A key topic within the field of the phenomenology of medicine has been the relationship between body and self in illness, including discussions about the otherness and mineness of the body. The aim of this article is to distinguish between different meanings of bodily otherness and mineness in illness with reference to the interpretation of the body as “saturated phenomenon,” inspired by the phenomenology of Jean-Luc Marion. With the help of Marion’s ideas it is possible to distinguish between two meanings (...) of bodily otherness and of mineness (objective and non-objective forms). These distinctions support and elaborate on ideas already found in the phenomenology of medicine and offer further insights into the nature of the experience of illness. (shrink)

Recent achievements in rehabilitative robotics modify essential parameters of the human body, such as motility. Exoskeletons used for persons with neurological impairments like spinal cord injury and stroke enter this category by rehabilitating and assisting damaged motor patterns, achievements thought impossible until not long ago. Unlike other examples leading to similar dysfunctions, such as diseases or tumors, the experience of an accident causing a spinal cord injury or the occurrence of a cerebrovascular accident is sudden and perceived as a radical (...) event. This often leads to deep consequences for one’s own body capacities. Exoskeletons attempt to alter this condition, contributing to forge a temporary abled body, although this currently happens in the restricted space of a clinic or a lab and under very controlled conditions for the predominance of users. Using qualitative empirical material from an ongoing study in sociology, including expert and narrative interviews as well as ethnographic visits in labs and centers that design and test exoskeletons, this article addresses the challenges and gains that people with stroke and spinal cord injury experience during their training with exoskeletons. The discussed cases contribute to reassess categories from the phenomenological paradigm, disability studies, and the role medical technologies play in contemporary body worlds. (shrink)

In this paper I will try to systematically lay out and describe the multiple dimensions of the embodied experience of illness, which until recently has been the main focus within the field of the phenomenology of medicine. In order to do this, I will turn to analysis of the nature of embodiment in Husserl’s phenomenology. I will argue that based on Husserl’s phenomenology of the body, one can distinguish four ways of experiencing one’s body, or four dimensions of embodiment. I (...) will distinguish between experience of one’s body as 1) a bearer of sensations ; 2) a seat of free movement, characterized by the faculty of “I can” ; 3) a material thing in a causal relationship with the material world ; 4) a material thing embedded in a social context. I will then apply the proposed classification of dimensions of embodiment to the experience of illness, focusing on the various ways these dimensions have been used within the phenomenology of medicine. This serves two purposes. Firstly, it provides a framework for classification of the existing interpretations of the experience of illness; secondly, it opens up a way for a comprehensive analysis of the experience of illness which includes both individual and social aspects of embodiment as well as their mutual intertwining. (shrink)

In some quarters within philosophy of medicine, more particularly in the phenomenological approaches, naturalism is looked upon with suspicion. This paper argues, first, that it is necessary to distinguish between two expressions of this attitude towards naturalism: phenomenological approaches to illness disagree with naturalism regarding various theoretical claims and they disapprove of naturalism on an ethical level. Second, this paper argues that both the disagreement with and the disapproval of naturalism are to a large extent confused. It then offers some (...) proposals to set up an agenda for future collaboration. (shrink)

According to recent approaches in the philosophy of medicine, biomedicine should be replaced or complemented by a humanistic medical model. Two humanistic approaches, narrative medicine and the phenomenology of medicine, have grown particularly popular in recent decades. This paper first suggests that these humanistic criticisms of biomedicine are insufficient. A central problem is that both approaches seem to offer a straw man definition of biomedicine. It then argues that the subsequent definition of humanism found in these approaches is problematically reduced (...) to a compassionate or psychological understanding. My main claims are that humanism cannot be sought in the patient–physician relationship alone and that a broad definition of medicine should help to revisit humanism. With this end in view, I defend what I call an outcomes-oriented approach to humanistic medicine, where humanism is set upon the capacity for a health system to produce good health outcomes. (shrink)

Although scars never disappear completely, in time most people will basically get used to them. In this paper I explore what it means to habituate to scars against the background of the phenomenological concept of incorporation. In phenomenology the body as Leib or corps vécu functions as a transcendental condition for world disclosure. Because of this transcendental reasoning, phenomenology prioritizes a form of embodied subjectivity that is virtually dis-embodied. Endowing meaning to one’s world through getting engaged in actions and projects (...) is most successful indeed when one’s body is “absent,” “transparent,” or, at least, if it is not in the center of one’s attention. This taken-for-granted nature can be disturbed by discomfort, disability, and disfigurement. Incorporation, so I explain, aims at maintaining or restoring the body’s taken-for-grantedness. My analysis of the case of a woman who successfully habituated to her mastectomy scar demonstrates, however, that habituation to a perceptible scar can only be understood partly in terms of incorporation. Next to a decrease of explicit attention for the scar and the discomfort it produces, the scar should also stop being a sign that refers to something else than itself. This is only possible, I argue, by taking the body’s materiality seriously, rather than it being wiped out as a result of transcendental reasoning. (shrink)

This paper considers how the experience of illness fits within Sartre’s account of embodiment in Being and Nothingness. Sartre makes some remarks about illness, but does not develop a full account. I show that the anti‐naturalistic ontological framework in which Sartre’s discussion of the body is placed, which opposes my ‘being‐for‐Others’ to my ‘being‐for‐myself’, imposes a revisionary account of illness, and how Sartre’s model of interpersonal relations affects his view of doctors, and their role in the illness experience. I note (...) and discuss the connection Sartre draws between illness and bad faith. I also point out that recent phenomenologically inspired criticisms of the medical establishment that draw on Sartre’s account of the body are limited by their failure to engage with Sartre’s ontology. (shrink)

In the context of the end of life, many authors point out how the experience of identity is crucial for the well-being of patients with advanced disease. They define this identity in terms of autonomy, control, or dependence, associating these concepts with the sense of personal dignity. From the perspective of the phenomenology of embodiment, Kay Toombs and other authors have investigated the ways disease can impact on the subjective world of patients and have stressed that a consideration of this (...) personal world can promote understanding and recognition of their experience. Based on the findings of qualitative studies of the perception of dignity and autonomy in patients at the end of life, this analysis assesses concepts such as being-in-the-world in illness, embodiment, lived body versus objective body or the gaze of the other from a Toombsian phenomenological perspective. (shrink)

How do we feel our body in emotion experience? In this paper I initially distinguish between foreground and background bodily feelings, and characterize them in some detail. Then I compare this distinction with the one between reflective and pre-reflective bodily self-awareness one finds in some recent philosophical phenomenological works, and conclude that both foreground and background bodily feelings can be understood as pre-reflective modes of bodily self-awareness that nevertheless differ in degree of self-presentation or self-intimation. Finally, I use the distinction (...) between foreground and background bodily feelings to characterize the experience of being absorbed in an activity, as opposed to accounts that imply that absorption involves bodily inconspicuousness. (shrink)

Despite the growing literature on childhood obesity and lifestyle intervention programmes focusing on weight loss, few studies have examined young persons’ experiences of being identified as candidates for such programmes and of participating in them. This paper does so. Juxtaposing insights from phenomenology with an approach inspired by Foucault, the paper shows how teenage girls’ bodily self-perception and bodily self-awareness are shaped in intercorporeal assemblages comprising other people and specific features or elements of the lifestyle programme.Inspired by van Manen’s hermeneutic-phenomenological (...) approach, with its point of departure in lived experience, this paper draws on interviews with Norwegian teenage girls participating in the same lifestyle programme and identifies three core thematic aspects of the girls’ experiences: being identified as a candidate for a lifestyle programme and not wanting this; negotiating the lack of weight loss and the scales; and bodily situated agency – feeling good and being able. Permeating all three themes are two central, interrelated phenomena: agency and resistance. Furthermore, the paper shows how a combination of Foucauldian insights and a phenomenological understanding of intercorporeality can help to shed light on the power, affective, material and temporal dimensions of dys-appearance (i.e., when one’s body appears as bad or wrong), as well as those of eu-appearance (i.e., when one’s body appears as healthy or strong), and thus contribute to the understanding of the girls’ narrated lived experiences.On the basis of these findings, we argue that weight-related treatment goals are not necessarily compatible with the strengthening of adolescents’ body images and self-esteem. However, whilst being obliged to attend to their bodies while in the programme, the girls also encountered unexpected, positive bodily feelings and experiences. Such events, we suggest, offer a means of resisting the more troubling dys-appearing bodily situations our participants described so powerfully. (shrink)

During recent decades various researchers from health and social sciences have been debating what it means for a person to be disabled. A rather overlooked approach has developed alongside this debate, primarily inspired by the philosophical tradition called phenomenology. This paper develops a phenomenological model of disability by arguing for a different methodological and conceptual framework from that used by the existing phenomenological approach. The existing approach is developed from the phenomenology of illness, but the paper illustrates how the case (...) of congenital disabilities, looking at the congenital disorder called cerebral palsy (CP), presents a fundamental problem for the approach. In order to understand such congenital cases as CP, the experience of disability is described as being gradually different from, rather than a disruption of, the experience of being abled, and it is argued that the experience of disability is complex and dynamically influenced by both intrinsic and extrinsic factors. Different experiential aspects of disability— pre-reflective, attuned and reflective aspects—are described, demonstrating that the experience of disability comes in different degrees. Overall, this paper contributes to the debates about disability by further describing the personal aspects and experience of persons living with disabilities. (shrink)

This article develops a phenomenology of suffering with an emphasis on matters relevant to medical practice and bioethics. An attempt is made to explain how suffering can involve many different things—bodily pains, inability to carry out everyday actions, and failure to realize core life values—and yet be a distinct phenomenon. Proceeding from and expanding upon analyses found in the works of Eric Cassell and Elaine Scarry, suffering is found to be a potentially alienating mood overcoming the person and engaging her (...) in a struggle to remain at home in the face of loss of meaning and purpose in life. Suffering involves painful experiences at different levels that are connected through the suffering-mood but are nevertheless distinguishable by being primarily about my embodiment, my engagements in the world together with others, and my core life values. Suffering is in essence a feeling , but as such, it has implications for and involves the person’s entire life: how she acts in the world, communicates with others, and understands and looks upon her priorities and goals in life. Suffering-moods are typically intense and painful in nature, but they may also display a rather subconscious quality in presenting things in the world and my life as a whole in an alienating way. In such situations, we are not focused directly upon the suffering-mood—as in the cases of pain and other bodily ailments—but rather, upon the things that the mood presents to us: not only our bodies, but also other things in the world that prevent us from having a good life and being the persons we want to be. Such suffering may in many cases be transformed or at least mitigated by a person’s identifying and changing her core life values and in such a manner reinterpreting her life story to become an easier and more rewarding one to live under the present circumstances. (shrink)

The aim of this article is to explore nuances within the field of bodily self-awareness. My starting-point is phenomenological. I focus on how the subject experiences her or his body, i.e. how the body stands forth to the subject. I build on the phenomenologist Drew Leder’s distinction between bodily dis-appearance and dys-appearance. In bodily dis-appearance, I am only prereflectively aware of my body. My body is not a thematic object of my experience. Bodily dys-appearance takes place when the body appears (...) to me as “ill” or “bad.” This is often the case when I experience pain or illness. Here, I will examine three versions of bodily dys-appearance. Whereas many phenomenological studies have explored cases of bodily dys-appearance, few studies have focused on the opposite of bodily dys-appearance, i.e. on bodily modes of being where the body appears to the subject as something good, easy or well. This is done in this article. When the body stands forth as good, easy or well to the subject, I suggest that the body eu-appears to this person. The analysis of eu-appearance shows that the subject can attend to her or his body as something positive and that this attention need not result in discomfort or alienation. Eu-appearance can take place in physical exercise, in sexual pleasure and in some cases of wanted pregnancies. I also discuss, briefly, the case of masochism. (shrink)

The aim of this article is to explore bodily changes following weight loss surgery. Our empirical material is based on individual interviews with 22 Norwegian women. To further analyze their experiences, we build primarily on the phenomenologist Drew Leder`s distinction between bodily dis-appearance and dys-appearance. Additionally, our analysis is inspired by Simone de Beauvoir, Merleau-Ponty and Julia Kristeva. Although these scholars have not directed their attention to obesity operations, they occupy a prime framework for shedding light on different dimensions of (...) bodily change. In doing so, we were able to identify two main themes: The felt “inner” body versus the visible “surface” body and the “old” body versus the “new” body. In different, though interconnected ways, these main themes encompass tensions between changes the women experienced as contributing to a more “normal” and active life, feeling more accepted, and changes that generated ambivalence. In particular, their skin became increasingly problematic because it did not “shrink” like the rest of the body. On the contrary, it became looser and looser. Moreover, badsmelling folds of skin that wobbled, sweated and chafed at the smallest movement, aprons of fat hanging in front of their stomachs, batwing arms, thick flabby thighs and sagging breasts were described as a huge contrast to the positive response they received to their changed body shape when they were out and about with their clothes on. At the same time, they expressed ambivalence with regards to removing the excess skin by means of plastic surgery. Through their own and other women`s experiences they learned removing the excess skin by means of surgery could be a double-edged sword. By illuminating the experiences of the ones undergoing such changes our article offers new insight in a scholarly debate predominated by medical research documenting the positive outcomes of weight loss surgery. (shrink)

Phenomenology in medicine’s main contribution is to present a first-person narrative of illness, in an effort to aid medicine in reaching an accurate disease diagnosis and establishing a personal relationship with patients whose lived experience changes dramatically when severe disease and disabling condition is confirmed. Once disease is diagnosed, the lived experience of illness is reconstructed into a living-with-disease narrative that medicine’s biological approach has widely neglected. Key concepts like health, sickness, illness, disease and the clinical encounter are being diversely (...) and ambiguously used, leading to distortions in socio-medical practices such as medicalization, pharmaceuticalization, emphasis on surveillance medicine. Current definitions of these concepts as employed in phenomenology of medicine are revised, concluding that more stringent semantics ought to reinforce an empirical phenomenological or postphenomenological approach. (shrink)

In this paper, an attempt is made to develop an understanding of the essence of illness based on a reading of Martin Heidegger’s pivotal work Being and Time. The hypothesis put forward is that a phenomenology of illness can be carried out through highlighting the concept of otherness in relation to meaningfulness. Otherness is to be understood here as a foreignness that permeates the ill life when the lived body takes on alien qualities. A further specification of this kind of (...) otherness can be found with the concept of unhomelike being-in-the-world. Health, in contrast to this frustrating unhomelikeness, is a homelike being-in-the-world in which the lived body in most cases has a transparent quality as the point of access to the world in understanding activities. The paper then proposes that the temporal structure of illness can be conceptualised as an alienation of past and future, whereby one’s past and future appear alien, compared with what was the case before the onset of illness. The remainder of the paper follows two paths as regards the temporality of illness. The first path explores the temporality of the body in relation to the temporality of the being-in-the-world of the self. One way of understanding the alienating character of illness is that nature, as the temporality of our bodies, ceases to obey our attempts to make sense of phenomena: the time of the body no longer fits into the time of the self. The second path explored in the paper is that of narrativity. When we make sense of the present, in relation to our future and past, we do so in a special manner, namely, by structuring our experiences in the form of stories. Illness breaks in on us as a rift in these stories, necessitating a retelling of the past and a re-envisioning of the future in an effort to address and change their alienated character. These stories, however, never allow us to leave the silent otherness of our bodies behind. They are stories nurtured by the time of nature at the heart of our existence. It is then claimed that the idea of life’s being a story must be understood in a metaphorical sense, and an exploration of how phenomenology addresses the metaphoric quality of its conceptuality is ushered in. It is pointed out that metaphors can be systematically related to each other and that they always have a founding ground in the orientation and basic activities of the lived body. Therefore, if the concepts used in working out a phenomenological theory of health and illness are, to a certain extent, metaphorical, one could, nevertheless, claim that the metaphoric qualities of the phenomenological concepts are primary in referring back to the lived body and the way it inhabits the world. (shrink)

In recent years, facial difference is increasingly on the public and academic agenda. This is evidenced by the growing public presence of individuals with an atypical face, and the simultaneous emergence of research investigating the issues associated with facial variance. The scholarship on facial difference approaches this topic either through a medical and rehabilitation perspective, or a psycho-social one. However, having a different face also encompasses an embodied dimension. In this paper, we explore this embodied dimension by interpreting the stories (...) of individuals with facial limb absence against the background of phenomenological theories of the body, illness and disability. Our findings suggest that the atypical face disrupts these individuals’ engagement with everyday projects when it gives rise to disruptive perceptions, sensations, and observations. The face then ceases to be the absent background to perception, and becomes foregrounded in awareness. The disruptions evoked by facial difference call for adjustments: as they come to terms with their altered face, the participants in our study gradually develop various new bodily habits that re-establish their face’s absence, or relate to its disruptive presence. It is through these emergent habits that facial difference comes to be embodied. By analyzing the everyday experiences of individuals with facial limb absence, this article provides a much-needed exploration of the embodied aspects of facial difference. It also exemplifies how a phenomenological account of illness and disability can do justice both to the impairments and appearance issues associated with atypical embodiment. (shrink)

This essay presents somaesthetics of discomfort as an extension of the field of somaesthetics as developed by Shusterman. Using the work of Peirce and Dewey as a foundation upon which Shusterman and Johnson have considered the body as the basis of aesthetics, I propose that somaesthetics of discomfort provides a means of enhancing bodily awareness and reflection useful for domains of inquiry, such as healthcare and design. Taking Peirce’s notion of the irritation of doubt in a literal sense, I explore (...) bodily discomfort as the inception of inquiry. I consider work done by phenomenologists concerning experiences of comfort and discomfort, which includes definitions of each. My argument follows the perspective put forth by Peirce, Dewey, and contemporary pragmatists that experience is qualitative and that feeling is at the root of reflection. I explain how discomfort may be considered a type of aesthetic experience and provide examples of bodily discomfort as somaesthetic. In closing, I consider somaesthetic focus on discomfort as fostering moral imagination and empathy. (shrink)

Bioethics influences public policy, scientific research, and clinical practice. Thinkers in Continental traditions have increasingly contributed scholarship to this field, and their approaches allow new insights and alternative normative guidance. In this essay, examples of the following Continental approaches in bioethics are presented and considered: phenomenology and existentialism; deconstruction; Foucauldian methodologies; and biopolitical analyses. Also highlighted are Continental feminisms and the philosophy of disability. Continental approaches are importantly diverse, but those I focus upon here reveal embedded models of individualized autonomy (...) in medical discourses and encourage awareness of medicine's normalizing edges, thereby drawing attention to lacunae in traditional bioethical frameworks. (shrink)

In this article I investigate the ways in which phenomenology could guide our views on the rights and/or wrongs of abortion. To my knowledge very few phenomenologists have directed their attention toward this issue, although quite a few have strived to better understand and articulate the strongly related themes of pregnancy and birth, most often in the context of feminist philosophy. After introducing the ethical and political contemporary debate concerning abortion, I introduce phenomenology in the context of medicine and the (...) way phenomenologists have understood the human body to be lived and experienced by its owner. I then turn to the issue of pregnancy and discuss how the embryo or foetus could appear for us, particularly from the perspective of the pregnant woman, and what such showing up may mean from an ethical perspective. The way medical technology has changed the experience of pregnancy—for the pregnant woman as well as for the father and/or other close ones—is discussed, particularly the implementation of early obstetric ultra-sound screening and blood tests for Down’s syndrome and other medical defects. I conclude the article by suggesting that phenomenology can help us to negotiate an upper time limit for legal abortion and, also, provide ways to determine what embryo–foetus defects to look for and in which cases these should be looked upon as good reasons for performing an abortion. (shrink)

This paper explores the process of aging from a phenomenological perspective. Supplementing the model of becoming old found in Simone de Beauvoir’s work with a phenomenology of human suffering and flourishing, it asks whether it is possible to lead a good life in the process of becoming old. Is it possible to flourish while experiencing bodily waning? Is it possible to flourish while experiencing the shrinking of one’s everyday world and the passing away of close others? Aging, at least in (...) its protracted phases, appears to become full of suffering rather than flourishing. What are the prospects of finding meaningful life projects despite old age? By making use of insight found in Heidegger and other phenomenologists the paper tries to develop a slightly different view on aging than the one found in Beauvoir, stressing the importance of embodied experiences and life choices, which not only depend upon societal oppression and being objectified by others, but also upon processes of nature and the possibilities of an intergenerational intersubjectivity. Resources for this project is found in the philosophy of affectivity developed by Heidegger and other phenomenologists of facticity, such as Maurice Merleau-Ponty, Charles Taylor, Helmuth Plessner and Hannah Arendt. (shrink)

This paper investigates the question of what an organ is from a phenomenological perspective. Proceeding from the phenomenology of being-in-the-world developed by Heidegger in Being and Time and subsequent works, it compares the being of the organ with the being of the tool. It attempts to display similarities and differences between the embodied nature of the organs and the way tools of the world are handled. It explicates the way tools belong to the totalities of things of the world that (...) are ready to use and the way organs belong to the totality of a bodily being able to be in this very world. In so doing, the paper argues that while the organ is in some respects similar to a bodily tool, this tool is nonetheless different from the tools of the world in being tied to the organism as a whole, which offers the founding ground of the being of the person. However, from a phenomenological point of view, the line between organs and tools cannot simply be drawn by determining what is inside and outside the physiological borders of the organism. We have, from the beginning of history, integrated technological devices (tools) in our being-in-the-world in ways that make them parts of ourselves rather than parts of the world (more organ- than tool-like), and also, more recently, have started to make our organs more tool-like by visualising, moving, manipulating, and controlling them through medical technology. In this paper, Heidegger’s analysis of organ, tool, and world-making is confronted with this development brought about by contemporary medical technology. It is argued that this development has, to a large extent, changed the phenomenology of the organ in making our bodies more similar to machines with parts that have certain functions and that can be exchanged. This development harbours the threat of instrumentalising our bodily being but also the possibility of curing or alleviating suffering brought about by diseases which disturb and destroy the normal functioning of our organs. (shrink)

A large slice of contemporary phenomenology of medicine has been devoted to developing an account of health and illness that proceeds from the first-person perspective when attempting to understand the ill person in contrast and connection to the third-person perspective on his/her diseased body. A proof that this phenomenological account of health and illness, represented by philosophers, such as Drew Leder, Kay Toombs, Havi Carel, Hans-Georg Gadamer, Kevin Aho, and Fredrik Svenaeus, is becoming increasingly influential in philosophy of medicine and (...) medical ethics is the criticism of it that has been voiced in some recent studies. In this article, two such critical contributions, proceeding from radically different premises and backgrounds, are discussed: Jonathan Sholl’s naturalistic critique and Talia Welsh’s Nietzschean critique. The aim is to defend the phenomenological account and clear up misunderstandings about what it amounts to and what we should be able to expect from it. (shrink)

Objectification is a real problem in medicine that can lead to bad medical practice or, in the worst case, dehumanization of the patient. Nevertheless, objectification also plays a major and necessary role in medicine: the patient’s body should be viewed as a biological organism in order to find diseases and be able to cure them. Listening to the patient’s illness story should not be replaced, but, indeed, developed by the physical examination of his body searching for the causes of his (...) complaints. Whereas phenomenologists have so far mainly been identifying the back sides of objectification in medicine, in this paper the aim is to analyze differences between detrimental objectifications and objectifications that do not deprive the patient of his subjectivity but, rather, at least in some cases, may lead the patient to feel more at home with his body. (shrink)