unhealthy obsession with sickness
Why is being ill now embraced as a positive part of the
We live in a world where illnesses are on the increase. The distinguishing
feature of the twenty-first century is that health has become a
dominant issue, both in our personal lives and in public life. It
has become a highly politicised issue, too, and an increasingly
important site of government intervention and policymaking. With
every year that passes, we seem to spend more and more time and
resources thinking about health and sickness. I think there are
four possible reasons for this.
First, there is the imperative of medicalisation. When the concept
of medicalisation was first formulated, in the late 1960s and early
1970s, it referred to a far narrower range of phenomena than is
the case today - and it was linked to the actions of a small number
of professionals rather than having the all-pervasive character
that it does now.
Essentially, the term medicalisation means that problems we encounter
in everyday life are reinterpreted as medical ones. So problems
that might traditionally have been defined as existential - that
is, the problems of existence - have a medical label attached to
them. Today, it is difficult to think of any kind of human experience
that doesn't come with a health warning or some kind of medical
It is not only the experience of pain or distress or disappointment
or engagement with adversity that is medicalised and seen as potentially
traumatic and stress-inducing; even human characteristics are medicalised
now. Consider shyness. It is quite normal to be shy; there are many
circumstances where many of us feel shy and awkward. Yet shyness
is now referred to as 'social phobia'. And, of course, when a medical
label is attached to shyness, it is only a matter of time before
a pharmaceutical company comes up with a 'shyness pill'. Pop these
pills, and you too can become the life and soul of the party!
One of my hobbies is to read press releases informing us of the
existence of a new illness, the 'illness of the week', if you like.
Recently I received one that said: 'Psychologists say that love
sickness is a genuine disease and needs more awareness and diagnoses.
Those little actions that are normally seen as the symptoms of the
first flush of love - buying presents, waiting by the phone, or
making an effort before a date - may actually be signs of a deep-rooted
problem to come. Many people who suffer from love sickness cannot
cope with the intensity of love and have been destabilised by falling
in love or suffer on account of their love being unrequited….'
Of course, an intense passion can and does have an impact upon our
bodies. But when even love can be seen as the harbinger of illness,
what aspect of our lives can be said to be illness-free? What can
we possibly do that will not apparently induce some sickness or
syndrome? Medicalisation no longer knows any limits. It is so intrusive
that it can impact on virtually any of our experiences, creating
a situation where illness is increasingly perceived as normal.
This leads to my second point - there is now a presupposition that
illness is as normal as health. Earlier theories of medicalisation
still considered illness to be the exception; now, being ill is
seen as a normal state, possibly even more normal than being healthy.
We are all now seen as being potentially ill; that is the default
state we live in today.
This can be glimpsed in the increasing use of the term 'wellness',
with well men's clinics and well women's clinics. 'Wellness', another
relatively recent concept, is a peculiar term. It presupposes that
being well is not a natural or normal state. After all, there are
no such things as 'sunshine clinics' or 'evening clincs'; such normal
things do not normally need an institution attached to them. And
why would you have to visit a wellness clinic if you were well,
anyway? It makes little sense.
Wellness has become something you have to work on, something to
aspire to and achieve. This reinforces the presupposition that not
being well - or being ill - is the normal state. That is what our
culture says to us now: you are not okay, you are not fine; you
are potentially ill. The message seems to be that if you do not
subscribe to this project of keeping well, you will revert to being
In supermarkets, especially in middle-class neighbourhoods, buying
food has become like conducting a scientific experiment. Individuals
spend hours looking at how many carbohydrates there are, whether
it's organic, natural, holistic. Spending time reading labels is
one way of doing your bit to keep well.
Being potentially ill is now so prevalent that we have reached a
situation where illness becomes a part of our identity, part of
the human condition.
Some of us might not flaunt it, walking around saying, 'I've got
a gum disease' or 'I've got a bad case of athlete's foot'. That
doesn't sound very sexy, and is unlikely to go down well at the
dinner table. But it has become acceptable to talk openly about
other illnesses - to declare that you are a cancer survivor, or
to flaunt a disability. As we normalise illness, our identity becomes
inextricably linked to illness. So it is normal to be ill, and to
be ill is normal.
The nature of illness changes when it becomes part of our identity.
When we invest so much emotion in an illness, when it becomes such
a large aspect of our lives through the illness metaphor, we start
to embrace it - and it can be very difficult to let go of that part
of our identity. This is why illness tends to become more durable
and last longer. Sickness is no longer a temporary episode: it is
something that, increasingly, afflicts one for life. You are scarred
for life, with an indelible stamp on your personality. This can
be seen in the idea of being a cancer survivor or some other kind
of survivor; we are always, it seems, in remission. The illness
remains part of us, and shapes our personality.
As this happens, illnesses start to acquire features that are no
longer negative. In the past, illness was seen as a bad thing. Today
you can read illness diaries in the Guardian and other newspapers
and magazines. We often hear the phrase: 'I've learned so much about
myself through my illness.' It becomes a pedagogic experience: 'I
may have lost a leg and half my brain cells, but I'm learning so
much from this extremely unique experience.' It's almost like going
to university, something positive, to be embraced, with hundreds
of books telling us how to make the most of the experience of sickness.
We are not simply making a virtue out of a necessity; rather we
are consciously valuing illness. From a theoretical standpoint,
we might view illness as the first order concept, and wellness as
the second order concept. Wellness is subordinate, methodologically,
to the state of being ill.
The third influence is today's cultural script, the cultural narrative
that impacts on our lives, which increasingly uses health to make
sense of the human experience. The more uncertainty we face, the
more difficult we find it to make statements of moral purpose, the
more ambiguous we feel about what is right and wrong, then the more
comfortable we feel using the language of health to make sense of
our lives. At a time of moral and existential uncertainty, health
has become an important idiom through which to provide guidance
This is now so prevalent that we no longer even notice when we are
doing it. For example, we no longer tell teenagers that pre-marital
sex is good or bad or sinful. Instead we say that pre-marital sex
is a health risk. Sex education programmes teach that you will be
emotionally traumatised if pressured into having sex and will be
generally healthier if you stay at home and watch TV instead.
There are few clear moral guidelines that can direct our behaviour
today; but we have become very good at using health to regulate
people's lives in an intrusive and systematic fashion.
Even medicine and food have acquired moral connotations. So some
drugs are said to be bad for the environment, while others, especially
those made with a natural herb, are seen as being morally superior.
Organic food is seen as 'good', not only in nutritional terms, but
in moral terms. Junk food, on the other hand, is seen as evil.
If you look at the language that is used to discuss health and medicine,
or obese people and their body shapes, it isn't just about health:
we are making moral statements. A fat person is considered to have
a serious moral problem, rather than simply a health one. As we
become morally illiterate, we turn to health to save us from circumstances
where we face a degree of moral or spiritual disorientation.
The fourth influence is the politicisation of health. Health has
become a focus of incessant political activity. Politicians who
have little by way of beliefs or passions, and don't know what to
say to the public, are guaranteed a response if they say something
health-related. Some also make a lot of money from the health issue,
from pharmaceutical companies to alternative health shops to individual
quacks selling their wares - all are in the business, essentially,
of living of today's health-obsessed cultural sentiment.
Governments today do two things that I object to in particular.
First they encourage introspection, telling us that unless men examine
their testicles, unless we keep a check on our cholesterol level,
then we are not being responsible citizens. You are letting down
yourself, your wife, your kids, everybody. We are encouraged continually
to worry about our health. As a consequence, public health initiatives
have become, as far as I can tell, a threat to public health. Secondly,
governments promote the value of health seeking. We are meant always
to be seeking health for this or that condition. The primary effect
of this, I believe, is to make us all feel more ill.
Here's a prediction - Western societies are not going to overcome
the crisis of healthcare; it is beyond the realms of possibility.
No matter what policies government pursue, or how much money they
throw at the problem, even if they increase health expenditure fourfold,
the problem will not go away. As long as the normalisation of illness
remains culturally affirmed, more and more of us are likely to identify
ourselves as sick, and will identify ourselves as sick for a growing
period of time. The solution to this problem lies not in the area
of policymaking, or even medicine, but in the cultural sphere.
published on spiked, 23 March 2005