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The healing body: Creative responses to illness, ageing and affliction

2024; Wiley; Volume: 30; Issue: 5 Linguagem: Inglês

10.1111/jep.13959

1365-2753

Pat McConville,

Empathy and Medical Education

Drew Leder's new book, The Healing Body, will be most useful for those hoping for help to understand, be deliberate about and harness healing responses to illness. These readers will find a well-paced, approachable description of possible ways of relating to illness, ageing and other trying human circumstances. The book is philosophically robust, so much that it could serve as an introduction to and stepping-off point for more in-depth studies in the phenomenology of health and illness, but is itself untroubled by the need to spell-out exhaustive philosophical demonstrations. The Healing Body completes a trilogy of book-length phenomenological investigations into embodiment. The first in this series, The Absent Body, explored the ways in which a person's own body appears and disappears to them in different states of health.1 Its clear and creative insights make it an exemplar of the use of classical phenomenology for understanding bodily experience. Some of the terms and concepts developed in it, such as dys-appearance, in which a person becomes aware of their body when it fails them in some way, have become touchstones for the subfield known as the phenomenology of health and illness. The series' second book, The Distressed Body, considered how bodies are constrained and distanced from themselves and from society.2 In this book, Leder analysed the experiences of individuals under pressure from illness and institutions. In addition to the personal and social effects of chronic illness, this analysis considered the stresses of incarceration and industrial animal farming. The scope of this book was not, then, the narrow phenomenology of the individual but systemic oppression and opportunities for inclusion. Concluding the trilogy, The Healing Body ranges in scale from individual suffering to systemic injustice, within and across three separate parts. More than its predecessors—and most other work in the field—the emphasis of this book is on health, rather than merely characterising illness. In the first and main part, Leder maps out what he calls a chessboard of 'Twenty Healing Strategies', which might be adopted by those suffering from illness. These 20 strategies are based initially in five phenomenological features of embodiment, such as how one may or may not identify with the body, or the temporality of embodiment. Each of these features corresponds to a possible healing orientation, and from each of these derives four different healing strategies. Each strategy offers both healing benefits and a shadow-side (an online chessboard is available on Leder's website: https://www.drewleder.com/chessboard-of-healing). One example is the strategy of 'refusing' illness, which relates to the feature of embodiment Leder calls 'I have (a body)' and the healing orientation of 'escaping the body'. Leder invokes the polio survivor and virtuoso Itzhak Perlman's refusal to know that it was not possible to play a symphonic work with a broken, three-stringed violin; and the military veteran Dawn Halfaker's refusal to be limited by her war wounds. Leder illustrates the shadow-side of refusal with his own premature attempt to return to normal activities, exacerbating post-Covid fatigue. A chessboard may be an imprecise analogy for the categorisation of these strategies but it and the priming questions Leder offers at the very start of the book are designed less for exactness and more for framing the book in a useful way. Leder's explicit goal is for The Healing Body to be a 'workbook for active healing', rather than an academic text of phenomenological research. Aiming at making a philosophical contribution as well as serving as a self-help guide risks delivering on neither. If the book leans more heavily in one direction than the other, it is towards the lay reader hoping to better understand and cope with illness and approach healing in a conscientious and constructive way. To this end, Leder's text succeeds at being accessible, down to earth and peppered with engaging and relatable anecdotes demonstrating the strategies he discusses. Alongside published illness narratives and literary works, Leder describes and unpacks the experiences of colleagues, friends and himself. The result is both colourful and compelling. On the other hand, or what Leder might call the shadow-side, the philosophical expositions of these healing strategies are not deeply developed. This is not to say that they are ungrounded in philosophy. Leder writes with the expertise and erudition of a scholar of the classical phenomenological canon. He calls on a wide range of phenomenological, philosophical and sometimes medical and sociological research with ease and authority. Importantly, he is sensitive to developments in contemporary and critical phenomenology. These perspectives enable him to incorporate sociohistorical conditions in his analysis, especially considerations of racism, sexism, capitalism and ageism. Aging, in fact, constitutes a minor theme of the book and one chapter is dedicated to the rehabilitation, or 're-possibilization', of elder life. But ultimately, his claims about features of embodiment, healing orientations and healing strategies are presented pragmatically, rather than being rigorously worked out from philosophical first principles. This is a feature of the book, not a bug. At one point, Leder expresses a hope that his sketches of these strategies will open possibilities for future research programmes. This hope seems well placed, and I can well imagine interest from scholars in pursuing these incipient threads. As a learning resource, the book offers an impressive introduction to a huge range of ideas and applications of the phenomenology of health and illness, including for those thinking philosophically about health for the first time. The catalogue of healing strategies accounts for a little under half the book. The remainder is divided into two parts. The second part, 'The Marginalized Body', contains two chapters focused explicitly on embodied injustice. In the first chapter, Leder draws on the aforementioned critical literatures as well as his own experience working with incarcerated people. He highlights the resonances between chronic illness and 'doing time'. The next chapter describes ageing in terms of bodily, temporal and worldly changes, and sets out four contrasting archetypes of possible ageing. This part does well to underscore the book's general point about healing attitudes towards challenging situations. However, it is also a somewhat partial survey of ideas Leder has developed more fully elsewhere. It can read as a pointer towards them, and an interlude in this book. The third part, 'The Inside-Out Body', shifts the focus from engagement with the world to more introspective and, indeed, interoceptive concerns. Its first chapter is on internal, visceral and autonomic being. Leder previously labelled this the recessive body and argued that it is, largely, perceptually absent.1 Here, in line with increasing research on interoception, Leder promotes the interior as offering important insights. He notes, perhaps critically, that we are culturally predisposed to 'interoceptive bypassing'. Despite this recalibration, Leder does not fundamentally alter his earlier view of the paucity of interoceptive sensation. On similar subject matter, the next chapter considers breath as a hinge between conscious and unconscious embodiment. This topic, too, is responsive to growth in studies of respiratory phenomenology in the literature, such as Carel3 and Škof and Berndtson.4 This chapter also reveals a motivation which underlies the book: the blending of spiritual attitudes and practices with medical and physiological facts. Although traditionally non-Western customs, such as meditation and yoga, feature throughout the book, they become prominent in this chapter. This attempt at uniting the healing insights of Euro-American phenomenology and Eastern practices culminates in the final chapter. At its start, Leder foreshadows that this is the book's most philosophically technical and spiritually expansive—even mystical—chapter. In it, he considers 'the duality of two forms of non-dualism', examining embodied phenomenology alongside Advaitic approaches which decentre the body. These parallel studies converge at the chapter's eponymous concept, the transparent body, which Leder seeks to introduce into phenomenological ways of thinking. Leder is clear that he is less concerned with persuading sceptics of the ultimate truth of this concept than with exploring the terrain and sympathies of these two traditions. I admit to being one of the sceptics. I was not convinced that the transparent body, which may have aspired to being the most original contribution of the book, is sufficiently well developed to be of lasting use to patients or thinkers in either tradition. This attempt to reconcile two traditions is both sincere and erudite, but I am not sure that it transcends the trope of using non-Western thought for self-help.5 But I am also not sure that this is a problem for a book which, first and foremost, offers a variety of ways into healing. Open access publishing facilitated by Deakin University, as part of the Wiley - Deakin University agreement via the Council of Australian University Librarians. The author declares no conflict of interest. Data sharing not applicable to this article as no data sets were generated or analysed during the current study.