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)

Scientific medicine has been successful by ways of an ever more detailed understanding and mastering of bodily functions and dysfunctions. Biomedical research promises new triumphs, but discontent with medical practice is all around. Since several decades this has been acknowledged and discussed. The philosophical traditions of phenomenology and hermeneutics have been proposed as promising ways to approach medical practice, by ways of a richer understanding of the meaning structures of health and illness. In 2000, Swedish philosopher Fredrik Svenaeus published a (...) book where he proposes that the phenomenological hermeneutics of Martin Heidegger and also the reflections on health and illness of Hans-Georg Gadamer offer important ways to approach the nature of medicine. In particular, Svenaeus argues that the goal of medicine is to promote and restore health, and that health ought to be seen as “homelike being-in-the-world”. Unhealth, illness, consequently should be understood as a situation where a person’s “being-in-the-world” in characterized by that lack of the rhythm, balance and “tune” of everyday living that characterizes not “being at home”. In this article, Svenaeus’ position is briefly outlined. Questions are raised whether “unhomelikeness” is to be seen as a metaphor, and, if so, if it is a fruitful such. Furthermore, I discuss whether or not a discourse on health and illness in these terms may be misleading in a situation where the ontological presuppositions of Heidegger are lost out of sight and the popular understanding of health psychology predominates. I also approach the question whether Svenaeus’ assumptions may inadvertently lead us to an unjustifiably broad understanding of the tasks of medicine. It is finally concluded that Svenaeus phenomenological and hermeneutical approach is both interesting and promising. There are, however, several questions that ought to be pursued further, and the step from philosophical analysis to everyday clinical discourse may be unexpectedly long and risky. (shrink)

In recent years limitations in the biomedical conceptualisation of health and illness have been well documented and a variety of alternative explanations produced to replace or supplement it. One such is Fredrik Svenaeus’s philosophy of medical practice, which is a development of Hans-Georg Gadamer and Martin Heideggers’ phenomenological and hermeneutical writings. This paper explores two texts, a short story by H. G. Wells, The Country of the Blind, and a poem by William Carlos Williams, Danse Russe to add further insight (...) into the ideas proposed by Svenaeus. Both texts were written before either Gadamer or Heidegger published their work. Analysis of the texts reveal examples of Heidegger’s understanding of ‘da-sein’, human-being, as the fundamental of human existence—how we relate to our ‘life-world’—together with its conditions including the tools we use to engage with and the moods that interpret the world. Emerging from this core relationship of being are the phenomena of health and illness, which are conceptualised as home-like (Heimischkeit) and un-home-like (Unheimlichkeit) being-in-the-world. In the texts the sense of home-like (and un-home-like) being is an ontological ‘web of significance’, to use Heidegger’s phrase, that creates, rather than results from a person’s psychological state. One factor that is not fully explicated in the philosophical accounts is the role that behaviour (as the physical-relating of a person) plays as a pre-requisite for agency, the ability to act in taken-for-granted ways. A person’s sense of authenticity, the extent to which someone makes their own choices rather than being led by what ‘others’ say, is linked with their ability to physically engage with and relate to their ‘life-world’. Finally, similarities between the ontological wholeness of poetry—the meaning structure of poetry—and of Dasein are noted. (shrink)

This paper offers a critical response to Fredrik Svenaeus’ use of the Heideggerian uncanny to analyse the experience of illness. It is argued that the uncanny is part of a culture of concepts through which the condition of modernity has been analysed by philosophers, social theorists, writers and artists. All centre upon the idea of alienation, and thus not being at home in the society that should be one’s home. This association will be exploited to offer a reinterpretation of Svenaeus’ (...) thesis as a sociological and political, rather than an ontological, one. By reviewing the work of Hegelian philosophers, Georg Simmel, and novelists, represented by Mann, Camus and McCullers, it will be argued that illness is bound up with social alienation, both as something that is caused by conditions of alienation and as an interpretative response to alienation. Seeing illness as a metaphor of the human condition in modernity allows the medical humanities to inform therapy, that would allow the patient to understand their illness, not as the ontological condition of Dasein, but rather as something mediated by modern social, economic and political conditions. (shrink)