the fetus. Since mother and baby
are clearly other to each other, both need to keep their immune systems from attacking each
other. Suppressor cells keep both the baby's and the mother's immune response from reacting to
each other. In fact, while the baby is in the womb, the baby's immune system responds to
everything as self. This carries some risk. If something does cross over from mother to baby and
get inside the baby's body, the baby will not be immune to it, tolerating something that may be
quite harmful. One horrifying example of this is rubella or German Measles. If the virus infects
the fetus in the first three months of pregnancy, the fetus will never be able to mount an immune
response against it, and will be born severely infected and malformed. The first time that the immune system is exposed to an antigen it may take quite awhile before it
identifies it as other. The specific T-cell that can identify it as other has to find it and set off the
alarm. Once it does, the cell begins multiplying geometrically and the immune response is quickly
activated. The first time that an antigen invades the body, many days may pass between infection
and effective response. Yet once that response is made, and the T-cells that can identify this
antigen clone themselves, multiply, and accumulate, immune response is much quicker and
effective the next time around. This is called immunological memory, and it is the reason vaccines
can protect the body against an antigen it has never been infected with. A vaccine is a dose of an
antigen in a harmless, noninfectious form, and it teaches the immune system to identify quickly
and respond to the real, infectious antigen. Although they circulate throughout the body, T-cells typically concentrate in lymph nodes, which
are immune stations for identifying otherness. Besides the blood circulatory system, T-cells have
another circulatory system of their own. The vessels of this system parallel the blood system, and
the fluid that circulates in them is called lymph. The primary purpose of this system is to be a
transport network for the immune system. When an antigen penetrates the body, the lymph
system will pick it up and carry it to a lymph node.(25)Lymph nodes are spread all over the body,
under the arms, in the groin, in the crook of the elbow, at the back of the throat, in the neck, and
in the belly. Lymph nodes are the body's preferred sites for reading otherness and eliminating it. Lymph nodes
are basically just wide spots in lymph vessels, lined by a variety of immune system cells scanning
for their antigens. Various lymphocytes--T-cells in one section, B-cells in another--line the walls
of the node, their recognition antenna extended into the flowing stream of lymph. An antigen
must run a gauntlet of these suspicious readers of difference until one of them grabs it, recognizes
it, and sounds the alarm. When the alarm is sounded, immune system cells start multiplying and
releasing chemicals that will inflame the surrounding tissue, causing the lymph node to swell. This
is why neck glands swell when people have a sore throat.(26) Besides the T-cell system, the body has another immune system to produce its identity, the B-cell
system. In evolutionary terms, the T-cell system is the oldest, and was operating 200 million
years before the B-cell system evolved.(27) The B-cell system evolved to duplicate the function of
the T-cell system because the T-cell system was not fully effective against bacteria. Bacteria can
divide and spread rapidly in the body--since it is warm and nurturing, the ideal environment--if
immune response lags. Even if the toxins they produced were not a problem, bacteria can quickly
take up so much space that they will disrupt the functioning of bodily organs. While T-cells
worked best against viruses, parasites, and fungi, they needed the B-cell system to quickly
respond to bacteria. The B-cell system is responsible for producing antibodies, complex
chemicals that destroy antigens. An antibody, or more technically, an immunoglobulin or gamma
globulin, is a protein with some carbohydrate attached to one end. Like the T-cell receptor for an
antigen, immunoglobulins very specifically interlock with the molecules of their antigens. The
cells that produce immunoglobulin, or antibodies, are B-cells, and they produce them in the bone
marrow. Unlike T-cells, B-cells live only a few weeks.(28) So the bone marrow has to produce a lot more of
them than the thymus does, which shuts down soon after birth. B-cells operate very much like
T-cells do, each cell being covered by half a million receptors for a single antigen. Like T-cells,
they concentrate in lymph nodes, waiting for their antigen to come by. If it does, it will read its
otherness, and wait for permission to attack. This permission comes from an inducer T-cell. Once a T-cell gives permission to attack, the B-cell will start producing antibodies and releasing
them. The antibody the B-cell makes is, in part, a protein form exactly like the receptor that
captured the antigen in the first place. Unlike T-cells, B-cells do not patrol around the body, but
rather stay in lymph nodes, releasing the antibodies that patrol the rest of the body--which one of
them can at 2000 antibody molecules per second.(29) Like T-cells, some B-cells can release
antibodies that will attack self, and, like T-cells, the immune response of these cells, is limited by
T suppressor cells. Humans make five different kinds of antibodies, or immunoglobulin, each solving different
evolutionary problems. The body always produces the five kinds of immunoglobulin in a strict
order when it is exposed to an antigen, the presence of any one kind of immunoglobulin indicating
the stage of the infection. T-cells control the whole sequence of antibody production by B-cells.
Immunoglobulin M, or IgM, is the first antibody produced by the body in response to the
recognition of an antigen. IgM is not very efficient, does not last long, and is unable to penetrate
inside tissues. Clustering in a pack of five antibodies, it is too large to do anything but float in the
bloodstream. More primitive species, like the shark, can only make IgM. While they seem to get
by with it (in fact, sharks never get cancer), humans have antigens that require more effective
antibodies.(30) IgD is the next immunoglobulin to appear after IgM, but it appears to be only a transitional
antibody, since it is secreted only in small amounts, and is quickly followed by the next antibody.
Perhaps it helps B-cells react to the messages that T-cells will soon be sending. The next kind of antibody that T-cells tell B-cells to make is IgE, the immunological gatekeeper.
When an antigen penetrates the body, an assortment of cells come rushing in by means of the
blood circulatory system. IgE's function is to dilate the blood vessels wherever an antigen is
detected, allowing all the different T-cells in the immune system to move out of the blood stream
and into the affected tissues. Releasing histamine-like agents, IgE is the source of inflammation
and swelling that occurs with allergies and with any infection. High levels of IgE in the blood are
used to diagnose allergies and parasites. After IgE has dilated the blood vessels, allowing the body's immune response to rush in, T-cells
instruct B-cells to switch to producing IgG, the main antibody that humans produce. IgG comes
in four subgroups: IgG1, IgG2, IgG3, and IgG4.(31) IgG1 is the primary one, protecting the body
from most of the bacteria to which it is exposed. But because some bacteria developed responses
that protected them against IgG1, the body evolved IgG2, another antibody specifically capable of
attacking these antigens. IgG3 attacks viruses before they get inside cells. After viruses get
inside a cell, antibodies are unable to do anything to them. IgG4 seems to play the same role as
IgE, opening up vessels to let the body's immune responses penetrate affected tissues.(32) IgA is the last kind of immunoglobulin. It is responsible for protecting mucous membranes and
inner skin that coats the nose, mouth, intestinal tract, bladder and vagina. The least aggressive of
the antibodies, IgA simply binds the antigen, immobilizing it so that it can be expelled out of the
body with mucous. (So it isn't really such a good idea to take decongestants when you are sick.) Antibodies are helped with a complement system of eleven chemicals always present in the
bloodstream. Once an antibody binds with an antigen, it activates the first of these chemicals,
which activates the next in turn until a powerful chain of reactions, cascading into and amplifying
each other, destroys the antigen. Each chemical in this series of eleven does something to
eliminate the antigen, ranging from dilating blood vessels, to destroying the membranes around
the antigen, to attracting bacteria-eating cells, like the granulocyte or polymorphonuclear
cells.(33)These cells act much like the macrophage, only more specialized for bacteria. They are
attracted and activated by the antibodies locked onto an antigen. Though the T and B-cells are the main operators in the immune system there are other cells,
looking like the lymphocytes, but probably different, that play important roles in attacking
antigens. These are the K and NK cells. Unlike the T-lymphocytes that are capable of killing on
their own, K (killer) cells kill only cells that have been coated with antibodies.(34) Since antibodies
cannot kill cancer cells alone, these cells seem to be particularly important for destroying cancer
cells. On the other hand, NK (natural killer) cells can kill without any help from other cells in the
immune system, but they do seem to be more effective when in the presence of T-cells. Because the body is made of so many different kinds of cells, and because the activities of these
cells--predation, grazing, movement, adaptation, and multiplication--duplicate what animals do
outside the body, the body is, in fact, an ecosystem, a diverse collection of different species in
dynamic interaction. But because this ecosystem also has an identity, an outside and an inside,
and because it has a mechanism--the immune system--to police these borders, it is also a polity, a
community that negotiates the differences that constitute it. This community maintains itself by
policing its inner ecology, allowing some species that find niches within it to thrive, while strictly
limiting others. Because it must distinguish between self and other, this process is full of
contestation, strife, and difference, and it is maintained by harmony, cooperation, and symbiosis. Back to Contents
Chapter 2
Dis/ease: The Challenge to Ecopolity
One middle-aged woman with lung cancer was given no real hope of recovery and rejected treatment altogether. She was a frustrated musician whose career was blocked, she felt, by her much-hated husband. He was an unemployed drug abuser, financially and psychologically dependent on his wife. The woman felt hopeless about her life before her diagnosis. Afterward, she simply went home to die. Her condition continued to deteriorate until, one day, her husband suffered a sudden stroke and died. Soon thereafter, her health improved rapidly. Within a month, X-rays confirmed the complete regression of the tumors in her lung.(35)
Lydia Temoshok
While they may be necessary for it to happen, disease is not something that can be simply reduced to an invasion by bacteria, viruses, fungi, or toxins because these organisms, by themselves, do not cause dis/ease. A contest within an ecopolity of identities and differences, dis/ease, for the most part, is the hermeneutical response the body, reading the world, interpreting it, mirroring it to itself, makes to an antigen--to the invasion of what the body, situated in a politics of alterity, has revealed as "otherness." Most of the symptoms of dis/ease--fever, congestion, inflammation, aches, tiredness--come not from the antigen itself, though many antigens do release toxins that will cause a variety of symptoms, but from the ecopolity's effort to reject the other that has come to be within it. Threatened, discomforted, challenged, the ecopolity protects the identity it has become by responding with dis/ease, discomfort at the presence of the other, and tries to expel it. Push it outside the body's ecopolity by eliminating it.
To be immune to dis/ease is to be exempted from engaging the other, from being caught up in a
politics of alterity with it. Immunity, as a word, originally had little to do with disease and much
to do with politics. Immune derives from the Latin immunis, which originally meant to be
exempted from a public service, burden, or charge--taxes, in other words.(36)Immunity was a
political privilege, limited to the few. It was only in 1880, or there about, that Louis Pasteur and
his associates started using it in connection to disease, inoculation, and infection. Before that, it
was used only in association with civic obligations, official duties, gift-giving, and exchanges. The
Latin immunitas is closely linked to munus, a civic obligation (as in a gift to the community), to
municipium, a town granted the rights of Roman citizenship (now our municipal), to municeps
and municipi, people who can hold public office, and to munificus, gift-giving, generous, and
lavish, as in being public spirited and contributing to the welfare of the community.
A word with definite class connotations, immunity is structured by its association with the word
community, and in particular with the word common, in the sense of low, vulgar, dirty. To be
immune was not to belong to that class of common people, to be other than them. But that was
only later, after a strong class hierarchy had developed. Before that inegalitarian turn of events,
public service was an obligation, a duty all participated in, not something sought, and it wasn't
long before some, thinking themselves better than others, saw public service as a burden, and
sought immunity from it, particularly if it meant being drafted to serve in the army. So, immunity is a privilege, an exemption from the dis/easing quality of politics, and leaves one
untroubled by the calling of duty, community, and obligation. If one is immune one does not have
to be engaged in the community's calling, in, as we will see later, its telos. Immunity, then, is
about being exempt from the boundaries--the many exclusions that separate identity from
difference--that surround and gather others to their callings. Naturally, many dis/easing antigens, seeking immunity from the body's politics of alterity, have
responded to the body's immune system by trying not to appear to be other to the body, to slip
past the ecopolity's boundaries like illegal immigrants sneaking past the border patrol, and taking
up a niche within the body. The strategy of these antigens is to convince the body's police that
they are self so that they can continue their life in a hospitable ecopolity, much like our
lymphocytes may have once done long ago in our evolutionary past. The bacteria associated with
Lyme disease have done exactly this for increasing numbers of people living in New England, and
it is precisely this ability to confuse the immune system, to subvert the boundary between self and
other and become immune to the body's distinctions, that makes it such a dis/easing antigen. Perhaps exclusively, a tick introduces the bacteria that causes Lyme disease into the body,
specifically the Ixodes dammini, otherwise called the deer tick. The bacteria that these ticks
release into the body are called Borrelia burgdorferi, after their discoverer, Dr. Willy Burgdorfer,
an international authority on tick-borne diseases, who works at the Rocky Mountain Laboratories
in Hamilton, Montana.(37) Lyme disease gets its name because it was first discovered by some Yale
researchers in Lyme, Connecticut. Borrelia burgdorferi is a spirochete, a corkscrew-shaped bacteria. Small and difficult to detect, it
does not stimulate the body's immune response as strongly as other antigens, taking four to six
weeks before antibodies are developed against it. Even after they are provoked, the spirochete
appears to be able to change the chemical structure of its outer membrane frequently, much like
HIV (Human Immunodeficiency Virus), making all but the most recent antibodies ineffective
against it. Also, according to Dr. Leonard Sigal, the spirochete can suppress some of the body's
immune responses.(38) Besides that, the bacteria can hide in the body's central nervous system,
where a blood/brain barrier protects it from peripheral immune system activities. Months or years
later, it can come back out into the bloodstream and reinfect the rest of the body. A wily
ecopolitician. More insidiously, the Lyme bacteria turn the body's immune system against the body. Antibodies
against it coat the surface of the bacteria, combine with the blood complements that magnify the
immune response, forming immune complexes, large clusters that travel through the blood and
accumulate in the joints.(39) As these clusters accumulate around the joints, they attract wandering
phagocytes, which release enzymes that attack not only the bacteria but also the different tissues
in the joints, creating arthritis-like symptoms. According to Dr. Jorge Benach, interleukin-1, a
chemical released by T-inducer cells to stimulate the immune response, damages the joint tissues
by making them release prostaglandin, a substance that causes fever and pain. It also makes them
release an enzyme called collagenase, which will break down the connective tissue in the joints. Like HIV, the Lyme bacteria can rapidly change its outer membrane surface to confuse the
immune response, forcing the B-cell system to continually make new antibodies to control it.
Some of these antibodies, as it turns out, attack not only the bacteria but also various body
tissues, including not only the joints but the brain, different muscles, and the heart. Antibodies are
just complicated chemicals; they cannot differentiate between self and other by themselves. They
just interlock with, and attack, whatever matches them. The spirochete can dampen and confuse
the immune response by taking on, perhaps evolving, chemical structures that resemble the body's.
A strong immune response, anything powerful enough to threaten the bacteria, also threatens the
body's identity. Recognizing that self is endangered by too aggressive a response, T cells
suppress the immune response, letting the bacteria survive. According to Dr. Leonard Sigal, the Lyme bacteria produce a chemical called flagellin, which is
structurally similar to a protein in the nervous system.(40) As a result, any antibody that the B-cell
system produces to attack this protein will also damage the nervous system, explaining many
nervous system problems that accompany late-stage Lyme disease--nerve dysfunction, irritability,
mood swings, memory loss, and, possibly, coma. In fact, many victims of late-stage Lyme disease
are mistakenly diagnosed as suffering from multiple sclerosis, a debilitating disease of the nervous
system. Lyme disease is called the great imitator not only because its symptoms resemble those of other
diseases, like the chronic fatigue syndrome and multiple sclerosis, but also because the bacteria
camouflages itself to imitate the body's identity, thus avoiding the full brunt of the immune
response. Unlike Lyme disease, which is associated with bacteria, AIDS is associated with a retro virus
called HIV, short for human immunodeficiency virus. Although they are a threat to the body's
identity in much the same way that bacteria are, viruses follow a completely different bio-strategy
in the body's ecopolity. Bacteria, like fungi or parasites, are independent, self-contained entities.
Often, bacteria link together in chains, sometimes tubular-like structures in tuberculosis, or
spiral-shaped structures in syphilis or Lyme disease. A chain of cells, they are little creatures
moving around inside the body, multiplying and feeding, trying to survive in their niche, maintain
their identity. Viruses, on the other hand, are more like fragments of a computer program than they are living
entities. Some scientists question whether they are alive at all, describing them merely as very
complex chemicals that use the apparatuses of living cells to perpetuate their chemistry. Viruses
threaten the body's identity, the ecopolity's peace, by invading a living cell, taking over the code in
its nucleus (its DNA) that defines its identity, and using it to reproduce. Whatever the cell was
doing before--making hormones, processing energy, converting wastes--the virus tells the cell to
use whatever materials on hand and make more copies of the virus. Remaking the identity of its
host for its own purposes, viruses replicate inside the cell until they burst, releasing them to infect
other cells. HIV contains codes for building the structure that protects mature viruses, enzymes
to catalyze the processes that allow it to insert itself in the cell's DNA and take it over, and a
complex array of regulatory proteins that, sensitive to their environment, govern the rate of viral
replication.(41) Because the information in them is so specific, so uniquely configured, viruses can only use
certain cells. Hepatitis B needs liver cells to replicate. HIV is unique in that it uses cells in the
immune system to replicate, mostly the T-4 lymphocytes, or inducer cells, but also, to a lesser
extent macrophages, or monocytes. In a healthy individual, T-4 cells comprise about 60% of the
T-cells, and T-8 cells, or killer cells comprise 30% of the cells. Once AIDS develops, the ratio
reverses, and killer cells become the most numerous.(42) As the T-4 cell population declines, they
are increasingly unable to signal B-cells to respond to antigenic challenge. The B-cell lineage that
produces antibodies is not itself infected, but, without the guidance of T-4 cells, B-cells begin to
spontaneously secret undirected and nonspecific immunoglobulins. Normal signaling and
feedback mechanisms break down and the B-cell system of antibodies does not respond to protect
the body's identity.(43) As this goes on, the body's ecopolity begins to disintegrate, its boundaries
weaken, and it becomes increasingly vulnerable to having its identity contested. Monocytes, cells that help tell T-4 cells about antigens in the body, can also be infected with
HIV.(44) Unlike T-4 cells, though, they do not die at infection but continue propagating HIV at a
low level for a long period. Upon infection, the number of monocytes increases, but, since these
cells have been made into "viral manufacturing plants," this only serves to spread the infection.
HIV infection in monocytes also damages their ability to identify and kill parasites and produce
interleukin, which is used to communicate with the rest of the immune system.(45) Without this
communication and interaction, the immune system is increasingly unable to defend itself against
microorganisms such as Pneumocystis carinii, an organism that, left unchecked, causes a
previously rare form of pneumonia. Usually, the immune system easily keeps it under control, but
when the monocytes are infected with HIV, they lose their ability to police, identify, and limit it. Besides that, Natural Killer (NK) cells, which play important roles in policing, identifying, and
killing tumor cells and viruses, lose at least some of their effectiveness without interleukin
messages from T-4 cells, though they are able to police the ecopolity independently. With NK
cells compromised, the possibility of cancers developing unchecked increases. Kaposi's sarcoma,
a rare and seldomly fatal cancer that develops as purple lesions on the skin, is quite common
among gay men who develop AIDS, and quite dangerous to them. Before HIV, it was primarily a
problem that afflicted elderly Jewish or Italian men, and typically they died twenty years later--of
something else.(46) AIDS turns it into a killer by destroying the cells that police against it, letting it
spread throughout the body unchecked. In other words, HIV takes over exactly the immune system cells, the T-4 cells, needed to police
its own replication. This is what makes it so deadly, so much a threat to the body's ecopolity.
More than that, in the process of reconfiguring the identity of T-4 cells, it suppresses the immune
response not only to itself but a whole variety of other organisms. The body is less and less able
to identify self and other, police the borders separating them, and is increasingly unable to resist
challenges to its integrity and it falls increasingly into disarray, then death. The total dissolution
of all the ecopolity's boundaries. HIV directly subverts, converts, and diverts the identity maintenance system of the body--the
ecopolity's police force--expanding its niche in the body's ecopolity in an unlimited way until it
destroys its own niche. At least eventually. But shifting perspectives, interpreting the situation as
the virus would, it actually is quite restrained and self-regulated. Within its RNA code, the virus
has a variety of instructions limiting its replication. Ten, maybe even fifteen years, may pass
between infection and the host's death--and much of that time the host will be either asymptomatic
or only relatively dis/eased by its presence.(47) In much the same way that AIDS brings on an identity crisis, cancer, too, is an identity crisis, a
disruption in the boundaries separating self and other. Contrary to the theory that cancer results
from a single isolated cell inexplicably growing out of control, cancer is a systemic event, a
disease that is only meaningful in the context of the body's identity. The best science on cancer
indicates that all of us are developing cancerous cells all the time. In fact we could probably say
that everyone "has" "cancer," or at least cancerous cells in our body, from the day we are born to
the day we die. Everyone.(48) And so what is diagnosed as cancer, a deadly threat to our lives, is
not so much the existence of cancer cells as it is the failure of the ecopolity to identify, police, and
kill them. Cancer is a crisis in identity, a failure to police the boundaries of self, not just an
invasion by perverted cells. If the body is able to police the distinction between self and other, it
is able to prevent cancerous cells from becoming cancer. As a disease, cancer is located not in the
cells but throughout the entire balance of powers in the ecopolity. Cancerous cells are different from healthy cells. Unlike normal cells, which die after a certain
number of divisions, and seem to have an awareness of, or a responsibility to, the welfare of the
other cells around them, cancerous cells separate themselves from this collective identity, form
their own, grow uncontrollably, and would live forever if they could.(49) Cancerous cells can be
kept alive indefinitely in a test tube while healthy cells will die in a few weeks, even under the best
of circumstances. (In fact, cancer cells as immortal cell lines are sometimes preferred in some
experiments because of that fact.) All cells have within them oncogenes, genes that govern the
process of mitosis, or cell division and multiplication. Oncogenes are activated to start this
process, and when it is completed, another regulatory gene close to them on the same
chromosome deactivates them. If something disrupts this process, if the mitosis-regulatory genes
do not deactivate the oncogenes or are not there to deactivate them, cancerous cells
result.(50)Viruses can pick up oncogenes, moving them from cell to cell, inserting them in their
DNA and making them cancerous.(51) Perhaps more commonly, the control mechanisms limiting
oncogenes are disrupted or destroyed by carcinogens, toxins in cigarettes, alcohol, charred food,
or industrial pollution. Or exposure to radiation, particularly accumulations of radon. Or
sometimes it just happens spontaneously. However it happens, once the genes that give them limits stop working, cancerous cells start
invading the boundaries of other communities of cells, disrupting them, displacing them, forcing
them to function poorly. And so there is an irony here: seeking to live forever, cancerous cells
undermine and subvert the community that would sustain them. Healthy cells are communitarian
in their teleology, in harmony with the whole body's identity; cancerous cells are selfish, in
harmony only with others like themselves. Healthy cells have a cause greater than themselves,
and are willing to surrender their individual identity to it, while cancerous cells have no cause and
grow endlessly without aim or purpose. As such, repudiating all purpose or calling, cancerous
cells are profoundly nihilistic. The body is hardly defenseless against cancerous cells. Usually, it can easily identify them as
"other" and destroy them. Even though cancerous cells are derived from cells marked as "self,"
their character changes enough, once they become cancerous, for the immune system to read
them as other. Within every body, T-cells exist that can identify every part of self as other and
attack it. Usually, these cells are kept in check by other T-cells, specifically the immunoregulatory
cells, but the potential is there for them to turn against any part of the body that does not conform
with the self's identity. Also helping T-cells police for cancerous cells and kill them are killer and
natural killer cells. Killer cells will attack any cell painted with antibodies, while natural killer
cells, prompted by the availability of interferon, identify and kill cancerous cells pretty much on
their own. To be identified as "other" by the immune system, the cancerous cell has to display some sort of
sign. Cancerous cells do this to varying degrees, and sometimes, in the most dangerous cases,
they show no signs of otherness at all. Besides that, apparently having formed some sort of
common identity, some cancers seem to be able to activate regulatory T-cells around them and
suppress the attack against them, almost as if the cancer cells knew the threat they
posed.(52)Interestingly enough, people in close daily contact with someone who has cancer--lovers,
family members, friends, care providers, and so on--tend to have immunological signs of having
fought off the specific kind of cancer that is afflicting their associate. Even though their body is
not carrying the cancer, their immune systems have identified the cancer and responded to it by
producing the appropriate antibodies, lymphocytes, and so on. If T-cells from these people are
mixed with tissue from the person who has cancer, these T-cells will vigorously start attacking the
cancer--much more aggressively than a stranger's would. One implication of this is that the
immune systems of the cancer victim's associates are more able to identify the cancer as cancer
and fight it than the person who is afflicted with it.(53) Allergies present another example of an identity crisis. Allergies are basically overreactions to
otherness--to something that is not really a threat to the body's identity, but is read to be.
Reacting to this antigen, which may be only pollen, the immune system frantically mobilizes a vast
armament to eliminate it. This immune response is not to be taken lightly. People die of allergic
reactions to insect bites, medications, pollen--whatever. Things that the ecopolities of other
bodies easily tolerate. Attempting to isolate otherness, keep it outside the ecopolity, the immune system responds to any
violation of its boundaries by increasing accessibility to the site where they were breached.
Circulating throughout the body and located in any tissue close to where a breach in the body's
boundary is likely, basophil and mast cells are continually policing everything around them,
checking to see if their antigen is present. These cells have an outer membrane that can bind IgE,
an immunoglobulin that B-cells produce. On the other end of the IgE antibody, projecting
outward so that it can easily read everything it touches, is the receptor for its antigen. Once the
receptor locks up with the antigen, the cell explodes, releasing the histamines that will swell the
tissues around it, letting the rest of the immune response into the damaged tissue, where it can
quickly identify and kill any invading antigens.(54) Ordinarily, not that much IgE is available to arm these cells. It is only after T-4 cells have issued
instructions for B-cells to produce IgE that these little mines become armed, ready to explode and
provoke the immune response. Usually, the release of IgE is sufficient only to cause a local
release of histamine where otherness is identified. But if too much IgE is released, the whole
body becomes hypersensitive to otherness, and little mines of histamine start exploding all over,
activated by the smallest trace of antigens. Runny noses, watery eyes, coughing, restricted breath,
achy muscles, and so on, result. Because it arms these mast cells, putting the self on hair-trigger
alert, allergies are often diagnosed by the levels of IgE in the blood stream. With allergies, the body's ecopolity dis/eases itself by becoming too intolerant to the otherness it
identifies; in autoimmune diseases like arthritis and diabetes, the body's ecopolity turns against its
own identity, identifying self as other and attacking it. Sometimes this is helpful and necessary
when self is cancerous, or infected with viruses and the only way to stop the disease is to destroy
the cells causing it. But sometimes, because of the self it has become, the immune system turns
against self, attacking it relentlessly and destructively. Autoimmune diseases are yet another
version of an identity crisis, an inability to differentiate and keep separate self and other, to be
immune to inappropriate callings. Every moment of the day, millions and millions of T-cells are policing the body's ecopolity and
deciding whether or not to signal other cells to attack it. In other words, they tolerate self, accept
it, pass it by, protecting it. The ecopolity of the body tolerates in two different ways: passively
and actively. Passive tolerance for T-cells is simply assuming, unless told otherwise, that
everything is self. Active tolerance is being told to tolerate self. John Dwyer developed a
humorous metaphor for how this works: Imagine a stray dog has adopted your family. You do not really want a dog but the kids want to
keep it. You debate the issue, shrug your shoulders, smile at the kids and the dog moves closer
to the fire. That is passive tolerance. On the other hand you may dearly wish to reject the
mangy dog and would do so if a superior authority did not intervene. "Henry," says mother
firmly, "the children would be broken-hearted if you do not let them keep that dog; don't you
even think of getting rid of it." That is active tolerance. The dog immediately curls up in your
favorite chair.(55) T-cells develop passive tolerance toward the self early in life. While the self is in the womb,
protected by a membrane that separates the fetus not only from the world but from the mother's
immune system, the fetus's T-cells learn to read everything they encounter as the self. Taught this
during the first 18 weeks in the womb, they remember it for their whole life, 60 years or so. With
the identity of the self firmly implanted in them, they are prepared for recognizing difference.
While all the T-cells are learning to identify the self, a special subset of T-cells, the
immunoregulatory cells, are learning active tolerance, to issue the commands that will suppress
any attack against the self. Later in life, new T-cells produced by the thymus are taught, in turn,
to recognize the self from other, older, T-cells. Since B-cells live only a few days, they are not taught how to read identity and difference. They
are controlled by the T-cells, which have the memory necessary for doing this. The ability of different immune systems to maintain and care for the identities and differences that
constitute the body varies greatly from individual to individual. Some are able to maintain these
differences, separating out self from other, quite effectively. Others are plunged into ambiguity,
and launch aggressive attacks against the self. Diabetes provides an example of how devastating
this turn against the self can be. The symptoms of diabetes develop when the pancreas, a gland that secretes chemicals to help
digestion, does not secrete the insulin necessary to regulate sugar levels in the blood. A serious
disease that causes disequilibriums throughout the body, diabetes is responsible for premature
hardening of the arteries, heart attacks, blindness, kidney disease, cataracts, and increased
vulnerability to infection.(56) If it happens early in life, life expectancy can be reduced by 27 years. Diabetes results when T-cells, reading them as other, start attacking the beta cells in the pancreas
that produce insulin, quietly killing them off one by one. It happens slowly over years and the
victim feels no pain, and does not show symptoms until 80% of the cells have been
destroyed.(57)Diabetes may develop because of a genetic predisposition to it, or because of an
immune system that is relatively poor at immunoregulation, but this confusion of self and other is
often triggered by stress, drugs, toxins, and infections. In particular, a virus infection like
Coxsackie, can disrupt the reading of self and other by infecting the beta cells of the pancreas and
damaging their membrane surfaces enough so that the T-cells cannot read them as self. Seeking
out the virus, needing to destroy the cells that are infected with it, but unable to differentiate
between them and those that are not infected, the T-cells start killing healthy and infected beta
cells alike. The ability of the body's ecopolity to police itself, to tolerate itself, is not just an inner struggle, as
we have seen in the last two chapters; it's an outer one too, as we will see in the next couple of
chapters. Self and other, inner and outer, identity and difference, are separated by
boundaries--boundaries that, depending on how the reading of them is situated, are continually
sifting and subject to deconstruction. And so the dis/ease of an "outer" identity can be manifested
with an "inner" disease, and the "inner" dis/eases of self can be expressed in "outer" dysfunction.
The inner identity that the body's ecopolity assumes is shaped, defined, and bounded by the outer identity that the world reveals the self to be. And so dis/ease is not situated just on one side of the boundary, the interior, as conventional medicine insists, but rather the inner politics of self is shaped, enabled, limited, defined, and constituted by the outer politics of the larger ecopolity of the world. The self the immune system recognizes cannot be separated from the self the world recognizes. Though there is a boundary separating inner and outer selves, the body from the mind, the politics of both intermingles, crossing the boundaries that would separate them.
Because disease is an emergent property of all the social, political, environmental, and biophysical
dynamics the dis/eased self is situated in, the cause of the disease, especially once it emerges,
cannot be adequately interpreted by reducing it to a single determinant. While one determinant
may originally predominate in a situation, it is never an adequate account of the cause. Because
the dynamics of the situation from which it emerges are always different, the fully adequate cause
of the disease is always unique, different for each individual that becomes a victim. As a result,
reducing a disease to a pattern of causality, a system of variables that could be duplicated in
controlled experiments, conceals the unique dynamics of the situation from which the disease
emerged. This is important because healing disease cannot just be reduced to manipulating what
would seem to be the cause. In a real sense, once a disease emerges, the cause of it becomes
secondary to healing. By the time a disease emerges from the dense matrix of forces that it is
situated in, too many things have been disturbed for the disease to be reduced to a single pathogen
or trauma. It involves much more than that because it is situated in much more than that, the
ecopolitics that constitute the identity of the self.
Back to Contents
Chapter 3
Psychoneuroimmunology
I once had a patient who dreamed an image something like a great "Y." She said, "That's
my mother sitting on my sexuality." I immediately saw what it was: She was drawing her
ovarian tubes. About a month later, she came in with a purple hand splattered on top of the
nest. The hand was so ugly my whole body just cringed back from it. I said "You know, if I
were you I'd go to a doctor." And she did. The doctor didn't find anything at first, so he gave
her an ultrasound. He was astonished. "How did you have any suspicion so early" he asked.
It turned out to be cancer.(58)
Marion Woodman
Over the last couple of decades, psychoneuroimmunologists have been discovering just how
complex the difference between mind and body is. Just as physicists some time earlier had
discovered that the differences separating space and time are contingent and form a
unity--spacetime--many scientists who study life are finding that the differences separating mind
and body are not absolute but are shifting, contingent, and dependent on the way they observe
them.(59) Relative. Indeed, some scientists are wondering if there is any boundary separating mind
and body at all, if there is only mindbody. Examples abound. In his book, Ernest Lawrence Rossi describes the case history of a man suffering from an
advanced malignancy of the lymph nodes--lymphosarcoma. The man had tumor masses the size
of oranges in his neck, armpits, groin, chest, and abdomen. His spleen and liver were enormous,
and he was taking oxygen by mask. The prognosis was, of course, terminal. A completely
hopeless case. The doctors gave him no treatment except for relief from pain. But, while he was
waiting to die, the man heard rumors of a miracle drug. He became convinced that it was his
"golden opportunity." He insisted that the doctors give it to him. Three days after his first
injection, he was up walking around. Ten days later the tumors had disappeared. Soon after that
the patient resumed a fully active life, working, and flying his plane. Completely healthy.(60) But
the miracle drug that he received was only distilled water.(61) Placebos consistently have amazing effects.(62) In one chemotherapy experiment, 30.8% of those
patients who received the placebo, the pill supposed to do nothing, lost their hair!(63)Studies of
people with multiple personality disorders reveal even more astonishing evidence of mindbody
unity. Different personalities in a person with multiple personalities can have different diseases.
Some may have allergies, some blood pressure problems, some diabetes, and others will be
remarkably healthy--all in the same body. There are even four cases where eye color changed
with the personality change!(64) How can this happen? According to psychoneuroimmunology, the brain is not an autonomous
organ of consciousness, processing information apart from the body, then commanding the body's
function via conduits of nerves, but rather, it is deeply situated in the body, entwined in it, acting
upon it, and reacting to it.(65) And so, it is not the brain that thinks, that remembers, that
commands, that feels; it is the entire body. The brain is not primarily, as our age of reason would
have it, a computer in charge of our consciousness, but a gland where chemical messages from the
rest of the body's ecopolity are delivered, read, interpreted, and responded to. As such, the brain
is an incredibly sophisticated pharmacy, receiving and dispensing a wide variety of chemical
messages--neurotransmitters for messages between cells, neurohormones for messages between
organs.(66) Through a network of nerves that touches every part of the body, brain and body work
together "to control precisely the amount and timing of the release of drugs in order to maximize
specific desired effects and minimized side effects."(67) Manufactured drugs merely mimic the
chemicals the body's ecopolity already uses to maintain its identity, just not nearly as precisely nor
as predictably. And, as the earlier example of the "miracle drug" that turned out to be only
distilled water shows, the body's ecopolity may have an ample reserve of "drugs," once the
appropriate imagery is taken within it, to cure even the most severe diseases. Recently, psychoneuroimmunolgists have traced the paths by which brain and body interact. They
have found that all immune system cells have on their surfaces receptors to neurotransmitters,
chemicals that transmit information from the brain to the rest of the body--epinephrine,
norepinephrine, acetylcholine, and so on.(68) Neurotransmitters are released not only by the brain
but also by nerve trunks and endings, making it possible for the brain to interact with immune
responses in specific parts of the body.(69) Immune response can be enhanced or suppressed by
injuries, lesions, or artificial stimulation in the brain, specifically in the hypothalamus, the
hippocampus, and the reticular formation of the midbrain.(70) A variety of neurotropic agents that
accumulate in the hypothalamus, and have the effect of blocking adrenalin, have been found to
suppress antibody production.(71) According to Hall and Goldstein, dopamine, a neurotransmitter produced in the brain, increases
following the introduction of an antigen into the body. The presence of the antigen is apparently
communicated to the brain, which interprets it, and then responds to it by sending out dopamine
to stimulate the immune system. When the portion of the brain that produces this chemical is
impaired, the immune system is weakened, and breast tumors tend to develop. Because
neurotransmitters and the immune system interact in a variety of ways like this, brain participation
in the immune response seems likely.(72)According to Bessedovsky and Sorkin, a whole range of
receptors for neurotransmitters and hormones have been found on immune system
cells--corticosteroids, insulin, growth hormone, estradiol, testosterone, B-adrenergic agents,
acethycholine, and so on.(73) In fact, according to Candace Pert and Michael Hoff, at least one
kind of immune cells, the monocytes, have receptors for virtually every neuropeptide discovered
to date--meaning that they can receive, process, and react to an incredible amount of information
from the brain. Probably every other kind of cell in the immune system is just as capable of
responding to these neuropeptides.(74) Contrary to the image of mind over body that has concealed so much of the body's ecopolity, the
flow of meaning and interpretation in the body is far from one way, from the brain to the rest of
the body. It goes both ways. Many different parts of the body release neurotransmitters,
including the immune system, the intestines, and the liver. According to Candace Pert, "The
entire lining of the intestine, from the esophagus through the large intestine is lined with
cells--nerve cells and other kinds of cells--that contain neuropeptides and neuropeptide
receptors."(75) What are ordinarily described as neuro-peptides, meaning brain chemicals, like
vasopressin, oxytocin, and neurophysin, are also secreted by other organs in the body, especially
the gastrointestinal tract.(76) And the brain isn't even the primary source of these chemicals that convey information. The
intestines secrete much more of these "neuro" chemicals, these conveyors of thoughts, than the
brain does.(77) These protein-like chemicals, all 50 or 60 of them, are thought to be the
neurochemical basis of emotion.(78) Remember that "feeling in your gut," that "gut reaction," or
that "fluttering heart," or that "broken heart," or whatever? All those bodily intuitions may be but
different parts of the body making their reading of a situation. By secreting neuro-peptides, these
different parts of the body interpret, integrate, and frame the context for the brain, which in turn
interprets the body's situation within the larger world. The brain does not read the world
independent of the body, and in particular, independent of the immune system. It is supported,
enabled, and limited by readings a variety of different parts of the body are making. In a real sense, thinking is not limited to the brain, as the Cartesian imagery of the body as
machine and Platonic model of the mind as master would have it. Meaning is retained, processed,
and circulated by the entire ecopolity of the body. Emotions, past experiences, thoughts, are
deeply embedded in the body, affecting its musculature, posture, chemistry, and appearance. All
the metaphysical hierarchies, family relations, institutional disciplines, authoritative evaluations,
and sexual practices, that the body has ever been implicated in are written upon its physiology,
making the body into a text of its past, a reflection of its context. These intersubjective thoughts,
metaphors, and images, not just the body's chemistry, produce identity and difference, maintaining
self against its alterity. If the body becomes dis/eased, it is revealing a truth not only about itself
but about the power relations that it is situated in, the context that surrounds it, the intersubjective
meanings that constitute it. But not without resistance, interpretation, or, perhaps, rebellion. Eugene Gendlin has argued that most interpretations of the body, from Freud to most modern
psychologists, are far too simple. In these various theories of the body, they reduce the body to a
blank slate, a canvas on which social order is imposed. Even as sophisticated thinkers as Deleuze
and Guattari argue that for the body to overcome repressive social control, it would have to be
"without organs," because organs are externally imposed social constructions that enable people
to engage others in an oppressive world. To become free of oppression, the body would have to
free itself of the social constructions that assure its repression. According to Gendlin, the
assumption these two thinkers--and most others--make is that the body's order is all externally
imposed, and none of it internally driven.(79) While Gendlin is quick to agree that bodies are
inextricably situated in order, and that social order does much to frame and constitute the body,
he insists that the body is not without powers of resistance, interpretation, and intuition. The
body is not autistic, a mere re-presentation of the social order, but a self-organizing being, capable
of impressing its orderings on the world. Gendlin insists that culture did not evolve separately from the body, but developed with it,
reflecting the already very complex behavioral order of the animal body. The evolution of society
is the evolution of the body. Language, social institutions, political organization cannot be
distinguished from the physiology of the body because they all coevolved. The body's supposedly
simple drives for sex, food, shelter, and sociality are in fact socially organized interaction patterns.
Concludes Gendlin, "Every animal species has been found to have complex unlearned interaction
patterns, such as food-search, nest-building, mating dances, rearing the young, and so on. The
autistic body of unorganized tension-desires is a fiction."(80) According to Gendlin, drawing on the vast social and linguistic history in which our physiology is
implicated, the body knows things that we may not know, at least not consciously. By focusing
on bodily-felt experiences--that ache in the gut, that tension in the throat, that heaviness in the
heart--and trying to put into language what the body feels, a person can reveal the thought the
body, in its considerable wisdom, is trying to express. The body's disease may not be so much an
externally imposed violation as a dis/ease with the world made possible by its own interpretation
of something wrong with the world. In other words, dis/ease can be the body's way of politicizing
a situation, of rethinking the way the self is situated in the world, of rebelling against an unjust
order. By expressing a disease, it is expressing its dis/ease with the order in which it is situated. Ann Weiser Cornell, a teacher of "Focusing," the technique Gendlin developed to express the
body's wisdom, once applied this principle to a sore throat. She was prepared to assume that it
was just the beginning of a cold, and she was depressed because it was going to frustrate her
effort to teach a workshop on Focusing the next day. But when she tried Focusing on it, she
found that the sore throat yielded meaning, . . . "something about how I was putting pressure on
myself to be an 'expert.'" She had lost herself to the they world, to how she appeared to others,
and her body was rebelling. By the next morning, after an attitude adjustment, she felt fine; the
sore throat was gone, and she never developed a cold. She tried it again later on a cold that
already developed. She focused on her most prominent symptom, a feeling of rawness in her
lungs. "After I had heard its inner meaning, having to do with having taken on someone else's
feelings, I had one of the most amazing experiences of my life--I felt the symptoms leave my body
in the space of about thirty seconds."(81) In each of these cases, Cornell's body had interpreted her
situation, became dis/eased with it, and manifested symptoms that contested it. By focusing on
her "cold" as if it were a bearer of meaning, allowing it to reveal itself as a rebellion against her
situation in life, she was able to resituate her self in a way that was more acceptable to her body's
ecopolity. Her body was not autistic, the passive victim of the world's violence, it actively
engaged her situation, formed its own interpretation of it, and insisted that she do something
about it--all without a conscious thought. The image of mind over body and, thus, separate from it is not politically innocent. As a
hierarchical system, it duplicates and reinforces the imagery that has legitimated authoritarian
political systems, subjected women, excluded other races, and exploited nature. The image of
mind over body has long been used in the West to justify the subordination of entire groups of
people who, the story goes, lack in full measure the mental ability to dominate their bodies. Since
they lack this measure of control, those who do not should run the polity for them. Make the
decisions. It is only rational, as Plato, that great legislator of body metaphors, pointed out. Politicizing the reign of any of these hierarchies must eventually politicize the image of mind over
body because it has often been used to legitimate them all. For too long we have bent our knee to
an image of the world that has created binary pairs--man and nature, male and female, light and
dark, branches and roots--and has made one subordinate to the other, seeking its exclusion and
silence because it was identified with body and the other was with mind.(82) And we have ignored
the fact that once we make one identity the lesser, the weaker, the incomplete image of the other,
we made both less than they could be. Ignoring the way in which identity and difference create
each other, we have concealed, exploited, and oppressed the reality of our bodies and dis/eased
our world by forcing a false image of difference upon them. Caught up in these hierarchical
systems, in the imagery of exclusion, control, and domination, the Western metaphysical tradition
has imposed its dream of power on the mindbody and made it false, inadequate, and dis/easing to
its nonhierarchical reality. By politicizing the imagery of mind over body we can help reveal the truth about what the body
is--an ecopolity--and help heal dis/ease. But, before I get ahead of myself, let me continue with
some more evidence on how false the image of mind/ body duality and hierarchy is to the
ecopolity's reality: In one experiment, as Jeanne Achterberg describes it, Barbara Peavey found
that biofeedback-assisted relaxation improves immune response.(83) Peavey collected a group of
sixteen people she concluded were under high levels of stress, and who also had low levels of
immunity--as measured by low lymphocyte counts and relatively inactive neutrophils. Splitting them into two groups, one control and the other the biofeedback group, she looked for
differences in the effects of relaxation. The biofeedback group got individual hour-long training
sessions twice a week on machines that helped them reduce their muscle tension and regulate their
body temperature. Members of this group also played tape-recorded cassettes at home that lead
them through relaxation exercises, which were designed to help them let go of distressing images.
The control group got nothing, and no one in the study was told that their immune response was
being studied. Peavey collected blood samples at the beginning of the study and at the end, and,
when she did the bloodwork, she found substantial differences. She found the biofeedback group's neutrophils were functioning much better than the group that
had not learned to relax.(84) Though the biofeedback group's white blood cell count did not rise,
the study did demonstrate that the body has a certain kind of wisdom that, if not hampered by
stressful images, is able to guide itself in a healthy direction. Simply letting go of distressing
thoughts, promotes health. Perhaps distressing thoughts become a tyrannical regime that
suppresses the expression of the body's dis/ease, preventing the truth about its situation from
emerging, and, thus, depoliticizing the body's interpretation of its reality. Many others have found that stress has significant impacts on the bodymind. During the 1991
Persian Gulf War, when Iraq attacked Israel with Scud missiles, researchers collected blood
samples from twenty-two male volunteers and gave them psychological tests. Unsurprisingly, the
researchers found that during the attacks anxiety and anger indicators were significantly higher
than during peacetime. The blood tests found that, "Natural-killer cell activity and cell-mediated
lympholysis were significantly elevated during the war, as were plasma levels of
adrenocorticotrophic hormone, neurotensin, and substance P."(85) The 1994 Northridge,
California earthquake had a similar impact on the immune systems of employees of the nearby
Spulveda VA Medical Center. Again researchers collected blood samples and distributed
questionnaires assessing degree of life disruption, mood, earthquake specific distress, and
repression. Those employees suffering the most distress had the highest levels of cytotoxic
T-cells.(86) But the effects of stress on the immune system are not limited to extraordinary events. Everyday
stress has an impact too. Air traffic controllers, whose job of keeping airplanes from crashing into
each other is quite demanding and stressful, have a similar immunologic reaction to stress.
According to one study, work sessions were marked by increases in the concentration and
secretion rate of salivary immunoglobulin A, as well as in the concentration of salivary
cortisol.(87)Similarly, tests in school have been found to reduce immune functioning in adolescents,
increasing their risk of becoming sick. "Examinations elicited significant changes in several
lymphocyte subsets and marked alterations in the three functional measures in all
students."(88)Furthermore, if a person is subject to chronic stress, like a stressful job or a troubled
relationship, the response to acute stress is exaggerated. The immune systems of those under
chronic stress react more dramatically than those who are not to a laboratory stressor, like mental
arithmetic.(89) According to Achterberg, the possibility of conscious communication with parts of the body
ordinarily thought beyond reach is really quite precise--once a relationship between thought and
body is learned.(90) In fact, J. V. Basmajian taught a single cell to respond to biofeedback. He
implanted very small electrodes in a motor nerve cell, and gave auditory feedback to that person
whenever the cell fired. Subjects quickly learned to fire it at will, even varying the firings between
long drum rolls and short bursts.(91) Achterberg believes that not a single part of the body couldn't be controlled, at least to some
extent, by biofeedback, though not without some difficulty. As an object of biofeedback
techniques, the immune system poses considerable problems because it is hard to get rapid
feedback from it in a noninvasive way--there aren't any machines around that can do that--and
even if there were, there isn't enough known about the body to know what should be cultivated in
it to promote health. Establishing inappropriate kinds of feedback might make things worse,
disrupting equilibriums, perhaps seriously damaging the body.(92) It turns out, however, that biofeedback is not really necessary. Yoga masters, for example, long
ago learned the art of communicating with their bodies in the most incredible ways--controlling
their heartbeat, their breathing, their brain waves, seemingly everything--without the benefit of
machines. Because thoughts communicate with the body, and the body communicates with
thoughts, a language of dis/ease seems possible. And why shouldn't it be? If the body's ecopolity
is dis/eased with the information contained in neurotransmitters, dis/ease should be able to be read
as a metaphor, though perhaps with difficulty. In a fascinating and important study, Jeanne Achterberg, with the help of her husband Frank
Lawlis, developed a language for understanding dis/ease, a system for reading the imagery of
cancer.(93) As other studies have suggested, people have greater access to their unconscious and to
bodily functioning when they are in a relaxed, meditative, state. Total relaxation releases the
imagination from external demands and frees it to turn inward, untroubled by conflicting thoughts.
When they put their subjects in these states, Achterberg and Lawlis found that cancer expressed
itself in metaphor and symbol, much like dreams do. After they had the subjects in their study do
a relaxation exercise to clear their minds, they instructed their patients to imagine their disease,
their immunological response to it, and then draw a picture of what they saw. According to Achterberg and Lawlis, the images that emerged in these drawings were as "real" as
any other symptoms of cancer. Far from being arbitrary and whimsical fantasy, unconnected with
actual pathology, these images, by constituting, expressing, and processing the body's dis/ease,
were as much a part of their disease as the tumor masses inside of them. "Mental" images are
always complemented by "physiological" responses. Achterberg and Lawlis noted: "During
imagery there is measurable tension in the part of the body involved in the visualization. For
example, there is tension in the muscles of the eye during visual imagery, in the muscles of speech
during sub-vocal thought, and in leg muscles when one imagines running."(94) If images can do this
to body, various parts of the body can be expected to reverse the communication and produce
appropriate images of their dis/ease. Achterberg and Lawlis do not remove themselves from the interpretive process, setting
themselves beyond it as neutral reporters of it. They insist that interpreting the images of dis/ease
is a complex circle--the patient offers their images, the healer interprets them, and returns images
of their own, affecting the patient's physiology and imagery, which can be expected, in turn to
affect the healer's interpretive imagery, if not their own physiology and internal imagery. The
interpreter of dis/ease is not objective, outside the hermeneutic circle, but a participant in the
healing (or dis/easing) process, contributing to the imagery that either heals or dis/eases. Once
the healer becomes involved in interpreting the dis/ease, the images the healer makes of it
physically constitute the dis/ease: We maintain that every physician utilizes some form of imagery in communicating with patients;
that it is the process involved in building a will to live; that it is the expectation transmitted to
the patient regarding the ability to return to health. In addition, it may be an underlying factor
in the bedside manner of the physician which conveys, among other things, an expectancy to the
patient involving the medical expertise. We also maintain that the placebo effect, or what the
patient imagines (or images) "ought" to happen following medical administration, directly
guides disease progress, and is inseparable from medical practice.(95) Achterberg's interpretation of the healing process challenges the conventional relationship
between doctor and patient, that of an authoritarian hierarchy based on the scientific expertise of
the doctor and the helpless ignorance of the patient. The doctor orders and the patient obeys.
Instead, Achterberg argues, the relationship should be a partnership, an egalitarian participation in
healing. This requires a disciplined humility by the healer. She must learn to respect the fact that
the patients themselves are, if they are allowed to be, excellent diagnosticians--potentially more
accurate at both diagnosis and prognosis than their doctors.(96) And why shouldn't they be? They
are the ones possessed by the imagery of the dis/ease, the ones for whom its irruption has
meaning, the ones who must submit to its necessity. As the ones dis/eased, the imagery they
interpret their dis/ease with constitutes the disease, defines it, and either promotes healing or
furthers the disease. Because the imagery of the dis/ease cannot be separated from the disease
itself, patient and healer must work with both to heal either. Disease is not a meaningless disorder that comes upon its victims from without, at least not
usually, and never completely. Disease is, at least in some circumstances, a disturbance of identity
that irrupts within circumstances of power/lessness and authority. A great deal of truth about the
diseased person's life is revealed by the irruption of disease. Achterberg and Lawlis write: "The
memory of an early home life inadequate to needs of support and security, a pre-disease event of
an emotional loss, and feelings described as helplessness or hopelessness all emerged in several
independent investigations."(97) Even infectious diseases happen more often to anxious and depressed individuals.(98)Contrary to
the conventional medical view that viral or bacterial infection is an unpredictable event that can
randomly afflict anyone, infection and subsequent suffering do not vary with degree of exposure
to pathogens but rather with the individual's vulnerability to them.(99) The cause of infectious
disease is not something independent of and external to the afflicted person but something that
emerges out of their life, their identity, and their location within systems of power.(100) Achterberg
believes that the whole notion of disease causation, with all of its comforting appeals to accident
and exposure, has to be rethought, and the meaning the disease has for the patient brought
forward. To reveal this meaning, she believes that the conventional hierarchy between doctor and
patient needs to be subverted, and that the patient needs to be able to authoritatively participate in
interpreting their disease. Achterberg hesitates to say it, but the clear implication of her writings is that the conventional
doctor/patient relationship is, from the very start, malpractice, a source of dis/ease itself. By
assuming the scientist's position of power and authority and by imposing uncontestable images on
her disease, the conventional doctor humiliates the patient's inner healer, retarding healing. In the
conventional image of healing, it is not the patient's power that heals, her ability to interpret,
integrate, and negotiate her dis/ease, but the doctor's intervention. Subjected to such authority,
the patient is dispossessed of her power, prevented from generating her own images of healing,
which may be more appropriate. Framing the disease in metaphors of machinery, invasion, and chemistry, such a relationship
conceals social and personal meaning of disease. To conventional medical science, disease is a
reality independent of the patient, a physiological object the doctor accesses by means of her
specialized expertise and the technology of observation. Outside this discursive regime, the
disease has no meaning. As Ivan Illich has argued, doctors have taken over the language of
disease, depriving the sick person of the words to interpret their body's distress and, thus, their
power for self-healing. Just as the language of science has come to dominate all interpretation of
the body, we have given those who master that language the power to silence all other
interpretations of disease. According to Illich, before science came to dominate all language about the body, the expressive
possibilities of ordinary language were quite extensive. Ordinary peasant language had many
popular expressions, proverbs, concepts, and categories with which to interpret disease. "(W)hile
the industrial worker refers to his ache as a drab "it" that hurts, his predecessors had many
colorful and expressive names for the demons that bit or stung them." Dependence on the
language of an elite profession, according to Illich, "makes disease into an instrument of class
domination . . . (T)he worker is put in his place as a subject who does not speak the language of
his master."(101) Because of the expropriation of the language of the body, the medical
establishment, Illich believes, "has become a major threat to health." Healing, Achterberg believes, much in agreement with Illich, is a recovery of power, or, as I
would say, an allowing and accepting expression of the self's own ecopolitics. And anything that
takes power away from the patient, silencing the inner politics of her body, thwarts healing. By
making the patient an equal partner in the healing process, by accepting the expression of her own
inner ecopolitics of identity, the patient gains first understanding, then hope, then trust, and this
empowerment contributes as much to healing as anything else.(102) To empower the patient, a language of images must be developed so that the patient's conscious
mind, their body's ecopolity, and the healer can communicate with each other,. When this
language is in place, the patient can learn the meaning of their dis/ease and can locate it in their
life, and then can confront the issues it emerged out of. While there are cultural symbols and
commonalities that allow some measure of preunderstanding, Achterberg's language of dis/ease is
a negotiated and intuitive one, built of contingent and shifting metaphors. Though some symbols
seem common, indeed archetypal, many of the images that spontaneously arise within the
meditations are deeply personal, biographical. Both patient and doctor need to learn how to read
them to figure out what the dis/ease means for that particular person. Failure to recognize the personal imagery of dis/ease, Roger Levin believes, is why so many
studies in psychoneuroimmunology have gone astray, failing in the same way that conventional
medical science has long failed. Seeking to quantify the experience of disease, to provide an
objective account of subjective emotions, many cognitive psychologists have tried to identify
specific attitudes, stressful emotions, or specific coping styles that cause disease. In the process,
they ignore the felt experience of disease, what the disease means in the context of the patient's
life, how the disease is an expression of dis/ease. Stressful experiences like the death of a spouse,
unemployment, or divorce can have widely different meanings to different people.(103) They will be
distressing in entirely different ways, depending on how they challenge patient's identity.(104) The
language to interpret dis/ease, while there may be many intersubjective and transpersonal
dimensions to it, must be built anew with each person. The process of building this language begins with the healer teaching the patient the physiology of
the body and the power of imagery. The more the patient is educated in the body's physiology
and in the power of imagery to promote or thwart healing, the more the patient and the healer can
interpret what is so dis/easing in the patient's life, contest the situation and the imagery that have
brought on the dis/ease, change it, and cultivate healing. To diagnosis the body's imagery,
Achterberg and Lawlis mapped out 14 different dimensions of healing. Each dimension is scored
by 5 different points.(105) After letting a vision of their dis/ease come to them in a meditative trance
. . . . Patients are requested to draw a picture which contains three things: (1) their tumors (or
disease, or cancer) as they picture it in their mind's eye; (2) their body's defense against the
tumor, or the white blood cells; and (3) their treatment, if any is being received. Frequently, the
patients will protest that they cannot draw. It is a good idea to assure these patients that detail,
not artistic ability, is what is sought.(106) Almost invariably, according to Achterberg and Lawlis, the vividness of the imagery of the cancer
cell was strong, low scores being rare. The vividness of the imagery, they believe, is a sign of the
patient refusing to acknowledge the existence of the disease. The vividness of the image was not
strongly related to disease response or future prognosis. However, the second dimension, the
activity of the cancer cells was. If the cancer cells were moving around a lot it suggested that
they had metastasized, moved out of their original site. It also suggested the patient's attitude
toward the spread of the cancer and their level of anxiety about it. "The crab, a frequently chosen
symbol in all groups studied, was also given generally low ratings because of the implications of
movement and the unpredictability of the response. On the other hand, the use of an animal such
as a slug would imply slow or reduced activity, particularly when used in contrast with the active,
powerful wolves or dogs representing the white blood cells."(107) The third dimension, the strength of the cancer cells, is one of the most important for predicting
the possibility of recovery. The harder, tougher, more immutable, or more powerful the symbol
chosen to imagine the cancer, the less hope the patient has for healing it. If they do not change
the hopeless imagery they use to interpret their disease, they will not rally their defenses and the
disease will progress, just as they imagine it will. The vividness and activity of the white blood
cells, on the other hand, symbolize the patient's self-image, their projection of themselves onto
their white blood cells. "If they fail to describe this aspect of self adequately, it may well mean
they feel defenseless or victimized by the disease, with little hope of recovery."(108) Self-generated
activity by the white blood cells, as people or animals would have, reflected a confident
self-identity, likely to resist the dis/ease. "Drawings containing snowflakes, bubbles, or other
symbols which have no energy source of their own would be scored low."(109) The size of the white blood cells and the size of the cancer cells reflects their relative strengths,
and may suggest the outcome of the disease. Whatever is true of the self's possibilities for
maintaining its identity against the disease is often projected onto the size of the white blood cells.
Similarly, the strength of the white blood cells reflects the patient's ability to defend identity.
"Strength implies destructive capabilities of the symbol and the general effectiveness of the
immune system in fighting the disease."(110) The patient may imagine the struggle against cancer in a variety of ways, ranging from violent
attacks involving tearing, biting, and ripping, to contemplative routines that proceed with much
deliberation. Whatever the image, the sign to read is the consistency of the image of the white
blood cells successfully engulfing, dissolving, or destroying the image of cancer cells. The image of treatment is another sign of how the struggle for identity is proceeding. If the
patient imagines treatment as little but a source of suffering, of hair loss, vomiting, discomfort--as
basically an invasion and a violation--it is not helping. But if the patient imagines it as a helpful
ally, targeting the cancer cells, making them sick or weak, and assisting the white blood cells, the
prognosis is more positive. Another sign of how well the struggle is going is how well the image
of treatment fits in with the other imagery. Is the treatment imagery appropriate or not, effective
or not, against the cancer images?(111) Other dimensions include the amount of symbolism in the imagery--overall, the more symbolic the
better. (Literal images of the immune system fared poorly, while symbolic images, like white
knights and sickly dragons fared well.) Overall strength of the imagery suggested how much the
patient was able to concentrate on it, as well as the regularity of the imagery. The imagery that
patients develop is a possibility enabled and constrained by the contingencies of their life, shaped
by lifelong experiences and competencies.(112) If, being blessed with many personal strengths and
abilities, they have had a history of winning struggles, they can easily imagine that in their struggle
against cancer. If exploitative, sexist, or racist institutions have consistently thwarted their life's
expression, the imagery of their struggle against cancer will reflect that reality, too. If they have a
poor self image, induced by abusive or neglectful parents, peers, spouses, or bosses, they will
project that image onto their white blood cells and their struggle against disease will be
accordingly passive, limited, and unaggressive. Achterberg's work suggests that life's experiences
may be far more enabling or destructive than we ordinarily assume because they give us the
imagery that constitutes our struggles against disease.(113) Achterberg observes that the ability to sharply distinguish self and other promotes healing and
recovery. People with an "ornery" disposition, born-again Christians, people with a strong sense
of self and of their self worth, do well against disease. Whereas "nice" people, the kind who make
"good" patients, are too often disowning their power, suppressing their life energy, and are unable
to take up the struggle to maintain identity militantly. Overall, images that are successful in
maintaining self against cancer are those representing "strength and purity," those "powerful
enough to subdue an enemy," and "pure enough to do so with justification."(114) Effective images
are often of white knights or of Vikings--heros who aggressively pursue their cause against the
other. Other symbols that are effective are of "large, powerful animals, especially dogs and
bears." Effective symbols are powerful, intelligent, aggressive, and relentless. That's what works,
at least in our culture. The images that don't work are often of "mechanical devices, such as vacuum cleaners, automatic
sprinklers, shovels, or picks, that might be used to dig out the cancer."(115) These images don't
work, Achterberg and Lawlis believe, because they don't have their own source of energy--the self
is dependent on something outside itself to maintain its identity, limited by something it has no
control over. These images are not self-sufficient, but other-dependent. Somewhat counter
intuitively, highly destructive elements like fire, poison, or acid are not good symbols against
disease either, since they may reflect the discomfort and pain of treatment. Ants are a particularly bad image, either as a symbol of the immune system or, especially, of the
cancer. Exclusively selected by women, ants are an image that is almost impossible to resist.
Ants leave behind themselves a regenerative trail that is impossible to erase. While some ants may
be destroyed, other ants will find the trail and continue following it.(116) Similarly, "crustacean
creatures such as crabs, scorpions, lobsters, or even octopi--animals that have in common a
tentacle (or a claw) that clings or grabs--are not good symbols."(117) These are hard shelled, well
protected, images of disease that bite and cling to the self, and are powerful and difficult to break
free of. It is not a coincidence that the word "cancer" is derived from the Latin word for crab. The task of the healer is to politicize the patient's imagery, first by allowing it expression, then by
contesting self-defeating images, and finally by cultivating images that promote recovery.(118) Most
of the time patients are quite cooperative, once the reason for a shift in imagery is explained to
them. "At other times it is a task fraught with trauma and difficulty. In such cases, the reasons
underlying the resistance require sensitive investigation."(119) That the disease is not just something
that just randomly happens to people, is attested to by the fact that all of Achterberg and Lawlis's
patients who recovered attributed their survival to a shift in self-image, a change in perspective
that allowed them to interpret themselves and their world differently. Just as the imagery of disease is yet another symptom of it, disease may be but a symptom of a
dis/easing life. Or more accurately, disease may be symptomatic of a whole world in pain--a
reflection of personal relationships that have become dungeons of torture, of career aspirations
thwarted, of needs--social, physical, emotional--unmet, of metaphysical and political hierarchies
that cast life's energies into the shadow, disowning them. Far from an arbitrary or random event,
we can read disease as symptom of dislocation, displacement, and disruption in the family, the
workplace, the community, the state, and the relationship between humanity, nature, and the
gods. Disease is a symptom of the world's pain. As such, it is a sign not just of the individual's
life, but of the world that worlds around her, its truths, its hierarchies, its revealings and its
concealings.(120) The world's politics does not take place just outside the body, independent of it, without any but
the most indirect consequence for it, but within it: in the immune system, the endocrine system,
the circulation system, the nervous system. The microcosm of the body duplicates, replicates, and
retains the play between self and other, individual and community, and identity and difference that
happen in the macrocosm of society. Symbols, words, practices, relations penetrate the body,
communicating their effects to every cell and organ in the body, as words and symbols
communicate with other people. For this reason, the healing rituals and symbolic practices of
shamanic cultures have real effect. Perhaps, one day we may even conclude that the symbolic
medicine that "primitive" cultures practice is more effective in dealing with dis/ease than
"scientific" medicine.(121) Power, metaphor, role, and identity affect our health all the time. Just as our consciousness does
not stop at our skin, but is intersubjective and transpersonal, neither does our physiology. Other
people, as expressions of the world's worlding around us, constantly affect our physiology by
affecting our thoughts, our self understandings, our social possibilities. They shape, define, and
affect our body's ecopolity by giving us our identities, telling us how intelligent we are, how
attractive, how popular, and how ashamed we should be of our failings and faults. We interpret
ourselves as others interpret us, celebrate in ourselves what others find worthy in us, and cast into
our shadow those things they do not, disowning them and denying them. As others interpret us,
they communicate with our immune systems, giving them the metaphors that they use to identify
self and other. Entangled in the bodies of ourselves and others, words are powerful. They can
heal and they can kill. Mere words. As Ornstein sums it up: So where we stand in our society, how we get along with our spouse, parents, children,
coworkers, the attention we give them, and the attention they give us, all are translated,
transformed, and transmuted directly and indirectly by brain mechanisms into changes in
hormone levels, shifts in neurotransmitters, signals to move and to stop moving, to attack and to
embrace, to sickness and to health, to life and to death.(122) Health is inescapably political then, because politics--which we can describe as the struggle for
identity, for meaning and coherence--determines the social, political, personal, and economic
situations in which we find ourselves. While modern medicine interprets only the mechanism of
disease, an ecopolitics of dis/ease reveals the images, interpretations, identities, alterities that give
it meaning and determine the body's response. And if the modern age, which seeks to reduce
everything to a mere mechanics of force and resistance, has dismissed any meaning in disease,
isolated it as a tragedy and ignored it as a metaphor, this does not mean that disease is
meaningless, only that the discursive politics of modern medicine, by requiring that everything
submit to its rules of discursive formation, has cast the political meaning of disease into its
shadow. By understanding disease as a meaningful individual response to being embedded in the
power relations of household, community, economy, state, and discursive tradition, disease
becomes dis/ease, a space for contesting harmful identities. Once this space for interpreting
disease as dis/ease is opened up, we gain new possibilities for healing it. The key is allowing a
language of dis/ease to emerge. This allows us to deal with its truth. Lydia Temoshok, discovered that cancer victims are almost invariably inexpressive, unwilling and
unable to tell the truth about how they feel, what they are. They conceal their feelings, trying not
to express them for fear that other people won't accept them. Almost without exception, she
observed, people suffering cancer are nice, polite, quiet, considerate. And almost without
exception, she found out, it is all a facade, a front behind which hides anger, resentment, and fear.
To the person suffering cancer, expressing these feelings, even though they are there and real, is
terrifying because it could provoke retaliation from others on whom they depend. They don't
have the power to tell the truth. Their self-identity and their position in society are caught up in
being pleasing to other people, being liked, being accepted, and so these inner emotions are a
terrifying threat to identity, and must be repressed, thrown into the shadow. As a result, people
who suffer from cancer tend to be giving, self-sacrificing, self-effacing. They resist temptations to
complain, they are compliant with authority, and eager to maintain a pleasant demeanor. This is
their strategy for getting by in a world that refuses to accept their claims on life. Their experience
of life's cruelties is politically threatening to others, a challenge to their identities, and so it is
repressed. So consistent was this pattern of behavior in people who suffered cancer that Temoshok gave it a
name--the "type C personality." In giving this name, Temoshok was consciously contrasting it
with the type A personality, which had earlier been linked to heart problems. According to
Temoshok, type C personalities are the polar opposites to type A personalities, everything they
are not. It is almost like each personality is bringing out, revealing, and producing the opposite
traits in the other. American civilization seems to reward and cultivate the type A
personality--aggressive, fiercely competitive, power hungry, self-centered, focused on only
egoistic needs. These are the traits that get people to the top of the social hierarchy and keep
them there. As they climb to the top, and take control of the world, the type A personality produces its others,
its enablers, and its subordinates. The type C personality is the result. It is the identity that the
type A brings out in others as it becomes itself. If they are aggressive, conquering, and
domineering, their identity requires others to be submissive, accepting, and obedient. If they
freely express their emotions, particularly their angry, hostile, and judgmental emotions, their
identity can only be secure if others, especially those beneath them, do not express theirs. Their
identity as top dog is a fragile one, easily threatened, and so it requires that any politicization of
their self interpretation be silenced. Needing to be the ones who authoritatively judge the world,
who fix in place the identities of others, they depend on the submission of others, on their need,
out of weakness and fear, to accept the identity imposed on them. To the degree that the type A's
are successful in the pursuit of their identity, others are forced to assume an identity that is
nonexpressive, compliant, and obedient: the type C. The type A and the type C personalities are doublets, neither of which could be without the other.
Together, they form a complete system of dis/ease. And hostility is the core item of exchange in
this relationship. While the type A personality has many faucets like competitiveness and
impatience, according to recent research, the one trait most strongly correlated with heart disease
and death from heart attacks is hostility, the angry rejection and condemnation of another.
Similarly, the core factor in the type C personality, Temoshok found, was the nonexpression of
emotions. As she observes: "I found most type C melanoma patients to be pleasant, passive, and
self-sacrificing. But I found all of them to be nonexpressive."(123) They are nonexpressive because
they have to be. The type A freely expresses their hostility--judging, condemning, isolating, and
intimidating others--while the objects of it, who are constrained to accept their judgments either
out of fear or powerlessness, must disown their hostile emotions. Otherwise, they risk becoming
the victims of more hostility. Like Temoshok says, type C personalities . . . "never choose to be
nonexpressors. They stopped expressing emotions at an early age in order to foster security in
their social environment."(124) On the surface, Temoshok's cancer patients seemed to be type B, relaxed, noncompetitive, never
throwing out-of-control temper tantrums. They seemed to be at peace with themselves and with
others. But when she examined them further, she found that: (I)t was clear that their lack of anger did not stem from a sense of inner peace. Their inability to
assert themselves was extreme and I did not see it as a healthy departure from the rat-race
mentality. Underneath their facade, there was a great deal of unexpressed anger, carefully
guarded feelings of anxiety, and in many cases, I was to discover, a deep-seated feeling of
despair. Put simply, these people were no type B's.(125) Uncovering all this inner anger and resentment was difficult. When asked, Temoshok's cancer
patients maintained that they were not angry, depressed, or resentful. Even when she pressed
them hard, they denied feeling these emotions. It was only after much effort that these emotions
came out. So completely fearing to own their emotions, the type C personality often not only
consciously denies these unacceptable emotions, they repress them completely, forcing them into
the unconscious. In the worst cases, Temoshok found that the type C personality will truly be
completely unaware of their anger, resentment, sadness, and fear. They would say that they did
not suffer from these dis/easing emotions, yet their body knew better. Temoshok and her
colleagues would videotape her interviews, then later do a careful analysis of her subjects' body
language and facial expressions. In slow motion, their subjects would often betray their real
emotions. After one woman laughed about how inconvenient her cancer was, for a fleeting
instant, too fast for Temoshok to see in the interview, "her mouth stretched downward and
dragged all the muscles of her face into a look of horror. (Her) expression was striking and
undeniable--a fleeting revelation of feeling rising up onto her face but not into her
consciousness."(126) The other subjects had a similarly repressed pattern of body language--a firmly set facial mask, a
forced smile, closed-mouth style of speech, minimal movement of the head, a squinty
defensiveness in the eyes, a nervous chuckle. There was a certain kind of emotional numbness
about them. They repressed their unpleasant feelings by numbing themselves to them, refusing to
acknowledge their body's feelings. They revealed this dramatically in another experiment that
Temoshok did. She and her colleague, Andrew Kneier, drew twenty cancer patients, twenty heart
disease patients, and twenty healthy people from a population of people going to University of
California Medical Clinics. She hooked them up to a machine that registers skin conductance
response--a lie detector in other words--and showed a series of slides that had statements written
on them designed to disturb the person--to provoke anger, sadness, anxiety, threats to
self-esteem, or threats to interpersonal needs. Like, "you've done nothing worthwhile," "no one
loves you," and "you're furious inside." As she expected, the cancer patients repeatedly said that what the slides said to them did not
bother them. But their body said something entirely different. The skin conductivity response
readings registered high anxiety, sadness, anger, fear, or stress, as she writes: As we predicted, the cancer patients had the highest Repressive Coping scores, the heart patients
had the lowest, and the healthy subjects were right in the middle . . . Whereas the cancer patients
reported far less upset than their bodies registered, the heart patients reported much more upset
than their bodies registered. This confirmed my hypothesis that cancer patients were mainly
repressors, heart patients are "hot reactors," and healthy individuals occupy a moderate middle
ground.(127) Perhaps with intended irony, Temoshok calls the difference between what cancer patients
reported about their dis/ease and what their bodies revealed the "mind-body split." Neither cancer
patients nor heart patients were able to tell the truth about their bodies. Between them and their
bodies a rift had opened up, concealing the truth. She writes, "I was often amazed when cancer
patients handed in written forms indicating how "unbothered" they were by certain slides, when
their SCR readings had skyrocketed during those very slides."(128) Temoshok's prescription for healing dis/ease is telling the truth--the truth about what the body
feels, the truth about what the self is experiencing. If a person cannot speak the truth about their
lives, their bodies will do it for them, revealing with disease the dis/ease in their lives. The truth
always happens, if only in a concealed, dysfunctional, and symbolic way.(129) Before Temoshok, other researchers like Sandra Levy had found that the expression of positive
emotions was healing. Levy had followed 36 women who had suffered a recurrence of breast
cancer. Two thirds of them had died seven years later. The one third that did survive all had in
common something that the two thirds who died did not, the ability to express joy in living. In
fact, the expression of joy was so important a variable that it was a more powerful predictor of
survival than anything medical doctors used to determine prognosis. But Temoshok maintains
that it is not only expressing joy that helps heal; expressing anger, distress, sadness, and fear helps
too. It is not the quality of the emotion that heals; it is that it allowed to be felt, expressed,
acknowledged. Allowed to be, expression heals, even the expression of opposites: "When I
break these qualities down I find both anger and joy, strength and the capacity to admit need.
One thread running through all the survivor studies is expression--expression of positive and
negative emotions."(130) The type C personality pattern is, according to Temoshok, a defensive strategy to protect one's
identity against painful circumstances in our families and society. By depoliticizing dis/easing
inner and outer situations, silencing troubling emotions, thoughts, and needs, it allows both the
self and the outer world to avoid having to change. The type C personality is a functional
response, the best that can be made, to a world that is unwilling to listen to or accept all the self's
needs, a world that requires many aspects of the self be thrown into the shadow. Temoshok, and others like her, emphasize expressing repressed emotions, but the political
implications of that are often ignored. The type C conceals their emotions because of their
circumstances. While they may be learned responses from an early age, as Temoshok believes,
and are inappropriate to their current life situation, this is not always the case. People disown
their shadow because other people, people who have the power to insist upon it, won't accept
these traits in them. When this happens, the disease is an effect of systems of power, hierarchy,
and exclusion. In these circumstances, accepting the shadow, allowing the expression of vital
truths about the self that others are not willing to accept, is a political effort, not just a personal
one. Before healing can happen, the significant others in a dis/eased person's life have to open up
a space for telling the truth, have to allow their identity to be contested. In the end, healing means
allowing the truth of the self's dis/ease with the world to be told, acknowledged, and, most
important, acted upon. Back to Contents
Chapter 4
Dis/ease as a Politics of Identity
Jesus said, "If you bring forth what is within you, what you bring forth will save you. If you do not bring forth what is within you, what you do not bring forth will destroy you."(131)
The Gospel of Thomas
Disease, as we discussed in the last couple of chapters, is not located just in the mechanics of the
body but also in the language, metaphors, and imagery that have possessed it, that the body is
entangled with others in. In the entire situation that has dis/eased the self. As Achterberg
observes: "The functioning of individual cells is the result and not necessarily the origin of
organized living. Cancer is no more a disease of cells than a traffic jam is a disease of cars. A
lifetime study of the internal combustion engine would not help anyone to understand traffic
problems."(132) While epidemiologists can predict that an increase of toxins in the environment will
increase the incidence of cancer, they have the greatest difficulties predicting exactly who will
develop cancer, this person and not that person. This is because cancer is, as most diseases are,
not just an effect of exposure but also of vulnerability. Even though exposure to toxins or
pathogens may be necessary, disease will not develop unless the body is, as a whole system,
unable to prevent it. In this chapter we are going to explore in more detail how dis/ease is located
in the world, in the vulnerabilities of identity and difference.
Much has been written about the power of visualization and meditation techniques to promote the
body's immune response, control blood pressure, speed healing, and many other things, but these
techniques, however powerful and effective, are only a continuation of conventional medicine if
they do not politicize and change the imagery and the situation that made the individual dis/eased
in the first place.(133) Healing, I contend, requires politicizing the transpersonal imagery and the
intersubjective identities that give life meaning, that is to say, expressing what has been concealed
and letting be what has been repressed. To politicize dis/ease is to polity-ize it. That is to say, to
bring it forth, to reveal it as something that belongs to the polity, something that the whole world
is involved in: the individual's family, their community, their state, and the entire biosphere. By
polity-izing it, dis/ease is revealed as a connection to others and all of nature, as relationships or
investments in alterities that need to be rethought, contested, and remade. Polity-izing disease means taking the situation as a whole and contesting everything that allows
disease to emerge. This would include, though it isn't heavily emphasized in this book, contesting
the social and economic dynamics that result in industrial pollution, overpopulation, and the loss
of biodiversity. Politicizing dis/ease is identical with making things whole, healthy again, because
the polity is the whole, in every way thinkable. When disease happens, nothing that allows it to
emerge should be excluded from being politicized because nothing is healed until everything that
is involved is healed. This includes our relation to other living things. They are as much a part of
a dis/easing life as people are, and as we shall see later, belong with us, as citizens of equal worth,
in the world's ecopolity. The toxins we poison them with become the toxins that dis/ease us. The polity, as I understand it, includes all of nature's economy, every living being we humans
share the earth with. Our health depends upon their health. Dis/ease in this ecopolity is an
irruption of truth, evidence that something is wrong with the way the world is worlding.
Politicizing dis/ease allows this irruption to be heard, understood, and healed. We will open up
discussion later about how this might be done with other species, but, for this chapter, we will just
look at the meaning disease can reveal in the lives of humans. According to Stephanie and Carl Simonton, people often develop cancer after a failure to find
meaning in their life, when it becomes a lie to their truth. Unable to change the power dynamics
of their life situation, they become despondent and depressed, feeling like they are the helpless
victims of life, and wish that they were dead. Cancer victims who have access to their inner
thoughts and feelings, often report that they wanted to die, that it was the only way they could
imagine escaping the pain in their life--the pain of loss, frustration, unresolvable conflict,
entrapment in meaningless and empty roles. Lacking images that would enable them to deal with
their problems, they lacked the power to heal their lives.(134) Forced to live the lie of a false self, death becomes, for some people, the final escape from a truth
they cannot admit to themselves. Sometimes, according to the Simontons, cancer suddenly
develops when people discover that their spouses are having an affair, especially if they are
religious and are unable to accept the idea of divorce or marriage counseling. Edith Jones faced this problem in the extreme when she discovered that her husband, the father
of their six children, was having extramarital affairs. She did not believe she could tolerate the
situation but she also did not believe in divorce. There appeared to be no alternatives and so
she felt trapped. She contracted cancer and soon died. For Edith, death represented a solution.
Other women might have found a basis for continuing the relationship, and still others might
have given themselves "permission" to obtain a divorce.(135) The identities that people pursue, the dreams that they use to interpret their lives, often become
prisons that dis/ease them, trapping them in a world false to their needs. Such was what happened
to June Larsen, another one of the Simontons' patients. Like many women trying to live up to the
image of the good mother, June invested her identity in her children. "As chauffeur, cook,
nursemaid, and counselor to her four offspring, June Larsen's days were a whirl of ballet classes,
music lessons, football games, slumber parties, and P.T.A. meetings."(136) Her husband was a
successful executive and spent little time helping raise their children, leaving it all to June. But
then her children grew up and left home.(137) When the last left for college, June said she felt "as if
a part of my life had been cut out of me." Deeply depressed,(138) unable to develop a relationship
with her husband, without a meaningful purpose in her life, she developed breast cancer with bone
metastases a year later.(139) According to the Simontons': June's primary identity had been tied up in her children. When thrown back on her own
resources she discovered that most of her skills were for nurturing others rather than for meeting
her own needs. She felt forced to accept that there was little left of her marriage. While the
actual external stress--the blow of her last child's leaving for college--may seem small, it totally
undercut the role that had defined her for many years.(140) Having available an alternative image of a meaningful and rewarding life--a renewed marriage,
new life roles, new intimate relationships--is essential to recovery from an identity that has
become dis/easing. Without an alternative image of a fulfilling life, unable even to imagine the
possibility, people cannot escape the prisons their identities have become. This is especially clear
when people retire from active careers. Suddenly, everything that had made their identity
meaningful and worthy is gone, self-image deteriorates, and troubling thoughts, long concealed,
start revealing themselves.(141) Another of the Simontons' patients, Sam Brown, was an executive, a man who felt important and
needed. But after he retired, people seemed uninterested in him. He didn't matter anymore. Over
the years he and his wife had grown apart, and conflicts hidden with her came to the surface. He
started to wonder if he had really accomplished anything in his life at all. Besides that, his friends
started dying and he began to imagine his own death. Only fourteen months after retirement he
had cancer of the bowel.(142) Loss that threatens identity can come about in many different ways, ranging from loss of intimate
others, to loss of financial security, to loss of self-image. When people realize, or are forced to
accept, that they are not the people they think they are or want to be, when an institution or
individual imposes on them an identity they feel is alien, the security of the boundary between self
and other is upset, and the immune system is no longer able to protect identity the way it used to.
They have become something they do not want to be. Otherness has violated them, transgressing,
erasing, or moving the boundary separating them and others, thereby weakening the power of
their immune systems to differentiate the two, and disease emerges. According to the Simontons, their patients invariably imagined themselves as victims, in some way
helpless to maintain the identities that gave their lives meaning. A couple of months, or as much
as a year and a half before they developed cancer, something happened in their lives that disrupted
their self-images, the dream of what they were, and they could no longer be the people they felt
they must be. The pattern for health and disease, the Simontons argue, is set in childhood when children first
take on their ideal images of self, when they form their Super Ego.(143) During this crucial period
of self development, they establish rules, consciously or unconsciously, and they start
differentiating themselves from others. They identify with certain people, most often their
parents, and they differentiate themselves from others. These others are those who are identified
as evil, unworthy, uncontrolled, unclean, irresponsible, perverted--whatever. "Most of us
remember a time," according to the Simontons, "in childhood when our parents did something we
didn't like and we made an internal pledge: 'When I grow up I'm never going to be like that.' Or a
time when some contemporary or adult did something that we regarded highly and we made an
internal pledge to behave in a similar way whenever we could."(144) These are the images that we
begin to live by, aspire to be, and as the years pass they actually become our identity. This can be good or bad. Invariably, when these identities are first adopted, they are the best
thing for the child to do, the most likely strategy for maintaining identity in the situation in which
they are embedded. Children are not dumb. However, as the child becomes an adult, these
identities, especially if they are unconscious and repressed, can become self-defeating, a source of
dis/ease when applied to inappropriate situations. Every identity has strengths that enable it to
maintain itself against the otherness it excludes and weaknesses that make it vulnerable to
disruptions that will dis/ease it. Whether a given identity will be a source of strength or weakness
depends upon the contingencies of life. Sometimes, the Simontons observed, identity is formed around traumatic or threatening
experiences in childhood. "If children see their parents engaged in terrible fights, for example,
they may make the decision that expressing hostility is bad. Consequently, they set rules for
themselves that they must always be good, pleasing, and cheerful, no matter what their real
feelings are."(145) Other children, trying to get some sort of protection in a threatening situation,
may assume responsibility for the feelings of other people. If someone is upset, angry, sick, or
depressed, they will try to make them feel better. Whatever personal sacrifice it takes. Cancer
victims are quite often "nice" people, the Simontons observe, along with many other researchers.
But such "niceness," they argue, carries with it the necessity for disowning, repressing, and
controlling large parts of themselves. Fearful that the caring and sympathetic identity they have
assumed will prove to be a facade, untrue to them, they devote much energy, often unconsciously,
to casting their anger, resentment, and hostility toward others into the shadows, where these
emotions fester, secretly dis/easing the self. Disease finally happens when too much of the self is denied, thrown into the shadow, and made
into an enemy. When the truth becomes unacceptable. Those who are most vulnerable to
dis/ease are those whose identities are inflexible, who are unable to adapt to the stress of
situations where their identity must change, and who cannot accept all the aspects of the self they
have become. Then, the truth no longer harmonizing with their self-image, they become
dis/stressed. The stress of an event, like the death of someone near, divorce, loss of a job, or
whatever, is not as important as the meaning it has for the individual's self-image. Dis/stress is the
interrelationship between identity and situation, between the ideal of self and the truth of self. Dis/stress happens when the individual cannot maintain their image of themselves in the situation
they are in. They must continue to do things "the right way," even if it is very much the wrong
way. Their identity has become a trap, a prison. It is the source of their dis/ease, and yet it
supplies the only self-image that they can accept in themselves. Disease usually sets in when they
realize there is no way out of the self they have become. Unwilling or unable to change their
situation or their identities, they begin to interpret themselves as victims, helpless before the
onslaught of a cruel and unfair world. Feeling helpless against the world, their immune systems
become helpless against cancer.(146) According to the Simontons, once people begin to interpret themselves as victims, they become
increasingly rigid, static, and unchanging--increasingly unable to change themselves enough to
manage the situation. Nothing will do any good, so why try? There is no hope. They give up
and start "running in place," pretending to go through the motions of their life. Outwardly they
may seem the same, carrying on as before, but it is all empty, a pretense. Their actions, their
roles, their identity has no meaning, no purpose, and so death becomes a solution. A way out. Some of the Simontons' patients are quite conscious of this thought process, of wanting to die,
and can recall with vivid clarity the moment when they came to this sad and bitter conclusion.
Others repress this thought process--it is too much of a threat to an image they must still maintain.
"Good people" don't want to die when the going gets tough, their false self insists, and so they
disown their need to die, throwing it into the shadows of the unconscious. Then pretend that they
are trying to live. "This process," the Simontons maintain, "does not cause cancer, rather it permits cancer to
develop."(147) As we saw, cancerous cells are always developing in the body. It is also possible
that this shift in attitude brings with it hormonal changes that encourages the development of
abnormal cells. Whatever. What ultimately separates people who are able to heal their cancer
from people who succumb to it is the ability to find meaning in life and affirm it.(148) The
Simontons contend that cancer victims heal themselves when they assume responsibility for the
meaning their lives have, and if it is meaningless, they heal themselves when they make it
meaningful again. The crucial point to remember is that all of us create the meaning of events in our lives. The
individual who assumes the victim stance participates by assigning meanings to life events that
prove there is no hope. Each of us chooses--although not always at a conscious level--how we
are going to react. The intensity of the stress is determined by the meaning we assign to it and the
rules we have established for how we will cope with stress.(149) Clearly, there are some problems here with the modernist theory of language and subjectivity the
Simontons use to interpret the world. They believe that language--and meaning--is something
that humanity can impose on the world, control it with, make it subject to the will. As I have
argued, this is not true. Language is there before we are, speaking us before we speak it, the
master of us before we master it. What meaning life has is not the result of any choice we make,
but of the world's worlding. Meaning cannot be mastered or controlled, willed or chosen. It
simply happens, or does not. We cannot choose to have a meaningful life, and we cannot assume
responsibility for the meaning of our lives. It is either there, or it isn't, as we will see in a later
chapter. If the Simontons are on weak ground when they claim that the victim of cancer wills the meaning
or meaninglessness of their life, they are right, I believe, when they argue that the victim of cancer
participates in their dis/ease when they don't let truth happen. Cancer is not an affliction that
comes randomly, without meaning; it is a revealing of truth, even if it is the truth that life has
become meaningless. By dwelling with this truth, by letting the world world, dis/ease reveals the
truth of much more than itself. Dis/ease reveals the meaning the world has, and this, when
accepted, can open up a space for a turning to happen, a recovery of meaning. And a recovery of
health. But this is not something the self can do by itself, I emphasize again. The modern world is a
demanding place. Many claims of judgment, merit, responsibility, and character are made against
the self. As technology gathers up the world as an object of control, increasing aspects of our
behavior are normalized, placed in hierarchies of productivity, intelligence, skill, sexuality, social
adjustment, and so on. With each scale applied to our lives, another aspect of the self is judged
unacceptable and cast into the shadow. In order to "fit in," to not be other to this regime of
power, people are forced to disown various aspects of their selves. To have a meaningful identity
in this system of power, one must become acceptable to the they world, the world in which the
other is collectively feared and repudiated. This process of normalization and submission before
the they world, is something completely beyond our control. We are not responsible for the
identities the they world imposes upon us, and we should not pretend to ourselves that we could
become other that what it has made us into just by choosing to. Much more than any virus or
bacteria, the they world has the power to infect us with difference and dis/ease. However, even though the Simontons' do not fully appreciate the power of the they world and the
extent we are subject to it, they do understand some of the dynamics. For example, when disease
is acknowledged, legitimated, and accepted by other people, according to the Simontons, it
brings with it enormous benefits. Being sick frees people of their responsibilities, allowing them
the space they need to accept the disowned parts of themselves--to become grumpy,
uncooperative, and unpleasant for a day or two. By being sick, people can evade the rules,
norms, and judgments that had long made them lie about themselves in order to go along with the
they world. As the Simontons' point out: Illness includes much pain and anguish, of course, but it also solves problems in people's lives.
It serves as a "permission giver" by allowing people to engage in behavior they would not
normally engage in if they were well. Think for a moment of some of the things that people get
when they are sick: increased love and attention, time away from work, reduced responsibility,
lessened demands, and so on. Because cancer patients are often people who have put everyone
else's needs first, they have obviously had difficulty permitting themselves these freedoms without
illness. In this way, illness works to suspend many of the attitudes that block people from paying
attention to their own emotional needs. In fact, when you are ill may be the only time it is
acceptable to drop the responsibilities and pressures of your life and simply take care of yourself
without guilt or the need to explain or justify.(150) Disease, however, can become a trap. If it gives people things like freedom, love, and the
attention that they have been denied and are starved for, they develop an investment in it. Part of
themselves, the part that has been so long neglected and abused, needs the disease.(151) And so
healing is resisted, thwarted. In order to prevent dis/ease and heal it, we need to think of ways to
give people the freedom to be themselves without resorting to such desperate strategies. The
world has to be loosened up, slack allowed, and the they world, in particular, has to be made less
tyrannical. This involves an ecopolitics of toleration, contesting the demands of judgment,
normalization, reason, and efficiency that make us present a false self to the world. The Simontons' patients often used disease as a way to escape the tyranny of the they world. For
example, a young man they called "Willie" felt hounded by the authority figures in his life--his
parents, his teachers, and his boss at a part-time job. They were always violating his space,
making him do things he didn't want to do. In a moment of rebellion, he ran off and joined the Air
Force. Not a good idea. There, outranked by everyone, he found himself surrounded by
authority figures relentlessly telling him what to do. Crowded, feeling violated, unable to find
anyone who had any sympathy for his situation, he began to fantasize about having a terminal
disease. That would make people feel sorry for him, give him some slack. Not long in this
situation, he got what he wanted, malignant lymphoma (Hodgkin's disease). "When told of the
diagnosis, he said he experienced a sense of excitement, almost happiness."(152) Realizing how
much he participated in his dis/ease, that he was using it to rescue himself from the demands of
authority figures, he went to the Simontons' for help. They worked with him to resolve his
problems with the demands others were placing on him. And it worked well with him; he
recovered. A young psychiatrist, who was another patient of theirs, had a similar problem getting the space
he needed in the they world. Six months before his diagnosis: "(A) long-term patient of his tried
to commit suicide and another person was killed as a result."(153) This young psychiatrist had been
experimenting with new therapeutic techniques, and when this happened, his professional peers
took the opportunity to harshly discredit his challenge to their orthodoxy. His self-image battered
by guilt and the attack of his peers, he became suicidal. Shortly after that he developed advanced
lympho-sarcoma involving his lungs and liver. Chances of recovery were deemed remote. According to the Simontons, his disease both silenced his critics (who would want to attack a sick
person?) and appeased his guilt for failing his patient. By having cancer, he got slack from his
profession and atoned for the responsibility he felt for his patient. He unconsciously needed his
cancer. But because he was a psychiatrist, he was able to understand this, and was able to resolve
his feelings. Despite being an unlikely candidate to survive, he recovered, and maintained his
practice. The psychiatrist's disease gave him a chance to heal his dis/ease by giving him the
temporary protection from the tyranny of the they world he needed to collect himself. A space to
become himself. In another case of the Simontons', a woman was a part owner in a business, and felt that she was
doing an unfair amount of work. Nevertheless, unable to say "no" to her partners, unable to
defend her boundaries, she did it anyway. Finally her body said "no" for her by developing
cancer. She realized she was using her illness as an escape and developed the skills to say "no" by
herself--a healthier way of protecting the boundaries of her ecopolity. The Simontons insist,
however, that disease only suspends a problem with the world. If the patient does not attend to
what is dis/easing them, confronting the attitudes, behaviors and beliefs that have trapped them,
they will recreate it again and again. Once acknowledged by others, disease opens up a temporary
space for healing, giving people permission to express forbidden thoughts, feel emotions deemed
unacceptable, and break rules they have long committed themselves to. Disease can heal. But,
according to the Simontons, if the victim does not learn to continue to give themselves permission
to these things, or get it from others, it returns. When they get well, the old rules apply and they
are trapped again. The Simontons believe that people heal only when they can accept change in themselves, when
they refuse to ignore their real needs, accepting responsibility for the care of themselves. When
truth happens. "It is essential to recognize that the needs being met through the illness are fully
legitimate and deserve to be met. The body is demanding attention in the only way it knows
how."(154) In order to maintain self, protect the boundaries of a worthy identity, people have to
learn to accept themselves as a whole, all their inner needs, and refuse the images and claims that
a harsh, judgmental, exclusionary, and disciplining they world would impose on them. To recover
from dis/ease, a person has to disrupt the patterns and images that had governed their lives, the
world that has violated the boundaries around their self-worth, and then develop new ways of
living, ways more caring and protective of their own identity. If carefully thought about as an ecopolitics of self, dis/ease can become a powerful and needed
stimulus toward personal growth. (And community growth, too.) Rather than living in a they
world, made up of fear of the opinions and judgments of others, dis/ease can be a time to become
more authentic, more real, more true to self. Dis/ease turns us toward death, that great oblivion,
and everything that is not solid or true to self is shaken loose, revealed as something false. And
so, the prospect of death can be profoundly liberating. "Held-in anger and hostility can now be
expressed; assertive behavior is now allowed. Illness permits the person to say 'no'."(155) The
prospect of death frees the self from old rules, and reveals that they are not needed or useful.
When the false self, the one demanded by the they world, is set aside there is more freedom to act,
more options to choose, more possibilities for a meaningful life available. More energy is
available for living and the depression that had haunted the self lifts. This changes the physiology
of the body, promoting healing, which in turn fosters hope, which again promotes healing. "Since
mind, body, and emotions act as a system, changes in the psychological state result in changes in
the physical state. This is a continuing cycle, with an improved physical state bringing renewed
hope in life and with renewed hope bringing additional physical improvement."(156) There is much that I respect in the Simontons' work, and much that I resist. The Simontons show
how disease develops out of identity, how it happens as an inner politics of self, but they remain
conventional in many ways. Though they insist on the unity of mind and body, they seem to
persist in believing that there is a mindbody hierarchy, that people choose their diseases, are
responsible for them, and can heal them by themselves if they work hard enough. Even though his
own work duplicates many of the results of the Simontons', David Spiegel has been harshly
critical of their interpretation of what dis/ease is, believing that it makes people inappropriately
guilty for their diseases.(157) He describes the Simontons' efforts as telling people that they can
"wish" their cancer away through visualization. While the Simontons use visualization, no
fair-minded reader of theirs would dismiss the extensive efforts their patients make at self
transformation as merely "wishing" their disease away. While Spiegel is unfair in his criticism of the Simontons, and while I would have, in turn, many
criticisms of his work, he does have a point about how the self may be dis/eased by assuming
responsibility for disease. As many critics of the visualization techniques the Simontons use have
complained, Susan Sontag perhaps most eloquently, they place a heavy burden of responsibility
on the individual to control their disease.(158) New Age guilt, as it has been dubbed. Assumed to
be choosing their own reality, controlling their own fate, disease victims are guilty of a crime
against themselves if they cannot visualize their disease away. Failing to make their disease
vanish, they are stigmatized with somehow desiring this evil. Responsible for it. This kind of responsibility is almost inescapable in a liberal state, built as it is with the notions of
individual subjectivity, freedom through control, and responsibility through choice. But
responsibility for disease is quickly called into question if it is reinterpreted as the happening of
world, as the happening of the alterities, differences, and images that constitute one's identity.
Disease is not located in a subjective choice, as the Simontons sometimes describe it, but in that
which is dis/easing the self--the powers, the relations, the structure of identities that produce and
reveal the self. Because these things are there before the one who chooses is, the self cannot be
held accountable for them, or the dis/ease they bring forth. Similarly, the others in the dis/eased
one's life, cannot be blamed for the disease either. Just as the victim of disease did not choose to
be dis/eased, the significant others in this person's life did not choose to dis/ease them either. That
which is dis/easing exceeds them all, is beyond any will, choice, or individual decision. Besides that, as Joan Borysenko argues most persuasively, guilt over disease turns the self against
itself, making it condemn itself with judgment and punish itself with reproach, and that, so long as
it does nothing to make the world better, does little to heal dis/ease.(159) In fact most guilt, as an
internalization of an authoritarian and abusive ideal of responsibility, choice, and will, is itself
deeply dis/easing. The pain of having become other to one's self, guilt is a commitment to
conceal, disown, and repress threatening aspects of the self--to be other than the self one is. In
the experience of guilt, the they world's judgments and condemnations are internalized, turned
against the self, and the self does to a part of itself what the world would do to it
altogether--repress, silence, and exclude it. In this way, seeking to be other than oneself, guilt
builds shadows in the self, angry, resentful, hateful, rebellious thoughts and emotions that, once
disowned and denied, must become dis/easing because they cannot be eliminated. Though it can
internalize the world's alterities, and come to fear and hate the other it has become, the self can
never be anything except the self it is. And so, unable to escape itself, it becomes dis/eased. This
dis/ease of the self takes up residence in the body's ecopolity and is expressed as disease.
Forbidden to politicize the world's pain by the they world, to call into question the they world's
judgments, exclusions, and production of alterity, the body silently somatizes it, turning its
dis/ease with its world into disease. I hope that by problematizing guilt, and arguing for its suspension, that the reader will not
conclude that I am justifying any kind of action, especially not all the cruelty, abuse, exploitation
that is all too common and dis/easing in our lives. That is the last thing I want to do. Instead, I
want to propose an alternative ethic of belonging, a way of being in the world that will cause less
dis/ease than the tyranny of the they world or the internal tyranny of guilt. Besides, there is little
evidence that guilt, especially the deeply self-loathing kind that the worst kind of preachers have
celebrated, makes people better, and much that it makes them worse. By throwing so much of the
self into the shadow, fostering self-loathing, and then concealing it as "altruism," "responsibility,"
and the "love of others," guilt produces and justifies a lie, a false self without integrity. To be free
of dis/ease, the self must own all aspects of itself. Of course, a good self, a self worthy of respect
and honor, will limit the expression of some parts of itself--like its resentment, its fear, and its
hostility--out of care and concern for the world. But it will do so not by denying their reality for
the sake of the they world. Accepting that it has its others within itself, refusing to disown its shadow, this self is both
humbled and empowered and can more effectively deal with those aspects of itself that would
harm the world and dis/ease others. It has the advantage of integrity and self knowledge, where
those driven by guilt have concealed much of their selves from themselves, and have made
themselves powerless to limit the more dis/easing aspects of themselves. We all have heard of
preachers who are caught with prostitutes, who con elderly people out of their social security
checks, and who preach love while practicing hatred against homosexuals, feminists, intellectuals,
and environmentalists. If it seems that these preachers are caught in the sin of hypocrisy more
often than less holy people, it is only possible because they have lost so much more of themselves
to the they world. Unless the world of alterities that trapped the self in dis/ease is healed, the self is likely to fall
back into the power plays that dis/eased it in the first place. Perhaps this is why visualization and
meditation, while they can have very powerful effects on the body, are not always effective
against some diseases. While they affect the body in very powerfully, they do not directly deal
with the situation that dis/eased the body. This, I believe, is sometimes why cancer and other
chronic diseases are so intractable. The individual has been treated, maybe very effectively, but
not the images or the world of alterities that surrounds them and builds their identities. Not the
politics of experience that is dis/easing them. By making dis/ease something political, a reality of the world the individual is situated in, and not
just of the individual themselves, the world's pain is expressed as a happening of world, and the
responsibility for it is dispersed and decentered, not turned against the self. If the world is
dis/eased with problematic alterities, and itself in need of healing, this way of revealing dis/ease
also does not burden other individuals with accusation, blame, and guilt. The responsibility for
the dis/ease, if it in fact can still be said to exist, is in the world that worlded it. Individuals do
build the world, and they do participate in all its dis/eases, but they do not, like disembodied
spirits, will the pain of dis/ease, choose it or prefer it, either for themselves or others, because it
happens before they happen. The world worlds before anyone chooses its happening. And when
it does happen as dis/ease, its pain can be responded to by gathering it up as a whole and healing
it as an effect of the polity it happens in. Again, the point to an ecopolitics of identity is not to fix the blame, to isolate the offender that has
caused dis/ease and punish them for their evil, but to make the world better, less dis/easing.(160) If
an individual has extensively participated in another's dis/ease, violating their boundaries and
forcing an identity on them that has made them vulnerable to disease, they are called upon to
participate in the healing of the dis/ease by calling into question the world that has worlded their
own identity. What is it about this identity of theirs--and its others--that requires such harm? For
example, is there something about the modern heterosexual identity that is threatened by
homosexuality, that must make it other, exclude it and attack it for its sinfulness and abnormality,
and, by making the targets of it internalize their identity as other to the norm, thereby make them
dis/eased with their identity?(161) AIDS, I think, suggests this possibility, how disease is not just a biological invasion, but a social
and political invention. The way AIDS is a disease, the way it harms and kills, may have at least
as much to do with an ecopolitics of alterity as it does with viruses. If a virus is necessary for
people to come down with AIDS, a politics of experience makes people more vulnerable to its
progression. I really wonder if it is merely a coincidence, or bad luck, that this modern plague
strikes the most marginalized portions of our society. Those stigmatized as other by
it--homosexual men, drug users, minorities, prostitutes. All of these groups of people are afflicted
with identities, associated with images, and condemned for morals that dominant American
culture finds unworthy, sinful, evil, unnatural, and abnormal. In the best of times these people are
discriminated against. In the worst they are ridiculed, harassed, physically attacked, and
sometimes even murdered.(162) Not even the strongest homosexual could forge a self-image that
would give them the self-esteem or the power to resist internalizing the identities forced upon
them. And now AIDS seems to justify their identity as other, legitimate it. But an ecopolitics of
identity, moving beyond a politics of guilt and blame, could call into question that experience of
self.(163) Diseases, like bodies, are cultural and political happenings. As parts of the ecopolity, they are
situated, context dependent, and happen in different ways in different cultures. According to
Leonard Sagan: We now know that one agent, whether it be bacterial, viral, or chemical, may produce different
diseases under different environmental conditions. For example, the Epstein-Barr virus (EBV)
is known to be associated in the United States with a rather benign disease common to college
students, infectious mononucleosis. In Africa the same virus is associated with a malignant
tumor of children known as Burkitt's lymphoma. In China the same virus has been identified
with the otherwise uncommon nasopharyngeal cancer. It has also been found in association with
several other cancer types. Finally, many people carry the virus without any evidence of harm.
This pattern is not unique to EBV; most infectious agents produce this same chameleon effect,
appearing in each person in a different guise and often being present harmlessly.(164) AIDS does the same. In many ways it betrays itself as a politics of experience, not merely a virus
on the rampage. First, HIV, widely believed to be the "cause" of AIDS, does not itself ever
directly kill people, it only destroys their immune systems, in particular the helper T-cells that
control the acquired immune response, and that makes them vulnerable to all sorts of rare and
exotic opportunistic infections, like Kaposi's sarcoma and Pneumocytis pneumonia, that then kill.
So, AIDS is a disease of vulnerability. HIV can remain in the body for many years without
apparent damage to the carrier's health. The Center for Disease Control believes that the average
period of incubation, which is the time between infection and the first appearance of symptoms, is
on average 5.5 years, and can extend for more than 11 years.(165) Furthermore, as scientists are increasingly concluding, HIV is possibly, by itself, inadequate to
cause AIDS. A co-factor to HIV may be needed to explain the development of AIDS. Some
more radical members of the scientific community, like Peter H. Duesberg, a University of
California at Berkeley researcher in molecular and cellular biology, even believe that HIV plays no
role in AIDS.(166) According to The Chronicle of Higher Education: Mr. Duesberg, a virologist who has won acclaim for his cancer research, is an outspoken critic
of any role for HIV, charging that the virus is incapable of causing AIDS. He contends that the
virus affects too few cells of the immune system to be dangerous and the HIV theory is
scientifically flawed because a virus that later immobilizes the immune system cannot exist in a
person's body for several years without causing serious ill effects. He believes that drug abuse,
malnutrition, and other factors can suppress the immune system and lead to AIDS without help
from HIV.(167) Most scientists strongly believe that Duesberg is in error, that HIV is necessary to develop AIDS,
and I suspect they are right. Recent research has been able to explain away many of Duesberg's
objections. But his work still suggests the possibility that the development of AIDS, the full-scale
disease, is more complex than the conventional theory of a simple infection would suggest. Other
scientists, like Root-Bernstein of Michigan State University, argue that, while HIV is necessary
for people to develop AIDS, other cofactors are also needed--perhaps infection by other viruses
like Epstein-Barr, hepatitis B, or herpes, or perhaps things as diverse as "malnutrition, blood
transfusions, cocaine use, the abuse of morphine-based drugs, or even the overuse of
antibiotics."(168) Another cofactor appears to be the death of an intimate partner, which has been
observed to accelerate the development of AIDS. (169)Cofactors are necessary, according to
Root-Bernstein, because not all AIDS patients develop the same symptoms. Gay men, for
example, are much more likely to develop Kaposi's sarcoma, a rare kind of skin cancer
characterized by purple skin blotches, than other people who are infected by HIV. Something
common to the gay community but uncommon to other communities can be the only explanation
for this difference. These observations support the possibility that AIDS, as a disease, is not only an infection but
also a social construct, an effect of a politics of experience.(170) As many have observed, the
character, course, and severity of AIDS are strongly affected by its sufferer's situation in society,
their identities, their roles, their relations with others. It is common knowledge among nurses
treating AIDS that people survive only as long as they have the emotional strength to fight it. The
desire to live is probably the single most influential factor in determining how long people with
AIDS live.(171) Shilts gives an example this politics of experience, of how harmful being other to
another person in a position of moral or parental authority is: . . . (O)ne patient's mother marched into her dying son's room and ordered out his longtime
lover. "I'm his mother and I don't want any faggots in this room," she announced brusquely.
"And I don't want any of those nurses who are faggots. They did this to him." The patient broke
down crying but was unable to speak because he was on a ventilator. A few days later, he died
without seeing his lover again.(172) Imagine the distress of having your own mother refuse your own identity like that, the power she
would have to make you experience yourself as other, evil, a pervert--and the effect she would
have on your immune system. Internalizing her authoritative reading of what you are, she would
infect you with difference, make you helpless with guilt. You were what she despised most, the
identity she most wanted eliminated. When this mother ordered all the "faggots" out of the room,
her obedient son did as she told him. He died. Shilts has another story of how the politics of
experience can be dis/easing: Deotis's nightmare started after his operation. He was running, running hard, among the cold
concrete towers in downtown San Francisco. Nobody was on the streets. He was alone except
for the policeman chasing him down. Deotis stumbled. The police caught him and started
kicking him in the stomach. "Can't you see I'm sick? Deotis asked. "Stop." But they continued kicking him. He started throwing up. Brown clumps of maggots and crawly
worms spewed from his mouth. He was coughing up the maggots when he awakened.(173) Soon after that nightmare, Deotis told his nurses that he didn't want to be a drain on people. He
died days later. An ecopolitics of identity would call into question the they world's condemning judgments like
these--their harshness, their exclusion, the identity they force on the other within ourselves and on
the others outside ourselves. It could allow difference to be, to go its own way, and, whatever it
was, it would find a way to respect it, if not gently listen to it. The healing possibilities of such an
ecopolitics of identity should not be underestimated. Pursued by enough people, the space for
acceptance it opened up might change the whole physiology of the AIDS plague. One example of how this ecopolitics of acceptance might heal is provided by Niro Markoff
Asistent. In November 1985, she tested positive for HIV. For at least a year she had been
suffering the from the symptoms of the AIDS-related complex (ARC). When she was diagnosed,
she expected to live only about five hundred days. She found her disease, ironically, to be a
profoundly healing event in her life. Since each day was now so precious, had new meaning, she
rearranged her life, giving up her commitments to an identity that was false to her needs. Until the dis/ease struck her, she tells us, she was always living outside herself, for others--her
parents, her husband, her children, even her spiritual master. She had been lost in a they world--in
being for others, in creating the appearances of an identity that would be rewarded by them and
silencing the realities within herself that would not. But now, having nothing left to lose, she gave
up those false identities and started living within herself, for herself, letting truth happen. She
took a very honest look at herself, and then accepted every part of herself, letting them all be.
Especially, she accepted the shadow parts of herself--her anger, her resentment, her fears--that
she had disowned in order to be acceptable to other people. By allowing the full expression of
her body's polity, she became whole for the first time in her life.(174) By May 1986, she was symptomless. Even more remarkably, she even tested negative for HIV
antibodies.(175) The doctors were baffled. She had been taking no drugs like AZT, in fact, nothing
at all that, by the terms of conventional medicine, could explain her cure. The doctors, she
complained, almost drained her of every drop of blood she had to run tests on it. In the end they
could not explain it--nothing in their medical discourse allowed them to appreciate the
connections between body, mind, and spirit that Asistent had established in her life--and so they
did what all good positivists do when evidence that they are confronted with does not support
cherished theories. They ignored it.(176) Perhaps the diagnosis of AIDS, by generating images of an immune system helpless against
relentless assault, is itself part of what makes the disease so deadly.(177) Consider what happens
when a person is diagnosed with AIDS: Their most intimate relationships with others are
radically troubled. They must tell lovers of their infection, deal with intense resentment and
anger, and suffer the humiliation of all the stigmas attached to AIDS. On top of that, friends start
shunning them, they often lose their jobs, their insurance, their homes. And they become the most
desperate of outcasts, alone, miserable--sometimes, surely, almost desperate to die.(178) Just to get
it over. Even the most doubting critics of psychoneuroimmunology might agree that such
distressing circumstances would significantly suppress the immune system.(179) Which is exactly
what HIV does. So just how much of the AIDS dis/ease is due to the virus and how much is due to the identity
people with AIDS must suffer? How many people die of AIDS because of what they are forced
to think about themselves? There can be no clear answer, and it may be a mistake even to pose
the question because it imagines a separation between thought and disease that does not exist.
However, at least part of the reason that people die of AIDS has to be the diagnosis itself. As
much as the virus does, the diagnosis invades people's identities, contests their self-image, and
leaves their body's ecopolity radically dis/eased. Asistent inwardly politicized this identity, letting it fully reveal itself, and, drawing upon
alternative possibilities for self, let it go. Instead of becoming a victim helplessly awaiting her
death, she started living life in the now, focusing her attention on the edge of experience, the
moment by moment happening of her life. Everywhere she went, she focused on what she was
experiencing at that moment, during long walks along the sea shore, cutting bread, painting her
nails--even in her experience of pain. She let go of the past and all its wounds and the future with
all its fears. Nothing existed but the present. In this way, she was able to let go of all the false
ideals of herself that troubled her, thwarting her life's expression. According to her, healing is not
anything we can force or cause; we can only allow it to happen by letting go of whatever keeps it
from happening. Healing comes when we allow the truth of dis/ease to be, and it is delayed and
prevented when we build walls of resistance, denial, and postponement to it.(180) Healing is
truth-telling. And it is discomforting, painful, and disturbing because to heal we often have to
learn how the identities that we have long used to comfort us and protect us are, in fact, exactly
what is dis/easing us. Asistent writes: I realize now that prior to my diagnosis I was living a life that mostly went against my own
nature, while I was pretending that was the way I wanted to live. I had kept experimenting with
various lifestyles, from housewife to jet-setter to spiritual disciple, in search of the one that
corresponded to my true nature. The pretense that life was fine had created such an enormous stress on my system that it
provided a perfect fertile ground for disease to erupt from. My immune system was so weakened
by this self-denial, and by a deep sense of unworthiness, that it was not able to respond
effectively to the invasion of the HIV infection.(181) Asistent never resorted to drugs, or any other promise of special therapy, a magic bullet that
would make everything better. She did not even plan to cure herself. Indeed, she fully expected
to die soon. She just let go of identities that had become a prison to her life, and let the truth
about herself happen. She did meditate an awful lot, and obviously she was a very sophisticated
meditator, but that was secondary, because she did not try to control her disease through
meditation and visualization. Since she was focusing on healing her life in its entirety, being cured
of AIDS was only a bonus for her. Politics involves other people--it is about relationships, after all--but it also happens when people
are alone, inside themselves, when they are healing the multiple identities that they have built to
deal with the world. When those identities have become false, a prison built of fear, and people
suffer dis/ease because of them, an ecopolitics of self will happen as a letting go of these
dis/easing identities. Pain, discomfort, and disease are inevitable parts of this inner ecopolitics,
and our wisest response to them is to learn what we can from them when they happen. Maybe
even be grateful to them for the lesson they teach. Regrettably, the AIDS pandemic promises to
teach us an awful lot about how confining, how dis/easing, our identities have become. In her book, Of Woman Born, Adrienne Rich argues that the patriarchal image of motherhood is
similarly dis/easing, forcing lies upon the body's ecopolity. By trapping women in the patriarchal
they world images of motherhood--unconditional love, unqualified commitment to the child,
emotional bliss in the development of another--it forces women to deny and cast into their shadow
all of their other experiences and emotions--anger for having so many demands placed on them,
frustration for having to deny themselves for another, helplessness for having so little of their lives
or their bodies under control. Good mothers do not feel those things, should not feel them, and
nothing is more frightening for an identity caught in these ideal images than the fact that they do.
The safety of the world is at stake. As a result of this need to protect a lie, the institution of
motherhood becomes an assault on the body, on the aspects of the self that do not conform to the
ideal image. Rich found that efforts to conform to the ideal made her sick. Her husband and her parents-in-law all had many eager expectations and assumptions about what
she wanted and what she was feeling. Rich, however, only later realized that "I had no idea of
what I wanted, what I could or could not choose. I only knew that to have a child was to assume
adult womanhood to the full, to prove myself, to be 'like other women.'"(182) Shortly before her
first child was born, she broke out in a rash.(183) The first, tentative diagnosis was measles and she
was admitted to a hospital for contagious diseases. After her first child was born, however, the
doctors changed their mind and diagnosed the rash as an allergic reaction to pregnancy.(184) Rich had three sons, and while she and her children were in quite comfortable financial
circumstances, she still felt empty, unfulfilled. ". . . I knew I was fighting for my life through,
against, and with the lives of my children, though very little else was clear to me. I had been
trying to give birth to myself; and in some grim, dim way I was determined to use even pregnancy
and parturition in that process."(185) She had lost her self, her power, to the they world of
motherhood, and, unable to imagine anything else, she was trying to recover it, give birth to it
again, by means of the very institution that had taken what she needed. It didn't go well. She
developed rheumatoid arthritis. And in her diary, after the birth of her third son, she reports
feeling: "Anger, weariness, demoralization. Sudden bouts of weeping. A sense of insufficiency
to the moment and to eternity . . . I weep and weep, and the sense of powerlessness spreads like a
cancer through my being."(186) Not a happy mother, this woman. Against those who would impose a depoliticizing image of "naturalness" on the institution of
motherhood to justify the cultural contingencies of its oppressions she snarls: "(T)he patriarchal
institution of motherhood is not the "human condition" any more than rape, prostitution, and
slavery are. (Those who speak largely of the human condition are usually those most exempt
from its oppressions--whether of sex, race, or servitude.)"(187) To sustain this dis/easing institution,
women have to internalize the image of women being redeemed by motherhood. Throughout patriarchal mythology, dream-symbolism, theology, language, two ideas flow side by
side: one, that the female body is impure, corrupt, the site of discharges, bleedings, dangerous to
masculinity, a source of moral and physical contamination, "the devil's gateway." On the other
hand, as mother the woman is beneficent, sacred, pure, asexual, nourishing; and the physical
potential for motherhood--that same body with its bleedings and mysteries--is her single destiny
and justification in life.(188) The result of internalizing these images, submitting to their power in the they world, is that
women develop intensely ambivalent feelings about their bodies. They reject them, feel shamed
by them, want to escape them, and yet can only justify and redeem themselves through them.
Nothing else is left to them. The result is that women do not have a healthy self-image, one that
can stand on its own and celebrate itself, and they become slaves to a false image of
motherhood.(189) The image of motherhood is profoundly alienating, Rich concludes, separating women from their
bodies and their feelings, permitting only "certain views, certain expectations, whether embodied
in the booklet in my obstetrician's waiting room, the novels I had read, my mother-in-law's
approval, my memories of my own mother, the Sistine Madonna or she of the Michelangelo
Pieta."(190) All these images became prisons of her body, denying her "every active, powerful
aspect" of herself. Requiring her to lie to herself and the world: I became dissociated both from my immediate, present, bodily experience and from my reading,
thinking, writing life. Like a traveler in an airport where her plane is several hours delayed, who
leafs through magazines she would never ordinarily read, surveys shops whose contents do not
interest her, I committed myself to an outward serenity and a profound inner boredom. If
boredom is simply a mask for anxiety, then I had learned, as a woman, to be supremely bored
rather than to examine the anxiety underlying my Sistine tranquility. My body, finally truthful,
paid me back in the end: I was allergic to pregnancy.(191) That really is what dis/ease is. The resulty of denying the truth, disease nevertheless tells the
truth. It tells us that something is wrong, is dis/easing us, and it forces us to pay attention. One
way or another, whether allowed to or not, the body reveals the truth of our world. Others agree with Rich. According to Lawrence LeShan, cancer is but a symptom of a deeper
dis/ease. As one of his patients, a woman with metastasized breast cancer, put it: What I hear you saying is that I have lived my life as if I bought my clothes off the rack. They
fitted pretty well, but were standard issue. And that if I want to set my immune system an
example I have to start living my life as if I were having my clothes made especially for me by a
top-level couturier--clothes and a life that is designed specifically for me, not for someone
approximately my size who wants to fit in with everyone else and be wearing whatever is
fashionable at the moment. That if I really get committed to this, then it will be as if my immune
system looks up, says, "Oh, this specific individual is worth fighting for. Why didn't you say so
before?" I've got to set my body an example by taking care of me and gardening who I am, not
just adjusting myself to whatever is on the clothing rack of life.(192) Using this interpretation of what cancer is, Lawrence LeShan has been remarkably successful at
healing it. His patients are, by the standards of conventional medicine, almost exclusively
"hopeless" and "terminally ill." The hospital he was associated with was mostly just a last resort,
a waiting room for people who were dying. And yet, once he refined his strategy, approximately
half these hopeless causes have gone into long-term remission and are still alive--some of them
twenty years or more later. Though half his patients die, usually after living longer than expected,
nearly all of them made their last days far more meaningful to themselves and others than they
were capable of doing before they began working with him.(193) LeShan was able to achieve this remarkable success only by discarding the discursive framework
which governs conventional psychotherapy and medicine. Instead of revealing and correcting
deviations from the norm, and attempting to make people better adjusted to the world, he helped
them politicize their identity, encouraged rebellion against the norms and demands of an
inauthentic identity. Rather than finding and focusing on what was "wrong" with people, because
that only normalized them, he worked with, and cultivated, what was right with them. Helped
them sing their own unique song. People were not always happy with the results. He writes: One of the signs I have used to tell how well I was doing with hospitalized patients was how the
floor nurses felt about my visits. As long as they seemed glad to see me, I knew the patient was
still being "good" (as defined by hospital standards) and therefore much less likely to get better.
When the floor nurses made it plain that they resented my coming, I knew that the patient was
becoming less concerned with the opinions and demands of others and was becoming concerned
with the growth of his or her own soul. I was making progress! And the patient was fighting for
his or her life!(194) One of his patients was a "lovely old lady," who had sacrificed much of her life for her family. It
took LeShan a long time to discover that she had a secret and unfulfilled passion for ballet. When
he cultivated her interest, bringing ballet stars to talk to her, encouraging her to write a book on
it, she quit being a "good" patient, started making demands and refusing to accommodate others.
Her family, upset and disturbed by the changes, started referring to LeShan as a charlatan, and
launched a vigorous campaign against him with the hospital clinical director. Her nurses were
equally frustrated. She would scream at them like a fishwife if they disturbed her writing
materials. She would gulp her food and be uncooperative when they needed her for X-rays, or
some other procedure. Instead of telling doctors that she was "feeling much better today," she
would complain about being stuck in the hospital and would demand better drugs. No one was
happy with what LeShan had done with this "lovely old lady." But she was. She was improving,
gaining weight, showing positive responses to every procedure they had available. And eventually
her family, seeing this improvement, relented in their campaign against LeShan, and started
helping her write her book. Healing, according to LeShan, is a process of cultivating and protecting a person's unique identity,
supporting it and enabling it to grow. By freeing people of the demands and fears of the they
world, he encourages the patient to open up a space where they can be themselves, reveal to the
world just what they are. Unconcerned about the opinions of others, the judgments of
institutions, being a "success," or whatever. LeShan insists that although his process encourages
rebellion against the norms and demands of society the results are never something that society
cannot accept, at least not a society worthy of endorsement. In fact, by becoming themselves, his
patients can make more meaningful contributions to society. Even gang members. Pedro, another of his patients, had been raised in the South Bronx and had joined the local gang at
nine. He really liked it. Feeling as if he belonged, he committed himself wholeheartedly to gang
life--the crime, the violence, the risks. He quickly rose through the ranks, becoming a "warlord"
by the time he was sixteen. The position was an important one, because he would be responsible
for everything when the gang was physically fighting with another gang. But then his gang fell apart. "Some of the brothers were arrested, some died on the streets, some
were drafted into the army, some moved away, some married and left the gang."(195)Pedro was left
alone, his life meaningless and empty now. Although he continued illegal activities, the thrill in
them was gone. About a year later, he developed a rapidly progressing case of Hodgkins disease,
which, at the time, was almost without exception fatal. He ended up at the hospital where
LeShan was working, and this challenge to his theory fascinated LeShan. Here was someone
whose whole identity was invested in being a gang member, being at war with the law and
civilization. So much so, that when he lost this identity, he got cancer. How was it possible for
such a person to "sing their own song," and yet live a life that society could accept? LeShan proceeded by finding out what made gang life so meaningful to Pedro: At one time I asked him if he could tell me what had been so attractive, so right about the gang
life. He explained it to me. "There was this group of men, see, and they cared about each other.
No matter how much you argued and fought with each other, you always knew you could depend
on the brothers. They were there for you when you needed them and you were there when they
needed you." Pedro went on to describe the rhythm of gang life. There were long quiet periods
when the members just relaxed, loafed, smoked, boasted about their exploits, and occasionally
got into long, lazy discussions and sometimes arguments about sports. Then there were periods
of intense excitement and danger when each man depended on the others for safety and
survival.(196) As he did with all of his patients, LeShan tried to imagine and create a situation where Pedro
could live out his unique identity, a space in which he could be comfortable being himself. It
turned out that he was cut out to be a firefighter. Pedro was quite taken with the possibility, and
together, they conspired to make it a reality. First, Pedro got his high school degree; then
LeShan finessed a job for him, fabricated a job history, and got his radiologist to issue a false
report about Pedro being cured. Finally, Pedro landed a job as a firefighter. Pedro made rapid
progress against his disease and went off medication a few years later. He got married, had
children, and was free of cancer, at last report, for more than twenty years. Though LeShan seems to be as apolitical as the Simontons, I read his efforts as being intensely
political. Instead of just psychologizing disease, interpreting it as only an interior process, LeShan
insists that his patients must change their situation in the world, if not the world, before they can
be healed. In LeShan's interpretation of dis/ease, it matters what kind of job a person has, how
others treat them, what kind of world they live in. When he is describing his efforts to heal,
LeShan invariably tells of how that he has had to contest hospital policy, work with families, get
people jobs. Instead of putting people on a couch, working with them only in his office, LeShan
goes on walks with them, visits their bedside, takes them out at night. He becomes involved in
their world, intervenes in it, politicizes it. On my reading of dis/ease, this is exactly what we need to heal the world's pain, a political effort.
In the next couple of chapters we are going to be looking at how politics is both dis/easing and
healing. Disease, we will find, is located not just in the individual but in the polity. Healing either
one requires politicizing the other. Back to Contents
Chapter 5
Dis/ease as Society and Politics
The great majority of us are required to live a life of constant, systematic duplicity. Your health is bound to be affected if, day after day, you say the opposite of what you feel, if you grovel before what you dislike and rejoice at what brings you nothing but misfortune. Our nervous system isn't just a fiction, it's part of our physical body, and our soul exists in space and is inside us, like the teeth in our mouth. It can't be forever violated with impunity.(197)
Boris Pasternak
Disease is complexly situated in the world, emerging not only out of the discursive objects that
ecology, biology, chemistry, and physics have produced in the modern age but also, I contend, out
of the organizing powers of language, sexuality, culture, history, economics, and politics. I say
this--and emphasize it--to caution the reader against reading this book as arguing that substance
of nature is without effect and that disease can be reduced to politics. Old habits die hard, and
too many people have misread psychoneuroimmunology or quantum physics as proving that mind
does dominate matter, that what people think is the only thing that matters. If the world is a
dream, it is only because it is a very, very soliddream. As Pasternak observes above, our soul
exists in space and is like the teeth in our mouth. Every discursive practice reveals some things as it conceals others, and none should be taken as
absolute. It is useful, sometimes, to interpret disease, as conventional medical science does, as
something caused by the forces of "nature," as represented by genes, bacteria, viruses, and
trauma. Not only that but the science of "unnatural" toxins like dioxins, PCBs, DDT, furans,
heavy metals and ultra-fine particles effectively does reveal at least some of the harm industrial
civilization is doing to the earth. It was, after all, conventional science that discovered how
incredibly toxic dioxin is, and how that pollutants are more toxic in synergy than separately. And
it is conventional science that has made possible a new and provocative discussion on the
complexity of the immune system and the greater ecosystem. However, to the extent that conventional science has fabricated nature as an object of study,
revealing it as a coherence of forces that can be manipulated in the controlled experiment, it has
concealed the full complexity of the situations that allow disease to emerge. By exclusively
focusing on how bacteria, viruses, toxins, genes, and trauma "cause" disease, it ignores how
dis/ease emerges out of the dense network of symbols, metaphors, images, institutions, relations,
and technological practices of which our world is built. By emphasizing its causes, conventional
science fails to see how disease emerges. I put the words natural and unnatural in quotes above because I want to make clear, unless
someone misread me, that I understand that they both designate temporally relative buildings that
have no independent existence from our language. The role that the word nature plays in natural
law, constitutional precedent, and ethical theory is unstable, subject to deconstruction, and can no
longer serve as the foundation to support the legal, ethical, and theological buildings that our
civilization has placed upon it. The search for the state of nature and natural law has been as
fruitless as any effort to find a natural remedy for dis/ease will be, and it ill behooves us to turn
down that path. However, while the distinctions between natural and unnatural, nature and society, and natural
and dis/eased ultimately refer to no realities that are not temporally situated, they can be useful if
qualified. By interpreting the evidence that conventional science discovers using these
distinctions, it is possible to go beyond its limitations, revealing what it would conceal. For example, despite the blindness inherent in their method, some researchers in epidemiology
have developed studies that suggest the complex situations from which disease emerges. These
studies have found that disease is "caused" not only by the machinery of nature but by culture as
well, by social and political systems. Though, as I have argued, the theory of causality underlying
these studies is problematic because the distinction between nature and humanity is problematic,
they nevertheless are useful because they suggest that disease emerges out of a complex
situation, the ecopolity as a whole. So, while the theory of causality is suspect in the
epidemiological studies that follow, and the methodology conceals what it needs to reveal, these
studies are, nevertheless, suggestive. . . . Many epidemiologists are struck by the fact that health care has been assuming an increasing
proportion of the U.S. economy. Not long ago, in 1950, the U.S. spent 4.4% of its GNP on
health care.(198) By 1984 it was more than 11%, as of this writing it is more than 14%, and it may
eventually pass 20%.(199) If all this money, and with it all the complex diagnostic technology,
exotic surgical procedures, and powerful drugs that it buys, are any measure, the United States
should have the best medical care in the world, the healthiest people. Yet the statistics are most disappointing. The average life expectancy of United States citizens
trails that of 18 other nations, including Greece, Spain, and Italy. Despite our heavy investment in
health care, infant mortality rates lag behind other nations that spend sometimes much smaller
portions of their GNP on health care. "In 1950 through 1954, the United States was seventh
lowest in infant mortality rates among the nations of the world; in 1960 through 1964, eleventh; in
1970 through 1974, sixteenth; and in 1982, seventeenth."(200) And in 1989, 24th.(201) Perhaps
embarrassingly high rates of infant mortality are merely an indication of economic inequality, and
of poorly distributed health care. After all, maybe as many as 37 million Americans do not have
health insurance, and so, timely access to health services.(202) Or maybe these statistics merely reflect the fact that Americans live a more unhealthy lifestyle than
the rest of the world--more pollution, worse diet, and so on. Everyone knows that Americans
smoke too much, eat too much fatty food, too much sugar, too much food contaminated with
pesticides, and just plain too much food, along with not getting enough exercise. However,
lifestyle does not explain the differences in longevity between different nations and different times.
Modern advocates of health recommend regular physical exercise, a largely vegetarian diet,
minimal stress, and not using addictive drugs. Yet these are circumstances that have long
prevailed among subsistence farmers the world over, and so why have they commonly died
around the age of thirty-five?(203) A good question. Eli Sagan believes that many of the differences in health and longevity between
different times and different nations can be explained by social, political, and economic
situations--by the images of authority, autonomy, power, and possibility that govern people's
lives. These things affect the health of whole nations. According to Sagan, class inequality didn't used to affect longevity all that much, at least before
the modern age. Though members of the aristocracy in the Middle Ages had unlimited access to
food, shelter, and clothing, they did not live much longer than the lower classes. "Among
members of the British aristocracy, life expectancy during the seventeenth and eighteenth
centuries varied between 30.0 and 38.8 years for males and 33.7 and 38.3 years for females."(204)It
is only at the end of the eighteenth century that the upper and lower classes begin to show
different life expectancies. Difference in longevity between the sexes also suggests that images of power and authority affect
health. As some feminists have long insisted, females are, at least immunologically, the stronger
sex, everything else being equal. Perhaps because of the genes on the extra X chromosome,
perhaps because of hormones, the female immune system in all mammal species has proven more
able to fight off disease and toxins than the male immune system.(205) And yet, human females have
not, until recently, outlived males. It is true that women die while giving birth, but that only
explains part, a small part typically, of the higher female mortality rate. Until the modern age,
women died earlier than men for a variety of reasons, many of them having little to do with a
distinctly female biology. Even prepubertal girls have had a higher mortality rate in premodern
societies than boys. Sagan speculates that sexism, the social hierarchy between the sexes, can help explain these
differences.(206) No doubt, part of the reason that little girls have a relatively high mortality rate
can be explained by greater physical neglect--inadequate care, nutrition, and clothing. Many
studies have documented how little boys usually get more of the basic needs of life than girls in a
variety of cultures, partly because boys are more economically productive than girls, partly
because, in patriarchal cultures, they are needed to transmit inheritance. However, might it not be
that little girls and women do not have as good of health as little boys and men because of what it
means to be female in a patriarchal culture? Being female in a patriarchal world carries with it an
identity that is not valued, affirmed, respected, acknowledged, and this kind of rejection,
exclusion, and repression has to have some affect on female self-image, and so, on the female
body.(207) Authority, culture, tradition, and life's role models have long told the female body that it is not
worth as much as the male body. It does not have the power, the intelligence, or the productivity
the male body has, and, more than that, the female body is often identified with nature, which
must be controlled and subdued, and with sin, which must be cast out. This contrast, which
makes being female the negative of being male, could be expected to impose on the female body
an identity that undermines its ability to maintain and sustain self against the world. However, the
harm done to the female body by the identity it is forced to bear is concealed by modern medical
science. Things like bacteria explain disease, and there is nothing that is political about these little
animals, is there? But perhaps if we look closer, we might find that the germ theory is not nearly
as good at explaining even such diseases as tuberculosis as modern medicine would have us
believe. Long one of the most deadly infectious diseases, tuberculosis was responsible for perhaps as much
as a quarter of the deaths in the nineteenth and twentieth centuries.(208) Historically known as the
"white plague" because of the cadaverous pallor its victims were marked with, it was romanticized
as a disease of poets, writers, and artists. Common knowledge had it that people with a
personality disposition typical among those people were uniquely vulnerable to it. Like cancer.
Yet like cancer, the role of personality in this disease was dismissed when Robert Koch
discovered tubercle bacilli in people dying of the disease. Personality became unimportant; the
bacteria's invasion of the body became the adequate--the scientific--explanation, and it supplied a
simple solution: isolate the bacteria, improve sanitation, stop spitting, and the disease would
disappear. Indeed, efforts at sanitation, then later at inoculation, did seem to stop the dreaded
disease. However, it only appears that way, according to epidemiologists. There is much about the story
of tuberculosis that suggests that sanitation, and then inoculation, and maybe diet and economic
development, had little to do with the decline and almost disappearance of the disease. Not a
purified and sanitized environment, but a more resistant body is what stopped the white plague.
While exposure to a pathogen is a necessary condition for developing a disease like tuberculosis,
it is never sufficient, as Sagan points out: "As early as 1893 Koch published a paper on the
existence of cholera organisms in normal and apparently healthy persons. Shortly afterward, it
was found that at least 1 percent of the healthy population of New York City harbored virulent
diphtheria organisms in their throats." Yet didn't come down with it. Besides that, Sagan adds, "
. . . the decline in infectious disease deaths appears to have preceded, rather than followed,
improvements in sanitation and to have occurred long before the decline in infection."(209) So, contrary to the germ theory of disease, exposure to a pathogen, while necessary, does not
explain why people become diseased. While the characteristics of an organism may help shape the
form of the disease, the incidence, extent, and outcome of the disease is primarily determined by
the victim's resistance to it. If someone who is dead or dying of tuberculosis has a lot of tubercle
bacilli in their body, is it so much a result of the bacillus invading the body as it is a body that is
helpless to resist it?(210) Other diseases, like measles, follow a similar pattern. Though exposure to the organism remains
more or less the same, people are, as the nineteenth century develops, ever more able to resist it,
to not die of it. It isn't the pathogen that has changed, since even today measles continues to
exact a high death rate among children in the third world. And it isn't access to clean water that
helps that much either. When clean water is introduced into many areas of the third world, while
there is an improvement in the incidence of infectious diseases, the results are not impressive. In
fact in one study in Brazil, where clean water was introduced, it was only about one-fifth as
important in reducing infant mortality in the areas studied from 1970 to 1976 as parental
education.(211) While sanitation is helpful, there is not all that much difference in exposure to
germs between a rural peasant village, where the incidence of infectious dis/ease is high, and a
modern society, where the incidence of infectious dis/ease is low. Though people in modern
societies may seem clean, their bodies are host to an incredible variety of microorganisms. Nearly
as much as anyone in the third world. Contrary to popular belief, according to epidemiologists, and to the stories medical doctors tell,
modern medicine has not contributed all that much to longevity in the modern age, either.
Modern doctors are consulted most often not for life-threatening dis/eases, but for pains and
discomforts. The quality of life is the issue of concern in most medical treatments, not longevity.
And it is really doubtful that modern medical science, even when it is trying to promote longevity,
is that effective. High blood pressure, for example, is commonly believed to shorten life. Yet the
drugs used to treat it may be toxic enough to shorten life. Besides that, the fact of being labeled
with high blood pressure causes stresses that may shorten life. Once the diagnosis is made,
patients typically become anxious about their health, and this often makes them feel helpless,
depressed, and fearful, which in turn undermines their health. It turns out that, after a person is
diagnosed with high blood pressure, they call in sick for work more often and report a decline in
their sense of well-being.(212) Besides that, malpractice, itself, is a source of much death. Lucian L. Leape, a member of
Harvard School of Public Health, wrote an article for the Journal of the American Medical
Association that is worth quoting at length: In 1964, Schimmel reported that 20% of patients admitted to a university hospital medical
service suffered iatrogenic injury and that 20% of those injuries were serious or fatal. Steel et
al. found that 36% of patients admitted to a university medical service in a teaching hospital
suffered an iatrogenic event, of which 25% were serious or life threatening. More than half of
the injuries were related to use of medication. In 1991, Bedell et al. reported the results of an
analysis of cardiac arrests at a teaching hospital. They found that 64% were preventable.
Again, inappropriate use of drugs was the leading cause of the cardiac arrests. Also, in 1991,
the Harvard Medical Practice Study reported the results of a population-based study of
iatrogenic injury in patients hospitalized in New York State in 1984. Nearly 4% of patients
suffered an injury that prolonged their hospital stay or resulted in measurable disability. For
New York State, this equaled 98,609 patients in 1984. Nearly 14% of these injuries were fatal.
If these rates are typical of the United States, then 180,000 die each year partly as a result of
iatrogenic injury, the equivalent of three jumbo-jet crashes every 2 days.(213) Medical malpractice kills the equivalent of three jumbo-jet crashes every 2 days in the United
States! If medical malpractice kills this many people, medical science would have to save an
awful lot of people to have a net positive effect. But it is not clear that it does, according to
Sagan: The decline in infectious disease mortality began long before the appearance of the first
antibiotic, penicillin, and even long before the widespread use of the first chemotherapeutic
agents, the sulfa drugs. By 1950, when effective antitubercular drugs first became widely
available, the death rate from tuberculosis, the major infectious disease of young adults, had
already fallen to a small fraction of what it had been in the nineteenth century.(214) Antibiotics are frequently prescribed in the United States, but there is little evidence to suggest
that they have much more than a placebo effect. Though enough antibiotics are manufactured and
used every year in the United States to treat two infectious illnesses for every man, woman and
child, the number of illnesses that would benefit from antibiotic treatment are estimated to happen
only once for a person every five to ten years.(215) Unfortunately, the use of antibiotics is not without complications, sometimes deadly ones.
Typically the side effects of antibiotics are only skin rashes, sun sensitivity, and other minor
problems. But antibiotics can have more serious effects. Sometimes they will provoke allergic
reactions so severe that death results. More commonly the use of antibiotics weakens the immune
system, making people more vulnerable to infections. This can happen in a variety of ways.
Sometimes antibiotic treatments kill off all the beneficial bacteria in the body--there are a lot of
them--and without them to limit the ecology of other organisms, like yeast, these diseasing
organisms will multiply uncontrollably. Left unchecked, yeast will release chemicals that further
suppress the immune system. There is also evidence that antibiotics directly weaken the immune
system by decreasing the formation of antibodies, harming the functioning of white blood cells,
and destroying bone marrow.(216) So the use of antibiotics, while helpful in particular cases,
possibly lifesaving in some, is not an unambiguous tool that always decreases mortality. And due to much abuse, antibiotics are becoming increasingly less effective. Many varieties of
bacteria are becoming resistant to antibiotics, partly because of over-prescription by doctors,
partly because of common use in animal feed. As a result, infections remain a threat to human
longevity. "In 1976, infections were considered to be the third most common cause of death,
being shown on death certificates more often (123,000) than deaths from all accidents (100,000),
or more frequently than deaths from diabetes, cirrhosis, suicide, and homicide combined
(110,000)." And Sagan concludes: "While there are undoubtedly individual exceptions, for the
population as a whole it appears unlikely that antibiotics contribute beneficially to our life
expectancy."(217) Contrary to expectations, according to epidemiologists, there is also little evidence that
vaccinations do much to reduce death rates either. In almost every major disease that can be
treated with vaccinations (smallpox, tuberculosis, measles, polio, and typhoid) the incidence of
infection had been declining before the vaccination for the disease became available.(218) Besides
that, prevention of one disease by vaccination seems to be compensated for by the development of
other diseases. So while vaccination may prevent the incidence of one disease it will have little
effect on the overall death rate because, once one disease is stopped, other diseases will replace it
as a cause of death, as Sagan points out: When vaccination against smallpox became available in the early part of the nineteenth century,
smallpox deaths, which occurred most commonly among children, fell precipitously. However,
the overall death rate was relatively unaffected, as deaths from gastrointestinal and other diseases
subsequently rose. One cause of death was replaced by another, as would be expected if there
had been no change in the immune defenses of the population.(219) Modern medical care doesn't seem to have much effect on longevity, and yet, it would appear,
those who have little access to it, die sooner than their wealthier peers.(220) It would seem logical,
as well as just and humane, that to equalize health care would equalize life prospects. It would
seem that way, but it doesn't turn out that way. Though lower socioeconomic classes do have
lower life expectancies than higher ones, the difference has little to do with access to health
care.(221) After World War II, England adopted a national health care system that did much to
equalize access to care for all social classes, or at least provide lower classes with good care.
"Although utilization of medical services increased considerably following institution of the
National Health Service after 1948, the differences in health among social classes remain as great
now, forty years later, and actually appear to be widening."(222) In the United States, Medicaid and
Medicare, though they have granted considerable access to the health care system, have also failed
to do much to reduce the different life expectancies of rich and poor. The different levels of health between rich and poor are not due to access to health care but, very
possibly, to different images of self.(223) In a society that uses income as an index of worth and that
justifies inequality as a sign of desert, effort, and ability, poor people can only have a poor
self-image. They are the others to a society of affluence, and their identity is made useful as a
means of discipline. "You wouldn't want to be like them, those trashy poor people, would you
now?" the they world says. And so, internalizing this image of themselves, the poor are less able
to protect self against other, succumbing to the challenges of disease more easily. Besides those
hidden injuries of class that Richard Sennett has described, there are others . . .(224) Recently, a study by Gregory Pappas, a researcher at the National Center for Health Statistics,
made this point about the relevance of class again.(225) Between 1960 and 1986, the differences in
death rates between classes widened significantly, even though during this period Medicaid
programs were set up to improve access to medical care for the poor. Pappas compared two
studies, the most recent one covering 44,216 Americans between ages 25 and 64 in 1986, and an
earlier one done in 1960. Over that 26-year period, the differences in income were increasingly
associated with differences in mortality. Of those who earned less than $9000, there were 16
deaths per 1000 for white men, 6.5 for white women, 19.5 for black men, and 7.6 for black
women. This, while those who had an income of more than $25,000 had a death rate of only 2.4
deaths per 1000 for white men, 1.6 for white women, 3.6 for black men, and 2.3 for black
women. Gregory Pappas concludes that, "The data provide an important critique for the health
care reform proposal. The implication is that even in a perfectly equitable health care system,
these problems will persist."(226) Equal access to health care will not equalize disease rates, in other
words. Several other recent studies agree with Pappas.(227) According to an editorial in the British
Medical Journal, ". . . the psychological effects of being low down the social ladder have
detrimental health effects, whatever the actual material conditions of life."(228) In other words,
even if everyone has an adequate diet, adequate housing, access to health care, and so on, their
health will be harmed by the politics of experience in an unequal society. George Kaplan and his
associates compared inequality in each of the 50 states and compared it with age-adjusted death
rates. The most inegalitarian states, Louisiana and Mississippi, where the poorest half of the
population got only 17% of the total household income, had the highest incidence of mortality, a
little more than 950 deaths per 100,000 people. At the same time, the most egalitarian states,
Utah and New Hampshire, where the poorest half of the population got 23% of the total
household income, less than 800 people per 100,000 died. Controlling for average income among
all states did not eliminate the differences--it was the gap between rich and poor that best
predicted mortality.(229) This is of particular concern because inequality has been dramatically increasing in the United
States for several decades.(230) The wealthiest 5% of the population got 17% of the nation's
income in 1977, but, by the end of Bill Clinton's first term in office in 1996, that grew to 21%.
The distribution of wealth, which is the total net worth of a household, is much worse. The
wealthiest 5% of the population in 1983 controlled more than half of the nation's wealth, 56%. In
1989, that portion grew to 62%. Peter Montague sums it up this way: "As a nation, we have
traditionally thought it was acceptable if the rich got richer, so long as the poor were minimally
provided for. These studies now reveal that such a situation is not acceptable. As the gap grows
between rich and poor, the health of the nation deteriorates, the social fabric unravels, and the
cost of maintaining community goes up."(231) The relationship between income distribution and mortality is hardly unique to the United States.
According to Wilkinson: The contrasting experiences of Britain and Japan illustrate the possible effects of income
distribution on health. In 1970 income distribution and life expectancy were similar in the two
countries and fairly typical of other countries in the Organization for Economic Cooperation
and Development. Since then they have diverged: Japan now has the highest life expectancy in
the world. Marmot and Davey Smith found no obvious explanation (in changing diet, health
services, or other aspects of life) for the rapid improvement in Japanese life expectancy. They
did, however, observe that Japan now has the most egalitarian income distribution of any
country on record. In Britain, on the other hand, income distribution has widened since the
mid-1980s and mortality among men and women aged 15-44 years has increased.(232) Another reason Japan does so well in longevity compared with other countries may be because
Japanese culture places such a strong emphasis on belonging within the community. There is
plenty of evidence that those who are integrated within a community, able to draw upon others
for encouragement, resources, and support, are healthier than those who are isolated and
lonely.(233) According to a study done in Alameda County, California, on seven thousand people
who were interviewed regarding the number of their friends and relatives, their church
membership, their marital status, and the intimacy and intensity of these relationships, those
people who had the most connections and the most intimate relations were less likely to die, when
they followed the study up nine years later, than those who were isolated. The difference between
social connection and isolation remained even when variables like socioeconomic status, cigarette
smoking, other health practices were controlled for.(234) And it doesn't have to be people to whom the self is connected. Pets seem to help as well.
According to a study of ninety-two heart attack patients who were discharged from the University
of Maryland, those who had pets were more likely to survive than those who didn't. Of fifty-three
patients who had pets, fifty survived, whereas only twenty-eight of the thirty-nine who didn't have
pets survived.(235) In a similar study at a nursing home of patients who failed to respond to
conventional therapy, pet dogs were given to fifty elderly patients. Those who accepted the dogs
showed considerable improvement. One elderly man, after not speaking for several years, began
talking after he got a pet.(236) In a study of members of the classes at the Johns Hopkins Medical School from 1948 to 1964,
attitudes toward family, family size, age of parents, marital status all turned out to influence
subsequent health. Closeness to parents was a powerful predictor of suicide, mental illness, and
tumors.(237) This is a most significant study because, these all being physicians, the influence of
education, socioeconomic status, and access to medical care had all been removed. Because connection matters so much, it is no accident that some researchers have found that
hostile cities kill. Dr. Redford Williams of Duke University Medical Center measured the levels of
hostility in 10 different cities and compared these with death rates in those cities. Philadelphia,
ironically the "city of brotherly love," had the highest hostility score and the highest death rate.
No surprise, New York was next. Honolulu, again no surprise, had the lowest hostility score and
the lowest death rate.(238) Trying to fix these kinds of problems by improving health care just don't work, as the Cornell
Medical School and the United States Public Health Service discovered when they teamed up to
improve medical care on the Navaho Indian reservation in the 1950s. The Navaho were suffering
from unusually high morbidity and mortality rates. (At one time, before their whole world was
shattered and they suffered from a variety of diseases the white man sometimes deliberately
introduced, Native Americans had most impressive life spans. It was typical for a small tribe to
have elder members in it living healthy and happy more than a hundred--all without modern
science or adequate health care. But all that changed with the coming of Euro Americans.(239) As
soon as Native Americans were introduced to "civilization," they became in desperate need of the
most sophisticated medical care.) Starting in 1957, and lasting for six years, the Cornell Medical School and the US government
tried to improve health by dramatically improving health care on the Navaho Indian Reservation.
Until then, the Navaho had only the most "rudimentary forms of medical care," as the government
described it. Infant mortality rates were three times higher than the rest of the United States and
tuberculosis was widespread, though nutrition was adequate and the water quality was good. The
Cornell-led group provided a well-equipped medical facility, well-qualified physicians, a variety of
consultants, teachers, and nurses, as well as air ambulances and radio equipped vehicles. They gave the best medical care that could be given. Almost all the Navaho got health checkups
during the six-year span of the study, and typically, two-thirds of the population got them every
year. Instead of waiting for people to come to them, health care workers went out to the Indian's
homes to provide care and to make checkups. Despite this most intensive effort, there was little
effect on infant mortality or the overall death rate. Children were still dying of diarrhea and
pneumonia at about the same rates after the intervention as they were before. In short, the US
government and the Cornell Medical School had nothing to show for all their well-intended
efforts. Nothing.(240) The failure of conventional medical theories to adequately interpret the reality of disease was
again demonstrated when the Federal Government decided to move more than ten thousand
Navahoes from their ancestral homes in 1974. The government supposedly was attempting to
resolve a land dispute between the Dinh and the Hopi tribes. (But perhaps this dispute was more
imagined than real. It turns out that the relocation allowed white business interests to mine the
region's multibillion dollar coal and mineral reserves.) The tribe forced to move, the Dinh,
suffered greatly--"loss of memory, disorientation, inability to concentrate, cases of partial
paralysis, and especially, severe depression and physical deterioration . . ."(241) Cisco Lassiter
explained the plight of the people facing relocation this way: Probably the most significant need of the premodern self is a sense of place. The modern self is
expected and encouraged to be mobile, independent, and able to adapt to constant social and
environmental change. For the modern self, all places are essentially the same: in the uniform,
homogeneous space of a Euclidean-Newtonian grid, all places are essentially interchangeable.
Our places, even our places for homes, are defined by objective measures. This relationship to
places is perhaps epitomized by the image of the "rugged individual" in white American
mythology. However, unlike the identity of the "self-made man," the Dinh's identity is
inextricably tied to its particular place on earth. Dinh self-awareness--Dinh identity and
individuality--is grounded in the earth, the tribe, the community, the family, and the
ecosystem--the Great Self. Without these connections, the primal self quickly begins to lose its
bearings and disintegrate. Its very identity depends upon the continuation of a devotional
connectedness to earth, ground, community, and ancestral place. The Dinh sense of "home" is
more closely tied up with their sense of who they are. In their experiential world, relocation can
cause the death of the spirit.(242) The despair of a defeated culture might also have something to do with the dis/ease Native
Americans are suffering, as the people of former communist countries are finding out. According
to the United Nations Children's Fund, since the collapse of communism in Russia and Eastern
Europe, the death rate has skyrocketed. Nine former communist countries have together reported
an "excess mortality" accumulation of 800,000 deaths between 1989 and 1993, a death rate that
"parallel(s) or even surpass(es) those normally observed in wartime conditions."(243) The main
cause of death has been a dramatic increase in the number of heart and circulatory diseases,
mostly among young and middle-age men. In Russia, deaths due to heart problems increased by
26 percent between 1989 and 1993. In addition, "poverty diseases" like diphtheria, cholera,
hepatitis, and tuberculosis started dramatically increasing in 1989, after a 40-year decline.
Murder, suicide, alcoholism, and domestic violence rates also dramatically
increased.(244)According to the UNICEF report, "The transition toward Western-style freedoms
has swept away traditional securities protected under socialism, leaving many men deeply shaken
by a loss of self-esteem." Yet Native Americans are one worse than the people of former communist countries. While the
collapse of socialism shattered the institutions that the people in these countries had long
depended upon to give their lives meaning, shaking everything firm and solid loose, Native
Americans must not only face all of that but permanently take on the identity of a defeated people.
Finding their most profound beliefs dismissed as primitive superstition or as evil paganism, they
cannot escape the image of a self that isn't inferior, when it isn't evil. Affirmation and defense of
self in the midst of subjugation, exclusion, and hostility are fraught with peril because the self is
unavoidably constituted by the history of alterity with which it is engaged. It cannot but become
other to itself, interpreting self the same way the dominant culture does. Defeated, humiliated,
humbled before overwhelming power, the identity of such a people can only be deeply
dis/easing--filled with self-loathing and resentment when it isn't paralyzed with self-doubt. The Christian West has long treated its own children much the same way it has treated the Native
American, as an other to be dominated, shamed, and defeated, and perhaps this explains why
health improved when the West became less devoted to traditional Christian child rearing
practices. In the traditional Christian world, everyone is guilty with original sin, a fall that
separates them from God. Adam and Eve rebelled against God, and so the task of every "good"
Christian parent is to suppress a similar rebellion in their children. Children are, on the traditional
Christian interpretation, unruly, rebellious, sinful, contrary, and so all of this must be beat out of
them. Here is how a Pilgrim pastor, John Robinson advised parents to care for their children: And surely there is in all children a stubbornness, and stoutness of mind arising from natural
pride, which must, in the first place, be broken and beaten down: that so the foundation of their
education being laid in humility and tractableness, other virtues may, in their time, be built
thereon. For the beating and keeping down of this stubbornness, parents must provide carefully
that the children's wills and willfulness be restrained and repressed, and that, in time, lest sooner
than they imagine, the tender sprigs grow to that stiffness, that they will rather break than bow.
Children should not know, if it could be kept from them that they have a will of their own, but in
their parents keeping; neither should these words be heard from them, save by way of consent, "I
will" or "I will not."(245) This kind of attitude toward the child, which identifies the child with rebellion, sin, and evil, and
dis/eases the self with guilt, fear, and resentment, is, I suspect, the source of many of our diseases.
This kind of child-rearing practice is a relentless attack on self, and it can be no accident that the
Middle Ages, which celebrated this interpretation of childhood, produced the most unhealthy
civilization in the history of the world. Privileging the supranatural, the male, the spiritual,
Christianity has long denigrated the natural, the female, the body. And the cost to the body's
ecopolity has been tolling. In contrast to the philosophy of "spare the rod, spoil the child,"
parental acceptance, affection, and nurturance have been shown to have a long-lasting effect on
the child's well-being. Breast feeding, cuddling, cooing, fondling, and simply holding affirms the
child's sense of self, strengthening its ability to resist challenges to it. Sometimes with dramatic
results. In 1986, some doctors at the University of Miami Medical School took forty premature babies
and divided them into two groups, one receiving special attention and the other not. Three times
a day, the special group had someone reach through the portholes of their sealed cribs and stroke
them and gently wiggle their arms and legs. Although each group was feed as much as they
wanted, the stimulated group gained 47 percent more weight each day, were more alert, and
developed faster than the control group, leaving the hospital an average of a week sooner. This
simple expression of care saved $3,000 per infant in the final bill.(246) It is not just premature babies that respond physically to affection, maturing children show similar
responses. Just after World War II, Elsie Widowson, a British nutritionist, discovered that
children in two different orphanages in occupied German grew at entirely different rates, though
they were both fed the same rations. The care the children received entirely explained the
differences in weight. At the orphanage called Vogeinest, where the children grew faster, the
matron in charge was kindly and admired by all the children. At the other orphanage, called
Bienenhaus, the matron, one Frl. Schwarz, was a strict disciplinarian, and the children did poorly
under her care. She was highly selective in her attentions, rewarding only those who were
obedient, and disciplining those who were not. The small group of children that she favored did
better than the others under her care, but not as well as the average child under the care of the
kindly matron at Vogeinest. As it happened, the kindly matron left her employment at Vogeinest,
and the strict Schwarz was moved in to replace her. Within weeks after she arrived, her new
charges slowed their development and eventually even fell behind the development of the children
at Bienenhaus, who now had a new matron.(247) More recent studies in the United States show how harmful distressing circumstances can
be.(248)Working class children are more likely than their better-off counterparts to become ill, more
likely to suffer adverse consequences from illness, and more likely to die. Low birth weight,
common congenital infections, iron deficiency, lead poisoning, hearing disorders, and
psychosomatic diseases are more common among poor children. Poor children are 75% more
likely to be admitted to a hospital in a given year, their average length of hospitalization is twice
as long, and their average total hospital days are four times as many as children in upper classes.
Poor children are much more likely to be out of school because of a chronic condition, will have
30% more days of restricted activities, and lose 40% more days of school because of illness.
Many illnesses, like asthma are more severe for them, and they are more likely to die of
life-threatening illnesses, like cancer.(249) The circumstances under which a child forms their identity affects their health throughout life. If
a child is suddenly deprived of a parent,(250) especially their mother, their health is particularly
vulnerable.(251) Because of the child's helplessness and dependency, loss of a primary caregiver has
a traumatic impact on the sense of self and the development of the inner healer that protects
self.(252) As a result, people who have lost a parent during childhood show increased vulnerability
to cancer, among many other things.(253) According to Lawrence LeShan, if a parent becomes sick
or dies, the child usually believes that they had something to do with it, that it is their fault
somehow. Parents are powerful figures, unlike children, and have a great deal of control over
what happens to them. If they get sick and die, it is because they choose to, the child might feel,
perhaps because the child wasn't "good enough," was bad and a burden, and the parent didn't
want to be with them anymore.(254) However, it isn't just connection to one's parent that matters. The role the parent has in the wider
world has a big impact on the child's identity. In industrialized countries, particularly the United
States, working-class families are more likely to be authoritarian, to be helplessly fearful of
change, and to prefer present gratification to future rewards. These attitudes are not chosen; they
are necessities produced and required by a disciplinary system of management that the working
class is caught up in.(255) The modern disciplinary system of production, especially for those in the lower classes, tends to
suppress autonomy and foster dependency, obedience, and curtailed expectations for self. Those
subject to disciplinary systems of management succeed by casting a whole list of what might be
otherwise considered virtues--imagination, creativity, self possession--into the shadows.
Disowning these dangerous parts of themselves in order conform to managerial discipline, the
members of the working class struggle desperately to maintain a sense of self-respect. However,
it is precarious and threatened. Through advertisements, conventions, and status, society
persistently renews images of their unworthiness, inadequacies, and failings. Because they have
no college education, little money, a small and perhaps shabby house or apartment, and an old car,
they haven't made it, and so they feel unsure of themselves. Made dependent on the vagaries of
the factory system of production, they are dependent on others for self definition. Their sense of
self comes from the outside, particularly from their power to consume, not from self expression. To get along, the members of the working class know they must go along, and they teach this to
their children. As Lillian Rubin points out, the children of the working-class quickly learn to feel
inadequate. Children know. They know when their teachers are contemptuous of their family background, of
the values they have been taught at home. They know that there are no factory workers, no truck
drivers, no construction workers who are the heros of the television shows they watch. They
know that their parents are not among those who "count" in America. And perhaps most
devastating of all, they know that their parents know these things as well. Why else would they
urge their children on to do "better," to be "more" than they are? Why else would they carry
within them so much generalized and free-floating anger--anger that lashes out irrationally at
home, anger that is displaced from the world outside where its expression is potentially
dangerous?(256) The individualist ethic of American society fixes responsibility for success or failure tightly on the
individual. The individual's success is their success. If you are not successful, there is no one to
blame but yourself, and so there is an intense amount of guilt and shame attached to the identity of
working class people. On the other hand, people in the middle and professional classes are likely
to be much more positive about themselves because they are the ones managing the factories, or
the ones who have professional careers, like law or medicine. As the ones controlling, managing,
and "helping" others, they build their identity on their difference with members of the working
class. Having made it to the top, they have something to contrast themselves with, an other that
identifies them as superior. This sense of accomplishment and superiority, combined with a
greater sense of autonomy and increased possibilities for self expression, makes their identity
more secure, less dependent on the demands of the outside world. So, the middle and
professional classes have, to some limited extent, the luxury of developing a sense of self that
develops from within. They are allowed to be what they are. And so, they are typically less
authoritarian, more future oriented, less fearful of change, more independent. And their attitudes
toward their children are likely to be more affectionate, less authoritarian, less controlling, while
still being demanding. The result of all this is to impose a dis/easing identity upon the powerless. Taking power away
from the members of the working class, denying them self-expression, and subjecting them to
disciplinary systems, undermines the self's inner healer, forcing it to turn its power over to the
outer world. If the self believes that it can handle the contingency of life, it is more likely to seek
it out, creatively respond to it, and draw strength from it. This gives the self the power to more
effectively deal with dis/ease that must come with life. Avoiding stress and contingency out of
fear for an insecure and threatened identity makes the self all the more vulnerable to the shifting
sands of life. Indeed, much of the joy of life comes from being able to risk the unknown, test
limits, respond to challenge.(257) The possibility of joy in the face of contingency is denied in an authoritarian setting and
upbringing. The identity of the self subjected to authority depends upon the interpretations of
another, in forces beyond its control, and so its value is determined not by an expression of its
own reality but by others for the utility of a system that has little interest in its welfare. Denying
and repressing self expression, authoritarian systems cultivate dependency, helplessness, and fear,
and as a result, pave the way for depression, frustration, and dis/ease.(258) Besides the prison of class ideology, differences in education may also explain some of the
differences between death and disease rates between different classes. Several studies have
observed that literacy and education strongly influence health. Some epidemiologists have even
argued that the dramatic expansion of literacy and education in the West since 1700 explains the
increase in longevity, not such things as diet, sanitation, and medical improvement. In statistical
studies, when these variables are controlled for, education remains the defining variable.
Historically, mass literacy is a rather recent event. Even in 1700, after the Enlightenment had
been deconstructing the authority of the Church for some time, trying to replace ignorance and
superstition with reason and science, 55 to 65 percent of Europeans were still illiterate. However,
by 1850, 90 percent of white American men were literate.(259) According to Sagan, differences in
mortality rates between those of high education and low education increased dramatically,
especially for women.(260) The same process is continuing today. Between 1960 and 1986, the differences in death rates
between people with different levels of education actually widened significantly in the United
States. Gregory Pappas compared two studies, the most recent one covering 44,216 Americans
between ages 25 and 64 in 1986, and the earlier one a similar study done in 1960. Over that
26-year period, the link between mortality and lower educational level increased by more than
20% in women and doubled in men. While white men who did not finish high school had a death
rate of 7.6 for every 1000 in 1986, white male college graduates only had a death rate of 2.8 for
every 1000. The death rates for white women who had not completed high school were 3.4 per
1000, 13.4 for black men, and 6.2 for black women. This, while their college graduate peers had
a death rate of only 1.8 for white women, 6.0 for black men, and 2.2 for black women.(261) Education is not a proxy for income, either. According to another study, when income level is
held constant, 30 percent more people with a college education report excellent health than
people who are poorly educated.(262) The common explanation for education influencing health is
that it raises income, which improves nutrition, grants greater access to quality medical care,
improves sanitation, and generally gives people all the things that money can buy. Yet when all
these things are statistically controlled for, education remains a strong variable for predicting
health. In fact, according to Samuel Preston, "factors exogenous to a country's current level of
income probably account for 75-90 percent of the growth in life expectancy for the world as a
whole between the 1930's and the 1960's. Income growth per se accounts for only 10-25
percent."(263) Education has a profound effect on personality, both shaping it and fostering self-expression.
Being able to read, write, and speak clearly and persuasively are not merely avenues to income
and status; they make it possible to be increasingly sensitive to one's feelings, to develop
self-esteem, and to maintain an identity against challenge. To think about one's situation and deal
with it. Dis/ease, as we saw earlier, is a concealed language of situation, a revealing of its truth.
Those who have greater facility with language, might well have greater possibilities for self
expression, for processing, working out, and healing the things that are dis/easing them. An
enabler, language reveals truth, gathering up the world and drawing it near. As the great poet
Holderlin once wrote, "Where word breaks off, no thing may be." Without the words to name it,
dis/ease would be unexpressed, unthought, and so, unhealed. And that really is what dis/ease
is--an unthought thought, a truth that remains concealed. Having a language to think the
unthought, bring it forth and name it, makes it possible to heal it. And so education, at least
perhaps the right kind of education, can heal and promote health. However, dis/ease is also a revealing of truth. When it happens it is never just a bio-mechanical
event, though it may sometimes be effectively understood that way, but is something situated in
the community, its language, its relations of power. Some words and thoughts and communities
are dis/easing because their purpose is to conceal truth, to repress the aspects of the self that are
threatening. Greater facility with this language of repression would only deepen its dis/easing
character. To heal, language must be able to reveal the dis/ease of situation. It must be honest,
caring, and respectful, not just subtle and precise. Facility with language should not be just a
means to power, the more the better, but a way to let truth happen. We moderns live in a world of great danger, cruelty, injustice, and inequality, though much of it is
concealed, dismissed as unavoidable, or trivialized by powers that benefit from allowing it all to
continue. If the prospect of massive nuclear war is no longer as likely as it once was, we face the
probability of ecological disaster caused by the population explosion and pollution. Not only that,
but modern industrial civilization, and especially the American version of it, has built a world of
alienating labor, gross inequality, patriarchal hierarchy, minute disciplinary control of many
aspects of life, unrealistic and oppressive standards of sexual beauty and physical attraction, and
an ideal of consumerism in which few are fully able to participate. The homeless crowd our
streets, those disaffected from the civilization of productivity crowd our prisons, and everyone is
buying guns and locking up their property. Entangled in this world we have built, most people, trying to maintain the identities necessary to
participate in our civilization of productivity, throw large aspects of themselves into the shadow,
projecting their disowned desires and faults onto others, and punishing them for the disciplines the
modern self must assume, and resents deeply. As William Connolly has argued, the unemployed,
the welfare recipient, the person of color, the delinquent, the mentally deranged, the sexual
deviant, the drug user, and so on are the others we use to build our "virtuous" self, the part of
ourselves that would be honest, hardworking, and normal.(264) This "virtuous" self can affirm its
identity only when its counter-identities are produced as other, and dismissed as other. Entangled
in these others, the identities we need to maintain our civilization of productivity conceal a great
deal of cruelty, exclusion, repression, and exploitive discipline. A lot that is--and should
be--dis/easing, to those who think about it. Though the virtuous self maintains it is not its other;
it is, in fact, inextricably entangled in the other's agony. A part of it. So what are we to think of a person who would deny that their identity is entangled in so much
pain, cruelty, and danger? Who would feel good about themselves in a world such as ours? Are
we to interpret their ability to deny their entanglements with their others, to not think about their
pain or be disturbed by it, as healthy? Or are we to interpret their good feelings about themselves,
their "health" as they go about building and renewing this civilization of alienation, domination,
resentment, and fear as manufactured, false, and delusional? Perhaps those who are healthy,
happy, sane, and normal in this age are so only because they can live a lie. And perhaps their
"health" does not reveal their virtue, as too many New Age theories of disease would have it, but
their failing--their failing to connect with the world, to see the deep pain there, or to acknowledge
their implication in it. This, of course, complicates everything greatly. By locating dis/ease in the dense complexity of
the lives we share with others, by situating it in the healthy as well as the sick and not in the
various isolated and irrupting incidences of disease, we diffuse the responsibility for disease by
confounding what conventional science could identify as a cause of it. We make it into a
happening of world, not the irruption of an event that can be isolated and studied as an isolated
cause. This move radically shifts the space for debating the meaning of disease. Instead of
interpreting it as an accident of nature, an effect of a scientifically controllable cause, we must
interpret it as something that emerges out of the way our world worlds, our life as a whole,
healthy or diseased. In the next part of the book, instead of reinterpreting what conventional science has found about
disease, we are going to shift the level of engagement and directly examine the way the modern
world worlds, the way that it dis/eases us. The modern world has constituted nature as a resource
for Man to use as he wills, and this, by making the material of our bodies and the earth that
sustains us into an object of control and subordination, dis/eases our lives with an ecopolitics of
exploitation. Ironically, we will find that what dis/eases us most in the modern age is exactly what
we have long celebrated, the rights we have given each other as human beings. By toleratingeach
other, as we do when we are at our best in the modern liberal state, we do many complicated
things. Most of all, we legislate the structure of the ecopolity. Doing it the way we have in the
modern age, we have dis/eased the earth and all that live on it. Back to Contents
Chapter 6
Healing the Earth
The USA slowly lost its mandate
in the middle and later twentieth century
it never gave the mountains and rivers,
trees and animals
a vote.(265)
Gary Snyder
A vote for mountains and rivers, trees and animals? Standing in our polity? A strange and
complicated idea to modern people. Out of bounds, unthinkable, untenable, irrational. Not
possible. These others that we own, eat, and use having a claim on us, how we go about ourlives?
Intolerable, surely. A transgression of our humanity, our property, our place, above all, our
rights. Let's get this straight. We own the mountains and rivers, the trees and animals. They are
ours to use as we will, to legislate, designate, and manage as we want. Besides, this is, as those who are mathematically inclined would insist, uncountable. After all,
what would get one vote? Why this mountain, and not that hill? And how would we equate the
votes of rabbits, which are many, against those of the coyotes, who, being predators, are not so
many? Surely the rabbits would make the coyotes' appetites felonious. And wouldn't that be
unfair? Coyotes do have a right to eat, we would surely want to allow, and who can they eat that
would not resent it? And just who is going to have the patience to tally the votes of the trillions
of insects that inhabit the earth? No doubt, considering the unimaginable numbers of insects and
microbes, we would need some sort of proportional representation for each species, one species,
one vote. Or something like that. But those would be easy problems compared to figuring out
what the deer, the coyotes, the eagles, the rabbits, the mountains, and the rivers all had on their
minds. Just how would one know? Communication, translation, and interpretation problems
abound.(266) Let's get serious, you, my fellow humans, might tell me. The poet is clearly out of bounds in
proposing that the mountains and rivers, trees and animals, should have standing in our polity.
That the legitimacy of the American state somehow depends on it. Do we really want to give the
deer a voice in the affairs of state? Wouldn't we, as human beings, be giving up all our power?
Our possession of the earth? Confusing the boundaries that separate us from the mountains and
rivers, trees and animals? And who is to say, if we did unsettle these differences, that some
foul-tempered and abused species, like the grizzly bear, wouldn't decide that the human species
was simply intolerable? Not at all. Maybe they would label us humans a threat to the ecosystem
(they would, after all, have considerable evidence and the sympathies of any fair-minded court on
their side), and move to outlaw us, forbid our reproduction? Make us other to the health and well
being of the planet and evict us from the biosphere? Sort of like what we humans have long been
doing to the wolves? Gloomy thought. But, if our bodies are ecopolities, as we saw at the beginning of this book, and
if the boundary between inside and outside is as problematic as any self-respecting postmodern
would argue it is, then we cannot assume that the plants and animals cannot have any standing in
the polity. As communities of plants and animals, we are really no different than they are, than the
whole planet is. If we are to heal ourselves, really heal ourselves, I believe we will need to open
our thoughts to the different perspectives of the mountains and rivers, the trees and animals. We
will have to decenter our polity, open its boundaries, include what has been other to it, and make
our polity into what it truly is, an ecopolity.(267) Instead of being anthrocentric, insisting on our
superiority as a species and the inferiority of all others, and dis/easing everything we inhabit with
their exclusion.(268) As almost everyone agrees, the well-being of almost every species on the entire planet is seriously
at risk in the modern age. Overpopulation by humans, the greenhouse effect, the ozone layer
depletion, the extinction of many different species, the loss of biodiversity, the polluting of the
ecosystem with toxic and radioactive materials, the risk of nuclear war--all these pose serious
threats to life on the planet. And fill the world with dis/ease and death. The poet is not just wandering off in mushy and metaphoric sentiment when he demands standing
for the mountains and rivers, trees and animals in the polity. Inextricably entangled in ecopolity
with them, we need them to save the planet, to heal the earth's dis/ease. But more than that, the
legitimacy of the modern state doesdepend on it because it is a matter of truth, of letting be what
we are, what the earth is. Of accepting our situation as earthly beings. Healing the earth requires
regaining our belonging in this ecopolity of beings, breaking down the boundaries of exclusion
that have concealed our complexly interdependent relation to all the other species on the planet. Just as the sun does not, like a moon, orbit around the earth, humanity is not the hub of the
ecosystem, the center around which every other species humbly revolves. We all are but a strand
of life woven in with the lives of other species. Eco dispersion, not anthrocentrism, describes the
true relationship each life has with every other life on earth. If this ecopolity is unknowable and
unthinkable because modern humanity has, like some horribly oppressive and stupid tyrant,
thrown it into the shadow, displacing it and silencing it with our shameless dreams of glory, we
must try to bring eco dispersion to light, revealing the ways in which we belong with the
mountains and rivers, trees and animals. By accepting the truth of eco dispersion, by tolerating
the belonging of every life form, we make peace with our own body's ecopolity and heal our
souls. As far as the modern anthrocentric polity--capitalist as well as socialist--is concerned, the earth is
there for it. The modern polity is above it, beyond it, and our freedom as human beings seems to
depend on overcoming it. Our earthly situation. We all seem to "just know it," and it is difficult
even to imagine otherwise, almost as if it were secretly forbidden. And, if we can, it all seems so
strange and unrealistic, so unscientific, irrational, sentimental, and innocent. And primitive,
especially that. Like the Native Americans. (And we know what status they have now.) I want to suggest that the possibility of ecopolity with the earth--and our bodies--only seems so
strange and impossible because it is dis/easing, because it threatens our identities, makes us fear
for our freedom, our mastery, our whole world. It upsets hierarchies like subject and object,
knower and known, mind and body, that have come to be quite comforting. It calls into question
things that seem to be unquestionable. It makes contingent beliefs that we had believed beyond
contingency, somehow inescapably rational, natural, inevitable. It would make us tolerate ways
of being--those of the mountains and rivers, trees and animals--that we would never have dreamed
of being called upon to consider, much less tolerate. But if we rethink the boundaries of our polity, consider the possibility of including within it, as
equals of ourselves, the broad dispersion of earthly beings we have formerly excluded from it, we
must allow the possibility that what seems so strange is so only because we have thrown our true
ecopolity with them into the shadow, concealed its possibility and made it seem impossible. There
is nothing inevitable, certain, or natural about the boundaries of the modern polity, the self, our
contemporary identities and its alterities, or the various claims of human sovereignty over the
earth.(269) They all are contingent, shifting, contestable, and they all can be remade to include what
was formerly excluded. Just as once, if Lynn Margulis is right, our immune cells were once
separate organisms, evolving separately outside our body, but joined with it in community, and
became the main mechanism by which its identity against world was maintained. There are ways of making the unthinkable, thinkable; the unimaginable, reality. One way is to
explore what is intolerable to us. What we Americans, in particular, insist on tolerating. And
what we conceal when we do . . . . Toleration, according to the Oxford English Dictionary, is derived from toll, which is a tax, a due
to be paid at the polity's boundary.(270) The meaning of toleration was originally built around the
practice of tolling, of the polity receiving its due, and was structured by the architecture of
tollbars, tollbooths, tollgates, tollhouses, and tollkeepers. Toleration becomes an issue at borders,
the boundaries separating inside and outside, native and foreign, citizen and alien, secular and
sacred, self and other. Before they can become immune to the challenge of otherness, those who
are tolled must come to acknowledge these differences, to accept the other's alterity, and to
acknowledge the polity's authority over it. To be tolerated is to accept the polity's authority to
define difference, mark its circumference, impose its law, and identify the foreign as foreign. To
be tolerant is to exclude otherness, silence it, and, maybe, war against it. (And so, tolerance is not
at all tolerant!) Toleration, as a word, traces its origins back through a rich variety of languages, including,
among others, Old English, Old Frisian, Old High German, Latin, Greek, and perhaps earlier. But
the Greek associations are the most revealing. The Greek word toloneion meant a tollhouse or a
custom house, which was from telones, a tax collector, which was from telos, a tax for the gods,
which in turn was related to telesma, a payment made at the boundary of the temple to fulfill
religious rites. Upon paying them, one became immune to challenge, no longer other to the body
politic. The god of the territory was acknowledged, supported with payments, prayed to. As we
saw earlier, immunity, which is derived from the Latin munius, for civic obligation or public gift
or sacrifice, had little to do with biology and much to do with political obligations.(271) To be
immune was to be free of (but nevertheless subject to) the sacrifices and the public payments that
the telos required. According to Martin Heidegger, telos is inadequately translated as end or goal.(272) A better
translation is limit or boundary because it is at the limit or boundary that the governance of the
polity, the god, the good, or whatever begins its revealing. The telos is the world within which
the god's interpretation of things prevails, governs, and exacts its due. Marking out differences, it
establishes contrasts, and gives things their identities, their names and characters, by separating
them from what they are not, what is outside them, beyond them. What is self and what is other,
what is going to be tolerated and what is not, just like the immune system. Only when a telos is
established, marked out, and differences established does the world world. Only then can there be
causes, happenings that gather things into being. Not just causes in the sense of bringing about,
one billiard ball clicking upon another, but, more importantly, in the sense of a summons or
calling.(273) A cause pursued because it has possessed one, claimed one as its own. As in a
charitable cause, a just cause, a religious cause. A cause that, as telos, gives one their identity,
their role, their place in life. The payment of taxes at the temple's boundary (and the temple's boundary was in many ways
identical with the state's authority) acknowledges and exalts the ruling power of the god who
causes such things by raising a toll up to it, as is called for by custom (another word that meant
tax), a duty expected at the state's boundary by the ruler or government. If the duty is faithfully
born, the bearer becomes tolerable to the god or the state, immune to further challenge. Now, to
be taxed or tolled is to be called upon, possessed by one's duty to acknowledge, obey, and exalt
that which marks out limits and boundaries and to pay it its due. It is to accept one's identity and
one's differences. Become responsive to them, accepting the ruling definition of inside and
outside, self and other, foreigner and citizen, good and bad, and so on . . . . The polity levies a tax to call its citizens to their duties, their sacred traditions or customs. No
citizen is immune to this calling. (A customer was originally a toll gatherer.) Because they are
inside the polity's boundaries, the citizens of the polity must fulfill their task, their cause, which is
revealed by the telos, the division of the world into identity and difference, self and other.
Incidentally, tax is related to task. Medieval Latin's taxa becomes, by various routes, most of
which involve French, Middle English's taske, or now our task, which is control led by a
taskmaster, the one whose command sets us about our tasks. The Latin taxare also means to
blame, to point out, to mention. So, to tax someone is to point out to them, to mention
persuasively (as only tax men can) that they must do their duties--or be held responsible for failing
to do them. Someone is taxing, tolling our patience, if they nag a lot, if they continually point out
to us our failures and call us to our tasks. (And stop grinding your teeth at the mere mentioning
of taxes, dear gentle reader, we must be tolerant of them, perhaps even grateful for the blessings
they return to us. It is our duty!) Now, it would seem, if our contemporary liberal friends are to be believed, that the toleration of
difference they urge upon us is not at all taxing--insistent that dues be paid, that a god be exalted,
or that a good must be sought. Everything is tolerated. Everyone is immune. There is no
outside, nothing repressed or concealed, nothing that is not a cultivated neutrality. Exalting no
god in particular, no center around which life must revolve, liberalism does not demand of us that
we do anything except respect other people's rights to property, free speech, assembly, religion,
and press. It is completely neutral, protecting everything that needs to be protected. The
unbounded freeway of politics--no tollbooths, no tollkeepers, no tolls to pay, and no gods to
exalt. But liberals, as Ronald Reagan long insisted, lie about other things too.(274) Stop and think how
taxing all this toleration of other people truly is. What is excluded from it, and what is immune to
it. The ACLU is in the business of protecting human rights. Not the rights of the mountains and
rivers, trees and animals. People are important, people matter. More than anything else in the
world. That is the telos of the ACLU, the boundary that it is defending, the biohierarchy that it is
legislating, the immunity it is conferring. Anthrocentrism, a polity that gives humanity total
immunity from the payments needed for belonging in the earth's ecopolity. Everything that is not
human is put into the shadow of this polity, silenced, prohibited, made alien, other. Taxed out of
existence. Perhaps, if we think about it for a while, we may find the taxes that liberalism imposes
on our planet--and our bodies--exceedingly heavy, and we may find it time for a tax revolt. Only the analytic tradition, in its unrelenting quest for unambiguous language, could permit
liberals to forget the intolerance the word toleration remembers. Believing in a world without
shadows, liberals insist upon toleration for the individual human subject, thinking that they set
everything free as they do. But as they surround humanity with toleration, marking out the
boundaries of the polity, they close off other possible ways of being while they impose their
instrumental interpretation of the world on everything. In their toleration for the individual they
legislate the boundary of the polity, concealing our true ecopolity with the mountains and rivers,
trees and animals, and excluding them as objects available for the subject's reason. As objects of
utility for human subjects, they become something to dominate and control. And so, liberalism's polity only tolerates the human way of being and interpretation of the world,
none others. Not the way of the soaring eagle, the wandering mouse, the whispering grass, the
chuckling stream. Liberal toleration is the toleration of an exclusive and anthrocentric telos, an
interpretation of things or an abiding truth in the order of things that puts humanity in the center
of the world, makes it immune to needs of all the beings of the earth, and gives it total control
over every other being in the world. Denying the truth of eco dispersion, going its way without
acknowledging the truth of its belonging in the earth's ecopolity, it becomes a dis/ease to it. Important to the liberal telos is the difference between subject and object, knower and known.
The world is different, other, by being understood as something objective, something beyond the
subject's limit, outside the protecting boundary. Once this telos is marked out, and the laws of its
polity enforced, it makes the toleration of the human subject into something needing protection.
(Heidegger and Foucault call the humanist vantage point produced by the modern difference
between subject and object, Man.(275)) Man, as this ecopolity now insists, must have his rights
protected, his freedom to say what he wants of the world, and use it however he wants. Once the
world is made into Man's object, it is his to use it as he wills, so long as it doesn't interfere with
the possibility of his humanity. And so, liberals must protect the humanity of even their most venomous enemies, the KKK, the
Militia of Montana, the Freemen, and the American Nazi party. So long as they are humans
within this liberal polity, each individual citizen is immune to control and have their right to make
of the world what they want, to take it as their property. And so, "mere" subjective opinion
becomes the correct interpretation of all religion, traditions, morals, and beliefs. Everything is laid
out before it. And, Man, as an individual and as sovereign citizen, rules all the earth by excluding
it from his polity. This emphasis on the individual as subject, as master of the earth, creates a problem for liberals.
Unlike Marxists, whose polity gives Man collective dominion over the world, liberals give it
equally to every individual human. With each individual their own telos, what is going to bind the
body politic together then?(276) Unite it and protect its sovereignty over the earth? If every belief
in the world's telosis but "mere" opinion, each individual's different and subjective, each immune
to the other, how are these autonomous sovereigns, each going their own way, going to come
together to meet common needs, like national defense, education, economic regulation,
environmental protection, and so on? How are they going to protect their boundaries, and keep
the other out of their polity? Having given the individual sovereignty over their telos, any interpretation of the world that
claims to know the good, the true religion, or the correct ideology, becomes irrelevant for a
shared political life. Other to it. And so, it becomes necessary to seek out something that can
demand universal agreement, something so obvious that no one can dispute it. Otherwise war
breaks out between mutually exclusive universal "truths" and the needs of no human will be
satisfied. As always in the modern age, built as it is of the difference between subject and object, between
the sovereignty of the will and the otherness of all the earth, technology is the solution. Absent a
traditional telos that gathers up the body politic into a common good, what can be agreed upon
are procedures, or technologies of justice for fairly resolving differences between different
subjective theories of the good. Procedures, or so liberals tell us, can be made into a value neutral
technology that will produce a solution to which every subject, whatever their personal feelings,
can agree. Liberals have accordingly come up with a large variety of procedures to insure that
things are fairly and equally distributed and that no one's personal telos prevails at the expense of
anyone else's--the most prominent of these, John Rawls' retreat to his Original
Position.(277)Though many liberals contest Rawls' thought, it does reveal contemporary liberalism's
general strategy for protecting and legitimating human sovereignty over the earth, of protecting
the differences that separate humanity from the rest of the earth. It reflects liberalism's general
strategy of separating knower from known, subject out from the earth and granting it sovereignty
over it. In the Original Position people assume a veil of ignorance that denies them knowledge of their
social status, their age, religion, sex, race, or anything else that makes them an earthly being.
They become totally abstract individuals, unsituated, disembodied, unencumbered.(278) They are no
longer living and breathing earthly beings, but rational beings, immune to callings of the earth's
ecopolity. Only their humanity remains. From this disembodied position of judgment and
legitimation people--and it is always only people, not eagles, not deer, not rivers--are to imagine
what kind of order they would consent to live under. Among other things, these humans would
supposedly consent to a society that permitted inequality only if every humanbenefited from it.
Inequalities between humans and the mountains and rivers, trees and animals, cannot even be
considered. Human choice thus comes to reign over the all the earth by being removed from it,
immune to it. Without ever even considering the possibility that the mountains and rivers, trees
and animals, might have a claim against this "justice." Or that it might be an injustice to exclude
them from the "humanity" of the Original Position. In the face of all difference, embodiment, and contingency--be it political, religious, racial, social,
cultural, or sexual--liberal toleration universalizes and then exalts its will to control by asserting a
boundary between the values I, as a human being, have and the person I am.(279) My deepest being
is not my natural or contingent being--my body, my biology, my relations to others or the earth.
My true self, my most important identity, the part of me that entitles me to toleration and
citizenship in the liberal polity, depends on none of these things. It stands apart from them. For
liberalism, to ever say that anything is my aim, ambition, or desire, is to imply a self, an abstract
will to control, that is most truly mestanding behind them, willing them. I am responsible for what
I am because I choose it, control it. For liberalism, this abstract and disembodied me that wills,
consents, and controls is most true to myself, prior to any of the aims, values, beliefs, or attributes
I may bear. But, this self, since it is a lie to the earth's ecopolity, is endangered, threatened by earthly
contingencies and ecopolitics that overwhelm it. Dis/eased by its truth, it needs protection from
the alterities it has excluded.(280) This self that controls itself is a characteristic of all normalpeople,
which is to say people whose mental condition, sexual condition, or bio-history--in a word their
eco-character--has not violated their sovereignty over their bodies.(281) Made subject to something
that is not their own will, dis/eased by their earthly belonging, some people are not capable of
their unearthly freedom, of using it in a rational, which is to say, exclusively human, way. Their
immunity revoked, they lose themselves to nature, contingency, their bodies, their past. Failing to
will their truth as the masters of the earth, they fail the criteria for citizenship in the anthrocentric
polity because something outside them has dispossessed them of it.(282) And so "for their own
good" we, who endorse the disciplines of humanity in this polity, lock these people up in
institutions, medicalize their problems, and reconstitute them as subjects, masters of the earth.
Such is the fate, as Foucault has taught us, of the insane, the delinquent, the pervert, and the
ideologically deformed. Unresolved the question who is more dis/eased: us by their reality, or
them by their suffering. Reason casts a dark shadow, and in its darkness are its others, those whose identities, by being
other to it, dis/ease the security of its ecopolitics. They must be conquered, controlled, isolated,
saved, but, above all, made safe by being made different. They have lost their power to dominate
the earth, to separate themselves from it and reign over it, and this position--Rawls' Original
Position--of power over the contingencies of life must be reclaimed, their citizenship restored to
them. (And not a few people have, therefore, wondered if the "insane" are not more sane than
those of us who are "normal." Perhaps their pain--and let no one doubt their pain--is the result of
revealing the world's pain in a way that all "normal" humans have managed to deny, trying to
maintain their citizenship in the human polity. To be healthy and "normal" in a dis/eased and
exploitive situation--and that seems to me a good description of much of contemporary life--is not
at all a sign of health, but of denial and repression.(283)) Dis/ease is the first signal that truth is
happening. If liberalism can now tolerate difference between individuals, it is only because it has rendered all
differences impotent by making them subjective, irrelevant, and nonfoundational. Removing the
"true self" from the body and the earth, severing all connections with them, liberalism's toleration
tolerates difference, then, only after difference becomes irrelevant, no difference at all. Far from
tolerating difference, liberalism is in fact a militant insistence on human power over the earth and
all the different ways of belonging in the ecopolity. All the earth's wonderfully different beings, all
the different plants and animals, mountains, rivers, forests, as well as all the different ways the
body is an ecopolity, are given over to the individual subject, who lords over the earth and the
body from places like the Original Position.(284) Subject neither to the interdependencies of the earth, nor the body's ecosystem, nor to the
belonging of community and custom, nor to any acknowledgeable teleology of goodness,
liberalism installs an abstract, disembodied, and unsituated individual as the sovereign subject of
the world, and casts it as the author of the only moral meanings that there are.(285) As the
sovereign subject of the world, immune to all the earth's callings, the world is the subject's to will
about as it would, unbound by the limits of custom, community, tradition, or the inheritance of the
earth. So long as we subjects do not do an injustice to the worlds other humans build, so long as
they too may will as they please, our choice as human beings carries full weight, whatever it is,
however it exploits the earth and dis/eases the body, and demands toleration from other humans,
simply in virtue of our having chosen it. This individualist telos of liberalism's toleration is only a variation, just as Marxism and Fascism
are their own variations, of the telos of modern technology, freedom through human subjectivity.
The way of modern technology, whether it happens as liberalism, Marxism, or Fascism, according
to Martin Heidegger, is to bring everything forth before the human subject and reveal it as an
object to be controlled.(286) Opening and setting the boundaries of a world in which the subject
wills its will, liberalism's toleration, like all the other ways of being modern, secures, enables, and
extends the reign of modern technology, protecting it by concealing its destruction of the earth.
As soon as we begin tolerating each other, sparing the earth becomes a subjective value, a good
that reasonable people may differ upon, and must tolerate, but need not respond to or act upon.
Certainly not a matter of truth. Protecting the earth is a subjective value, and so in its quest for toleration, modern liberalism, like
all other distinctly modern ways of being, conceals from itself its truth, the fact that its shadow,
the truth of itself it has disowned, is dis/easing the earth and the body. The modern way of
control is a way that knows only Man's utility, a way that offers as a sacrifice anything that
becomes an obstacle to the glory of Man's reign over the earth. Neither the beauty of the forest,
the mystery of the desert, the awesome power of the whale, nor the haunting call of the wolf can
really be heard or seen when the world worlds as Man's instrument. If the earth is to be spared
this slavery, if the body is to be healed of this dis/ease, liberalism's toleration, among other modern
ways of being, must be deconstructed, revealed as a teleology that conceals an imperative for
unbounded control that is as dis/easing to the body as it is destructive to the earth. Perhaps this desecration and concealment of the earth's mystery and the body's ecopolity could be
tolerated, briefly giving the devil his due, if liberalism ever delivered the freedom that it promised.
And yet, ironically, this freedom, so carefully protected by the ACLU, is but a trinket. When
people are situated in the power relationships, the factories, and institutions that modern
technology sets up to secure Man's dominion over the earth the freedom to control becomes the
imperative to submit to control, to silence any expression of the body's dis/ease with the
anthrocentric polity.(287) As Marx pointed out, once situated in a liberal economy people must "consent" to become
appendages to the machines at which they work. Their motions, their lives, even their thoughts
are made into an instrument of human dominion. So much so that a haunting paradox emerges,
the more the machine achieves Man's dominion over nature, the more dominated the worker
becomes; the more the system of modern production reflects Man's capacity for reason, the more
dis/eased are these who toil within it. If everywhere human subjectivity is an accomplished fact,
everywhere Man is subjected to a power that denies him his subjectivity, and dis/eases his body
with an ecopolitics of repression. Liberalism is able to lie to itself about this irony because its
telos must tolerate human subjectivity, not only in the political realm, but in the economic realm,
where logic of the contract frees workers for their subjugation. The irony of human submission in the age of Man's subjectivity is inevitable because liberalism's
toleration celebrates and protects control in its polity, surrounding it with rights and mighty
judicial institutions to protect those rights. To secure the anthrocentric polity, the world must be
controlled, fixed in place as the objective, made available as a means for control.(288) Seeking
control and building to assure it, humanity becomes deeply dependent on its possibility, subject to
the logic that it requires. Vast systems, huge bureaucracies, world economies, and powerful
tools are built to get all the earth under control. And to assure this control, Man, the discursive
formation that Foucault and Heidegger spoke of, must take his place within such mechanisms of
control, submitting to the logic of control by becoming an instrument himself. He becomes a
resource, a tool that must be disciplined, a worker that can be fired on a whim. A means, rather
than an end. Now an object instead of a subject in this anthrocentric polity, he dis/eases himself
by making himself into his other, something he would expel from his polity. But we do not have to live in dis/ease like this. If we listen carefully, a different way of being, a
way that would spare the earth, let the body's ecopolity be, and allow us to hear the whisper of
the world worlding could open up to us. Instead of seeking the subject's abstract, timeless, and
disembodied truth, and dis/easing our selves by becoming its alter reality, we could accept our
belonging in the earth's ecopolity. Dwelling this way, we would know that our truth is not
removed from the earth, outside it, beyond it, timeless and eternal, but is instead within it,
temporal and local, relative to time and place. As dwellers in ecopolity with the earth, the truth of
our being would become something we daily handled, dwelled amid, and invoked as we drew near
to the web of life sustaining our bodies. No longer seeking domination over the earth or our
bodies, we could join them in community. Become friends, not only with each other, but with the
mountains and rivers, trees and animals. Truth, as Heidegger tells of us of the fourfold, comes to us, not as a correspondence with a
supranatural reality, as all versions of modernity would have it, but as a mystery bringing itself
forth from the fields of the earth that feed the ones we care about, the sky that lights up our days,
the death that gathers our life together as a whole and makes it our own, and the gods that daily
provide our actions with an interpretation.(289) As dwellers in ecopolity with the earth, it is not our
calling to toll-erate the subjectivity of other humans as they gather the world up as their means
and impose their will upon it, but to listen to that which presents itself amid the cares of our life
and, in all its sundering dispersion, to spare it, keep it safe from a technology--or a way of
bringing things forth--that would deny them their difference. If we listen carefully, freedom does not reveal itself as control, as the security of the subject's will
(and then toll-erated as such) but, going back to the word's origins, as the care that friends show
each other, the love that a lover gives the beloved. Freedom is a caring that nurtures and
cultivates the beloved, letting it come forth into its own truth, and then letting it go its own way,
just as a gardener does for the plants under her care. Freedom is a bringing forth that gently
nurtures and cultivates the thing, letting it become the destiny that the earth, in its mystery, had
for it.(290) Such a gentle revealing brings forth the mystery of the earth and the body and lets them reveal
themselves as a mystery. This friendly way of revealing is not necessarily harmonious,
comforting, or free of all dis/ease because it does not insist on unities, the certainty of attunement,
or the security of community--even while it pursues them. It lets differences be, sparing and
protecting them. If harmony, concord, and community are good things, the ecopolitician knows
that they are always ambiguous, accompanied by their shadows, and bring their own, often
concealed, injustices. Dis/ease can be healed, but it can never be eliminated. Being a friend to the earth's irrupting anarchy and the body's ecopolity means acknowledging the
shadows that accompany every affirmation, and allowing cherished dreams of harmony, concord,
and community to be dis/eased by that which they exploit and oppress. By accepting the earthly
reality of alterity, contingency, and difference, the ecopolitician honors, respects, and becomes a
friend to her adversaries, even her own shadow. And thereby sets the world free.(291) Liberalism and modern technology are, as anthrocentric ecopolities, utterly incapable of such
friendship, or such freedom. Seeking to control the world, seeking to abolish their dis/ease with
the earth's truth, they put a boundary between humanity and the earth, forbidding their ecopolity
by making them other to its reign. Giving humans the right to vote, to worship, to speak, to come
and go as they please, liberalism denies a similar dignity to the mountains and rivers, trees and
animals. They have no standing in Man's polity. If we are to free the mountains and rivers, trees
and animals, from our dis/ease at their truth and heal their dis/ease with our reality, we must find a
way to listen to them and include them. We must find our freedom not in control, not in
separating ourselves from the earth and our bodies, placing our truest selves beyond them, but by
dwelling on the earth, in caring for our bodies. In being friends with the happening of the world's
ecopolity. Perhaps we can learn to listen to the mountains and rivers, trees and animals, by evoking them in
ritual, dance, poetry, myth, and meditation.(292) Perhaps, it is possible to communicate with them
in altered states of consciousness--trances, dreams, prayers.(293) Of course, it is difficult to know
them, to really adopt their perspective, to actually think like a mountain. Such pure communion
presupposes unities and harmonies that may not be sustainable.(294) We are, after all entirely
different beings, situated in entirely different ways, and the differences between us and a mountain
are incommensurable. But, as ecopolities, we do have a common boundary, one that is porous,
shifting, changing. Our belonging to each other as earthly beings. And perhaps there are
identities, harmonies, resonances that can bridge such differences, if only because we participate
in each other's embodiment, give each other our identities. What would we be without the
mountains? What would they be without us? Each of us is the body that we are because of the
other. That gives us something in common. And we should not make the mistake that humans have intelligence and mountains none. That
difference is much more problematic than it would seem, even without invoking any sort of
mysticism. Ant colonies, as biologists have recently discovered, display collectively an
intelligence that none of them alone are even remotely capable of approaching. By reacting to
their situation in relatively simple ways, ants collectively manage to "think" in surprisingly
complex ways. Maybe an ant colony is as "smart" as a mammal.(295)Mountains are much more
complicated than ant colonies; perhaps they are as much more intelligent. Moreover, as Alan
Watts has argued, it is very difficult to decide whether "intelligence" resides in us or in our
situation, the larger world. The boundaries separating knower and known are not as secure as
they would seem, and can easily be subverted, inverted, erased.(296) Is it the world who thinks me,
or I who think it? Mountains and people share a common situation, if different perspectives on it. Since each of us
is involved in the other's body, perhaps we can approach each other in metaphors, dreams, and
myths. Perhaps the language of the unconscious, of archetypes, morphic resonances, and of
energy fields of one type or another can bridge our differences, even if ordinary language cannot
even begin to. Transpersonal psychology, for example, has well established that the boundaries of
the self are quite problematic. The self is hardly identical with the individual, and in fact it almost
certainly includes other people, other times, other cultures, and perhaps even, other species. Sometimes, for example, psychotherapists have dreams that can only be meaningfully interpreted
as their patient's dreams.(297) And Jung discovered that quite often his patients had access to
knowledge that just wasn't possible for them. Their dreams often reflected a deep understanding
of medieval alchemy, Egyptian myths, and many other things that had no presence in their daily
lives. And often their dreams reflected knowledge of extremely obscure myths that he himself did
not know.(298) Shamanic cultures have been particularly successful in communicating with the mountains and
rivers, trees and animals. During ritual dances among the Pueblo Indians, for example, people will
be seized by the spirit of the deer, and dance as the deer dance, or they would be seized by the
spirit of corn, or the squash blossom, or whatever. According to Gary Snyder, when they did this,
" . . . they were no longer speaking for humanity, they were taking it on themselves to interpret,
through their humanity, what these life forms were."(299) In doing so, these plants and animals
gained standing in tribal politics. They had someone to speak for them, interpret them, present
their perspective. They could be understood. They belonged in the polity. Native American cultures typically do not draw a boundary line between their community and
nature. In fact, for them, nature is urban, and political. According to William Bevis, "The
woods, birds, animals, and humans are all "downtown," meaning at the center of action and
power, in complex and unpredictable and various relationships. The way they interact resembles
Black street jive, not Walt Disney idylls of pastoral escape."(300)Pretty-shield, a young shaman in
training, tells what politics is like in this polity that does not know a difference between humanity
and nature. "One day in the moon when leaves are on the ground (November) I was walking with my
grandmother near some bushes that were full of chickadees," Pretty-shield continued. "They had
been stealing fat from meat that was on the racks in the village, and because they were full they
were all laughing. I thought it would be fun to see them all fly, and tossed a dry buffalo-chip
into the bushes. I was a very little girl, too little to know any better, and yet my grandmother
told me that I had done wrong. She took me into her arms, and walking to another bush, where
the frightened chickadees had stopped, she said: "This little girl is my granddaughter. She will
never again throw anything at you. Forgive her, little ones. She did not know any better." Then
she sat down with me in her lap, and told me that long before this she had lost a close friend
because the woman had turned the chickadees against her."(301) For shamanic cultures the earth is not radically other, outside the polity; nature is part of the tribe,
and humans are just one group among many, neither superior nor subordinate. Every species is
part of a political setting--deer, buffalo, chickadees, humans--and all play out their identities in
this polity. Between the different species there are struggles, resistances, rules, contests, and
disagreements. And respect, harmony, and cooperation. Shamanism is not a religion, with principles and laws, and it does not prescribe a metareality; it is
a way of relating, of communicating, and of being in this politics between different species and
different individuals in the ecopolity. It does not use dogma, a priesthood, or any other
institution. As such, it is the most democratic of spiritual experiences.(302) Anyone can gain these
experiences with practice. The shaman is primarily a message bearer, a mediator bridging
different worlds, connecting this world, the underworld, and the heavens all together. An
ecopolitician. Perhaps James Der Derian would call them mytho-diplomats, and liken them to the angels that
carried messages from God to humanity.(303) But unlike the verbal messages the angels brought,
shamanic communication, which connects humans to the mountains and rivers, trees and animals,
is often not by means of language but preverbal images, like in dreams.(304) Using symbols,
metaphors, images, and resemblances, the shaman crosses boundaries, overcomes differences,
dissolves otherness, and reveals underlying relations and wholes. The truth of the world as
ecopolity. Apparent reality is subverted, the limitations of language and convention are gone
beyond. And so, good and evil, life and death, man and animal become one. By going into altered states of consciousness, the shaman can see things differently, know things
that ordinary reality conceals. If things are out of balance, if there is dis/ease and disharmony in
the ecopolity, the shaman tries to restore balance and health. Heal rifted relationships by
communicating across boundaries of difference, shifting them around, opening up concealed
realities.(305) "Health," according to Jeanne Achterberg in this tradition, "is maintaining
communication among the animals and plants and minerals and the stars."(306) This "health," this ecopolity, is not a fixed unity, a norm, or a principle. It is something that
simply happens when boundaries are crossed, erased, moved. A truth revealed, it can even
sometimes happen even as dis/ease. Shifting boundaries about, when isolation, difference, and
dis/ease seem overwhelming, shifts perspectives and understandings, allowing an experience of
ecopolity with the world that exceeds any dis/easing prison of identity in which it is trapped.
Dis/ease is identical with fear, isolation, resentment, and the militant maintenance of boundaries.
It is the insistence that the telos' it protects are inherent in the order of things, are of
transcendental goodness, and just have to be the way they are. Health, or the shamanic consciousness of ecopolity, is seeing the contingency and the connection
between opposites--good and evil, life and death, individual and community, humanity and nature.
Health comes when we know that no telos of goodness, harmony, community, concord, justice,
or of health itself is ever adequate to the shadows, connections, and contingencies that create and
bridge the differences in the ecopolity. Something always escapes any telos, and health, the truth
of the world's ecopolity, is establishing connection to it and allowing expression of it. Ecopolity with the earth, as a shamanic perspective, calls into question the toleration we, as
humans, lavish on each other. But, please don't get me wrong, dear reader, before I close this chapter. I do not want an end to
the Bill of Rights; in fact I actually support the ACLU in its efforts to protect them. I do,
however, insist that we recognize the shadow that haunts such efforts. In tolerating each other, as
we do in our liberal moments, we separate ourselves from the earth and our bodies and invigorate
the perspective of control and domination that isolates us from our ecopolity with all beings,
turning us into the death and destroyer of our world. Our toleration of each other does not need
to end; the boundaries of what are tolerated have to shift, become larger, much more inclusive of
the otherness and difference it has excluded. More truthful to the ecopolity we are and are parts
of. That is what we are called to do, if we are to heal the world's pain. Back to Contents
Chapter 7
Causing Dis/ease
I have heard it said that illness is an attempt to escape the truth. I suspect it is actually an
attempt to embody the whole truth, to remember all of ourselves. For illness is not just
something that happens to us, like a sudden sneeze or passing storm; it is part of who we are
all the time.(307)
Kat Duff
Dis/ease, as I argued in the last chapter, is a manifestation of ecopolitics, revealing the
consequences (and the shadows) of hierarchy, exclusion, and repression. In saying this, I am
dissenting from the modern interpretation of dis/ease, which, by interpreting it only as material
object, dissociates it from anything but the contingency of the body's machinery. Dis/ease has
meaning, I believe, and though it is hard to interpret it, making its ecopolitics available can heal it.
In the end, with all their use of incantation, ritual, symbolism, and altered states, that's all shamans
do: heal dis/ease by revealing its truth.
Truth, and here again I dissent from the mainstream Western tradition, is not anything eternal,
objective, or fixed, but something temporal, situated, contextual, and relative. It is not a
correspondence with the absolute, the metaphysical laws of nature, the independent reality of the
object, or the will of God, but a building shaped by the ecopolity in which we dwell. A revealing
of truth, dis/ease only happens within the ecopolity that gives it boundary, the telos that marks out
what is self and other to it. In the end, healing means tolerating the truth of the world one has
built, accepting its telos, and its alterity. As a result, because dis/ease is as inescapable as truth, it
sometimes can only be healed by letting it go its course, letting be what must be. Quite simply,
dis/ease is just part of life's struggles, and reveals the troubles and defeats of the spirit, as Henry
David Thoreau observed in his journal: It is a very remarkable and significant fact that though no man is quite well or healthy--yet
everyone believes practically that health is the rule and disease the exception--And each invalid
is wont to think himself in a minority . . . But it may be some encouragement to men to know that
in this respect they stand on the same platform --that disease is in fact the rule of our terrestrial
life--and the prophecy of a celestial life . . . Seen in this light our life with all its diseases will
look healthy--and in one sense the more healthy as it is the more diseased-- Disease is not the
accident of the individual nor even of the generation but of life itself. In some form and to some
degree or other it is one of the permanent conditions of life-- Life is a warfare, a struggle--and
the diseases of the body answer to the troubles and defeats of the spirit. Man begins by
quarreling with the animal in him and the result is immediate dis-ease. In proportion as the
spirit is the more ambitious and persevering, the more obstacles it will meet with.(308) Since life is a warfare, a struggle without end, dis/ease is but a symptom of life. Here, Thoreau is
using words frequently used to describe politics--struggle, warfare, quarreling--to interpret
disease. In doing so, he shifts the boundary separating mind and body. Disease, "the rule of our
terrestrial life," is the result of "of the troubles and defeats of the spirit." Dis/ease emerges when
man quarrels with the animal in him, repudiating it by trying to rise above it to a spiritual beyond.
As I argued in the last chapter, disease is but ecopolitics, a struggle to mark out the boundary
separating self and other. As is well known, the word politics is from the Greek polis for city.(309) The word is built of the
alterity between city ways, which gathers people together to share a common life, and country
ways, which leaves them dispersed, each person going their own way. To be political, then, is to
share something in common with others, to belong to them and join them in common cause.
Since this common cause would be dis/eased, disrupted, and dispersed by the inclusion of its
other, such a gathering together is a struggle to maintain identity, requiring a force that will
exclude whatever is foreign to it: the police. As with the body's immune system, the polity's
police identifies both self and other, defines what belongs and what does not, and expels whatever
is not common to the polity. The ecopolity's telos can only be maintained by policing the
boundary that defines it. An expression of alterity, politics is built of two alternating moments: First, to politicize is to
gather together, a moment that identifies self by making things whole, complete, all the same.
This is the moment that the telos is owned, gathered around. But, secondly, to politicize is also to
reveal difference, separate out identity. This is the moment when the telos expels whatever is
other to it. When opponents politicize the presence of the other, they are each trying to make the
polity whole by excluding the other. Seeking to heal the community, both sides dis/ease it by
infecting it with difference. Because the world is made possible by difference, politics is the
struggle to maintain identity, to distinguish self from other. And because every identity, by
affirming self, produces its other, the struggle can never end. The polity's shadow always haunts
its telos. This means that dis/ease is inevitable. The life together in a ecopolity produces the
differences that constitute it. As we saw earlier in Neil Jerne's discussion of the immune system,
the immune system responds not to the exterior world but to its interpretation of the exterior
world. The other is a production of self's identity. As a result, dis/ease always has to happen
because the other always has to be policed. The moment we gain an identity, we are born to
suffering. According to this new paradigm , dis/ease is not caused by a merely random mechanics of the
body--a genetic malfunction, an invasive agent like bacteria, viruses, or toxins, or a physical
trauma of another sort--but rather emerges out of an ecopolitics of self and other. It has meaning.
If disease is a manifestation of truth, and not of nature's contingency, then the responsibility for
disease becomes an intensely political and ethical issue. As I will argue in the chapter after this
one, shifting the space for interpreting what causes disease opens up a space where old
philosophical issues about the nature of good and evil emerge again. Yet, for now, let us explore
how this new paradigm reveals dis/ease as a politics of experience. . . Let's consider, for a moment, the work of Dean Ornish, whose efforts have led many to rethink
what heart disease is. According to conventional medical science, heart disease is really
something quite simple--cholesterol clogs up the arteries leading to the heart, blocking the flow
and preventing oxygen from getting to the muscles. The heart, according to this image, is a
pump, and blocking the flow of oxygen-rich blood to it makes it operate inefficiently, like an
engine running without air, and risks making it fail completely: a heart attack. Imagined this way,
the cure is obvious--unclog the arteries, or provide a bypass. And this is exactly what modern
surgery does. Clogged arteries are either bypassed, or unclogged, and, at an enormous cost
($40,000 per operation) that solves the problem. For awhile. But only for awhile. Dean Ornish complains that even though people's chest pain often goes away
after one of these operations, they go home and continue the same behavior--eating the same
food, continuing to smoke, dealing with people and stress the same way. And so, they often
come back, years, or even months, later, complaining of the same pain. Ornish likens modern
medical treatment of heart disease to trying to cure an overflowing bathtub by bailing it out. A
better way of dealing with the problem would be to turn the faucet off. Open-heart surgery fails
to heal heart dis/ease because it is trapped in the images it interprets the body with. According to
Ornish the images have to be opened up, the origins of heart disease rethought: The heart is more than just a pump. It's not enough to deal with the heart as a mechanical
device; we have to deal with the emotional heart, the psychosocial heart and the spiritual heart.
If we can learn to open our heart in these areas, we may find that the anatomical heart begins to
open too, in ways we can measure more easily.(310) Notice how the shift in images is also a shift in the interpretation of heart dis/ease. Not just
anatomical blockages, but emotions, psychosocial relations, and spiritual realities--these are what
are clogging up the heart, closing it off, making it dis/eased. According to Ornish, heart disease is
a metaphor for the lives people live. When it happens, it has meaning. By thinking of it this way,
he renames, reinterprets, and relocates social reality--politicizing relationships. But, we have
always interpreted heart dis/ease this way to some extent. How often do we talk of people with
an open heart, a broken heart, a hard heart, a kind heart, a closed heart? Or use the heart as an
image to indicate their charity, or lack of it, their love, or lack of it, their feelings, or lack of them?
These heart metaphors aren't just a poetic renaming of social interpretations; they are images that
directly operate to inform and constitute the body's physiology, an indication of how the heart is
functioning. The metaphors have meaning because the body, as an ecopolity, is constituted by
systems of alterity, like the immune system, that produce its identity. The heart is a social organ: It is vital to connecting all the parts of the body politic, keeping the
body whole by circulating oxygen and nutrient-rich blood and carrying wastes away. The heart
connects things. A heart that is unconnected socially becomes dysfunctional anatomically. This is
not a moral tale, it's physiology. Within the mindbody, metaphors are as tangible and as carnal as
anything that has weight, chemistry, or density. Because the mind/body split is a fiction,
metaphors for the heart are incarnated in our bodies, mediating the role of the heart. If we are to
treat heart disease, we must take the metaphors literally. Or rather, perhaps, give up the
distinction between literal and metaphoric, just as we have given up the distinction between mind
and body, and problematized the distinction between inside and outside, self and other, individual
and community, and humanity and nature. When the heart is "objectively" described as pump, as conventional medical discourse is in the
habit of doing, this too is a metaphor, but one so well worn that we have forgotten. When we
interpret the heart this way, all the metaphoric images of Cartesian physiology are being invoked:
the heart is like a water pump, a hydraulic pump, an air pump--something mechanical, in other
words. This kind of mechanical metaphor, while useful to reveal some of the heart's functions,
conceals others. So, the question isn't whether to interpret things literally or metaphorically but
which metaphors are the most useful for healing. When we use language, we understand things
by understanding metaphors, images and words that rename, reinterpret, other things. Metaphors
are what language uses to builds networks of resemblances that connect words together to make
it possible to interpret the world. A literal reading can always be deconstructed to reveal a
metaphoric meaning. Because of this, when Ornish insists that metaphors long used to interpret
the heart can be taken seriously to interpret physiological functioning, he should be taken literally.
At least seriously. In a carefully controlled series of studies, Ornish examined just what happened when metaphors
interpreting heart disease were shifted, when the causality underlying heart disease was rethought,
and the whole person became a target for healing heart disease. In these studies, Ornish and his
associates took a number of patients with heart disease and randomly split them into two groups.
The first was the control group, and was treated only with conventional medicine; the other
retreated to a farm where they ate a very low fat, low cholesterol, low sodium, vegetarian diet.
This group also practiced meditation, progressive relaxation, breathing exercises, and visualization
techniques; simple yoga exercises, and group therapy.(311) The results surprised even Ornish, who expected only a gradual reduction in heart problems.
Instead, he found improvements in just a few days, and dramatic improvements within
weeks--results that turned out to be highly statistically significant.(312) Many people in the study
group reported a marked reduction in frequency and severity of angina pectoris, the chest pain
that comes with heart disease, and some became free of pain for the first time in years. In a 1990
study, Ornish's average patient reported a 91 percent reduction in pain in the first week of the
program.(313) Besides that, they reported fewer backaches, headaches, and other chronic pains.
Many patients also reported that they felt an increased sense of well-being, and a greater
appreciation of life. Some patients who had been disabled by the disease before the program
could return to work full-time. Others found that they could walk several miles a day. Though
there was no intention to lower blood pressure, Ornish found that he often had to decrease blood
pressure medication to keep his patients' blood pressure from becoming too low. All of this in
just weeks. As Ornish expected, a follow-up study half-a-year later found that those who stuck
with the program continued to improve. And it wasn't just what has been dismissed as the placebo effect, a psychological delusion. A
variety of physical measurements revealed that heart disease in those who complied with the
program was measurably reversing. The blockages in the coronary arteries were shrinking, blood
flow was increasing, and the heart was working more efficiently. Blood cholesterol levels fell by
almost 40 percent. The control group, on the other hand, showed an increase of chest pain of 165
percent, a decrease of blood flow to the heart, and worsening coronary artery blockages. Four
years later, the people in the lifestyle change group showed even more reversal, while the others
continued to get worse. Ornish's work, reveals that heart dis/ease emerges out of lifestyle, out of the politics of life
situations, and is not caused merely or simply by a mechanical weakening of the heart. What
many heart dis/ease patients are really suffering from is a broken heart, not plaque build up.
Ornish writes: In doing this work, I have had a chance to spend a lot of time with the same group of patients
over a period of years. We got to know each other very well. They were about as different from
each other as you could imagine--in age, race, religion, socioeconomics, demographics, sex,
sexual preference, disease severity, you name it. At first, it seemed the only thing they had in
common was heart disease. But over time we began to realize that many of them had something
else in common: an emotional or spiritual disease. By this I mean the sense of loneliness,
isolation and alienation that I think is epidemic in our culture.(314) Ornish finds what he calls the "deeper causes of heart disease" in not only the individual's
attitudes and their lifestyle but in the way society has been developing. One hundred years ago people had social networks, they had extended families, they had a
church or synagogue that they went to regularly, they had a neighborhood that they grew up in
and they knew their neighbors, they had a job that they worked at for many years. These days,
many people don't have such a sense of community and belonging. Even the nuclear family has
melted down. The two-parent family with children from the same two parents, is in the minority
now in many parts of this country.(315) Alienation, isolation, resentment, anger, hostility--these are the causes of heart disease, according
to Ornish, and they are not just something that people choose, or fall into. They are responses,
adaptations, to the power dynamics of modern society. Heart disease is a dis/ease of a
competitive, hierarchical, exclusionary, judgmental, and dominating world. Winning and losing
matters a lot in this kind of world; it matters a lot for career, for income, for reputation, for
intimacy. Winning is valued so highly because it promises to deliver the power to get the
intimacy, the love, and the connection that the loser will be denied. However, the irony is that
winning, by means of domination, hierarchy, and exclusion, fosters resentment and increases the
isolation, alienation, hostility, and loneliness that are dis/easing people. Heart disease emerges out of the need to win in a hierarchical and exclusionary world because it
makes people dependent on the recognition of others, the approval of the they world. A person's
self-worth, their interpretation of what they are, depends on another outside themselves, someone
they must control and dominate--becoming their desire, the object of their respect, need, or envy.
This return from the other, wrested by strife, alone validates their identity. The desire to be the
desire of others, which as Hegel described in his dialectic of Lordship and Bondage, initiates a
struggle for mastery that is capricious, incidental, and ambiguous.(316) And inevitably dis/easing. Is
winning recognition truly that valuable if all you get is the envy, jealousy, or resentment of
others? An empty recognition by someone who is unworthy because they have lost the struggle
for recognition and domination? Every victory in such a world of desire, domination, and power
dis/eases the heart by denying it the things it truly needs--connection, love, intimacy, community.
Mutual recognition, the joy of finding the best of oneself in another that one finds worthy. Locked in this struggle for domination and recognition, Ornish notes, people adopt dis/easing
strategies for numbing the pain of a world locked up in a war for recognition. I ask people in our studies, "Why do you eat so much, work too hard, or drink too much, or
smoke?" They say, "To you, as a doctor, it looks maladaptive for us to do these things because it
increases the risks of something bad may happen to us. But to us, it's very adaptive because it
helps us get through the day." For many people, just getting through the day is a lot more
important than living to be 86 instead of 85. People often use these behaviors as ways to deal
with isolation and to ward off emotional pain. A well-known food writer told me once, "Fat
coats my neurons and numbs the pain." Some people use the TV control as an anesthetic,
surfing through the channels as a way to numb themselves.(317) Ornish's prescription for healing the dis/eases of the heart involves breaking down the boundaries
that people have used to isolate and protect themselves. He recommends practices like
meditation, which releases the self from the tyranny of the ego, allowing an "I-less" sense of being
in the world, and learning how to talk to people in ways that don't feel like attacks or judgment,
like there is a war going on. And . . . Group support is another way. Our groups started out as places where people could exchange
shopping tips, recipes, or types of running shoes--and it evolved into something much deeper.
We realized that people need a sense of safety, a place where they can let down their walls and
defenses and talk about what's really going on in their lives without fear that anyone is going to
judge or reject them. Too often people think, "I feel lonely. But I have to hide parts of myself
because if people really knew me they'd like me even less." That way of thinking sets people up
for losing either way. If they don't get the love and respect they want, they lose; and even if they
succeed in getting it, it's not for who they really are, it's only for the image they're projecting.(318) Finding a safe space to tell the truth, to be accepted as one is, is the key to healing the dis/eases of
the heart. Denying, repressing, throwing into the shadows important truths about one's self for
the sake of recognition and dominance are the cause, or at least an important cause, of heart
dis/ease according to Ornish. Healing it involves not so much open heart surgery as providing a
safe world to live in, a world in which telling the truth about oneself is safe. Telling the truth
about oneself, and being accepted anyway--that is what causes healing. There are many aspects to Ornish's lifestyle change program for heart dis/ease--meditation, diet,
yoga, communication skills, visualization, and group support. Departing somewhat from
conventional scientific methodology, Ornish argues that isolating the primary agent in his
program for healing would be hard, if not impossible. Each aspect, by itself, may not be
significant but when combined with the others becomes significant. For instance, is diet the key to
lowering cholesterol, blood pressure, and body fat, or is it participating in the community of
dieters--talking, supporting, mutually recognizing--that does it? Maybe yoga has nothing to do
with improving the body's health (unlikely, but suppose it for a second), but the practice of it is,
nevertheless, a discipline, and doing it helps develop the disciplines of meditation, visualization,
dieting, and communicating. Unlike conventional medicine, which would try to isolate the
primary causal agent through isolation in experimentation, Ornish resists such efforts, seeking
instead to draw all the agents together into a whole that is greater than any of its components. According to Ornish, rethinking the metaphors used to understand what heart dis/ease is would
not only be good medicine but very cost effective as well. Modern medicine literally and
figuratively bypasses the real causes of heart dis/ease, working only on alleviating the symptoms
of it. Such efforts at denial are as expensive as they are ultimately futile. In a letter he wrote to
Hillary Rodham Clinton he notes: Last year (1992), over $14 billion were spent on coronary bypass surgery in the US at an
average cost of at least $40,000 per operation; much more when complications occurred. Over
$5 billion were spent on coronary angioplasty at an average cost of over $15,000 per operation.
Intensive lifestyle modification is much less costly. For every patient who decides to change his
or her lifestyle rather than undergoing bypass surgery, at least $40,000 are saved that would
have been spent.(319) Ornish is fairly conventional in his rethinking of the causality of heart dis/ease. And his peers are
quickly accepting his interpretation of it, partly because his research methodology is so
conventional. And at least one major insurance company, Mutual of Omaha, now is willing to
reimburse people for the lower costs of his lifestyle program. However, other scientists, like Rupert Sheldrake, are more radically undermining the theory of
causality that has underpinned scientific method. Radically calling into question the conventional
theory of causality, the division between mind and matter, knower and known, and the claims the
"Laws" of Nature have on science, Sheldrake can probably be called the first completely
postmodern scientist. Rather than attributing causality to a coherence of forces, and insisting on
mathematically defined Laws of Nature that are eternal, universal, and unvarying, he believes that
things happen the way they do because they have happened that way in the past. The "Laws of
Nature" are not laws, but habits, patterns that resonate with similar patterns. Things happen they
way they do not because it was all predetermined, given from the moment the universe came into
being, but because they happened that way in the past, and having happened that way once, they
set up a pattern, a framework for chance, that tends to make it happen that way again. This pattern is a field. Every thing that comes into existence--each blade of grass, each tree, each
mouse, each human being--sets up a field, a pattern of identity, and that pattern influences the way
anything resembling it happens. Like Plato, Sheldrake believes in formative causation, but unlike
Plato the forms that govern the emergence of things are not removed to an eternal and universal
beyond, but are situated in the contingencies of the present. Things happen the way they do not
because some sort of natural law, as immutable as it is inescapable, requires it but because the
contingencies of the present, and the past, and the future, shape the emergence of things,
providing them with a governing telos. By insisting on the contingencies of formative causation, Sheldrake problematizes the patriarchal
and legalistic metaphors used to interpret how things are supposed to happen in nature. Although many people no longer believe in . . . God, his universal laws have survived him to this
day. But when we pause to consider the nature of these laws, they rapidly become mysterious.
They govern matter and motion, but they are not themselves material nor do they move. They
cannot be seen or weighed or touched; they lie beyond the realm of sense experience. They are
potentially present everywhere and always. They have no physical source or origin. Indeed,
even in the absence of God, they still share many of his traditional attributes. They are
omnipresent, immutable, universal, and self-subsistent. Nothing can be hidden from them, nor
lie beyond their power.(320) The possibility of "The Laws of Nature" made a certain amount of sense when there was a
theology of nature and a Law Giver of Nature whose will caused things to happen the way they
did. However, that Law Giver has died, at least as the cause of the way things thing, and the
patriarchal, hierarchical, and metaphysical metaphors that have limited the interpretation of
causality that he fathered are now suspect as well. Unlike the Laws of Nature that God inscribed on the universe at the beginning of time, real laws,
the ones that govern people, are contingent. Case by case, they adapt, evolve, and
change--sometimes slowly, lasting centuries, sometimes rapidly during revolutions. However they
change, they are situated in the way the world worlds at any given moment. As with human laws,
so too with the way things happen in nature. Take the formation of crystals. Modern science, by combining chemicals, is continually creating
crystals that have never existed on earth before. Yet there is something very mysterious about
how this happens. The first time that a compound for a crystal is made, it usually just sits there
for a long time before it crystallizes. However, the next time the compound is made, it crystallizes
much more quickly. According to Sheldrake, once the structure of the crystal has been formed
once, it creates a field that all subsequent crystals can resonate with, making it easier for them to
form the next time. Each time the crystal forms, the field becomes stronger, making it easier for
the next crystal to form.(321) Scientists have long known that the crystallization of a compound can be speeded up by seeding it
with crystals, and they have explained the different lengths of time that it takes a new crystal to
form by just attributing them to the presence or absence of seed crystals. The problem for this
theory is that somehow, once a new chemical has crystallized, that same chemical will crystallize
quicker the next time, although an entire ocean may separate the two experiments and they are
done only a few minutes apart. It seems, according to Sheldrake, that the first crystallization sets
up a pattern, a field, that any similar chemical could somehow resonate with, no matter where it is
located, causing it to form the way it does. As it is with crystals, so it is with everything else.
Fields, patterns of morphic resonance, as Sheldrake renames them, determine how things happen. So the cause of a thing does not depend upon its material mechanics as much as on the fields it
resonates with. Things are not pushed by mechanism, but are pulled by their form, their
resemblance to other things. Their telos. This theory of Sheldrake's can explain many things in
nature that conventional science has found mysterious, anomalous, and unexplainable--such as the
communitarian behavior of termites, ants, and flocks of birds. According to Sheldrake's theory of
formative causation, communities, both animal and human, develop and organize themselves by
means of nested hierarchies of morphic fields. Each individual organism's field resonates with the
fields of all the others, and together they form a whole that exceeds them all, which each
individual draws upon and resonates with to form its identity. Some animal communities can become so tightly integrated that they can be regarded as a single
organism. Surprisingly, the Portuguese man-of-war is not an individual organism, but a society of
many specialized organisms. At the top of the community are individuals modified to be gas-filled
floats, below them are other individuals that have modified themselves to squirt out jets of water
to move the entire ecopolity. Below them other individuals specialize in ingestion and digestion
of nutrients for the others. Others form long tentacles to capture prey, others provide protection
against the outside world by hardening themselves, and yet others perform an exclusively
procreative function.(322)Because each individual resonates with the field as a whole, each
individual effectively becomes an organ for the others. Other communities have distinctly self-organizing characteristics. For instance, honeybees keep
the temperature of their hive within a couple of degrees year around. When temperatures are low,
they seal all the holes, leaving only a single entrance, and increase their activity until it warms the
hive up. When the weather is warm, the workers fan their wings to increase air circulation in the
hive. If that is not enough, they bring in water, which is spread and allowed to evaporate,
carrying away the heat.(323) Believing that such organization could be programed by genetics or by
education is hard to do. A field that establishes a pattern and makes each individual part of a
whole, gathering each part into a single polity, makes a lot more sense. Schools of fish, flocks of birds, and herds of animals show similar characteristics of formative
causation, of a group mind. Numbering anywhere from two to three million, schools of fish can
move in tight formation, breaking and turning in unison. Astonishingly, there is little evidence of
any one individual, or group of individuals, organizing or controlling school movements. When
the school turns or reverses direction, individuals who were following or at the margins suddenly
become leaders, and just as suddenly become followers when the school takes another direction.
Tight organization without any evidence of hierarchy. A group mind is especially in evidence
when the school is under attack by a predator. The school will form a hole, split in half, flash
suddenly away from the predator, and then regroup to confuse and distract the predator--all while
the various members of it never run into each other. Despite sudden and startling events, each
fish appears to know exactly where to go when attacked and where its neighbors will go.(324) Vision cannot explain this school behavior because fish will school at night, and even when fish
have been blinded in experiments they still school. Flocks of birds do much the same
thing--wheeling, turning, swooping in immediate unison, a pattern so coordinated that it is as if
the flock were simultaneously and collectively thinking the same thought. Slow motion film
studies of large flocks of dunlins prove that the coordination of the flock is happening to fast to be
explained by visual reactions, according to Sheldrake: These (slow motion films) revealed that the movement was not exactly simultaneous, but rather
started either from a single individual or from two or three birds together. This initiation could
occur anywhere within the flock, and manoeuvres always propagated through the flock as a wave
radiating from the initiation site. These waves moved very rapidly, taking on average 15
milliseconds (15 thousandths of a second) to pass from neighbor to neighbor. In the laboratory,
tests were carried out with captive dunlins to find out how rapidly they could react to a sudden
stimulus. The average startle reaction time to a sudden light flash was 38 milliseconds. This
means that it is very unlikely that they can bank in response to what their neighbors do, since
this banking response occurs much quicker than the measured startle reaction time.(325) Yet the startle reaction response would still only be part of the time necessary. Not only would
the bird have to sense the movement wave around them (and birds seem able to do this in every
direction around them, front, behind, above, and below), they would have to grasp the entire
flock's movement as a whole, and determine how to move in complete harmony with it. A
complex process of reckoning and coordination, which if worked through, would probably take
much more time than just a startle response, and would be terribly exhausting to maintain besides.
In other words, a flock of birds organizes itself faster and more complexly than can be explained
by conventional science. The behavior of schools and flocks provide striking examples of anomalies conventional science is
incapable of explaining. Even more interestingly, intelligent animals, like groups of chimpanzees,
display field characteristics too. Jean Bolen, following Sheldrake, reports this story about some
monkeys. Off the shore in Japan, scientists had been studying monkey colonies on many separate islands
for over thirty years. In order to keep track of the monkeys, they would drop sweet potatoes on
the beach for them to eat. The monkeys would come out of the trees to get the sweet potatoes,
and would be in plain sight to be observed. One day an 18-month-old female monkey named
Imo started to wash her sweet potato in the sea before eating it. We can imagine that it tasted
better without the grit and sand; maybe it even was slightly salty. Imo showed her playmates and
her mother how to do it, and her friends showed their mothers, and gradually more and more
monkeys began to wash their sweet potatoes instead of eating them grit and all. At first, only the
adults who imitated their children learned, and gradually others did also. One day, the
observers saw that all the monkeys on that particular island were washing their sweet potatoes. Although this was significant, what was even more fascinating to note was that when this shift
happened, the behavior of the monkeys on all the other islands changed as well; they now all
washed their sweet potatoes--despite the fact that monkey colonies on the different islands had
no direct contact with each other.(326) Apparently, this colony of monkeys set up a field of behavior that the other colonies of monkeys
could resonate with once it became well-established as a group pattern. According to Sheldrake's theory of formative causation, both individual and group behavior are
shaped by the morphic field of the group, its telos. What social scientists have described as
culture is not just history, tradition, or language; it is a transpersonal field, a group mind. By
assuming an identity within the group, all the members resonate with the group as a whole. Not
only that, any similar group, though it may be separated by time, distance, or means of
communication will resonate with it, too. Newtonian science, trying to make everything into a machine, has passed much too much off on
genetics as a cause, according to Sheldrake. Since life is a machine, the conventional metaphor
goes, genes are like computer programs, giving the body form, structure, and organization;
informing it how to reproduce, grow, behave in society, and age. Though it seems scientific, and
drapes itself in the rhetoric of mathematics, the gene theory of causation is still a metaphor, a very
deceptive and concealing metaphor that throws much into the shadow. The genetic program is an extremely vague, loose, slippery concept, the vital factor or soul in a
modern mechanistic guise. In fact the computer analogy as a whole, which is so popular
nowadays, demonstrates again the intensely anthropomorphic quality of mechanistic thinking,
projecting human preoccupations onto the whole universe. It does this in a way, I think, far more
insidiously than even the worst of the animists. It now takes our current preoccupation with
computers and information technology and projects these onto all nature, including ourselves.(327) Genetic theory, combined with the rigors of the controlled study, has led to an almost fanatical
commitment to twin studies to explain dis/ease as something genetic, or not genetic. Twins who
are separated at birth, raised in different families, provide a neat control for genes, bringing into
sharp relief the effects that different diets, different child rearing practices, and different
environments have on the development of dis/ease. Because the twins separated at birth are
genetically identical, and yet everything else about them varies, when both develop a dis/ease
simultaneously, such as heart dis/ease or colon cancer, the cause is supposedly genetic. However,
if one develops the dis/ease and the other doesn't, it supposedly means that the cause is upbringing
or environment. The theory of formative causation throws a monkey wrench into all these
studies. Since the twins are alike, they resonate with each other, setting up a field that connects
them together, though they were separated from birth. It is almost a regular feature of "Oprah" or "Donahue" to have identical twins who were separated
at birth and united years later describe their miraculous similarities to the TV audience. Typically,
they will have married spouses with the same first names, gotten married on the same day, wear
the same brand of clothing, drive the same model and color cars, wear rings on the same finger,
have the same career trajectory, get divorced at the same time, and so on. Genetic theorists
celebrate this as a triumph of the gene, how genes can cause everything. Still, more sensible
people are left wondering at the end of these programs if genetic theory isn't carrying too heavy a
load. Are genes so informative that they can actually determine the model and the color of the car
that one buys? What evolutionary advantage could there possibly be for such precise and detailed
control? Indeed, how could such things, so recently emergent, have any evolutionary meaning to
the gene at all? Far from isolating genetic causality from environmental causality, as twin studies are supposed to
do, they actually point to the absurdity of mechanistic theory. The theory of formative causation
can easily and gracefully explain these remarkable coincidences. Indeed, from its interpretive
vantage point, these coincidences are hardly remarkable at all. They are to be expected. Life is
not a machine, and identity is not something that can be reduced to genes. Sheldrake insists that his theory of formative causation can not only explain the behavior of
schools, flocks, and herds, it can also help interpret much more complex human societies. An
identity is a field, resonating with similar identities. Though there are an enormous number of
differences, hierarchies, and alterities in any human society, all of them are set up, maintained, and
organized by their own formative fields, each one nestled within many others. Identity is not
merely intersubjective; it is transpersonal, a part of the collective unconscious and formed by
morphic fields. Different identities within these morphic fields are but a nested hierarchy of fields
within fields. Our political language often captures in bodily images the reality of these fields, as Sheldrake
notes: The parallel between societies and organisms is so pervasive that it is built into convention
phrases such as the body politic, the arm of the law, and the head of state. Economies too are
thought of as if they are living organisms: they develop and grow, create demands, consume
resources, can be healthy or sick and so on. Political discourse is replete with phrases that take
for granted the reality of collective entities such as parties, pressure groups, social classes, trade
unions, companies, corporations, governing bodies. Such vaguely defined concepts as the will of
the people, the national interest, spheres of influence, and the defence of the realm are not mere
abstractions: they play a major role in shaping political actions and have come to have
enormous effects on the world.(328) Nations, economies, and states are fields of transpersonal consciousness, and everyone within
them, and every entity like them, resonates with them. The identities that people take up within
these fields--male/female, straight/gay, worker/boss, educated/uneducated, mother/father,
child/parent--are shaped, limited, and enabled by morphic resonance with those who have played
out these identities before. Though the whole resonates with each, some individuals may be more
able to resonate with these fields, pick up on them, and so are more able to speak for the whole.
This consciousness is not merely the individual's consciousness, it is the field's consciousness. The
claim by priests, shamans, prophets, and elders that they speak for the whole may be true in a way
never realized before, and so may their claims that gods, guardian spirits, or their ancestors speak
through them. Sheldrake's theory of formative causation and morphic fields closely resembles what Carl Jung
calls an archetype, a pattern of being contained in the collective unconscious. Carl Jung
developed these concepts when he discovered that his patients often dreamed of things--ancient
gods, myths, obscure rituals and initiations--that they consciously knew nothing about or had ever
been exposed to. Sometimes the archetypal motifs were so obscure that even Jung knew nothing
about them until he researched them. Still, somehow his patients could resonate with these
obscure and ancient gods, myths, and rituals in their dreams, and use them as symbols to interpret
the lives they were leading. According to Jung: The collective unconscious is a part of the psyche which can be negatively distinguished from a
personal unconscious by the fact that it does not, like the latter, owe its existence to personal
experience and consequently is not a personal acquisition. While the personal unconscious is
made up eventually of contents which have at one time been conscious but which have
disappeared from consciousness though have been forgotten or repressed, the contents of the
collective unconscious have never been in consciousness, and therefore have never been
individually acquired, but owe their existence exclusively to heredity. Whereas the personal
unconscious consists for the most part of complexes, the content of the collective unconscious is
made up essentially of archetypes.(329) Jung, along with one of his patients, the physicist Wolfgang Pauli, problematized the materialist
theory of causality by breaking down the boundary between psychic reality and physical reality.
In other words, their work suggests that physical things may, in some way, be mental
constructs--the universe a thought, or more poetically, a dream. Jung noticed that just when his
patients were undergoing a crisis, strange coincidences in the physical world would
happen--synchronicities. In one famous instance, Jung was working with a woman patient who
was dogmatically rational, and it was making treatment particularly difficult. In one session the
woman described a dream in which a golden scarab appeared. Though the woman didn't know it,
Jung knew that such beetles were important symbols to the ancient Egyptians, who saw it as a
sign of rebirth. While the woman talked about her dream, Jung heard tapping at the window
behind him. Drawing back the curtain, he opened the window, and in flew a gold-green scarab.
Enchanted, Jung showed the woman. Her excessive rationality shattered by this coincidence, the
woman started making steady progress in their sessions after that. A synchronicity is a seemingly random event in external physical nature that has inner psychic
meaning, and can be interpreted just like a dream. According to Jung, these seemingly impossible
coincidences often happen, suggesting that psychic images somehow affect physical reality and
make contingent nature into a metaphor to be interpreted. Jung defined a synchronicity as "the coincidence in time of two or more causally unrelated events
which have the same meaning." The physical appearance of the scarab coincided with the psychic
appearance of it in the woman's dream. Together, these two appearances bridged the boundaries
separating matter and mind, defying conventional causality. Yet, because the coincidence is too
striking to be random, there was something that caused these two things to happen, something
that made them appear together. Jung describes it as an "acausal connecting principle," but he
really means a way of causing things to happen that exceeds the mechanical theory of causality.
Causality is usually described as a chain of cause and effect, stimulus and response, and it
proceeds in a precise, predictable, and calculable way from beginning to end. Nothing is
supposed to happen without some sort of originating material cause, some stimulus that sets it all
in motion, transmitting its impulse down the line, like a line of dominos falling into each other. In
principle, such a causal framework for interpreting the world would exclude "acausal
connections." They would be forbidden, a violation of science, and thus something superstitious
and mystical. Unreal. However, suppose that science is just a projection, an ideology, a framework for interpreting the
world that conceals as it reveals. Suppose that science, and modern theories of causality, are
always inadequate to the earth they would capture, constrain. Suppose, despite being impossible,
that things like synchronicities are common and real, as is this following example: A certain Monsieur Deschamps, while a boy in Orleans, was given a piece of plum pudding by a
certain Monsieur de Fortgibu. Then years later he discovered another plum pudding in a Paris
restaurant and asked if he could have a piece. He was told, however, that the pudding had
already been ordered--by M. de Fortgibu. Many years afterward M. Deschamps was invited to
partake of a plum pudding as a special rarity. While he was eating it he remarked to his friends
that the only thing lacking was M. de Fortgibu. At that moment the door opened and an
extremely old man, in the last stages of disintegration, walked in. It was M. de Fortgibu, who
had got hold of the wrong address and had burst in on the party by mistake.(330) If stories like this are true, and no doubt you, my reader, have examples of your own to tell like
this, then there is something amiss with the theory of mechanical causality, something that
exceeds, escapes, and is concealed by scientific convention. The fact that these things are common
in all of our lives, yet are dismissed because modern knowledge insists on it, means that something
very basic about the way life happens on earth is being concealed from us by our methodology. According to the dream of modern science everything can be reduced to a mechanism of atomistic
movements. However, if this is true, how is it possible, in a universe that we all know to be
random, chaotic, and full of quantum undecidables, for anything as awesomely complex as a living
organism like a human being to happen? So many chemical interactions, so much cellular
diversity, so much organic intricacy. If the universe is both mechanically causal and random, if
reductionism and atomistic coherence could completely capture the truth about everything, such
harmony could not happen. The body would break apart long before the harmonious intricacy of
any living being were reached. While much is revealed by reducing things to their constituent parts, as modern science does,
what actually makes something alive is concealed--the goals, the purposes, the meaning. These
are what cause life--not cause in the reductionist sense, but cause as a calling, a meaning, a telos.
A living organism would not be living unless its cause gathered all its constituent parts together,
making them resonate as a whole. The telos of an organism is what makes it living, coordinating
the role of each part in the ecopolity. Without this calling, the irrupting and random diversity of
any living being could never become whole. David Peat explains it this way: From the perspective of the body, the mutual coordination of functions, the organization of
flows, and the harmonization of structures appear almost as synchronicities. Indeed, they are
the synchronicities of living organisms for they involve meaningful coincidences in which the
meaning lies within the context of the body's ordered functioning and the coincidence involves
precise synchronization (or coincidence) of events occurring in remote parts of the body. While
at one level it is possible to analyze these organic synchronicities in terms of the release of
hormones, blood sugars, neurotransmitters, and so on, at another level these patterns are a
function of the body as a whole and an expression of its meaning.(331) What makes a living thing alive is not the mere linkage of its machinery; it is the whole, the
morphic field, the synchronicity between matter and meaning that gathers it together. Without
this summons toward wholeness, morphogenesis, the generation of a living being, could not
happen. The telos of the organism guides the billions of cells through differentiation, enabling
them to make their separate identities meaningful and whole by harmonizing with the function of
other cells in remote areas of the same body. The body's telos is what enables the cells of the
optic nerve, for example, to grow from the retina of the eye and move toward the brain,
connecting to a network of millions of nerve fibers, which, in supporting combination with cells
and organs throughout the body, makes sight possible. No information contained in genes could
possibly make that happen. Sight can only happen because it makes sense for it to happen,
because, in the context of the body's situation in the ecopolity, it is meaningful for it to happen.
That is what causes it to happen. Contrary to what the ideologues of science would have us believe, synchronicity, or the
coincidence between the psychic and the physical, is not alien to modern physics. Many of our
most respected physicists, like Heisenberg and Pauli, have argued that the universe is a thought.
Heisenberg's uncertainty principle establishes a connection between mind and matter by radically
making problematic the independence of the observer. For Heisenberg, a thing happens because it
is observed to happen. Or rather the act of observation determines, limits, and enables the object
observed. Nothing happens until it is observed, only the potentiality of an object, which is
infinitely diverse. And so the observer, or the thoughts and images that govern the observing,
determine what is observed. The configuration of the experiment, the image of reality it lays out beforehand, constructs the
subatomic particle the experiment reveals. The subatomic particle that is observed does not have
an existence apart from the experimental situation imposed on it. Yet, the new physics insists, this
does not make the object observed unreal because the interaction between observer and observed
is real, even if it cannot be analytically separated. When quantum mechanics was first being
developed, many physicists turned to philosophy, and especially epistemology, to make sense of
what they could no longer deny was happening in their experiments. Radically introducing the
observer into the experiment, Heisenberg argued that quantum experiments were not about
subatomic particles; they were about our knowledge of these particles--the contents of our minds,
not the independent reality of nature. What modern physics does is situate our knowledge of the universe, bringing it home to dwell
with us. While quantum mechanics problematized the absolute independence of the observed the
most radically, Einstein's special theory of relativity did it first. According to special relativity, the
separation between two events (and an event is defined by the three spatial coordinates and a
single temporal one) varies according to the location of the observer. Two different events can be
simultaneous but separated by great distance, or colocal and separated by much time. The same
two events. Since space and time form a continuum--spacetime--how the events happen depends
on the situation of the observer. Or, extending the metaphor from physics to epistemology, the
truth of the events is relative to the observer, a truth that can be made radically different once the
events are made relative to another observer differently situated. Relativism has become something of a dirty word among academics threatened by
postmodernism. To these academics, caught up in a world divided between subjectivity and
objectivity, relativism suggests an aimless and ungrounded amorality. Since the truth--particularly
moral truth if the example of special relativity is extended to it--is not absolute, but shifting and
contingent, it can be anything, they fear. There are no morals, no principles to guide our life
together, no absolutes on which we can agree. Anything is permitted--the torture of the innocent,
the exploitation of the weak, the abuse of the powerless. According to their view, relativism is a
radically dangerous idea, which threatens the very foundations of civilization. However, the view
of these academics, being built on assumptions about the absolute character of truth, misses the
point. Truth need not be a correspondence with an absolute and eternal metaphysic to be true,
something that is the same always and everywhere, however it's observed. Instead, truth can be
true because it is something situated in our lives, established by the existence of our location and
time. According to relativity, there is truth, but it changes because it is situated, relative to the
observer, limited and enabled by the locus of observation. As Heidegger has insisted, every
revealing is a concealing, every truth throws into the shadow other truths.(332) The happening of
truth is relative to the dwelling place. By insisting that the object have absolute ground,
modernist science conceals many other truths about the world, its poetry, its beauty, its pain, its
mystery. To know these other truths about the world, and to know what dis/ease really is, we must unseat
the demand that truth be absolute, the same always and everywhere, and rethink the way things
happen. As Heidegger insists, a thing's cause is not just what brings it about, but also, and more
importantly, what brings it forth, what reveals it.(333) A thing happens not just because of the
material forces that have shaped it, but also, and more importantly, because of what gathers it into
being. The world in which it worlds. Before a thing things, it is called, a way is opened up for it,
and that calling is situated in a world's worlding, brought near by the dwelling of mortals. Truth is
something handmade. When a thing happens, it is gathered together and brought into being, and
the calling that brought it forth, was there before it, preceding it, making it possible. The calling
caused it to happen, but not exclusively in any directly material way. Similar to Einstein and all the creators of quantum mechanics, Heidegger interprets causality by
situating it, drawing it near, bringing it down to the earth. If quantum mechanics is right about
the universe being a thought, Heidegger's argument that things thing because of the calling of
world touches not only the way we think and what we know, but the physical reality of all the
different beings of the universe as well. Thought does not float free of the earth, lost in subjective
whim, but resides within the universe's body. Perhaps it is not altogether irrelevant, once we
deconstruct the hierarchies between mind and body, spirit and earth, and life and matter, that
scientists are beginning to wonder if consciousness does not have quantum mechanical properties. If it did, many things modern science has dismissed as anomalous, superstitious, or fraudulent, like
the transpersonal phenomena that Jung brought attention to, or telepathy and precognition, or
various "spiritual" hauntings, could be understood on terms that would not be nearly as dis/easing
to the well-established truths of modern science as many scientists fear. For example, according
to quantum mechanics, once a particle has interacted with another particle, the two remain
related, in some sense a whole, no matter how much space or time separates them. If one particle
moves one way, its complementary particle responds simultaneously, faster than the speed of
light. In other words, nothing happens unless the rest of the universe happens. Everything is
connected to everything else, no matter how far apart in space or time. If this is true, then things
like Sheldrake's morphic fields, Peat's synchronicities, and Jung's archetypes are not so really so
absurd. It turns out that eukaryotic cells (the cells that come together in ecopolities to form the bodies of
all animals on the planet and most plants, but not bacteria, blue-green algae, and viruses) have a
cytoskeleton of microtubules.(334) These small hairlike structures covering the cells of most living
things, Roger Penrose believes, . . . (M)ay be the result of an ancient 'infection' that took place some thousands of millions of
years ago. The cells that previously inhabited the earth were the prokaryotic cells that still exist
today as bacteria and blue-green algae, and which possess no cytoskeletons. One suggestion is
that some early prokaryotes became entangled with--or perhaps, 'infected by'--some kind of
spirochete, an organism that swam with a whiplike tail composed of cytoskeletal proteins. These
mutually alien organisms subsequently grew to live permanently together in a symbiotic
relationship as single eukaryotic cells. Thus, these 'spirochetes' ultimately became the cells'
cytoskeletons--with all the implications for the future evolution that thereby made us possible!(335) Largely ignored until now, these cytoskeletons may explain why, as Lynn Margulis has observed,
even single-celled beings like a paramecium seems conscious, able to create, remember, recall, and
use representations of themselves and their environment.(336) What is more important, they may
also be the reason eukaryotic cells can join in common cause to form the body's ecopolity,
enabling each cell to resonate with the purposes of the larger whole, integrating the individual
within the community. A clue of their function was revealed when Stuart Hameroff, an anesthesiologist at the University
of Arizona's medical school, discovered that gaseous anesthetics like ether or halothane
temporarily "turned off" consciousness, without disrupting other body functions, by disrupting the
electromechanical functions of the microtubules in the brain's neurons. The protein molecule of a
microtubule, as its name suggests, has a tiny hole running its length, and a single electron can slide
back and forth in this tube, interacting with other electrons in other microtubules within a
quantum field. Anesthesia apparently works by locking this electron in place.(337) Microtubules,
Hameroff discovered, operated somewhat like the integrated circuits in a computer. They could
send waves very efficiently up and down their length and interact with the waves in neighboring
microtubules. However, unlike a computer circuit, a wave in one microtubule would resonate
with others, setting off synchronous waves in them, much like a tuning fork resonating with
another tuning fork. The purpose of these microtubules, Hameroff believed, appeared to be to communicate and
process information, much like a computer chip. Only, if this model is right, the brain would be
much more capable than any computer, even a supercomputer. While present-day computers are
approaching 1014 operations a second, this model suggests that the brain is capable of
1024operations a second, a figure that Penrose believes computers are unlikely to ever approach. Still, even if they did, they still could not become conscious, not even in the way that a single
celled paramecium might be, because, according to Penrose, there is something fundamentally
noncomputational about consciousness, a qualitative difference between it and consciousness no
matter how great the capacity for computation. Penrose believes that this difference involves the
capability that eukaryotic cells have for achieving large-scale quantum coherence.(338) Large-scale quantum coherence is similar to the phenomena of superconductivity, superfluidity, or
the action of a laser beam: ". . . (I)t is as though the entire system containing a large number of
particles behaves as a whole very much as the quantum state of a single particle would, except
that everything is scaled up appropriately. There is coherence on a large scale, where many of the
strange features of quantum wave functions hold at a macroscopic level."(339) When large-scale
quantum coherence happens, as in a laser beam, the different photons overlap each other, share
their boundaries, and behave as one, a single photon. The system becomes so coherent that a
physicist can write a single equation to describe the whole system.(340) Once large-scale quantum coherence begins, each part resonates with the whole, drawing
everything together to form a single entity, making possible the emergent properties that happen
when certain materials are super-cooled, when a light beam becomes coherent, or when a laser is
focused on a holograph. Computational processes, like in computers, only add things, one bit to
another bit. No matter how powerful computational process, the bits never come together and
resonate with each other, forming a large-scale whole greater than they are added together
separately. In a holographic image, for example, each part of the image contains the whole. If we
break a holographic image into pieces, we are still able to get the same picture from each piece,
though fainter. Just as in a holographic image, quantum coherence integrates the part within the whole, the
individual within a community. As David Bohm and the California neurosurgeon Karl Pribram
have argued, consciousness does not accumulate through the process of computation, in which
nothing is concluded but the final sum, but rather it happens in a global way, a holographic way
that gathers up each part as a part of the whole.(341) This is what understanding is, a global and
integrated happening, not an additive accumulation.(342) Each part must resonate with, somehow
be with, reflect the presence of, reveal the situation of, every other part of the self, gathering them
into moments of the whole. Without such holistic resonance, no identity could be formed, and no
contrast with other would be possible. Nothing would be gathered together to form self, or set
apart to form other. If large-scale quantum coherence is what makes consciousness possible, it would be of the
greatest importance not only for political theory but also for our understanding of what dis/ease
is. Dis/ease could not be limited to a mechanical breakdown or an invasion by a pathogen; it
would have social and political meaning. Roger Penrose begins to suggest the dimensions of this
when he points out that the immune system probably operates as a result of quantum
effects.(343)Like every other cell in the body, the cytoskeleton of immune cells is covered with
microtubules. In other words, the ecopolitics of self and other that happens within the body very
possibly is governed by quantum effects. And if it is, everything about dis/ease would have to be
interpreted as quantum effect. And so, what, if all this is true, causes dis/ease? What is dis/ease? We can tentatively say that it is
something governed, in part, by archetypes, morphic resonances, synchronicities, and large-scale
quantum coherence. If a living thing is also morphic field, then isn't dis/ease a conflict between
morphic fields, a contest between meanings, a disruption in the body politic? In other words, a
political event? If synchronicity is a fact, if indeed inner psychic events do have a coincidence with outer physical
ones, then how are we to interpret the development of something like a germ infection? Could
there be something about the self's morphic field that resonates with the agents of infection that
calls them near, allowing the dis/ease to emerge? The disease would not be so much an accident
of infection, but a realization of an identity linking thought and agent of disease. Psychic imagery
resonating with physical reality, each calling the other into being? This is a most troubling
thought. Yet we have a documented instance--Jung's golden scarab--of a dream of a bug
coinciding with its actual appearance. If a psychic state can do that, it can just as easily coincide
with an infection by a smaller bug, some bacteria or a virus. Once we accept the fact of
synchronicity, which makes physical coincidences as subject to interpretation as dreams, then we
have no choice but to speculate that the occurrence of dis/ease can be a meaningful coincidence.
At least sometimes. Or perhaps, as we speculate in such thoughts, we are still caught in a hierarchy that needs
deconstruction--that of mind over matter. That they are separate, and that mind dominates,
controls, matter. Perhaps we are postulating too much control over this process, an "I" that
chooses it. Perhaps such control, and such a self that would assert such control are fictions. The
boundaries of the ego, especially those of the self, are problematic, and identifying the self
controlling the happening of dis/ease is even more problematic. Such a controlling self is a fiction
of a world of mechanical causality, of wills that set events into motion, and would have little to do
with the self's quantum reality. There may be no such originary wills. There may only be fields of
meaning, transgressing the boundaries separating selves, and tossing individual bodies around like
corks floating on a stormy ocean. Before we judge those who suffer dis/ease, we need to rethink
what it means to be responsible for dis/ease, as we will do in the next chapter. Back to Contents
Chapter 8
Responsibility for Dis/ease
For every sufferer instinctively seeks a cause for his suffering; more exactly, an agent; still more specifically a guilty agent who is susceptible to suffering --in short some living thing upon which he can, on some pretext or other, vent his affects, actually or in effigy: for the venting of his affects represents the greatest attempt on the part of the suffering to win relief, anaesthesia--the narcotic he cannot help desiring to deaden pain of any kind.(344)
Nietzsche
The problem of evil. Why in a world made by a God of love, justice, and perfection do the
innocent suffer disease? Why are babies, who could not possibly have sinned, born deformed;
why do children, who are too young ever to intend evil, suffer the most horrible diseases and die
before their time; why, later in life, do the innocent suffer, the guilty prosper, and those who love
greatly go unrequited? How can disease have meaning in a world created by intention if it
happens without justice? These are questions that have haunted the faithful for centuries. The
existence of dis/ease calls into question the existence of God. How to interpret the irruption of disease, suffering, and evil? What meaning do they have if they
do not serve justice? Cruelty, sadism, malignant brutality? A loving, just, and perfect God
allowing the triumph of hatred, injustice, pain, and suffering--in a world he created? The great
mystery. What did God, who could so easily intend otherwise, intend by disease? Driven by the demand to make sense of the world it was lost in, needing to comfort the faithful
amid the trials of life, and desperate to make something responsible for dis/ease, Christianity has
long struggled to provide answers to these questions. Answers that are in their own way, by
supposing an evil will as the truth of disease, as diseasing as the dis/ease they would comfort.
And though many no longer believe in God, at least not the way the Church Fathers would like,
and though the modern state is committed to the separation of church and state, we remain
haunted by the shadow Christianity has long cast over disease. If modern science releases us from
the judgment that Christianity would condemn disease with, modernity would still, once the space
for interpreting it shifts the way that it has been, hold us to similar kind of responsibility for it.
Now that God is dead, what could be more dis/easing than a world in which disease, once again,
has meaning? If, as the new science of psychoneuroimmunology maintains, disease is dis/ease, a result of
thoughts, actions, images, metaphors, and relationships, then, once we place this possibility in
modern liberal institutions where we hold subjects responsible for their actions, dis/ease becomes
something chosen, something that people are responsible for. If we can no longer exclude and
dismiss disease as mere mechanical chance, as the new science of psychoneuroimmunology
assures us we can't, disease becomes a choice, something the self has control over. That is the
conclusion that the modern subject would make. And so, if there is disease, there is the dis/ease
of judgment, even if it is a judgment quite unlike the one Christianity would make. Not sin, but desperate and depraved choice--that is why the innocent suffer now. At least part of
the time, because, no doubt, modern institutions would still insist on random contingency, and
would comfort us with things we "don't yet know." Nevertheless, having reduced everything to
mechanical causality, and having laid the whole world out as an object of control, and now finding
that the material of disease is, in part, thought, modernity cannot fail to make judgments about it.
To make the subject responsible for it. And to be again dis/eased by the mystery of the meaning
of disease. To escape the harsh judgments Christianity and modernity would make of disease we must
rethink, deconstruct if you will, the responsibility for dis/ease. Relocate the cause of it, its telos.
If we are to heal the world's pain, we must do this because, as Joan Borysenko has eloquently
argued, guilt for disease is one of the most dis/easing things about disease. Healing the pain of
guilt's dis/ease means coming to terms with the responsibility for it, the possibility it is the result
of moral transgression, of an evil will, and so, of justice asserting itself. This means coming to terms with the Augustinian imperative, the insistent claim upon us that
there is a timeless and universal moral order and that we temporal and limited beings are subject
to its judgment and deservedly punished for violating its perfection. Even if Augustine's God is
dead, as Nietzsche would argue, his metaphysics of guilt, judgment, and just punishment lives on
in a variety of modern dreams of moral order--transcendental reason, the laws of nature, the
original position, utilitarianism, proceduralism, and contractualism. Removed from the earth into
a universal and timeless realm of principles, these dreams of a just order are used to judge the
temporally situated subject, condemn and exclude deviation, difference, and the other in much the
same way that Augustine did. Even when God has died nothing has changed. According to Augustine, suffering happens, and we justly deserve it because, although created
perfect, the first man of his own free will chose to depart from the harmony of God's order, to
dis/ease the world with disobedience. As Augustine writes: The soul, in fact, rejoiced in its own freedom to act perversely and disdained to be God's
servant; and so it was deprived of the obedient service which its body had first rendered. At its
own pleasure the soul deserted its superior and master; and so it no longer retained its inferior
and servant obedient to its will. It did not keep its own flesh subject to it in all respects, as it
could have kept it forever if it had itself continued in subjection to God.(345) It may seem harsh, excessive, and unjust to punish us for this disobedience--what did we have to
do with Adam's choice?--but that would misunderstand the enormity of the sin, as Augustine
writes: The injunction . . . was so easy to observe, so brief to remember; above all, it was given at a time
when desire was not yet in opposition to the will . . . Therefore, the unrighteousness of violating
the prohibition was so much greater, in proportion to the ease with which it could have been
observed and fulfilled.(346) By defying God's moral order, which is the essence of universal and eternal perfection, and willing
their limited will in opposition to it, Adam and Eve fell out of harmony of heaven, and all of
humanity ever since has paid for their disobedience with dis/ease. Dis/ease happens because of
our discordance with the metaphysics of God's truth. That is Augustine's reading of it, but as Bill
Connolly points out, that is only one reading of many possible. For instance: It is not so clear that this "origin story" presents a blissful, harmonious state from which
humanity "falls." There are ambiguity, uncertainty, and tension in the garden "from the
beginning." The smooth-tongued snake is part of the "original condition," and its actions recoil
back on the divinity who engendered it. Yahweh appears on this reading as an unsteady
character who has a slippery grip on the effects of its own power. Moreover, the knowledge of
"good and bad" that emerges is an advance in some respects even if it is experienced as a
setback in others.(347) Contrary to Augustine's reading of the story of Adam and Eve, Connolly argues responsibility for
dis/ease need not fall exclusively on Adam and Eve. Yahweh deserves more than a share, and
perhaps the snake is not so evil--he does expand the human capacity for self-reflection, and for
moral responsibility. Read this way the responsibility--and the guilt--for dis/ease would be shifted
from humanity to God. Yet Augustine cannot read the text this way. From the beginning, he has
stipulated an omnipotent and perfect God, totally in command of the universe. That God cannot
be held responsible for all the suffering in the world; no trace of limitation, flaw, negligence, or ill
will can be attributed to him--that possibility would be too dis/easing. Since God is all powerful,
all knowing, and all good, he could never will the suffering that we suffer. If he did will suffering,
he couldn't be what he has to be. Imperfect, limited, and sinful, humanity alone has to be
responsible for all the dis/ease in the world. The alternative is too terrifying. God's will has to be
pure and faultless from the beginning or we would be the creation of a god that intended evil. We
would not intend evil; we would be evil because God was evil. However, by saving God and
making humanity alone responsible for evil, we delude ourselves more than we reveal the truth, as
Voltaire once craftily pointed out: "God created man in his own image, and man quickly returned
the favor." According to Connolly: The gap between the god and evil is produced by the free will (Augustine) attributes to the first
two actors (Adam and Eve). The human will is invented to protect a will-ful god above all, but it
is presented as an intrinsic property of human being that lifts it to the highest position among
god's creatures because its composition reflects the image of god's will. The attribution of evil
to these first acts flows from the way they deviate from the intrinsic moral order Augustine
identifies in Eden.(348) However, dis/ease, suffering, and evil do not have to be interpreted the way Augustine says they
have to be. Augustine is not the last word, and there are many other ways to read the Bible. For
instance, the book of Genesis can be read just as easily as a story about the inevitability of the
shadow and the existence of alterity as a story about the fall of humanity: In the book of Genesis,
remember, God created everything by creating separation and difference. Alterity. He separated
light from darkness, day from night, the earth from the seas, and the seasons from each other. As
he made these distinctions, many other things became possible. Rising from the sea, the earth
brought forth many kinds of vegetation, the waters left behind brought forth swarms of living
creatures, and the sky held up flocks of birds. Finally, when all the earth was filled with life, God
created man, and then, woman. As God was doing his creating, he repeatedly stopped to observe
to himself how good it all was, all this alterity. And, it should be pointed out, evil was there, from the beginning. As the story goes, God,
himself, put the tree that bore the fruit of a knowledge of good and evil in the Garden of Eden. If
God were really as good, as full of love, and as all knowing as Christianity has always said he was,
then why did he create such a dangerous thing? Then create man and woman? And then leave
them near it where it could dis/ease them? What loving parent would do this? Only if it were his alter being. More than any other actor in this story of origins, God is the most
powerful, reflective, and foresighted, and so, the most capable of assuming responsibility. He, if
anyone, has to participate in the evil that happens--it originates with him, the father of the
universe. The evil that happened is his shadow. And so, perhaps because he wanted to keep the
knowledge of good and evil to himself, perhaps because he secretly wanted Eve to do what she
did, he put the tree in the garden, then he forbade Adam and Eve to eat its fruit, telling them that
to do so would bring death. However, the serpent, the ancient symbol of life, knowledge, and
sensuality, told Eve that God was lying, that she would not die if she ate the fruit, and that she
would only become like God, knowing the difference between good and evil. True to the
serpent's word, Eve and her husband did not die when they ate the forbidden fruit but became
self-aware, able to know the difference between good and evil. Suddenly knowing that they were
sexually different, and becoming embarrassed by it, they tried to conceal their differences by
making clothes for themselves. Like an abusive parent caught lying by his children, God was not pleased. In a fit of uncontrolled
rage, he cursed the serpent, condemning it to live forever in the dust; then he condemned Eve, and
all her sex, to painful childbirth and eternal submission to man; and then he condemned Adam, and
all his sex, to a life of miserable toil. God, and god alone, dis/eased the world with suffering and
pain. And then, to make sure that humanity did not become yet more like himself, eliminating the
last difference from him by eating the fruit of the tree of eternal life, God drove Adam and Eve
out of the Garden of Eden, and put a flaming sword to guard the entrance. Nice guy! Despite Augustine, understanding why God punished Adam, Eve, and the serpent so severely is
hard, at least by the readings of contemporary Christianity. Surely it was not beyond God to
forgive them all. He has been called on to forgive much worse crimes. Some early Christian
Gnostics, who felt their readings of the Bible were as authoritative as anyone else's, believed that
the serpent was the real hero in the story.(349) Sacrificing himself for humanity, opposing himself to
a despicable creator, the serpent brought something sacred, holy, and good to
humanity--knowledge of its true spirituality. He revealed to us what our God kept in jealousy; he
gave selflessly what our God told lies about. He told the truth. By teaching divine wisdom, he
made man and woman better than they were before. Other Christian Gnostics believed that Eve was the real hero.(350) Rereading the usual hierarchy
that made Adam the higher, more spiritual symbol, they argued that it was Adam, not Eve, who
was lost in sensuality. To these people, Eve symbolized the part of the self seeking spiritual
wisdom, while Adam symbolized unenlightened humanity overall, male and female. Adam was
awakened to his true spirituality by the feminine part of himself, Eve. Resisted by the soul's
ignorance, attacked by its fear, and read as so many things she was not, the Eve part of Adam
overcame everything in her spiritual quest, drawing Adam upward to his true spiritual reality.
When the creator told him to ignore her voice in himself, Adam lost contact with the spirit. Ever
resourceful, Eve appeared to him as the serpent, and seduced him into seeking knowledge,
drawing him on to a spiritual wisdom that reads all opposition as unity. As the Gnostic poem
called "Thunder: Perfect Mind," describes wisdom, symbolized as Eve: I am the first and the last. I am the honored one and the scorned one. I am the whore and the holy one. I am the wife and the virgin. I am the bridegroom, and it is my husband who begot me. I am knowledge and ignorance. . . I am foolish and I am wise . . . I am the one whom they call life and you have called Death. . .(351) The Gnostics teach us that many wonderfully creative, though incommensurable, readings like this
of Adam and Eve and the serpent are possible. The Gnostics also teach us that once we read the
story of Adam, Eve, and the serpent not as history with a moral but as a myth we can learn much
more about what we are, what morality is, and what dis/ease is. As myth, the story of Adam and
Eve teaches us, as it is written in the Gospel of Philip: "Light and darkness, life and death, right
and left, are brothers of one another. They are inseparable. Because of this, the good are not
good, nor the evil evil, nor is life life, nor is death death."(352) So, a deep reading of good and evil moves beyond and overcomes the dis/easing struggle of
alterity separating both. No moral, judgment of exclusion, or condemnation of evil can be drawn
from the story about the Garden of Eden because it is an ambiguous myth of being.(353) The
struggle between good and evil is, ultimately, not dis/easing because each is possible only because
the other, the contrast from which its identity originates, exists, dissolving both into underlying
unity. From their brotherly relationship to each other, good and evil build the world, a structure
of contrast in which each knows the other by knowing difference. Because of this structure of
alterity, it is always possible for either good or evil to become the other when the world that they
have built together is imagined in a different way, from a different perspective. Since each is
dependent on the other to define themselves, and since each is in the other, doing one always ends
by making it possible to imagine the other as its truth. So, depending on what we invoke for interpreting their actions, any major actor in the Garden of
Eden can be plausibly judged good or evil, the source of dis/ease in the world, because, in their
most true being, each is not themselves but the relationship of alterity that makes both possible.
Good and evil are only alter aspects of the same thing, an inseparable whole. Only a limited
vantage point on the world makes them different, and dis/easing. And so, there can be no final
judgment against evil, no intentional choice that makes it happen, because to choose good is to
become evil. Wisdom is knowing this, and dis/ease comes with denying it. It is the same for the other great dis/easing duality that was mythically generated in the Garden of
Eden, life and death.(354) It is ironic that the serpent brings morality to Adam and Eve. As God
says, morality promises death, but it is brought to Adam and Eve by the universally acknowledged
symbol of life and health, the serpent. According to myth, the serpent is a symbol of life and
health because it sheds its skin, only to be born again. Casting off its skin, it casts off
death.(355)Now, it seems strange for God to say that Adam and Eve will die if they eat the fruit life
brings and come to know good and evil. However, perhaps he knows that morality is deadly
because it judges, condemns, and dis/eases life. Life is always guilty of transgressing the
boundaries that morality lays down for it. Overflowing with desire, sexuality, and passion, life is a
dis/easing force, bursting with freshness and vitality. Formless, always growing, changing, and
becoming different, it must be lived at the expense of the boundaries that would contain it, direct
it, make it uniform and moral. Life lives by being dis/easing and troubling, by overcoming
boundaries, barriers, obstacles, and prohibitions. On the other hand, morality dis/eases life, seeking to make it submit to form, order, principle, rule,
law. To make it bounded. Trying to keep life within its boundaries, morality seeks to freeze
things, to keep them from growing, changing, becoming different. Yet we all know that when life
quits growing, it begins to die. So, morality, as God originally said, brings death. On this
reading, no wonder he, the creator of all life, tried to keep Adam and Eve from eating the fruit of
the tree of knowledge. It would kill them, dis/ease their lives with judgement, guilt, and shame.
Such knowledge is truly a monstrous and evil thing, but the serpent brought it, the universal
symbol of life. So we are left to wonder if there isn't another aspect of life, a shadow part of it
that seeks its alter being--death. As it is lived, life must seek out what is good for it, what nurtures it and helps it grow. Doing
this, it interprets this good, that bad, creating a bipolar hierarchy that identifies whatever is a
dis/ease to it. Economizing its effort, it forms boundaries, reading the world as good and evil, the
forbidden and the permitted, the healthy and the sick. And so, as life lives, it learns the
knowledge of good and evil--morality. As inevitable as it is tragic, this is the great irony of life. Growing, it ages; living, it dies;
overcoming death, it brings it forth. If we look at nature, at the cows eating grass, the lions their
prey, and birds their insects, we see that life lives only because it kills, eats other living things.
Life lives on death. Life seeks death, and death life, because both of them are really the same.
They are each dis/eased by the other. As metaphors for being, both are always becoming the
other, reversing roles, changing into different forms. Death changes by decaying or by becoming
part of another life, and life changes by growing or by killing. Life and death are inseparable
twins, alternating readings of the same thing. On one reading, the Garden of Eden is a place of harmony, unity, and nonduality. Life and death,
good and evil, male and female, God and humanity, are not separated from each other there, but
when Adam and Eve eat the fruit of the tree of knowledge, they suddenly know duality,
difference, alterity, and they are dis/eased by it. Suffering enters the world. And so they must
leave.(356) Ability to imagine difference, to know alterity, is the reason we have Fallen. To be
what we are, is to be dis/eased by what we are. This is the tragedy of life. The horrible thing about the way we have Fallen--and we could have Fallen in other ways--is that,
relentlessly affirming one image of being--morality, the Christian tradition has dis/eased life.
Refusing to understand that its dualities are really a unity, it elevates one over the other,
sanctifying one while making the other into its shadow. In the moral tradition that we have
inherited, life is imagined as corrupt, and every natural impulse is sinful unless it has been
circumcised somehow. Bound up and made other. Just as the symbol of life, the serpent, bought
evil into the world, woman, the sex that gives birth to life, brings evil into the world. Identifying
the serpent with sin, woman with sin, and so all life and nature with sin, the Christian tradition has
worshiped death, while oppressing women and opposing nature. It is no wonder that the way of
life it has built is destroying the earth and threatening to end all life. A dis/ease if ever there was
one. As Goethe had Mephistopheles--the name he gave Satan in his play, Faust--describe himself as
that power which, always seeking evil, always does good. The history of Christianity is the
reverse of Satan's--seeking to do good, it does evil. Attempting to extinguish its other, to bound
it up in silence, mark it with exclusion, and condemn it, Christianity acts out of hatred, fear, and
resentment. It has, by its act of opposition, become the satan it would condemn. This is its
tragedy. Yet let's be careful here. Before we deploy Christianity's strategy against itself, trying to heal the
dis/ease it has afflicted the world with by blaming it for all the suffering in the world and hold it
responsible for it, we must consider the agent here. Is it an intention, a command willed, a path
chosen? Should we hold Christianity, or more precisely the priests that have long taught it,
responsible for evil, suffering, and dis/ease? Perhaps not. A thought that thinks us, that is there
before we are, it is without intention, will, or design. This judgment is simply there, a part of the
world worlding, a happening that has gathered us up and required our attention. Condemning it,
we only reduplicate what it is all about, renewing the notion of moral agency, responsibility, and
sin that it has dis/eased the world with for so long. Let me propose an alternative mythic reading of what evil, dis/ease, and suffering are, a reading in
which they happen as world worlding, as a tragic conflict between identity and difference, and not
as something we have chosen. This will be a story of how the world's pain came to be when its
truth is revealed through alterity. Let us imagine (willfully if you please!) that Satan was once
God's most beloved and beautiful archangels, second only to God in beauty and power.(357)Perhaps
we can also imagine, supposing that pure evil, the dis/ease the world is infected with, must find its
origin in pure intent, that he was God's most passionate lover, his first and most devoted follower,
wanting to eradicate all distance, all difference, between himself and God so that everything
would be a total correspondence with God's goodness and beauty. A seamless identification with
God. However, demanding purity and total correspondence with God's being, which was universal and
eternal, Satan's love for God became totalitarian, hierarchical, and exclusionary--infected with
difference--when he saw imperfection, discord, and evil in God's creation. Seeking a perfect
correspondence between God and God's creation, he had to draw distinctions between flesh and
spirit, good and evil, body and mind, knower and known, eternal and temporal, universal and
limited, and then he had to demand that all these differences submit to God's truth and be judged
by it. Everything in God's creation had to love God exactly as Satan did--totally, unreservedly,
eternally, perfectly. However, since nothing else in God's creation was as able as Satan to
correspond as perfectly with God's intentions, to tell the truth the way he could, this was
impossible. The world was different--temporal, limited, situated--and its truth so qualified. And
so, Satan's unqualified love for God transmuted itself into an unrelenting hatred for all of God's
creation.(358) Ironically, as it would be in this myth of mine, this difference that dis/eased Satan's peace was part
of God's design, a necessity of creation. There is no identity without its difference, not even for
God (as Hegel would have it). And so, dis/eased by difference, seeking the world's total identity
with God, Satan became the critic of humanity, and he took it upon himself to teach us how
different we are, how flawed, sinful, and dis/easing, while calling us toward his pure reading of
God's truth. Hence his other name, Lucifer, which means the light-bearer--the revealer of truth.
Demanding identity with God and his truth, Lucifer revealed the world's difference--its lack, its
failings, its lies, its disharmony--so that this gap between humanity and God could be closed.
Infected with the difference he would eliminate, he taught as we teach, by testing, judging, and
rhetorical opposition. By becoming the devil's advocate. Seeking to reveal the world's truth to
us, who had fallen from it, he became what dis/eased him most, the agent of difference, of lies,
dis/ease, and dishonesty. And so, his story is as tragic as it is ironic. Satan became evil intending
good. Originally, the meaning of Satan and devil were not as pejorative as they are today.(359)Their root
words in Greek meant only opposition, differentiation, contestation. A disagreement between
identities, alterity. Using difference and discord to reveal our sins, Satan imagined himself
showing us the error of our ways, bringing us back into harmony with God. In this, he was
indistinguishable from God's intention for him, but as a reader of this correspondence, Satan was
not God. He was different, his reading was differed, differentiated, distant, a supplement
secondary to God's intentions, however perfectly it duplicated them. It was false. Between God
and his First Reader there was difference, unbridgeable difference, unavoidable misreading. The
dis/ease Satan opposed. And so, satan also means adversary because Satan's role as First Reader
meant opposing himself to God. Becoming his alter being, his Other.(360) As time went by, and alterity became more necessary to the happening of world, Satan took upon
himself the role of judge of humanity's love for God, losing himself in the rhetoric of opposition,
which he deployed more to exalt his own beauty than to serve God. Then, as the author-ity that
judged all reading of God, Satan falsely identified himself as God, the author of the world,
assuming his power to give meaning to the happening of world, secretly and unconsciously
replacing God's intentions with his. Doing what he had to do, Satan assumed responsibility for
something he could not, the existence of difference and evil. Where before they had happened as
tragedy, as the inevitable and blameless expression of alterity that separates identity and
difference, now they happened as will. Choice. People became responsible for their suffering. Puffed up with pride, enamored with the beauty of his will, Satan turned against God's author-ity
and divine truth, and he cast himself down into Hell, the dwelling place of darkness and delusion,
where he became the God of Shadows. Isolated from God, throwing into the shadow the irony of
his own opposition to God, lies, delusions, and deceptions became the means by which Satan
maintained his exalted image of himself. His false self. Caught up in the task of maintaining this
false image, forever terrified that the truth of his shadow reality would emerge and mar his image
of himself, Satan ignored the dis/ease his lies and misreadings wrought, as he did the possibility
that he himself was the source of what he condemned. Secretly and unconsciously embittered by
his downfall, resenting what he had become, blaming anything rather than himself, he forever
plotted revenge against God and God's world. Seeking responsibility for the evil and difference in
the world, someone to blame for them, he, and the angels that followed him to Hell, became the
purest expression of the hatred, death, and destruction that they had so opposed. Dreaming a dream of pure truth, concealing the difference its identity reveals, the ideal self,
cannot easily acknowledge its fall; it has to project it onto other people, making them responsible
for their evil. They are the agents of Satan. What they become for us fully justifies their
destruction. We are blameless, the agents of God's justice. And so, the purifying response
against the ideal self's dis/ease begins. Trying to cleanse the world of what has dis/eased it, ignoring the difference it is infected with, the
ideal self demands of others that they become responsible for the world's moral purity, but deep
down, concealed in its shadow, the ideal self knows that the boundaries it has drawn between self
and other are fabrications. It knows that the responsibility for evil cannot so easily be sorted out.
It knows that it is evil, that its love is false, that the dis/ease it blames others for is its own.
However, having forced others to accept this holy image of itself, and desperately needing to
believe it true of itself, the ideal self cannot admit this. It cannot bear the pain of self-reproach, of
accepting its own participation in a world infected with difference. Knowing that the image it
presents and dominates others with is false, it fears the sting of its self-ideal more than anything
else, so it avoids its judgment by keeping appearances up, denying responsibility while sacrificing
others to it. The lies the ideal self tells itself, the enemies it creates, the destruction it inflicts, and
the shadows it builds--the ideal self does it all in order to not have to bear the dis/ease it would
feel if the image of its perfection was ever shattered. The pain would be unimaginable. It would
not be itself, but its other. Outwardly placid, heroically fighting evil where it meets it, the ideal self inwardly lives in terror of
the moment when its ideal of responsibility, so brutal to other people, turns against itself,
revealing itself for what it is, the other it would purify. Then, may God have mercy on it, the ideal
self would have to live in the Hell it intended for other people. Perhaps a merciful God could
forgive it, but the ideal self itself never could. So, instead of understanding, acknowledging, and
accepting its inner dis/ease with itself, it lies, scapegoats others, makes them over into its own
alter image, and then seeks their destruction. Because of the boundaries it must police around
itself, the alterity it must oppose, the ideal self is caught up in something we might call original
sin. By insisting on its purity while concealing its reality, it becomes a truly ignoble, mendacious,
and pathetic sinner, letting others suffer for its dis/ease--scapegoats to its shadow reality,
sacrifices to its vanity. Power over other people makes it possible for the ideal self to do this, making sure its lies, images
of perfection, and delusions of moral purity are not contested or falsified. Driven by a fear of
being revealed for what it is, while exploiting the fears, hatreds, and resentments of other ideal
selves, a deeply dis/eased ideal self can become incredibly powerful, a leader of world historical
proportions, like Hitler or Stalin. The more power this ideal self has, the more its shadow feeds
on itself, concealing its reality, making the world ready for yet more terror, delusions, and brutal
lies. When it has possession of an absolute power, the ideal self can sail to unimaginable heights
of delusion and depravity. Intoxicated with its absolute power to judge the world and impose its
reading on it, possessed by unassailable delusions of moral purity, it would not hesitate to destroy
the earth to save its exalted and holy image of itself. If war or ecological disaster ever destroys
the world, be assured that those doing it will do it in God's name, and in the behalf of freedom, the
oppressed, the poor, and moral truth. It is a strange and twisted irony that the greatest acts of evil are always caused by those seeking to
destroy those responsible for evil and the suffering it brings. There is something tragic and
inevitable about opposition to evil that draws evil to itself, setting it up to play its role of angry,
resentful, and vindictive destruction. Evil brings forth evil, and absolute power, absolute evil.
Whenever there is something to be opposed, evil is the first to read it as evil, the first to judge it,
and the first to take the lead against it. And the more absolute the power of the evil opposed, the
more evil and powerful the opponent to evil becomes. And the more dis/easing. The purpose of this myth of mine is to tell a story about how that evil, as a dis/ease of the spirit, is
inescapable, part of the tragedy of life. It cannot possibly be avoided. Dis/ease exists because we
live, breathe, and know, not because we are evil and have chosen it. This myth explains why it is
a mistake to respond to the irruption of dis/ease with yet more guilt, exclusion, judgment,
condemnation, and anger, to blame people for their suffering and condemn them for it, because
that only forces into the shadow yet again what has been so dis/easing in the first place. The
dis/eases of identity are not located in the full self, the self that accepts as its own the alterities its
identity reveals; they are a fabrication of a false self, of the part of self that denies its shadows, and
fears them because of how its ideal would judge what is in them. Healing begins by suspending
such judgments while it lets the fear that would make these judgments reveal themselves for what
they are. And so, the responsibility for dis/ease is located in a false self, but it is useless to deploy
guilt and judgment against it, to condemn it for the choices it has made. That will heal nothing.
We must address the structure of alterity, the other within the self, before healing can happen. Nevertheless, what are we to do when evil happens and must be opposed, an evil that is
destroying everything holy, noble, and good? An evil like fascism, racism, sexism, or any other
abuse and violation of the innocent? An evil like the greed that is destroying all the earth with
pollution? To know difference, oppose it, and protect what is good without suffering Satan's
tragedy? This is the great question an ecopolitics of healing must answer, for there is much in our
world that should be opposed, like the destruction of the earth, the proliferation of the means of
war, the exploitation of the powerless, and all manner of illnesses from cancer to heart disease.
Opposition to these things is good, and yet the act of opposition, of contestation, itself is
dis/easing, evil. So, what is one to do? This question has haunted me for a long time. As dis/easing as it is, I have
grudgingly accepted the necessity of becoming a satan, an obstacle to the expression of another's
identity. The world is infected with difference, and some people must be opposed. Otherwise,
truth does not happen. Refusing to establish and maintain difference, to make distinctions between
good and bad, when the dis/ease in your community demands is not a virtue but a weakness.
Although the boundary separating good and evil is contingent, problematic, and subject to
reversal, it does need to be policed. Toleration has its limits. An apology, I suppose, but the
truth. If this means that you must become what you denounce, this is not all bad. Finding you enemy
inside yourself, ironically, gives you the strength to oppose their plans. So, instead of being
ashamed of your faults, and trying to throw them into the shadow, you should recognize them,
honor them, and use them. They are the only things that permit you to recognize in others what
you must oppose in them--and must heal in yourself and your community. Projection is not
always something to be avoided, as too many psychologists have concluded, but a much needed
ability, one that is necessary to engage others, especially others who are truly dangerous.
Projection is the only way that we can know them. It only becomes a fault when you refuse to
recognize that the evil you condemn in others is also within yourself. If you are going to
moralize, it is important to recognize the shadow side of morality, the side that is the more
dis/easing the more it is concealed. Of all moralists, Nietzsche was the one who best understood the shadow side of morality.
Morality, he argued, is not a revealing of transcendental truth but an all-too-human dis/ease the
weak suffered when the powerful violated them, infecting them with resentment.(361) It started
when the powerful made the weak slaves to their will, ripped them out of their lives, and thwarted
their will to power. This was horrible enough, but what the weak did was worse. Resenting what
the powerful made them into, and dis/eased by their inability to maintain their identity, the weak
retaliated by infecting the powerful with feelings of guilt and sin, and ideals of moral
responsibility, choice, and subjectivity. Eventually, the poisonous rancor of the weak controlled the uninhibited powerful by making them
reinterpret their own identity as immoral, wrong, evil, other. The powerful became dis/eased with
inner guilt, slaves to the resentful morality of the weak, responsible for their suffering. Seeking to
control the powerful by locking up their identity in a prison made of guilt, sin, and evil, this
morality was driven not by love but by hatred, not by forgiveness but by resentment, not by
humility but by the will to dominate. This Christian "morality" was not a transcendent truth but a
shadow politics of revenge that did not respect life's vitality. Concealing its angry truth with pious
homilies about the virtues of love, forgiveness, humility, and charity, it deeply dis/eased the self
with ideals that threw large aspects of the self into the shadow. Good Christians did not feel that
way, even if they did. And so, the Christian self had a lot to feel guilty about--and as Foucault
observed, confess. Christianity was born of dis/ease on Nietzsche's reading, of a recognition of life's suffering,
contingency, meaninglessness, and fragility. Pained by the way the world happens, it sought a
cause and a remedy for the world's pain. A way, if not of controlling or eliminating the world's
pain, at least of giving it meaning, by justifying judgment against it. If there is an identifiable
agent responsible for the world's pain--a bad will, an evil desire--it can be named, judged, and
opposed. At least part of the sting from the serpent's bite can be taken away this way by making
it meaningful, a moral tale. However, this attribution of causality is a fiction, a fabrication born
not of its truth but of human need. There is suffering, pain, dis/ease, and death in the world,
according to Christianity, because there is a will that willed it, a choice that affirmed it. And any
choice that chooses dis/ease can only be evil, can't it? And, at least to affirm its difference, it must
be punished. Perhaps with Hell, at least with condemnation. This is why we have subjects, as
Connolly points out: From a Nietzschean perspective, the self constituted as a unified, self-responsible agent contains
resentment within its very formation. The basic idea behind this formation is that for every evil
there must be a responsible agent who deserves to be punished and that for every quotient of evil
in the world there must be a corollary quotient of assignable responsibility. No evil without
responsibility. No responsibility without reward or punishment according to desert. No
suffering without injustice, and no injustice unless there is a juridical recipe for redressing it in
life or afterlife.(362) This imposition of subjectivity on the self brings much dis/ease with it, much alterity, much
discipline, many demands, many confessions, much submission. Once a sense of agency is
attributed to dis/ease, there are many others to oppose within the self and in the world, others that
shadow the self and threaten its identity. Because they have troubled both the ideal self and the
world with pain, these others must suffer our revenge for what we have become, as Connolly
again describes it: This revenge eventually becomes consolidated into the creative demand that everyone acquire
the honesty, meekness, industriousness, and virtue we are already compelled to assume.
Certainly weakness is here transformed into merit, so that what the slave must be becomes the
standard against which every difference is defined as a deviation to be punished, reformed, or
converted. . . . Humans resent the transiency, suffering, and uncertainty of redemption that
mark the human condition. We suffer from the problem of our meaning, and we demand that
meaning be given to existential suffering. So when the idea of a purpose in existence residing in
nature or a god loses its credibility, the insistence that we are rational, responsible agents comes
into its own . . . . We give meaning to existential suffering, then, by holding ourselves responsible
for it.(363) So, the subject is a dis/ease of the self. Healing the body, and the body politic, must begin by
deconstructing the subject. Responsibility for dis/ease must not be interpreted to reside in an evil
will, a choice, or an individual agent, but rather in institutions of alterity, structures of difference,
systems of identity. While individuals can and should be challenged to heal dis/ease in themselves
and others, the focus must never be limited to their ego or their will but must include the
ecopolitics of their situation. Only that strategy will avoid infecting the self, once again, with
difference, guilt, and resentment. Above all, an ecopolitics that would heal dis/ease must be very
careful that it doesn't become a politics of resentment, yet one more way to punish the evil, to
fabricate false ideals of agency and responsibility, to silence and exclude the other, and to build up
the shadow. In the next chapter we will explore some possibilities for healing dis/ease. Back to Contents
Chapter 9
Healing Dis/ease
As (Jesus) went along, he saw a man who had been blind from birth. His disciples asked him, "Rabbi, who sinned, this man or his parents, for him to have been born blind? "Neither he nor his parents sinned," Jesus answered "he was born blind so that the works of God might be displayed in him. As long as the day lasts I must carry out the work of the one who sent me; the night will soon be here when no one can work. As long as I am in the world, I am the light of the world." Having said this, he spat on the ground, made a paste with the spittle, put this over the eyes of the blind man, and said to him, "Go and wash in the Pool of Siloam" (a name that means "sent"). So the blind man went off and washed himself, and came away with his sight restored.
The Gospel of John 9:1-8
When we discover evil in the world, we dis/ease ourselves with it, and we accept a call to oppose
it, but, when we do, we also risk revitalizing the differences that built it in the first place. Seeking
good, we risk evil. Seeking to heal, we may dis/ease. Seeking to stop hatred, we may generate it.
Whenever we would destroy evil completely, eliminating it without trace, we make it into our
shadow, concealing its inescapable reality within ourselves. When we oppose evil in this
way--innocently, totally, and seeking its complete destruction--we must always submit to its reign
upon earth.
So what do you do, my reader, when something like a shameless corporate outlaw, shows up on
your doorstep, and makes plans to pollute everything around you? What do you do when your
community is infected with an ideology of hatred like that advocated by the Freemen, the Militia
of Montana, the Christian Coalition, or the Wise Use movement? What do you do when the weak
are exploited, the powerless are abused, and the innocent treated unjustly? You must oppose
these things, even if it means doing it militantly, aggressively, and without apology. You must
accept the necessity of becoming an agent of difference, a source of discord and dis/ease. And
that is the problem. How to stop evil without becoming evil; how to heal hatred when the only
way open is to refuse it, to infect everything with opposition, contest, and dispute? Many people say that love is the answer, and, of course, they are right. Loving your enemy. But
can love, real love and not just the moralizing appearance of it, ever happen without truth first
happening? And how can truth happen when the other hates you, refuses to accept your reality,
and everything about you is twisted into lies? Before healing can happen, the oppositions that cause dis/ease must be dissolved. Instead of
being lost in simple relations of opposition to the things that dis/ease us, the participants in the
struggle must shift their perspectives, acknowledge the relativity of difference, accept opposites or
alterities as wholes, and go beyond them, tolerating difference while locating it in a field more
complex than mere opposition. Once this shift toward acknowledging the relativity of difference
happens, the judgment, exclusion, and subsequent destruction that are the source of so much
dis/ease in our life become something else, something greater, something w/holy. Accepting the relativity of difference is important because it is utterly hopeless to try to find, as
Christianity has always tried to do, an absolute reading of the evils that dis/ease our lives, and then
make our lives pure by eliminating their presence. Separated, as we are from the teachings of the
historical Jesus by the uncertainties of time, language, and suspect records, we cannot lay claim to
the certain knowledge necessary to justify such exclusion. Even if we could, if we had an exact
historical record of everything he said and did, it would still be useless for establishing
transcendent principles. Our relation to Jesus is not absolute, unequivocal, or unchanging, but
fraught with the mystery of distance. We dwell in an entirely different world than the historical
Jesus did. To begin with, our relationship to our world and to each other as sexual, economic, natural,
political, and spiritual beings is ruled by the images that modern science and technology have
pictured the world with. As heirs to the Enlightenment, and the world of reason it has built, we
are possessed, body and soul, by a radically different technologies, economies, languages, and
contexts than Jesus lived amid. Living in a world incommensurably distant, we simply cannot
read Jesus' words as he meant them in his. No correspondence is possible between his intentions
and our reading. However, despite this unbridgeable distance, something of Jesus still speaks to us in this
desecrated time of ours, rises up out of our unconscious, and makes its demands upon us. Veiled,
concealed, unapproachable, yet near and seductive, the myth of Jesus calls across the void of time,
promising to save us. Just how the story of Jesus could do this is concealed in mystery, but this is
part of its allure. Who, after all, cannot be saved by a mystery? One of the most dis/easing things about modernity, in both its Christian and its scientific turns, is
that it has disarmed the mystery of myth, either by making it useless or by making it into an article
of prescribed faith. In both of the twin orthodoxies of science and religion, mystery is excluded,
isolated, interpreted as a threat. Fearing the misreadings it might foster in those who seek it out,
the feelings of awe it inspires, they forbid its distraction. "Believe in us," these great institutions
demand, "we already have the answers, the absolute truth--even in our admissions of ignorance.
If you go off on your own after mystery, you will surely be lost. Then, woe to you, heretic! For
mystery is the mother of all misreading--all heresy, delusion, error, and sin. Listen to it and you
will become an outcast to truth." But it is the mystery of myth that heals. Welling up within us, speaking as our own inner voice,
mystery guides us through error, while requiring it, past delusion, while making it inevitable, and
beyond sin, while forgiving us for it. Enchanting us through our limitations, mystery is the
irruption of wonder in our lives, calling us to what is most near to it. Whenever we are
awestruck, we are healing because we are living our lives where we are. If we are to follow the mystery that Jesus poses to us, we must read him not as a historical figure,
not as an unequivocal fact and past event, but as an imponderable reality, a myth and symbol
about the ambiguities of our lived existence.(364) By reading the story of Jesus this way, we are
drawing near to the truth of our lives. Seeking out what Jesus really said, what he really was like,
and trying to capture in his words God's eternal authority, removes us from our lives by making us
submit to something impossibly cold and distant, destroying the living mystery that we all dwell
amid and that possesses each of us. Why is the story of Jesus' life so important to us? It can't be
anything he, a historical figure, did; it can only be what he became for us. In this there has to be
truth. Living amid the myths and symbols of Jesus' life, something deep within ourselves is trying
to find to us, and if we are to let it find us, we must not let the institutions of science, theology,
religion, or history conceal it with their morality, their rationality, or their authoritative readings.
Let us reread the story of Jesus, then, as a myth revealing the mystery of dis/ease in our lives. No
doubt we will fall into error, but so what? Are we ever free of it? As myth and symbol, one reading of Jesus that I have found provocative is that he was trying to
undo the dis/ease that moral knowledge had done in the Garden of Eden, to suck the poison out
of the serpent's bite. When Jesus dies on a cross, he dies on a tree, which symbolizes the tree of
immortal life, and he, himself, is the fruit.(365) This, according to some readings of the Gospel, is
the same tree of life that was in the Garden of Eden, the one that made God expel Adam and Eve
from Paradise to keep them from eating its fruit. When its fruit is eaten, the duality that caused
humanity's fall from paradise is overcome, our sins are forgiven, and we become one with God.
And everything is as it was--untroubled, whole, peaceful. Free of dis/ease. According to this reading, contrary to what Christianity has taught as orthodoxy down through
the centuries, Jesus tried to save us, not by making us moral, but by freeing us from morality.
Morality was his opponent, his most seductive temptation, and Satan, the bringer of morality, was
his most persistent enemy. Strange reversal, this reading, but notice, my reader: Everything that
Jesus taught was an attack upon the morals of his day, and, ironically, the morals that Christianity
would dis/ease the whole world with in his name. In parable after parable, Jesus dissolved the
dichotomies that excluded people, making them into society's others. Saying "Do not judge,
unless you will be judged," he saved in their turn the adulterer, the prostitute, the tax collector,
the Roman soldier, the leper, the thief--everyone that moral society condemned. But he did not save these people by making them socially acceptable again, he saved them by
reevaluating, reversing, and deconstructing the morality that excluded them. Not the rich, but the
poor will inherit the earth. Not the pious, but the impious--those who break the Sabbath, ignore
the traditional dietary regime, and fail to do various rituals of purification--will go to heaven. Not
the moral, but those who the moralists have always known that they were better than--the
ignorant, the poor, the immoral, the criminal, the diseased--will be saved. No wonder the moral authorities crucified Jesus! Troubling the security of their identities, he
could only have been an agent of evil, if not the devil himself. Being what they were, good
moralists, they could hardly have interpreted Jesus as anything except an immoral subversive,
dedicated to destroying everything that they worshiped and believed in. And they were right. He
was making friends with their shadow, the part of themselves they were dis/eased with, the part
they were trying to judge, condemn, and destroy. Contrary to what the Christian tradition has
always wanted to believe, the religious authorities of Jesus' day were neither hypocrites, people
who only appeared to be moral but were something else entirely, nor were they corrupt, hardly
even bothering with the appearance of morality. The religious authorities of Jesus' day must have
been at least as moral as such authorities ever are; otherwise, moral gossip being what it is, there
should at least have been some sort of independent suggestion of scandal and disgrace, and there
is none.(366)This lack of historical support for religious hypocrisy suggests that Jesus was not
criticizing the moral authorities for their moral failures but, much more fundamentally, for what
they were. For the dis/ease they brought into the body politic. Whenever Jesus makes moral statements and reads someone as evil, he, ironically, usually directs
his condemnations against the moralists. They are the ones who are most frequently urged to
reform their ways, to look at themselves forthrightly, to remove the beam in their own eye before
they correct the sins of others. No doubt, it is to restrain moralizing, and its inevitable tyranny
over its shadow, when Jesus enjoins: "Do to others as you would have done to yourself." Jesus
excludes the moralist, himself, when he, knowing that nothing is more sinful than a moralist, sets
the condition of all moral judgement: "Let he who is without sin . . . ." Even when Jesus takes whip in hand, chasing the money-changers out of the temple, he is
attacking the authority of morality. By long tradition in his day, the temple grounds were used as
a marketplace. In return for a tax on the things they sold, vendors could set up a sales booth and
sell their wares. The tax was a major source of income for the temple and the religious
authorities. As long as large beautiful buildings and a wealthy priestly class are necessary to
maintain public righteousness, it is necessary to take care of business.(367)Morals exact their due in
many ways, but the way moralists always prefer it paid (shall we indulge in cynicism?) is in cash.
That way they can get rich. Using the temple grounds to pay for this was an entirely reasonable
response to their need. Jesus, however, was not nearly so reasonable or understanding. He drove the money-changers
from the temple. He wanted to subvert and destroy a tradition that granted moral authority its
income, hitting it where it hurt the most. Perhaps that is why the moral authorities hated him
enough to grovel before the Romans, of all people, and beg them to crucify him, their nemesis.
For these moralists, it must have been a joy to see this dangerous, impious, and totally immoral
revolutionary betrayed, humiliated, crowned with thorns, dragged out, and nailed to a cross.
After much trial and tribulation, good at last won out over evil. As it did forever after.
Christianity was nothing, if not moral. Nietzsche once said that the last Christian died on the cross. And he did. The moment he died,
Jesus became the Anti-Christ, the opponent to everything that Christianity became.(368) Teaching
love and forgiveness when morality demanded hatred and exclusion, living a life of acceptance
and inner spirituality when authority depended on resentment and ritual appearance, Jesus went an
entirely different way than his followers, especially Paul. Instead of demanding belief in a laundry
list of principles, like the doctrine of the trinity, the authority of the Church, the saving power of
sacraments, and the hierarchy of mortal and venial sins, Jesus lived a life without hierarchy,
judgment, or exclusion. As Nietzsche observed, Jesus was inhumanly free of the resentment that brought such dis/easing
things forth. Though a victim to horrible suffering, he did not need consolation because he did
not become a slave to his suffering. Incredibly, he did what so few have done before or since.
Dying a horrible death, he forgave his persecutors, and not just with words. He did it deeply,
authentically, or so the story goes. This possibility, which we all mysteriously need, is truly
astonishing, if not altogether inhuman, a much more incredible feat than walking on water, healing
the sick, or rising from the dead. Perhaps only a god could do such a thing, for the true tragedy
of being a victim of horrible suffering is not the injustice of it, but the alchemy of evil that is
wrought in the victim's resentment. An effort to tame, control, and subdue greater power,
morality is the victim's revenge against abuse. It is, as Nietzsche insisted, ugly, cruel, harsh,
vindictive, and, above all, deceitful. But Jesus did not follow this path because he did not resent
what was done to him. He accepted his suffering. As our mythical savior, Jesus did not try to redeem mankind by providing us with a universal
reading of law, rule, and judgement. He taught the weak a way of suffering, of being a victim
without becoming a victim. He gave us a practice, a bearing to take before judges, guards,
accusers, and every kind of humiliation and calumny.(369) He does not resist the reading the
authorities made of him, nor defend his rights, nor condemn his accusers, nor become angry, nor
make anyone responsible for their actions against him. He does something truly incredible: He
forgives everyone! And how we need this, this forgiveness! Is this not what makes the story of
Jesus so compelling to us? A story about healing through unconditional forgiveness. . . The life of our mythical redeemer, as it is written, was nothing else than this practice. Freed from
the distinctions demanded by morality, he no longer needed formulas, rites, or sacraments to come
to God. Having abolished all distances within himself, accepting and affirming his shadow, he was
already with God. It is not correct belief that returns us to unity with God--it only acknowledges
the distances that separated us from him--but the practice of our life. By living the kind of life
Jesus lived, we can abolish every distance, separation, or difference that has dis/eased our life.
We can make friends with our shadow, and heal ourselves. The Kingdom of Heaven is not
coming as a historical event on this reading, nor is it located in any sort of a supernatural beyond,
but rather it is a way of life that is not dis/eased with itself. We do not need to die, be forgiven by
God, or wait for his second coming to be free of dis/ease; we only need to resist the temptation to
exalt our ideal self and, from its heights, trouble the world with its others. Or does this way only leave the evil free to continue their exploitation, abuse, rape, and murder?
Forgiving the evil, even loving them, may stave off resentment, and the monstrous morality that it
gives birth to, but it leaves evil unopposed. The harm it does to the world. If the true follower of
Jesus has dissolved the tyranny of evil in themselves; they lose all power to oppose it in their life.
In our world, built as it is by a long history of binary hierarchies that insist upon its reality, evil
remains quite real. Quite destructive, quite horrible, and most certainly quite inescapable. It will
have its victims. And once we give license to evil, you, my resistant reader, may tell me that there
will be a lot more of it to forgive. Perhaps. When we invoke the possibility of evil, we are called upon to oppose it, and, in
opposing it, we revitalize the binary knowledge that has made it possible, and upon which we
have built our world. We make our shadows into our enemies. Opposing evil, we doom
ourselves to more of it. More judgement, more exclusion, more condemnation, more oppression,
more control of the other, more moralists, more self-righteous sanctimony, and so on. We
dis/ease ourselves with difference. The world we dream is the world we build, and the world we
build becomes the world we dwell in. In the face of this discord, the unqualified forgiveness of
Jesus is so seductive because it allows us an escape from being infected with difference, being
trapped in endless alterity. Yet, if we eliminate these structures of evil, we eliminate all distinction, difference, and
knowledge, for knowledge and truth are made of difference and distinction. Are we to eliminate
evil by eliminating truth? Concealing from ourselves the truth that the poor are exploited, that the
earth is being destroyed by Man's greed, that our leaders are corrupt, and that our moralists are
evil? If we succeed in this quest, how can we even imagine that we would be any better off? Just
the contrary, we would be replacing reality with delusion, truth with lies, and an ordinary evil with
a truly monstrous evil. And wasn't it Nietzsche who described Jesus' attempt to abolish evil by
abolishing all knowledge of it as idiocy, childish idiocy? A persuasive charge. Once you have dissolved the alterity that creates knowledge of good and
evil, you have no knowledge at all, only ignorant bliss. Repudiating all external experience, any
kind of principle, formula, law, faith, or dogma, the Kingdom of Heaven is a return to childishness
in the spiritual domain. Without difference to dis/ease the self, to make it mark out its boundaries,
there is no identity. In this world of unbounded acceptance, the difference separating inner and
outer is erased, and everything becomes self. The world becomes a parable, a metaphor for
reading the reign of this inner world. What truth this way of life knows, it knows only by an inner
light, an inner voice of affirmation, an inner pleasure. Truth becomes a feeling of potency, of
self-worth, and inner value. Nothing can challenge it, argue with it, or prove it false. Forgiving,
then forgetting, all opposition, it cannot even imagine a truth contrary to its own, and so this way
of being need not bother entering into any sort of dialogue with difference. If another opinion
contradicts it, opposes it, perhaps nailing it to a cross, this inner world only responds with
heartfelt sympathy and pity. This way of being laments the blindness of the other because it sees
the light, but it makes no objection to the trial it is forced to undergo. It simply accepts it.(370)This
is no way to respond to evil! Maybe Nietzsche's interpretation of the psychology of Jesus is a useful one, and maybe not.
Maybe we make our strongest relations with other people through an inward journey that
overcomes the differences that separate self from other. Maybe we cannot know other people, be
with them, have compassion for them, until we know ourselves. That means owning our shadow,
accepting it is ours and making friends with it, instead of projecting it on others or repressing it in
ourselves. Not only that, but the teachings of Jesus may be a way of expanding the boundaries of
the self to include others, if not all the earth, by ceasing to confront them as other, and that could
greatly enrich the self by making it stronger, more peaceful, more caring. By dissolving the differences separating self and other, by becoming the world's worlding, the self
can find itself in its others and not be dis/eased by them. This could be tremendously liberating.
Many false, unimportant, petty, hateful, and cruel oppositions would simply disappear. The self
would not be dis/eased by its identities, and much truth could be revealed about the unities
underlying differences. Maybe Nietzsche was not as generous a reader of Jesus as he could have been. But even if he
were, that is not all that Jesus, as myth and symbol, is to us, especially not after we have read
Nietzsche. As the hero and champion of morality, Jesus is the most ironic of all moral teachers,
especially given what Christianity has become. Whatever Jesus was to his own time, he is now
much more than he was because of his unfaithful followers. Because of their misreadings, they
have made a relativistic reading of morality possible for us. If the psychology of Jesus was to
return to the Garden Eden, to dissolve the past and abolish all separation, the ironic use and
reversal of Jesus' teachings by the Church makes it possible for us to reread them. The Church has made it possible for us to think about what it would mean to abolish all moral
separation, yet retain it, and then go beyond it--to relate to morals in a different way. It did all
this first. It retained Jesus' teachings, more or less, but by invoking a different perspective on
them, a universalist and eternal relation that insisted on maintaining difference instead of
dissolving it, it completely reversed their content. But, because we are aware of the relativity of
morals now, of the ways in which they are situated in time, place, language, and politics, we do
not simply return to Jesus' teachings. Where Jesus moved only in a circle, returning to the
infantile preduality of the Garden of Eden, we can move in a spiral--returning, yet not returning,
dissolving difference, yet retaining it. By making multiple and contradictory readings possible,
and simultaneously true, relativity remakes structures while retaining them. Endlessly capable of
resituating the reader, relativity reveals multiple truths, and, in the tense play between their mutual
impossibility, goes beyond them all. By means of the relativity of situation, evil becomes good,
and good, evil; morality becomes immorality, and immorality, morality; and while all of these
identities are maintained, they all become different than they were, dispersed among many
possibilities. More whole, less dis/eased by their others. As we wander through these relativistic reversals, they bring to the past, which was caught up in
the absolute play of opposition, an entirely new reading of identity and difference. Recreating the
past, relativity creates an entirely different horizon of the present. Always in transition, always
recreating things anew, relativity defeats the possibility of absolute knowledge, because nothing
can be completely fixed, mastered, or captured in the logic of either/or. Forever wandering, but
always situated in time and place, relativity is always subject to the meanings it recreates,
reverses, and rereads. So while situation permits us, in a relative way, to judge this or that evil or
good, that judgement is never forever fixed, never centered around one thing. Another reading is
always possible. By resituating the poles between which morality has long been suspended,
relativity loosens them up, disperses them, making possible a more imaginative response to the
problem of evil in our midst. Not without some dis/comfort and dis/ease though. Without moral certainty, we relativists can
never have the security of knowing that we are acting in a moral way again. Dispersed among
many interpretations, we can never be sure that we are good, only good. For those who have
desired nothing as much as the comfort of being only good, of complete moral purity, the thought
is a horrible one. While nothing is more evil than a moralist, no one is more anxious about their
morals than a relativist. Accepting our shadow, forever haunted by the dispersed ambiguities of
morality, postmodernists like myself are always doing, no matter what we do, something we
shouldn't be. Our shadow haunts us. If moralists can read unambiguously the differences
separating good and evil, they are blessedly unable to read the ambiguities involved in moralizing.
They can, they believe, do good without the slightest concern that they also do evil. We, on the
other hand, knowing the dispersion of relativities involved in opposing the other, are not
protected by such blindness. As a result, no one is more moral in their treatment of the other than a postmodern relativist. This
is not a statement of pride, but of humility. Where a moralist can conceal from themselves the
shadow--the lust for power, the resentment, the jealousy, the envy, the anger, and the hatred--in
their morality and their aspirations to goodness, no relativist can. We know how unacceptable
our attempts at goodness can be, how much we dis/ease the world when we would heal it. We
cannot ever be pure in anything we do; evil is always within us, as is good. Whatever we are is
established by the context we are embedded in. The very best we can do is tilt the balance slightly
in favor of good--of life, compassion, friendship, and love. And we know that we risk bringing
many horrible things with them when we do--death, contempt, hostility, and hatred. It is a tragic
life, the relativist's. Nothing comes without its shadow. Its angry dragon. The relative self described above stands in sharp contrast to the absolute self established by
Christianity. Throughout the history of Christianity, the self has been imagined as an
interiorization of the invisible God beyond, a radically free, self-determined, monad, a pure and
unequivocal totality. We are, as it is written, created in the image of God, a singular being that
willed the universe into being. This image of the self as a singular unity, bounded up as an
exclusive identity, must be contested, its borders remade to include the context that has long been
excluded from it. Far from being a singular entity, the self is an embedded ecopolity built of
alterity, a relative being in which the distinction between inner and outer is problematic, shifting,
and contingent. Other people, like one's parents, one's friends, and one's adversaries, are a part of the self--their
manners, their beliefs, their interpretations of the world contribute much to the self's interior
politics. Coming from the exterior world, these images of others become part of the interior
world, the identity one is. But then, because the self is building an exterior life with these others,
these interior images, are returned to them, suitably reinterpreted by the self's inner politics,
making these others, once again, what they are. There is no self without the ecopolity's alterities,
no identity without its borders extending beyond itself to the other. And so, the happening of identity is a political happening, a politics of experience in which images
are contested, revisioned, suppressed, and enabled, both within the self and outside in the larger
ecopolity. Because the boundaries of the self are so problematic, because the "causes" making
things happen include images, relations, situations, communities, hierarchies, and so on, dis/ease is
never just an individual's life event. It is a happening in a larger world. Healing dis/ease, at least
in part, involves healing the entire ecopolity in which the dis/eased self is situated. As James
Hillman puts it as he argues that psychotherapy is not enough alone to cure the dis/ease in our
society: If more than half the marriages in America end in divorce; if most of the not-yet-divorced
marriages one sees are not, to say the least, wonderful; and if most of the relationships around
you are falling apart, and are haunted, boring, or miserable, then clearly the fundamental cause
can't be individual. If it is happening (as it is) across every level of class, ethnicity, and region,
then the cause can't be found solely in the study of families, either. Doesn't something that
happens no matter what kind of family you come from cancel out family as the prime source?
Obviously the family as a form is being subjected to pressure on a massive, collective scale.
Thus your family is just one wrinkle of a collective event, important for you to know, perhaps,
but not to be confused or treated as a cause. It should seem self-evident to say this, but in
Western thought it's a radical idea: There must be something collective in the cause of a
collective phenomenon.(371) Or, as Hillman says, "city is psyche." The self is not something in you, your body perhaps, you
are in the self, and the self is much larger than you are--a city, a nation, a planet. What does this mean? It means that each city ought to have its own school of therapy, like the
Vienna School, the Zurich School, the schools of Nancy and Paris. It also means you can't
honestly do therapy apart from the city in which it takes place. It means therapy has reached its
city limits.(372) Perhaps what an ecopolitics of healing does more than anything else is tell the truth, the truth that
there are many truths, and the unfortunate truth that some of them have been excluded, silenced,
repressed. Concealed. Healing comes with accepting discordant truths--the truths that have long
been discomforting and too dangerous to be allowed out--and letting them be. But at the same
time, healing means contesting the power, be it as a boss, a parent, a spouse, an institution, or an
ideology, that has silenced these truths, and not letting that power be. Refusing to tolerate
repression, healing builds a space of tolerance to let truth happen, even a truth that is threatening
and dis/easing. By letting the truth of difference happen, by letting every living being ssing the
special song of joy they were born to, the wholeness, joy and beauty that make such differences
possible are revealed. By letting such difference be, healing must take many risks, face many
fears, and accept many shadows. As such, it is a deeply courageous effort. Few things can be as threatening or troubling, or dis/easing, as the truth. Some people, families,
groups, institutions, or nations, caught up in trying to protect a hegemonic identity, will do
anything to avoid it, and will attack anyone for revealing the shadow within themselves. These
kinds of identities maintain themselves by promoting their fear and their hatred. Trying to avoid
being dis/eased by the truth they have disowned about themselves, they must conceal the truth
about themselves from themselves and others. Such a life, so filled with fear and hatred,
concealment and denial, is deeply dis/easing. But, if telling the truth is dis/easing to such an
identity, not telling it is worse. Denied and disowned, the truth still haunts their life, returning
again and again. Needing to protect themselves from the truth their life reveals, these kinds of
identities must control others with guilt, an inner rejection and condemnation of the aspects of self
that others find threatening. Born of concealment, fear, and self-rejection, such guilt is deeply
dis/easing, as Joan Borysenko argues: Unhealthy guilt is an autoimmune disease of the soul that causes us to literally reject our own
worth as human beings. It is an affliction that robs life of joy. Instead of acting out of love and
enthusiasm, we are led to act out of self-protection. Unhealthy guilt causes life to become
organized around the need to avoid fear rather than the desire to share love. Guilt creates a
psychic optical illusion that causes faults and fears to stand out while pleasure and happiness
recede into the background. The result is a loss of joy and gratitude that creates fatigue,
negativity, and depression. In guilt we say no to life.(373) Guilt is the wrong way to respond to dis/ease. The fact that dis/ease is not just in the individual
but in the world as well means that I, as a dis/eased individual, don't have to own and be the cause
of all my misery. I don't have to suffer guilt for my dis/ease because I, as an individual, am not
exclusively responsible for it. I have little power to choose my dis/ease, and less control over how
the world worlds. Dis/ease is a happening that greatly exceeds me, and knowing this draws me
out of myself, the boundaries of my identity, and relates me to the world in which I live. If it is
the world that is dis/eased, to heal myself, I must heal the world. Made relative in this way,
healing becomes a political effort. And by turning my attention away from my faults and failings,
my guilt, my sin, my "evil" character, dis/ease can be a blessing, because it is a calling to care for
the world, to bless it and heal it. By calling me beyond myself, by directing my attention to the
world's worlding, the boundary of pain that has isolated me from others, and made me dis/eased,
is broken apart, and I can identify my pain in others and do things to make it better. Since the body's dis/ease is situated in family, personal, and hierarchical relationships, contesting
those relationships means engaging the body. Within its tissues, muscles, fibers, fluids, and bones,
the biochemistry of an inner and outer politics of identity is retained, and a dis/easing politics of
self can be revealed, and then healed, through body work using techniques such as Therapeutic
Touch, Holotropic Breathwork, Focusing, Bioenergetics, Yoga, and many others. What makes
these efforts healing, and the thing that is common to all of them, is that, by engaging the
resistances of the body, they often reveal concealed truths about the politics of experience the
body is caught up in. Dis/ease happens when the truth of abuse, exclusion, repression, and
subordination has been denied and made into a shadow. The truth would be too threatening to
both self and others, so, forbidden expression, the soul's troubles become physical dis/ease.
Working with the body in a safe, accepting, and caring situation reveals this politics of exclusion,
making it possible to contest it. Perhaps Eugene Gendlin's Focusing technique most directly reveals how bodywork is a political
contest between images and feelings that have not been previously allowed conscious expression.
One of the most recurrent images that both Gendlin and all of his associates use is that of
"clearing a space," creating a situation of tolerance where silenced feelings and images can come
forward and safely communicate their need.(374) The "inner critic," the voice of the they world and
of abusive authority, is bounded up and isolated, protecting troubled feelings and images from its
wrath and ridicule. Although the inner critic is allowed to speak in this space, and be understood,
it is never allowed to get away with silencing other thoughts, images, or feelings--any other part
of the self. Within this space, guilt and shame are reinterpreted and honored as merely
mechanisms for protecting the self. Anticipating hostile interpretations of the self by others, particularly authoritative others, the inner
critic projects its fears for the self out into the they world, returns from it with an ideal image of
the self, and then tries to protect the self from the projected condemnation of the they world by
making the self act in a way that will not provoke its wrath, rejection, revenge, resentment, or
anger. The inner critic is the voice within the self that condemns the other "unacceptable" parts of
the self, making them submit to its authoritarian control. And so, the first step in recovering the
shadow aspects of the self is to restrain the inner critic, inwardly contest the truth of its images,
and open up the possibility for other inner images to present their truth. Focusing is an inner
democracy of the self, allowing all parts of the self to be without condemnation, judgment, or
fear. In the process of allowing them to be, it transforms them, makes them more true to what we
are by dissolving the false boundaries that have concealed the unity of alterity. The unique thing about Focusing is that it is a nonauthoritarian way of telling the truth. In the
usual therapeutic setting, an authoritative expert interprets the symptoms of dis/ease, be they
dreams, dysfunctional personalities, projections, or bodily disorders, and knowing more about the
dis/ease than the individual suffering it, the expert interprets its symbolism, and situates the
individual in the context of dis/ease. In Focusing, however, finding the truth of dis/ease is done
without this hierarchy. The truth of the dis/ease is revealed by a felt sense, an inward bodily
reaction to an interpretation. When an idea expresses the body's truth, it feels right, there is a
bodily shift. Sort of like when something is on your tip of your tongue, you can't think of it, so
you keep turning it over and over, trying this possibility and that. And then you hit it, and there is
a sudden surge of relief. That is a body shift, a felt sense of truth. This felt sense of truth,
because it draws upon all of the body's possibilities, all of its history, the entire unconscious, even,
perhaps, all of its transpersonal archetypes, can reveal much more about the self than the
conscious ego can. Gently opening up a space of tolerance where everything in the self can be
presented, it can tell the truth about dis/ease in a way that conventional therapy cannot.
Grounding truth in something other than external authority, Gendlin calls this felt sense "bias
control"--a process of truth telling that separates the right interpretation out from any
interpretation. Though expert Focusers facilitate the process and have much they can offer to interpret dis/ease,
they do not impose their diagnosis on it. That is left for the body. As a practice for revealing
truth, Focusing is not sited in professional relationships and institutional settings, nor is it
confirmed with "scientific" diagnosis. And, rather than insisting on a professional therapeutic
relationship for the development of its practice, it uses newsletters, self-help seminars, and
self/community-help groups. Not needing authoritative interpretation, it is largely an anarchical
practice for revealing the truth of dis/ease. Although it is an intensely inward experience, by emphasizing and cultivating listening skills
directed toward the inner aspects of self, it opens up possibilities for a more accepting politics of
alterity with other selves. Opening up an inner space of tolerance to listen to discordant thoughts
within the self, it also opens up a space of tolerance for listening to discordant others. Gendlin is
quite hopeful that this new inner politics of self that he is proposing will have deeply transforming
and healing possibilities for the outer world as well. The last part of his book, Focusing, deals
with the effects that this anarchical space for healing and truth telling could have on society as a
whole.(375) Though it does open up a space for the toleration of difference, conventional liberalism has fallen
considerably short of the kind of politics necessary to heal dis/ease. Dividing the world up into
subject and object, opinion and truth, procedure and purpose, its boundaries dismiss as trivial and
unimportant what must be attended to--the shadow side of self and other. Truth for liberal
scientism is something objective, something that can be established through repeatable scientific
experiment, and permanently fixed as a law of the universe. The body's feelings, on the other
hand, are something subjective, opinions that are without weight or truth. Dismissing the inner
world--the body's felt experiences--as subjective opinion, liberalism conceals the truth of
oppression, exclusion, and marginalization in the dichotomies that it reveals the world with.
Contrary to the way liberalism would interpret mere opinion, it matters what the body feels--its
feelings of dis/ease--and attending to those feelings as truth could reveal much about injustices of
the world in which we live. Concealing the political origins of dis/ease by interpreting them through the framework of liberal
scientism could be described as our collective shadow. Wanting to prevent a politics of dis/ease,
to believe that we are good, humane, tolerant, and caring, we try to conceal the harm our pursuit
of a liberal identity causes by making disease into an object of science. Fearing what a politics of
dis/ease would reveal about ourselves, we project the causes of dis/ease outward, onto an
indifferent world made of bacteria, viruses, toxins, and genes. And we blind ourselves to the fact
that the dis/ease we fear is something that we are. Since science has allowed our dis/eases to
become so totally inhuman, so other and indifferent, we do not need to call our identity or our
ecopolitics into question when they happen. Safe, so very safe. Though we have suppressed and concealed it from ourselves, we all know, deep within ourselves,
that the "miracles of modern medicine" have dispossessed us of our calling, jerked us off center,
and concealed what is really dis/easing us. This knowledge is embodied in the fearful refusal to
call our identity into question when dis/ease happens. We refuse to do this because we know
what would happen if we started really thinking about what we are, about the injustices in our
lives--the shadows, exploitation, and fear that too much of it is built with. Everything would be
shaken loose, put into question--our self image, our relationships, our standing in the community,
and the structure of our polity. And so, as we build the modern age of medicine, we build a
shadow world to comfort its pain--a world of antibiotics, genetics, surgery, and mathematical
abstraction and quantification. While modern medical science does have considerable power to heal, and should not be just
discarded, it nevertheless allows us to avoid confronting what is really dis/easing us. Though
medical science has given us many benefits, it has moved us out of the dwelling places where
people live and die, where identities are always at risk before their others, to a utopia of politically
neutral objectivity where dis/ease cannot call the world into question. If life refuses to fit into the
world of scientific medicine, we force it, ignoring the things that don't fit, comforting ourselves
that they were irrelevant. But they aren't; they are the things that matter the most to healing,
things like self-understanding, loyalty, trust, love, friendship, compassion, anger, fear, and hatred. If we are to heal our world, we must come to celebrate the quiet peace of meditation, the
wandering solitude of the soul, the unqualified loves of a life of affirmation and joy. We must
retract our shadows, accept the fact that the dis/eases we have been fighting are not in an
exclusively external nature, but in the world that builds our identity, in an ecopolitics of alterity.
As ecopolitical entities, we are the dis/ease we have been opposing. Concealing this knowledge
from ourselves, we have become prisons of fear, enemies to ourselves and to nature. If we are to
heal the world's pain, we must quit running from our shadow, and become friends to our dis/ease. Before the healer can overcome her dis/ease, she must overcome herself --her shadow, her fear,
her blindness, her ignorance of herself--and become a friend not only to herself but her world.
She must open herself up, deeply putting into question every truth she had thoughtlessly accepted
out of fear or resentment, and then find a way to let the things that matter most to her guide her
life--her care for her self, her family, her homeland, and her gods. When she overcomes herself,
the healer will know that her truest calling is not to eliminate dis/ease, becoming a thoughtless
machine for the destruction of alterity, but to care for the world. The healer does not heal
dis/ease just to destroy pain, but to reveal the friend's truth--to protect, save, spare, and free. The
calling of the healer is to be a guardian of the earth, to keep safe the space of mystery in which the
world worlds and the earth becomes itself. Some time ago, I had a dream about friendship. Also, I think, about what it takes to heal, become
whole. Being a friend is a lot like jumping into an abyss. Taking risks to be with another, hoping
they will catch you before you hit the rocks. I dreamed I was in a mythical age where I lived high
up on rocky cliffs in caves with winged dragons. The dragons would come out of their caves
where I lived with them and fly down below into the abyss. I would jump off into midair, and
they were supposed to catch me as I was falling, and together we were supposed to fly off, a
happy team, and do mythical-heroic sorts of things. This mad ritual was some sort of cultural
thing, a test or developmental trial of some sort. By doing it over and over again we were
supposed to learn how to be there for the other. But the dragons didn't always do their thing. I
would fall all the way into the abyss, bounce off the ground, and climb the cliffs again and again.
I was getting tired, battered, and somewhat testy. I remember wondering why I couldn't just
climb on while the damned dragons were in their caves, but it was forbidden. Dragon master lore,
or something. Both for myself and the dragon. We both had to go through the trial, and learn
something from it. Maybe, now that I think of it, that is the unavoidable essence of friendship, the test that makes it
real by giving it expression--taking risks, hoping the other will catch you when you need to be
caught. Without the risk-taking, the possibility that the other might not fly under you and take
you to safety, the team lacks a history of understanding each other, of counting on each other, and
so their friendship is not fully developed. It has no truth. And maybe friendship is a lot like a
dragon too--magical, powerful, and able to carry us to places we couldn't otherwise get on wings
of enchantment. Breathing fire, possessing enchanting magic and awesome strength, the dragon is
also a capable and powerful ally, more than able to take on the friend's role of sparing and
protecting. Maybe friendship makes us into dragons. In more than one way. The dragon is an ambiguous symbol. It can mean all sorts of good things
like wisdom, luck, endurance, strength, protection; it also can mean all sorts of evil things like
uncontrolled rage, unconstrained destruction, boundless greed, and great spiritual evil. The
fire-breathing dragon that swoops down and destroys entire villages is a common mythical theme.
Friendship gives us many wonderful things: belonging, mutuality, strength, wisdom, and joy. It
makes our lives magical and enchanted because friends make each other into more than they could
ever be apart. But once friendship is broken, and love turns to hatred, friends become the worst
kind of enemies, dragons out to destroy each other's villages. The dragon is often a symbol of our shadow, the unlovable parts of ourselves, the things we don't
want to be. Which can be greed, jealousy, envy, hate, but a