Abstract
This article studies the phenomenology of chronic illness in light of phenomenology’s insights into ecstatic temporality and freedom. It shows how a chronic illness can, in lived experience, manifest itself as a disturbance of our usual relation to ecstatic temporality and thence as a disturbance of freedom. This suggests that ecstatic temporality is related to another sort of time—“provisional time”—that is in turn rooted in the body. The article draws on Merleau-Ponty’s Phenomenology of Perception and Heidegger’s Being and Time, shedding light on the latter’s concept of ecstatic temporality. It also discusses implications for self-management of chronic illness, especially in children.
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Notes
On the aims, strategies, and contributions of this article with respect to health issues, first compare Toombs 1990, pp. 227–228, for the point that Western medicine has, since the “rise of pathological anatomy,” conceptualized disease as a thing spatially located in the body, whereas phenomenology returns us to the patient’s lived experience of illness by also paying attention to the illness’s temporality. [Also see Toombs (1992) and the remarks on time and illness in Corbin (2003).]
Toombs works within Husserl’s phenomenological framework to give nuanced and important descriptions of illness and disease as temporally rather than spatially constituted objects. I contribute a discussion of temporality as linked with freedom, and of the relation between bodily processes and ecstatic temporality.
Also see Wild (2003, p. 171), who observes that “People with illnesses and injuries hold taken-for-granted knowledge that can be used to develop and test nursing interventions. Uncovering this knowledge from people’s unconscious awareness is necessary because people cannot ordinarily discuss what is taken for granted, and researchers may not know what questions to ask because the knowledge to form questions is missing. Phenomenological methods can promote access to this embodied knowledge of people living with chronic illness and injury.” But part of what is ‘unconscious’ and what prevents us from asking the right questions are inherited conceptual frameworks—such as the linear conception of time—that we take for granted in the natural attitude. In other words, access to embodied knowledge is not enough, for we also need to interrogate traditional conceptual frameworks. But of course embodied knowledge can help on this head. The aim here is to have phenomenological analysis and embodied knowledge enlighten one another.
References will be given using the page numbers of the German edition, which are provided in the margin of this edition.
The methodological point that our usual thinking activity might be biased is at the heart of Bergson (1991). It is hard to read the Phenomenology of Perception without thinking that this point and Bergson’s style of philosophizing influence its strategy.
This point is complicated by the fact that experiments and illusions are usually produced by us in light of at least hypothetically endorsed theoretical frameworks. So these require further conceptual analysis to ensure that what we learn from the disturbance is no mere artefact of the theory. Merleau-Ponty is expert in this procedure. But we also need to free ourselves of our usual frameworks in trying to read illnesses in their own terms.
See, e.g., Kelly (2002), which surveys some criticisms of Merleau-Ponty’s analysis whilst supporting Merleau-Ponty by arguing that his position fits with evidence from current neurological results (which latter Merleau-Ponty, I think, would subject to further analysis).
It must be emphasized that Merleau-Ponty turns to Schneider’s case to gain insight into the existential structures underlying the range of human existence. Merleau-Ponty urges that “Illness…is a complete form of existence” (1962, p. 107; 2002, p. 123). His study does not aim to describe Schneider’s experience as a curiosity or deviation from a norm that is to be valorized, but rather to see how Schneider’s variation on existence, seriously described in its own terms, stretches ‘the’ norm of existence, whilst giving insight into its underlying invariant structure.
This point echoes Heidegger’s distinction between “state-of-mind” (Befindlichkeit) and mood (Stimmung), versus understanding (Verstand). As being in a mood, we are in the sway of a world that appears wholly this way or that, for example, as gloomy. As understanding, we grasp the world in terms of our own possibilities, we are our “own potentiality-for-Being” (see 1962, pp. 134–145). Schneider does not wholly understand his world, he is in its sway. Cf. the language of reckoning with the possible (Merleau-Ponty 1962, p. 109; 2002, p. 125), but note that there are good reasons to think that Being and Time only comes to influence the Phenomenology of Perception in the writing of the temporality chapter; see Geraets (1971).
I use the term “the chronic” first of all to contract the cumbersome locution “person living with chronic illness,” but also, in this word-choice, to anticipate and emphasize the point (developed below) that the experience of a certain kind of time (chronos) is central for the person living with chronic illness. The term might suggest a kind of essentialization that reduces the chronic to her or his chronic illness. But the term is being used in a descriptive, versus essentializing or valuative way. The intention is precisely to indicate that the person in question is thrust into a different relation with time, which relation, however, does not yet essentially define them. The mariner cast upon the waves (versus the land-dweller) has to deal with the sea, but different mariners do so in different ways; so too the chronic (versus those who are free of chronic illness) must, for the most part, deal with a different sort of time (chronos)—yet different chronics can deal with this time in different ways.
Here I adapt Heidegger’s usage of “falling” and so on; see Heidegger 1962, pp. 175–180. Crucially, this falling is always a “falling away from”—it retains a relation to that from which it is falling away. The thought here is that chronic disturbances could never completely dislodge us from ecstatic temporality.
That is, ontologically accused of being all and only X, cf. Heidegger 1962, pp. 44–45.
Strictly adhering to the ontological dimension of Heidegger’s project would require, in this and the following passages, speaking of Dasein (of a kind of ontology) rather than speaking of “I,” “one,” or “my.” But this way of speaking would make Heidegger’s point more difficult than necessary for our purposes, and obscure the important implications for thinking about the phenomena.
See Heidegger 1962, p. 240: “By its very essence, death is in every case mine, in so far as it ‘is’ at all. And indeed death signifies a peculiar possibility-of-Being in which the very Being of one’s own Dasein is an issue.” These claims about death clearly echo Heidegger’s initial ontological formula for Dasein as being its ownmost possibility and as being in each case mine (1962, pp. 42–44).
The account of ecstatic temporality given below draws on Russon (2008) and Kukla (2002) which give lucid discussions of the temporal issues at stake in (respectively) anticipatory resoluteness and conscience. Dahlstrom (1995) gives a very helpful survey of the literature on this topic in Heidegger, in the course of defending Heidegger’s position.
See footnote 7.
To use Heidegger’s technical terminology, in which resoluteness is kin to Socratic courage.
This strategy of discussing anticipatory resoluteness in terms of answering questions is drawn from Russon (2008). The Socratic example and the points about improvisation are my improvisations on this theme.
In Plato’s Phaedrus, a beginning question as to where Phaedrus is going and coming from turns into the point that learning and reading cannot depend on already provided scripts.
See Kukla (2002) for an analysis of the temporality of conscience.
See Malabou (2005) for an extended discussion of this theme via Derrida, Heidegger and Hegel.
This need is of course paradoxical in the context of freedom.
Conceptualizing the relation between ecstatic temporality and provisional time in relation to the body, or discussing the role of the body in Heidegger’s discussion, would take a separate article, at least.
See Russon (2003) for the point about “companion” and further connections between eating, the social, and establishing the sense of human projects, and Ciavatta (2003) for the point that in the family setting food becomes a site of socially mediated meanings. Also see Levi-Strauss’s classic observations about the relation between food and the social.
As noted above, there are objective ranges for levels that are too high. There are also objective standards for the too low, but these are not ranged. Below 3.9 is low, and below 3.3 is getting into a danger zone.
Thanks to the anonymous reviewer for pointing this out.
If left entirely untreated, the diabetic body enters interlockingly vicious cycles. Not enough glucose gets into the muscle and brain, but the body needs energy, so the diabetic craves and slurps up glucose, and pumps out excess insulin to take it up, to no avail; the excess glucose together with insulin instead convert into fat, which increases insulin resistance, making the body even worse at using what insulin it has got; more glucose is craved, blood glucose levels go up, and, chillingly, this is toxic for insulin producing cells; increased insulin resistance thus spirals into decreased insulin production, making the whole situation worse; glucose becomes a toxin, and parts of the body start working on their own to get rid of it, passing it off in urine, sweat, tears. But the body still needs energy to move. So it starts digesting itself (ketoacidosis), muscle feeding on muscle. What was a living whole with an overall temporal cycle that worked through alimentary interaction with the world, is now an internal war, an Empodeclian free-for-all in which the body becomes its own aliment.
My thanks to Jehangir Saleh for his insightful and thoughtful description of this phenomenon.
My thanks to Tessa Reed for discussing this dream with me.
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Acknowledgements
Versions of parts of this paper were presented at the International Conference of the Merleau-Ponty Circle: Body and Institution, George Mason University, October 2006 and Health Studies Day 2007, Trent University. I would like to thank audience members for their questions and enthusiasm. I would also like to thank Emilia Angelova and the anonymous reviewers at Human Studies for helpful criticisms of earlier versions of this paper.
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Morris, D. Diabetes, Chronic Illness and the Bodily Roots of Ecstatic Temporality. Hum Stud 31, 399–421 (2008). https://doi.org/10.1007/s10746-008-9104-y
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DOI: https://doi.org/10.1007/s10746-008-9104-y