EXISTENTIAL MEDICINE

Illness and Identity

Illness is intimately connected with identity. Whenever we ‘do not feel ourselves’, but instead feel out of touch with or just different to ourselves in some way, this can occasion a sense of dis-ease or malaise, one which may in turn find expression in bodily symptoms or disease. What feels discomforted or ‘threatened’ by us feeling different is not our ‘immune system’ but our immune self. This is the self that generally does not allow what we feel to affect our sense of who we are – to alter our felt sense of  self.  Thus we say ‘I feel good’ or ‘I’m not feeling good’ as if it were the same ‘I’ in both cases. This is the way the immune self protects us from feeling ourselves – this very ‘I’ – in a different way. The so-called ‘immune system’ and its ‘defences’ is but a physical expression of the immune self and its defences. These defences serve primarily to protect a sense of unchanging identity – in particular that unchanging mental or ego identity represented by the unchanging word ‘I’. It is the over-activity of the immune self – the ego – that actually ‘weakens’ our body’s physical immune ‘defences’. Yet this very ‘weakening’ can help us to overcome our identity defences through illness – for through illness our most intimate bodily sense of self is altered in a way the ego cannot deny.

We can feel different in positive as well as negative ways – and feel a different bodily sense of self without experiencing dis-ease or getting ill. Nevertheless, all illness begins with a sense of ‘not feeling ourselves’ – feeling different in a way we find discomforting and are ill-at-ease with. Not feeling ourselves however is a part of a natural process through which we can learn to feel another self. This is a fundamentally healthy and healing process, for by letting ourselves feel other, different selves to the one we normally identify with we quite literally come to feel more of ‘ourselves’. We become more whole by feeling more of our whole self or ‘soul’ in all its sides and aspects. This is what I term the health process. Out of an initial sense of ‘not feeling ourselves’ may come something else however. Instead of allowing ourselves to begin to feel and accept another, previously foreign sense of self emerging within us we may feel ourselves possessed or invaded by some ‘thing’ that is foreign or alien to us – that is ‘other than self’ or ‘not self’. We  then immediately brand this ‘thing’ as bad and seek to eliminate it.

What I call the illness process begins with not feeling ourselves but rather than leading to us feeling another self, leads instead us to us feelling something other than self or not-self  ‘getting at us’ or ‘making’ us feel bad or ill. Completely ignoring the meaning to be found in feeling a new and previously ‘foreign’ sense of self pervading our bodies, medical science looks only for the cause of symptoms in some sort of ‘foreign body’ -for example in the form of a virus or a cancerous tumour made of so-called ‘non-self’ cells. This is the exactly the same bio-medical model that led Hitler to regard the Jews as ‘foreign bodies’ – together making up a sort of malignant ‘tumour’ invading and growing in the ‘body’ of the Volk – and needing to be surgically ‘cut out’ and annihilated. Alternatively the ‘illness process’ may take us from not feeling ourselves to feeling no self – to completely losing any sense of self and with this, losing our mental bearings in life. Having become completely identified with a part of our whole self or soul – its loss is felt as a loss of identity as such, a loss of our soul.

The difference between health and illness, as between so-called ‘mental’ illness on the one hand and ‘physical’ illness on the other, all comes down to how our immune self or ‘I”  responds to the initial bodily sense of not feeling ourselves and instead feeling a sense of dis-ease attributed to something other-than-self – or else fearing or feeling a total loss of self. The ‘defences’ of the immune self are manifold. It may bring about a weakening of the physical immune system in order for the body to be able to manufacture and identify something ‘not self’ (for example an infection or tumour) for the body to fight. This in turn helps the individual to forge a temporary identity as a ‘patient’ – someone with a medically defined disease. A new identity may also be forged through some form of recognisable ‘mental illness’. The individual may become ‘paranoid’ – perceiving threats to the immune self as coming from the world or hallucinated spirits or voices rather than their body. Or they may over-identify with other people – real or imaginary  – to substitute for a basic sense of loss of self. The variations are endless, and highly individual – yet no more so than the endless variety of defences that so-called ‘healthy’ or ‘normal’ people deploy to defend their sense of an unchanging ‘I’ – the immune self. Chief among such defences include are health fetishism supported by a culture of health fascism – one in which anything and everything but the immune self –  whether smoking, specific types of food or so-called ‘unhealthy’ lifestyles –  is turned into a scapegoat for disease. Thus arise the typically military metaphors used by medical science and the commercial health industry alike – for example the mantra of ‘strengthening’ the body’s immune ‘defences’ to ‘fight’ disease.

Illness as Pathology or Pregnancy?