Abstract
Phenomenology of illness has grown increasingly popular in recent times. However, the most prominent phenomenologists of illness defend a psychologizing notion of phenomenology, which argues that illness is primarily constituted by embodied experiences, feelings, and emotions of suffering, alienation etc. The article argues that this gives rise to three issues that need to be addressed. (1) How is the theory of embodiment compatible with the strong distinction between disease and illness? (2) What is the difference between problematic embodiment and illness? (3) How is existential edification, that illness can give rise to according to the phenomenologists, to be understood? The article then engages in an analysis of Heidegger’s and Waldenfels’ phenomenology with the ambition of developing a notion of existence, which can transgress the psychologization of illness. Rather than arguing that illness is constituted by experiences of suffering and alienation, it emphasizes that broaches upon conatively guided activities constitute illness.
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Notes
In this context, phenomenology of illness specifically refers to the theories of Carel, Svenaeus, and Toombs. The use of the term ‘PHI’ is therefore a generalization of several quite diverse positions and might seem to be an oversimplified and artificial construct of a theory. What the theories do share, however, is a certain psychologizing approach to phenomenology, and I therefore elect to use the term “PHI” throughout, although the reader should be aware that the philosophies of Carel, Svenaeus, and Toombs are quite nuanced and internally varied.
Here I am not suggesting a theory of the transcendental Ego but rather the utilization of transcendental phenomenology as a method of investigation.
In the article Die phänomenologische Forschungsrichtung in der Psychopathologie, Jaspers writes: “Die psychopathologischen Phänomene legen eine solche isolierende, von Zusammenhängen abstrahierende, phänomenologische Betrachtung, die nur sehen, nicht erklären will, sehr nahe” (1912, 399).
A similar critique could be made regarding chronic illness.
This is an issue because, according to Husserl, phenomenology as a rigorous science is predicated on not being a method of individual introspection but a systematic analysis of structures of appearances (Husserl 2009), i.e., in not being descriptions of ‘my’ private experiences but of phenomena ‘as such’. In principle, phenomenology is an intersubjective enterprise that seeks to investigate essences of appearances. Heidegger strongly underscores the ontological level, i.e., structural or essential features, instead of the ontic or empirical as the main focus of the phenomenological analysis as well (2006, § 3–4).This elaborate discussion between naturalized and transcendental phenomenology is, however, far too extensive to be done justice in this context (cf. for example Zahavi 2013, 2019). Both approaches naturally have their merit, here, I simply wish to make the point that an analysis, which draws less on private experiences and more on the analysis of transcendental conditions, might alleviate some of the issues that PHI faces.
Which is almost a pejorative term in this context even though Descartes is much more nuanced than he is given credit for. In Descartes’ view, the soul does not relate to the body like a sailor on her ship who can jump overboard when danger looms (Descartes 2013: 113). The union between body and soul is much more intimate, it forms a unity, and the soul is “truly joined to the whole body” (1989: § 30) though this connection is difficult to (satisfyingly) explain on dualistic terms.
Cf. Svenaeus (1999, 138) for a similar point.
Cf. Plessner’s work Lachen und Weinen. Eine Untersuchung der Grenzen menschlichen Verhaltens (1982), wherein Plessner argues that laughing and crying as liminal phenomena expose the dual aspect of human nature.
Heidegger explicitly refers to The Death of Ivan Ilyich in Being and Time as an example of a person who does not shy away from their death as ‘One’ does but gains an authentic relation to it (2006, § 51).
It has been suggested that Heidegger’s reassurance that the inauthenticity of “das Man” is not a negative valuation (2006, § 38) nears that of a performative contradiction, given that there is an unmistakable air of negative judgment both in the terminology and the descriptions of the inauthentic life, to which labels such as alienation (‘Entfremdung’), being lost (‘Verlorenseins’) are attached.
‘Evil’ is a quite normative translation of ‘Unheil’, which can also mean ‘misfortune’ or ‘catastrophe’.
“Das Seiende, dem es in seinem Sein um dieses selbst geht” (Heidegger 2006, § 9).
Though this is a Husserlian term (Husserl 2012), I use it to stay within the conceptual framework of PHI.
Cf. the essay Der Kranke als Fremder (Waldenfels 2016). Here, alienation is to be understood in a different way to Svenaeus’ understanding thereof and I will get to the difference shortly.
Cases of permanent, progressive pathology lend themselves well to illustrating this, but an example of a person who suffers an unexpected heart attack could be equally relevant. Though a single event, the heart attack might threaten and invalidate the orders of meanings and ability for temporal projection in much the same way as sclerosis.
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Acknowledgements
I am indebted to associate professor Lasse Nielsen, professor Søren Harnow Klausen and the research group Values, Welfare and Health at the University of Southern Denmark in general for their very constructive feedback on earlier drafts of this paper. I would also like to thank the reviewers for their fair and constructive critiques of earlier drafts of this article.
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The research is funded by the Human Health project at University of Southern Denmark.
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Nielsen, T.H. Issues for a phenomenology of illness – transgressing psychologizations. Med Health Care and Philos 25, 603–613 (2022). https://doi.org/10.1007/s11019-022-10100-4
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DOI: https://doi.org/10.1007/s11019-022-10100-4