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Illness as Metaphor and AIDS and Its Metaphors Paperback – August 25, 2001
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From Publishers Weekly
"In Illness as Metaphor , Sontag argues that the myths and metaphors surrounding disease can kill by instilling shame and guilt in the sick, thus delaying them from seeking treatment," wrote PW. She sees, and discusses provocatively, a similar process at work in the case of AIDS.
Copyright 1989 Reed Business Information, Inc. --This text refers to an out of print or unavailable edition of this title.
“Susan Sontag's Illness as Metaphor was the first to point out the accusatory side of the metaphors of empowerment that seek to enlist the patient's will to resist disease. It is largely as a result of her work that the how-to health books avoid the blame-ridden term 'cancer personality' and speak more soothingly of 'disease-producing lifestyles' . . . AIDS and Its Metaphors extends her critique of cancer metaphors to the metaphors of dread surrounding the AIDS virus. Taken together, the two essays are an exemplary demonstration of the power of the intellect in the face of the lethal metaphors of fear.” ―Michael Ignatieff, The New Republic
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'Theories that diseases are caused by mental states and can be cured by will power are always an index of how much is not understood about a disease.
Moreover, there is a peculiarly modern predilection for psychological explanations of disease...Psychologizing seems to provide control...over which people have no control. Psychological understanding undermines the 'reality' of a disease.'
Sontag traces, historically, the ways different diseases and the people who contracted them have been viewed. She spends time discussing tuberculars--waif-like, pale, romantic--and cancer patients--repressed, the 'cancer personality,' shame--then goes on to debunk these notions by stating that once the cause, cure, innoculation is found, the 'myth' or popular psychology of the disease no longer holds.
In this edition, in the final chapter about AIDS and its metaphors Sontag writes that she'd written the first part of the book (all but the AIDS chapter) while a cancer patient and in response to reactions she saw in fellow patients. She saw guilt and shame; and she saw these as impediments to people's treatments. For she knew she had an illness and she set about to cure it medically, in the best possible way, while others passively accepted the 'metaphor' handed to them and, thus, did less to help themselves best. She felt frustrated or saddened by their psychologizing and self-blame and wished to write to others that their physical illness is a physical illness and the best route to recovery is to think only of how to find the best medical treatment.
And she wrote this by demonstrating the history of myths that surrounded illnesses and the way these myths evaporated as soon as its true mechanism (the virus, or otherwise) was found.
Some holes in her argument can be found in the field of Health Psychology, which has proved that optimism generates faster post-operative recovery or a heartier immune system, among other 'psychological' correlates of disease to illness. Still we speak of a "type A" personality and a possibility of a heart attack, etc., which I believe is not entirely unfounded -- stress creates a drop in immune response and other health deficiencies.
However, I am a patient and a former psychotherapist. I was reared in psychology as others are toward priesthood. I grew up sent to therapists for any ills and was raised with the thought I be nothing but a therapist when an adult -- which I did become. Then I became diabled, from physical injury. My own disability is largely pain-related; the pain is severe and in locations that make it impossible to function. Much of my injury does not show up on contemporary tests -- EMG's, CAT scans, MRI's, bone scans, sonograms.
So I turn to psychology. I know I've got a physical injury. But if it can not be cured (and I go back to my original quote: that which is least understood, we psychologize), perhaps I am, in part, a cause of it. This had been a comforting notion to me: if I can do this to myeslf, I can also undo it. For me, psychologizing helped put me in the driver's seat.
Sontag at first put me in the driver's seat in a new, determined, knowing way. I know my injury is not something that is "in my head." At first, Sontag's argument was a weight off my shoulders, an eye-opener. I underlined the passage above: yes, that's right; they don't know what's wrong with me so they blame me. A doctor once said to me: "When I can't find anything wrong with someone I assume there is nothing wrong with her."
Sontag set me in motion. She went into motion, knowing cancer wasn't a word to whisper (remember when we whispered that 'c' word?), but something to pursue with a vengeance. Her book was liberating. I know I don't want to be sick, unable to do the things I want to, regardless of how neatly one can analyze my personality and show otherwise. This is physical.
Then reality. I've got sometihng and it isn't curable and it is debilitating. I am in doctors' offices all the time; fighting beaurocracy all the time. I wanted my psychologizing back. My security blanket had been removed with this "epiphany" of sorts. If it's not in my head, and I can't cure myself, and doctos can't cure me, I'm incurable. Her philosophy, then, became saddening.
I began to analyze her: perhaps she recovered so well because of her strong personality, her [psychological] strength. It's a chicken/egg question.
Sontag writes things that are clear and other things that can be argued. Overall, her essays have changed societal thought -- from Against Interpretation to On Photography to Illness as Metaphor and various others; she is brilliant and a powerfully good writer. Anyone who can make us look at something in a new way, make us think something through in a new way, is easily well-worth reading.
Anyone who is ill, particularly chronically, undiagnosed or misunderstood should read this book. Agree with it or not, but read it. Read others that say the opposite, read about your own illness, but read this book: I would call it mandatory.
In Illness As A Metaphor, Sontag focuses on two illnesses, tuberculosis and cancer. Tuberculosis was viewed as a "glamorous disease" whose "victims" were the highly sensitive: "TB is is celebrated as the disease of born victims, of sensitive, passive people who are not quite life-loving enough to survive." Cancer, on the other hand, was seen as a disease caused by repressed emotions. Both TB and cancer were considered mysterious illnesses until tuberculosis was determined to be caused by a bacillus and was curable, while the etiology of cancer remains unknown and uncurable. Following the discovery of a cure for tuberculosis, a more dramatic shift was seen distinguishing between tuberculosis and cancer.
In AIDS and Its Metaphors, which serves as a fine companion to Illness As A Metaphor, Sontag takes up the specific case of AIDS. AIDS and Its Metaphors was published in 1988, while Illness as a Metaphor was published ten years earlier, before the emergence of AIDS into the global conscious. Sontag, herself, ties the two texts together by beginning the second one with a response to critics of the first text and explaining how she was misinterpreted. Sontag explicitly refers to her own diagnosis of recovery from cancer at the time of the earlier publication, and her awareness that the metaphors applied to illnesses can be stigmatizing and thus harmful to those carrying the disease, even to the point of causing premature death. This stigmatization prevents people from seeking out timely, effective treatment.
Sontag readily admits that thinking is not possible without the usefulness of metaphors. The thrust of her argument is to undermine the use of certain types of metaphors. In both texts, Sontag takes issue with militaristic metaphors applied to illnesses and AIDS -- an illness is an "invasion" which must be met with an "attack" preferably by the body's own "defense system." Sontag urges the abandonment of military metaphors for illness and AIDS arguing that such metaphors serve no useful purpose and may in fact have harmful impacts.
Sontag's erudition is on display here, with her encyclopedic knowledge of the Western canon of literature and philosophy as well as US and French cinema, but always as a means to exemplify, to clarify, rather than to simply impress the reader. Therefore, these texts hardly are ones for the general reader. Nevertheless, even if the reader is unfamiliar with all of the external references from which Sontag draws, the writing is sufficiently clear that the general reader should not have any problems understanding these two "small book[s]." Nevertheless, these texts most definitely are intellectualizations of illness and of AIDS; they fall into the genre of cultural criticism, and therefore do little to the understanding of illness or AIDS as such, but, rather, how illness and AIDS are interpreted by society and the meanings attritutable to these phenomena.
Although the texts are short, they are packed with insights. More than a single reading is recommended in order to discover the full richness of these two texts. Both are outstanding works which further enhance Sontag's legacy.
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Illness as Metaphor was first published in 1978, since when the world-wide epidemic of AIDS has taken first...Read more