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Illness as Metaphor and AIDS and Its Metaphors
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Listening Length: 4 hours and 37 minutes
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Audible.com Release Date: March 1, 2018
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An important concept is discussed in this book: the idea that diseases come with a set of what Sontag calls metaphors, but what I would term associations, that have little if any relevance to the true nature of the disease. I can think of many current examples of diseases that are freighted with non-medical associations. Addiction is one that comes to mind. Another is the “epidemic†of gun violence, which, like AIDS, is being blamed on a marginal group, the mentally ill. Other less politically fraught include obesity & chronic fatigue syndrome, which, like cancer as discussed in the book, have the metaphorical baggage of somehow being rooted in the character of the sufferer. We would, according to Sontag, be better off with a medical model for these conditions, so that appropriate knowledge about them can be sought & cures secured.
Language is the essential vehicle by which meaning is transferred, and a deep exploration of language can reveal covert meanings lying beneath the overt text. Susan Sontag is one of the US's finest intellectuals, and in these two texts Sontag applies her piercing intellect to the topic of how language is used with respect to illness, how illnesses are used as metaphors and what metaphors typically are associated with an illness. She seeks to remove the mythologizing associated with diseases, mythologizing which almost invariably produces negative results.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.
Fascinating. I had heard of Ms. Sontang over the years, but this is the first time I've ever read one of her works. Siddhartha Mukherjee mentions her a lot in The Emperor of All Maladies, so I thought I'd give it a read. She really knew how to write. Very well-researched work on the history of how society conceptualizes illness.
This is a quote from the book that I would consider its thesis statement: '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.
Excellent writing, illuminating ideas.
she knew roaring and realpolitik
I got this book for class. Sontag is a tough read. That's not an understatement. But she makes great points about how we, as society, stigmatize certain illnesses. I think it is a very eye-opening book, but is so much more effective when this book/essays can be discussed, especially in an academic setting. The four stars is just because I didn't choose to read this book on my own.
Excellent timeless value to ideas about illness
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