Sick Societies and Being Stuck in the "Metabolic Ghetto"

Neoliberal societies often put the onus of blame on the individual. It’s the individual’s fault they have diabetes, cardiovascular disease, obesity, and hypertension. Their diets are too high in the “bad fats”, they contain too much sugar, and too much grease. It’s their fault they’re obese and diabetic and have heart problems, right?

Well, in short – no.   A group of articles I’ve recently read emphasized the role of structural inequities in the prevalence of metabolic syndromes and chronic diseases (i.e. cardiovascular disease and diabetes) among marginalized populations and populations affected by imperialism (Kuzawa and Quinn 2009; Wells 2010). They demonstrated that structural inequities have profoundly impacted the health statuses of racialized groups through several generations, casting these groups in the “metabolic ghetto” (Wells 2010). Moreover, they all studied how one’s fetal environment could predict the health outcome of the resulting adult, arguing that an infant’s birth weight, as a proxy of the fetal environment, alongside a mother’s nutritional health could provide insight into whether the infant will experience a myriad of adult chronic diseases. However, while these racialized and marginalized groups fancy an exit from a lifetime of chronic disease and the management that comes with it, they are warned that too rapid an exit from the metabolic ghetto could lead to further health problems. So, where does that leave them? Are there missing pieces to the puzzle? Are birth weight and the mother’s nutritional status and overall maternal capital the only variables pertinent to predicting an infant’s susceptibility to adult chronic diseases?

Matthew Gillman, a physician and Professor and Director of the Obesity Prevention Program in the Department of Population Medicine at Harvard’s Pilgrim Health Care Institute, argues that there are several epidemiological challenges in studying the fetal origins of adult chronic disease. He maintains that while fetal life is an important “bottleneck” of development, it’s certainly not the only pertinent one in determining the susceptibility to adult chronic disease (Gillman 2002:294). Alternatively, he suggests that studies would benefit from having multiple measures of height and weight through the individual’s lifecourse, to distinguish prenatal influences from influences occurring at various points in infancy, childhood, and later (Gillman 2002:295). Gillman also argues that fetal growth and size at birth are not synonymous, as fetal size at birth is only a snapshot of the trajectory of fetal growth throughout gestation (2002:296). He maintains, “To what extent gestational age predicts adult outcomes is an unresolved question, but an important one. In general, determinants of preterm birth and fetal growth are not the same” (Gillman 2002:296). Finally, Gillman maintains that, “to make policy recommendations now regarding fetal programming is dangerous” (2002:298). He argues that as developing countries undergoing epidemiological transition from infectious disease to chronic disease, successive generations of individuals are likely to have even larger proportions of cardiovascular disease, type 2 diabetes, obesity, and hypertension. Moreover, this is heightened through the ‘nutrition’ transition from an active, low-calorie lifestyle to a sedentary, high-calorie lifestyle; thus, Gillman argues that it is premature to make policy recommendations regarding fetal programming, since birth weight is only a  marker for underlying aetiological or causal pathways, the true aetiological factors are still unknown (2002:298). Until they are identified, it is impossible to calculate the attributable risks or design interventions to modify them (Gillman 2002:298).

So, while Wells suggests that public health initiatives should target “multiple interventions through the transducing medium of maternal capital” (2010:13), Gillman maintains that these initiatives should “hold off” until the link between fetal origins and adult chronic diseases is more clearly understood – understandably so. Meanwhile, the biomedical paradigm of prevention is well underway, telling individuals to be #motivated, by encouraging them to #eatclean, #traindirty, #pushthepace, and #dominate. Unfortunately, not everyone necessarily has the means to do this – specifically, those marginalized populations. For those individuals in today’s neoliberal society looking to manage their diabetes, control their weight, or control their cholesterol to be a “good” and “healthy” citizen, eating “clean” and healthy comes with a price, whereas McDonald’s adds new items to their value meals and mails out coupons once a month. Moreover, these individuals are told that their lifestyles contributed to their chronic diseases; which, may be true. However, larger structural inequalities causing intergenerational health inequities may be the real aetiological pathways of adult chronic disease. It’s a classic case of what Arthur Kleinman calls, “social suffering” – if we find a treatment for society, we find a treatment for inequalities.

Boxers and DNRs: Exclusivity and Agentive Embodiment

  Nancy Scheper-Hughes and Margaret Lock have suggested the power of emotions to bridge their three conceptualizations of the body: the individual body, the social body, and the body politic. They argue,  “Emotions affect the way in which the body, illness, and pain are experienced and are projected to images of the well or poorly functioning social body and body politic” (Scheper-Hughes and Lock 1987:28). Because emotions have the ability to affect and to permeate across all three body conceptualizations, Scheper-Hughes and Lock (1987) maintain, “they provide an important ‘missing link’ capable of bridging mind and body, individual, society, and body politic” (29). By asserting that emotion is the “mediatrix of the three bodies” and given the ontology of the three bodies, they draw specific attention to the ways in which experiences of the body are simultaneously thought and sensed, as well as how they have both a social, moral, and cultural dimension. However, due to the lack of vocabulary, tools, and concepts to address, what they call “the mindful body”, medical anthropologists at the time were restricted to studying the mindful body in terms of intensified pleasure and pain.

           Fast-forwarding almost three decades later, anthropologists have begun to ask different questions and in asking these different questions, they have arrived at different answers. Instead of conceptualizing the body as a “thing-like” object, anthropologists began to more thoroughly conceptualize the body as process; essentially, in changing their conceptual framework, the ontology of the body changed from “thing-like” to process. This shift in ontology allowed anthropologists to gain access to a more nuanced vocabulary, tools, and concepts to address “the mindful body” in terms of embodiment. This response paper will concentrate on embodiment in terms of the papers by Loïc Wacquant and Carolyn Rouse.

           Loïc Wacquant, Professor of Sociology and Research Associate at the Institute for Legal Research, Boalt Law School at the University of California, Berkeley, focuses his attention to the “diverse ways in which specific social worlds invest, shape, and deploy human bodies and to the concrete incorporating practices whereby their social structures are effectively embodied by the agents who partake them” (1995:65). In his paper, “Pugs at Work: Bodily Capital and Bodily Labour among Professional Boxers”, Wacquant explores how professional boxers – most of whom are “embedded in a social setting that puts a high premium on physical force and prowess” (1995:65) – conceive of, care for, and rationalize their body as a form of capital. He applies Bourdieu’s (1986:241) definition of capital to his analysis: “accumulated labour (in its materialized form or its ‘incorporated’, embodied form) which, when appropriated on a private, i.e., exclusive basis by agents or groups of agents, enables them to appropriate social energy in the form of reified or living labour”. Complicated at best, Bourdieu’s definition of capital extends beyond the notion of material assets and argues that capital can also be social, cultural, or even symbolic. Nonetheless, Wacquant conceives boxers are holders of and even entrepreneurs in bodily capital (1995:66), in that their bodies are simultaneously a means of production – the raw materials he and his handlers have to work with and on – and for a good part, a somatized product of his past training and extant mode of living (1995:67). Boxers, or pugilists, are constantly working on their bodies, improving their bodies, toning their bodies, and pushing their bodies to perfection. However, “much like fixed capital and like all living organisms, the body of fighters has inherent structural limitations” (Wacqaunt 1995:67). Here, Bourdieu’s influence on Wacqaunt becomes quite obvious. The inherent structural limitations the body of fighters are subject to, demonstrate how pugilists’ bodies become deposited in a form of lasting dispositions or trained capacities and structured inclinations or propensities to think, feel, and act in certain determinant ways (Wacquant 1995). Applying Bourdieu’s ideas, Wacquant would maintain that boxers do not simply train, discipline, and improve their bodies because they “want to win”; rather, boxers partake in these bodily endeavours because the structure of amateur and professional boxing - and even the larger societal habitus of professional athletes capitalizing their strength, determination, and bodily physique – deposits, determines, and guides aspiring and professional pugilists to the “want to win”. However, Wacqaunt maintains otherwise; instead, Wacquant nuances Bourdieu’s “would-be” argument, by arguing that pugilists participate in this extensive and rigorous training of the bodies to become a form of capital, because of the “unconscious fit between his (pugilistic) habitus and the very field which has produced it and into which, therefore, it fits ‘like a hand in a glove’ (Wacquant 1995:88). The interplay between the individual and the field demonstrates how pugilists, in a sense, embody their social, cultural, and symbolic surroundings, as “The boxer’s desire to fight flows from a practical belief constituted in and by the immediate co-presence of, and mutual understanding between his (re)socialized body and the game” (Wacqant 1995:88). Essentially, Wacquant is arguing that the boxer becomes embodied or inhabited by the very game he/she embodies or inhabits (1995). However, what happens when the individual is unable to embody his or her dispositions? What happens when the desire to fight is unexpressed by the individual and is, instead, transferred to other individuals around them? How do those individuals embody the desire to fight?

           Carolyn Rouse, Professor of Anthropology at Princeton University, wrote an incredibly moving and heartwarming article on how two determined parents constructed cultural metaphors to effectively reach out to the medical professionals who were against continuing their daughter, Jasperlynn, on life support. Rouse documents how Jasperlynn’s parents controlled their embodied dispositions and how those dispositions were read by medical professionals, and how they attempted to author their subjectivity “by first specifying the sign value of particular objects and then associating themselves with those signs” (Rouse 2004:514). She introduces this process of embedding oneself in a meaningful array of symbols “embodiment-by-proxy”, which she maintains, she uses proxy to denote how objects, or what she calls “translational symbols”, are used to signify the subjectivity of someone other than self (Rouse 2004:522).  With this, she describes how Jasperlynn’s parents were more concerned about the presentation of their children and how their children’s subjectivity was read when they were with themselves (Rouse 2004:522), Jasperlynn’s parents believed that the medical professionals would read their subjectivity through their children. For instance, they represented Jasperlynn’s meaning and value, in particular, by dressing her up and combing her hair, by placing a Bible on or near her bed, and by ascribing meaning to her gestures. Applying Rouse’s concept of “embodiment-by-proxy”, Jasperlynn’s parents, by representing their unconscious daughter in this way, they are attempting to essentially, “bring life back” into Jasperlynn, by replacing Jasperlynn’s lack of inner subjectivity with material and symbolic subjectivity. As Rouse maintains, “The Washingtons were put in a situation of having to prove the value and meaning of Jasperlynn’s life so that the hospital staff would continue to invest emotional and material resources in the continued care of their daughter” (1995:524). The Washington’s struggle to reify the subjectivity of Jasperlynn and their struggle to make her body meaningful to medical professionals demonstrates Rouse’s concept of “embodiment-by-proxy”, as it shifts the focus away from the structural determinants of subjectivity and shifts the focus towards how the Washingtons situated themselves relationally to others symbolically and discursively in their struggles of bringing life, subjectivity, and meaning into Jasperlynn’s body. Moreover, the Washingtons’ struggles were only amplified by their marginalized social situation. Rouse notes, “For marginalized individuals whose presumed subjectivity is mired in tropes of inferiority, attempting to author semiotic ideologies for purposes of social agency is part of a communicative battle” (1995:515). For marginalized individuals, navigating one’s mindful body through the “violences of everyday life” is already troubling; therefore, navigating one’s marginalized, “inferior”, and un-mindful body through the violences and the bullying of the biomedical system is more horrifying than can be described. The battle between the biomedical system and the Washingtons’ demonstrated how both parties used “embodiment-by-proxy” to change the others’ dispositions towards Jasperlynn – while the Washingtons’ used it to prove Jasperlynn’s subjectivity and bodily meaning, the medical professionals used it to continually assert that Jasperlynn’s body lacked life, subjectivity, and meaning. The disposition of most the medical professionals involved with Jasperlynn was that she was essentially dead and that the Washingtons’ decision to not sign the DNR was both “irresponsible and selfish”. Nonetheless, the efforts of the medical professionals to effectively bully the Washingtons with complicated medical vernacular and guilt, were futile, as the Washingtons remained relentless in their efforts to change the medical professionals’ attitudes towards the very real subjectivity Jasperlynn still maintained. Essentially, Rouse states, “Embodiment-by-proxy describes how people reanimate themselves in other by locating through signification they cultural relevance and agency” (1995:527). The parents of Jasperlynn were able to reanimate themselves in Jasperlynn through their deep commitment to God and family, effectively transforming medicine’s object to include the family (Rouse 1995).

           Wacquant’s article describes how a boxer’s embodiment is through practice and discipline – how their desire to fight is constituted within the game or fight itself – therefore, demonstrating the role of individual agency in embodiment. Rouse’s article serves as a sharp contrast to Wacqaunt’s implication, as in the case of marginalized bodies, these bodies often have little to no agency; that is, their agency is restricted by structural limitations. Wacquant and arguably, Bourdieu’s conceptualization of embodiment seems to integrate the concept of agency quite thoroughly, in that subjects have the agentive power to develop specific tendencies or dispositions. Can this conceptualization of embodiment be applied to all individuals? What happens when marginalized individual come to embody their sense of restricted agency – that is, will they begin to accept their socially perceived inferiority?

           It seems to me that if we accept Wacquant’s conceptualization of embodiment, the bodies and subjectivities of marginalized individuals will forever be stigmatized as “inferior” and, in time, will come to embody that inferiority. When or if marginalized individuals embody that inferiority, the structural inequities will only become heightened and more problematic in a neoliberal society, which will naturally have severe social, political, economic, and health consequences. There needs to be an alternative conceptualization of embodiment that can be applied to more accurately fit the dispositions of marginalized individuals, where the desire to fight is not synonymous to the desire to survive.

Three Bodies, No Soul

 In the 1980’s, a number of articles containing conceptualizations of the body were circulating. These conceptualizations of what the body was, what the body did, and what the body represented set the context of Nancy Scheper-Hughes’ and Margaret Lock’s 1987 essay, The Mindful Body: A Prolegomenon to Future Work in Medical Anthropology. In this prolegomenon, the authors pull together all of the existing literature of the body in the 1980’s and argued that there were actually three bodies – the individual body, the social body, and the body politic – therefore, setting the stage for future anthropological work to further study and theorize the body. Scheper-Hughes and Lock (1987) argue that the “first and perhaps most self-evident level is the individual body, understood in the phenomenological sense of the lived experience of the body-self” (7). In other words, the first body – the individual body – is the site of the self; that is, it is the experience everyone has in their individual bodies. It is the “I” centred experiences of the body; therefore implicating that the “I” in the body is a cultural construction. The social body, according to Scheper-Hughes and Lock (1987) refers to the “representational uses of the body as a natural symbol with which to think about nature, society, and culture” (7). Essentially, the social body is a symbol that is shaped through dominant social ideologies and hegemonies and therefore, reflects and expresses the core social values of the society in which the body is situated. Finally, Scheper-Hughes and Lock (1987) maintain that the body politic refers to the “regulation, surveillance, and control of bodies (individual and collective) in reproduction and sexuality, in work and in leisure, in sickness and other forms od deviance and human difference” (7-8). Influenced by Foucault, the body politic stems from Foucault’s notion of biopower, in which the exercise of ‘control’ or the manifestation of governance or even the action of discourse, shapes bodies and produces new forms of practice and new kinds of social relationships. The execution of biopower in relation the body politic is seen through governmental laws regarding reproduction and information collected from the population through the census, as the “stability of the body politic rests on its ability to regulate populations (the social body) and to discipline individual bodies” (Scheper-Hughes and Lock 1987:8). These three bodies are representative not only of three separate and overlapping units of analysis, but also three different theoretical approaches and epistemologies: phenomenology, structuralism and symbolism, and post-structuralism (Scheper-Hughes and Lock 1987). Nonetheless, while all three bodies are important to analyze, this reflection will focus on the social body and it’s symbolic theoretical and epistemological approach, as seen in the articles by Taylor (1988), Turner (1957), Yafeh (2007), and Wade (2011).

           Mary Douglas symbolically analyzed the social body. Douglas maintained that the individual internalized social facts through the body and argued, “Just as it is true that everything symbolizes the body, so it is equally true that the body symbolizes everything else” (1966:122). It follows, then, that the experiences of the body are representations and expressions of the society in which the body is situated. In Taylor’s (1988) ethnographic study of the concept of flow in Rwandan popular medicine, he found that Rwandan popular medicine was ontologically Aristotelian, in that the body was comprised of humors. More specifically, Taylor (1988) found that the humoral flow of bodily fluids was symbolic of Rwandan beliefs, practices, and culture, and concern issues related to social and biological reproduction. According to Taylor, “Liquids figure prominently in this symbolism for they mediate between physiological, sociological, and cosomological notions of causality” (Taylor 1988:1343). For instance, women who were unable to produce breast milk were biologically and socially diagnosed as “blocked beings”, as their inability to produce breast milk was caused by a blockage of flow, which in turn, represented them as a socially “defect” being. Another example Taylor (1988) found was that socially perceived “mad” people, were supposedly biologically understood to have a lack of saliva and therefore, dry mouths. What these two examples demonstrate is that any lack of humoral flow meant a lack of Rwandan normalcy. More importantly, in the gift economy of Rwanda, the lack of liquid humoral flow between a woman and her child in the form of breast milk meant that an exchange could not occur. Taylor argues that this liquid exchange is not simply something material; instead, it is symbolic of Rwandan culture, tradition, and social practices. A “blocked being” is therefore defunct not only in terms of being able to transmit the material liquid (i.e. breast milk), but also in terms of not being able to transmit Rwandan culture and meaning. The body of a “blocked being” in Rwanda is biologically, physiologically, and socially unable to symbolize society and instead, becomes a symbol of “defect”.

           Similarly, in Turner’s (1957) ethnographic study of symbols in Ndembu ritual, he found that the milk tree was a polyvalent symbol in Ndembu society. For some informants, the milk tree symbolized a woman’s womb, whereas for other informants, when discussing the milk tree symbolism in the context of the girls’ puberty ritual, they tended to stress the “harmonizing, cohesive aspects of the milk tree symbolism”, as well as the aspect of dependence (71). Turner explained, “The child depends on its mother for nutriment; similarly, say the Ndembu, the tribesman drinks from the breasts of tribal custom. Thus, nourishment and learning are equated in the meaning content of the milk tree” (71). From all of these polyvalent meanings of the symbol of the milk tree, Turner maintains that all of these meanings reflect the principles and values of social organization, as well as a woman’s relationship to her body. Women’s bodies become a site for Ndembu social inscription, akin to how children’s bodies become a site for gender inscription, as in Yafeh’s (2007) ethnographic study on the cultural construction of femininity in kindergarten girls.

           Yafeh (2007) maintains, “The child’s body is not static, it changes incessantly, and therefore it plays a crucial role in children’s lives and in their experience of themselves” (517). Much like Douglas’ views on how individuals internalize social facts through their bodies, Yafeh further argues that children’s bodies specifically, internalize socio-culturally constructed gender norms through their bodies. However, where Yafeh’s argument gets interesting, is when she sats, “Haredi girls embody a unique concept of time reflecting the importance attributed in their culture to reliving the past as a formative experience of both present and future identities” (Yafeh 2007:520). The Jewish concept of time, according to Yafeh (2007), “becomes a marker of cultural affiliation and female identity through an active enactment of the girls’ past, present, and future bodies” (520). In other words, Yafeh maintains that kindergarten Haredi girls are taught to embody a past ideal, modest feminine body in their ultraorthodox Jewish religion and are then expected to reproduce that body in their future adolescent and adult lives. The hegemonic ideal of Haredi femininity, as implied by Yafeh, is something durable – static, almost – and most importantly, something both teachable and attainable to and for young girls to reproduce. Obviously influenced by Mauss’ “Techniques of the Body” and Bourdieu’s concept of habitus, Yafeh’s description and argument of the type of femininity that young Haredi girls are taught and expected to embody and reproduce is something socio-culturally constructed and endemic to that society, where this type of femininity is “constituted along a continuum of past, present, and future female identities” (542). For Yafeh, the body – specifically, young girls’ bodies – is a “symbol (and concrete) bridge between past and future identities” (543). While very interesting, Yafeh’s argument about time and femininity being static in Jewish tradition fails to recognize the dynamism of social life and leaves hardly any room for any sort of social change in perspectives of femininity or perspectives on religion. Many critics of Bourdieu’s notion of habitus use this same argument, as Bourdieu maintained that habitus is something that is durable and long lasting; habitus can be described as dispositions or tendencies, which draw upon past experiences that shape present behaviour, perceptions, actions, interpretations in the present moment and have a tendency to be reproduced – much like the hegemonic ideal of femininity in Yafeh’s ethnographic study.

           Wade’s (2011) study almost speaks directly to both my critique of Yafeh’s article, as well as to general criticisms of Bourdieu’s notion of habitus. In Wade’s (2011) ethnographic study of the more malleable habitus of Lindy hop dancers, she addresses the criticisms of Bourdieu’s habitus as being “deterministic”, and responds by arguing that habitus is instead, determining; thus, allowing for social change. She argues that there are two lines of thought on this: (1) Habitus can the target of conscious manipulation; and (2) Reconceptualization of the social structure which is said to embody the habitus. To clarify (1), Wade argues that we are aware of our body habits and are able to consciously change our body habitus, much like her Lindy hop dancers. To clarify (2), because habitus is structure dependent, a reconceptualization of the social structure itself can give rise to various forms of habitus, as she nicely states, “If a society is understood to be monolithic, then the habitus will be as well” (Wade 2011:226). Wade maintains that because not many people have focused on “habitual inertia”, there has been little empirical evidence on the potential of habitus to permit social change. She argues that her research on lindy hop dancers subverts the notion that habitus often works against the “out-of-place individual”, and instead, “the same phenomenon can also be seen as an opportunity to diversify their bodily tools” (Wade 2011:227).

           Interestingly, this article allowed me to observe some important parallels between Bourdieu’s notion of habitus and Foucault’s concept of discourse, as both have been argued to limit the agency of the individual and limit the space of social change. For Bourdieu, social structure creates habitus, which is durable and has a tendency to be reproduced through individual bodies. For Foucault, discourse creates subjects, which are then trained to reproduce, enact, and adhere to the discourse, in order to remain within the boundaries of the discourse and to not be labeled as “deviants”. These subjects created by Foucault’s discourse are trained to be docile; that is, compliant, through panoptical surveillance and through the pervasive and pleasurable “rules” of the discourse. Foucault’s concept of discourse seems to mirror Bourdieu’s construction of social structure. If the discourse is the social structure, then the pervasive and pleasurable “rules” of the discourse could arguably be described as Bourdieu’s habitus, as both the rules of the discourse and Bourdieu’s habitus are durable, long-lasting, have a tendency to be reproduced, and as Wade (2011) noted, work against the “out-of-place individual” – the non-docile body that is situated outside of the discourse. This observation leads me to the question, if Yafeh and Wade used a Foucauldian theoretical approach to their conceptualizations of both childrens’ and dancers’ bodies, would they have argued differently? What would Yafeh have said about those bodies who were “unteachable” and who failed to fit within the discourse of ultraorthodox Jewish religion? How would Wade talk about her lindy-hop dancers? Would she reach the same conclusions? Moreover, what would the bodies of those unteachable, “deviant”, and “blocked-being” children and Lindy-hop dancers be symbolizing about their respective societies?

Power(ful/less) Bodies

   What is the relationship between body and power? Does a body have power? Is the body an object of power? Or, is the body a subject to power? In Power/Knowledge: Selected Interviews and Other Writings 1972-1977, Michel Foucault analyzes the body’s relationship to power in an interview with the editorial collective of Quel Corps in June 1975. In his eloquent responses to a series of questions, Foucault analyzes, problematizes, and emphasizes the importance of the human body in relation to his notion of power. Overarching this discussion of bodies is his concept of discourse. While a Foucauldian discourse is not meant to be focus of this post, a brief review of what a Foucauldian discourse is may be helpful.

           A Foucauldian discourse provides a way for understanding, creating meaning, and producing knowledge through language in a certain historical context. According to Hall (1997), a discourse has six key elements: (1) It creates statements that give us a certain kind of knowledge; (2) It has rules which prescribe certain ways of talking about topics and exclude other ways at a particular historical moment; (3) It creates subjects and creates relational power between subjects; (4) It is a project with totalizing desires; (5) It regulates and conducts bodies; and (6) It is historically situated and can be supplanted by different discourses to regulate social practices in new ways (45-46). A Foucauldian discourse, then, is both a way meaning is organized in order to make reality possible and sets of power. The idea of discourses being sets of power in relation to the body will be the focus of the remainder of this response paper.

           Returning to the questions posed at the beginning: What is the relationship between the body and power? Does a body have power? Is the body an object of power? Or, is the body a subject of power? In response to the first question, Foucault would maintain that such a seemingly simple question is actually deserving of a much more complicated answer. In order to properly answer that question, he would have to know what kind of body we were asking about, when and where that body was situated, and what other discourses were simultaneously acting upon the body in question. Moreover, even if he did have all of that information available, he would still likely argue that “As always with relations of power, one is faced with complex phenomena which don’t obey the Hegelian form of the dialectic” (1975:56). Nonetheless, throughout this interview, Foucault seems to argue that the body is both an object of power and a subject of power.

           Because discourses create subjects – bodies – they become subjected to the sets of power within the discourse. However, discourses also creates relational power between bodies; thus, bodies become objects of power. Foucault argues that the “Mastery and awareness of one’s own body can be acquired only though the effect of an investment of power in the body…by way of insistent, persistent, meticulous work of power on the bodies” (1975:56). Because discourses have totalizing desires – which can be both pleasurable and pervasive – Foucault is really arguing that the “highly intricate mosaic” (1975:62) of institutions in power have invested a significant amount of power within our individual bodies, so that we begin to become aware of our bodies in terms of maintaining the “normal” and “ideal” healthy body. Our bodies are insistently, persistently, and meticulously “educated” from the time we are children to adhere to and to resemble a “healthy” individual. The pervasive and arguably, pleasurable power of such a discourse becomes exemplified once our bodies become self-regulating – we begin to insistently, persistently, and meticulous watch, discipline, and regulate our bodies from becoming “unhealthy” or deviant bodies. This is the goal of the discourse: to produce docile bodies that exercise self-surveillance. The social body, according to Foucault, is the docile body (1975:55). He maintains, “the phenomenon of the social body is the effect not of a consensus but of the materiality of power operating on the very bodies of individuals” (1975:55). Essentially, what Foucault is arguing is that the social body/society – a collection of individual, docile bodies – is a material manifestation of the sets of power operating within the discourse. The social body/society is not constituted by the universality of individual wills, rather, the social body/society is constituted by multiple, dominant, and interconnected discourses that work together to produce specific types of docile bodies, as well as specific types of “deviant” bodies situated outside of the discourse. An ethnographic example of multiple, dominant, and interconnected discourses working together to create both “ideal” and “deviant” bodies is Sarah Horton and Judith Barker’s 2009 ethnographic study on oral health and undocumented immigrants in California.

           Foucault has argued, “One needs to study what kind of body the current society needs…” (1975:58). Horton and Barker’s (2009) ethnographic study on oral health and undocumented immigrants in California demonstrated that California “needs” bodies that adhere to a “sanitary contract” between the state and it’s citizens. They argue, “Hygiene remains a potent symbolic marker of racial difference, and public health has continued to justify the exclusion of certain groups” (Horton and Barker 2009:785). Further, they maintain, “personal hygiene perhaps bears an even greater symbolic load as a marker of capacity for self-governance” (Horton and Barker 2009:785). In their exploration of the way public health campaigns’ anxieties about Mexican immigrants mothers’ caregiving practices have served as a potent site for constructions of Mexicans’ “deservingness” of citizenship, they focus on the increased public health concern for Latino children’s oral hygiene. They document how Mexican immigrants mothers have continually tried to provide their children with the oral hygiene they need, but have encountered substantial obstacles in order to simply comply with the public health campaigns. Moreover, they document a “new era of public health – one concerned with encouraging individual self-governance and self-responsibility rather than with policing public health through coercive eugenic measures” (Horton and Barker 2009:788). This shifts the burden of responsibility from the state to the individual – an adoption of neoliberal philosophy – which consequently caused the mothers who were unable to access or afford the oral health care for their children, to feel as if they had failed. Similarly, it has led public health officials to view these “unsuccessful” mothers as “poor caregivers” and thus, the disciplinary action against these Latino children with poor oral hygiene becomes justified.

           Horton and Barker’s 2009 ethnographic study exemplifies how multiple discourses work together to create “ideal” and “deviant” bodies. The discourses of neoliberalism, public health, and citizenship all work together to form specific types of bodies – those that perpetuate the discourses (i.e. public health officials, Denti-Cal policy makers, nurses) and those that deviate from the discourses (i.e. undocumented immigrants like Mrs. Madrigal). While some “deviant” bodies continually tried to become to “ideal body”, they were unsuccessful. They were unsuccessful not because they had “poor caregiving practices”, as the discourses have led them to believe; instead, they were unsuccessful because the discourses were arguably constructed to have them “fail” and to experience the inherent structural violence within the overall ontology of Foucauldian discourse.

           Reading the words of Foucault in conjunction with the work by Horton and Barker have made me realize the truly dark perspective Foucault must have had on human nature during the time of his writing. With his concept of discourse producing docile and deviant bodies, alongside his statement of “One needs to study what kind of body the current society needs…” (1975:58), is he really arguing that society innately needs “deviant” bodies in order to perpetuate the ideologies and hegemonies that the everyday citizen otherwise takes for granted (i.e. getting an education to better the self, going to the doctor to ensure good health, exercising to maintain good health)? Is he arguing that society needs the “deviant” bodies to serve as a reminder of what will happen if the docile body transgresses? If all of the bodies created by the discourse share relational power between them, then perhaps Foucault is arguing that societies need an “ideal” and a “deviant”; the “ideal” serves as something for the “deviant” to work towards, whereas the “deviant” serves the “Ideal” as something not to transgress towards. However, if all of this is true, then Foucault’s concept of discourse severely limits individual agency and really tends to ignore social diversity in terms of thinking and action.

           He maintains that once docile bodies become more and more aware of their own bodies, as an effect of the power of the discourse. “But, once power produces this effect there inevitably emerge the responding claims and affirmations, those of one’s own body against power” (Foucault 1975:56). The same body that was both an object and subject of power, “inevitably” begins to question that power as “Suddenly, what had made power strong becomes used to attack it. Power, after investing itself in the body, finds itself exposed to a counterattack in that same body” (Foucault 1975:56). How is this subversion of power in the body “inevitable”? What does that mean? How does it happen? Is it instantaneous or does this “inevitable” change happen over long periods of time? Does it only happen in docile bodies? What about those “deviant” bodies, who blamed the system all along – was the subversion of power in their bodies also “inevitable”? In terms of the relationship between the body and power in relation to discourse, Foucault has cemented his position that the body is both a subject and object of power; however, in terms of how that relationship develops in different discourses at different times, his argument seems to soften. Further, if he is arguing that discourses change through “inevitable” subversions of power in individual bodies, then it seems to me that his “battle should have continued” (Foucault 1975:56).

"Botho" and the Trouble with Foucault

Honestly, throughout most of my undergrad, I often wished that Foucault would fouck-off, but this Frenchman has some seriously intriguing insights into how and where power is situated within society. 

Multiple discourses often work together to accomplish a common totalizing goal: to produce docile bodies that exercise self-surveillance. For Foucault, the social body is the docile body and maintains, “the phenomenon of the social body is the effect not of a consensus but of the materiality of power operating on the very bodies of individuals” (1975:55). In other others, Foucault is arguing the social body (society) – a collection of individual, docile bodies – is a material manifestation of the sets of power operating within the discourse. The social body/society is not constituted by the universality of individual wills, rather, the social body/society is constituted by multiple, dominant, and interconnected discourses that work together to produce specific types of docile and deviant bodies in specific contexts at specific times. The deviant bodies produced are often situated outside of the discourse (Li 2007). Moreover these deviant bodies are often viewed by others situated within the discourse as “troubled”, “deeply disturbed”, or even “disgusting”; therefore, resulting in efforts to minimize the visibility of these adverse or abject bodies through governmental policies. This response paper will look at how these discursive, “troubled” bodies are managed, ignored, and kept hidden from the docile, social body through the ethnographic works of Livingston (2008), Herrera et al. (2009), and Kawash (1998).

           Julie Livingston, Professor of History at Rutgers University, has written about how people in Botswana manage their feelings of disgust towards “aesthetically impaired bodies” (Livingston 2008:288) or ill and disabled bodies, in a context where a “humanistic ethos is stressed in the public discourse of nationalism” (Livingston 2008:288). In Botswana, the Setswana concept of botho – a Tswana ethic of humanness, which acknowledges that one’s actions affect others and is referred to the enactment of moral sentiment (Livingston 2008) – is deeply engraved in the publics’ consciousness and has been indoctrinated  into the Botswana government’s new, high-profile national development strategy that aims “to propel its socio-economic and political development into a competitive, winning and prosperous nation” (Livingston 2008:293). Livingston maintains, “Since its incorporation as a national principle in 2000, botho has become central to a range of national discourses about citizenship and community” (2008:294). The multiple discourses of nationalism, citizenship, community, and arguably, botho are simultaneously working together in Botswana to create specific types of subjects – subjects that can facilitate the accomplishment of the government’s national development strategy; subjects that can and have the ability to propel Botswana’s socio-economic and political development into a competitive, winning and prosperous nation. These multiple discourses strategically exclude the ill, disabled, and aesthetically impaired bodies (among others) which pose challenges for the enactment of botho. Livingston argues, “Disgust can be embodied in a relational sense…it often emerges in one person in response to the bodily aesthetics of another” (2008:290). This feeling of disgust is problematic because it compromises the humanity of the ill, disabled, and aesthetically impaired body (Livingston 2008). However, Livingston maintains that many people in Botswana attempt to manage their feelings of disgust towards these adverse bodies, by deliberately striving to ameliorate, subvert or transform their disgust into respect and compassion – deliberate acts with botho (Livingston 2008:296). Sometimes, aesthetically unpleasing bodies may act with bothothemselves, by relying on aesthetic transformations (i.e. provision of artificial limbs, surgical reconstructions, etc.) to rework their bodies. In other instances, aesthetically impaired “disgusting” bodies would intentionally exclude themselves from participating in social life. For example, Livingston mentions how a 60-year-old woman with stage two cervical cancer confided in her that she never left her home any more because she was terrified that everyone could smell her rotting vagina (2008:298). While her neighbors, daughters, and friends tried to encourage her by visiting her and extending invitations to their homes and events, she was afraid ‘it will not be nice for them’ if she took them up on their offers (Livingston 2008:298). Another example cited by Livingston, are the cancer patients going to the hospital to receive treatment – they would not sit in the waiting room, but would stand in the corridor by the entrance, as an act of botho to the medical staff and other patients. These examples demonstrate that sometimes, to have botho means to excuse oneself from public spaces. In Botswana, the pervasiveness of botho and the things society does to manage their feelings of disgust to aesthetically impaired bodies, as well as the things aesthetically impaired bodies do to act with botho, illustrates the power of emotion; not only as inner experiences, but also as powerful social forces that impact the bodily, emotional and material well-being of others (Livingston 2008:299). Moreover, this ethnographic example demonstrates how multiple discourses act together to create docile subjects that are subsequently forced to confront and manage their distasteful feelings of disgust towards the socially excluded, “deviant” aesthetically impaired bodies situated outside of the discourses.

           Hererra et al. (2009) explores how Mexican street youths attempts to control and understand their lives, relies on a control of and identification with their bodies. Mexican street youths’ bodies are aesthetically marked by difference – through abominations of the body, blemishes of character and distinctions of race, nation, or religion, through their dress, odour, colour, and shape, as well as their interaction with society through consumption or work (Herrera et al. 2009:68). Hererra et al. maintains that Mexican street youths strategically use their bodies, mark their bodies, hide their bodies and effectively manage their bodies to accentuate their identification as street youth, and at other times, to obscure this identification (2009:68-69). For example, windscreen washers – commonly considered as dirty drug users by mainstream society – don yellow T-shirts that signify their membership to a particular organization. In an effort to “unsettle” or subvert the perception that all people wearing yellow t-shirts are drug dealers, Manuel, Ramon, and Rodrigo all try to present their bodies in ways that reduce of soften the stigma associated with street youth, by “cleaning themselves up” through haircuts or showers (Herrera et al. 2009). While some street-youth generally tried to present their bodies in ways that fit better under the dominant social discourse of how youths shouldlook like, therefore attempting to reduce their marks of difference, not all street-youth necessarily “buy into” the discourse. For instance, Carlos, a windscreen cleaner, has several visible tattoos, particularly on his face; thus, leading the authors to imply that he has no real interest in strategically managing or controlling his body for the purposes of working on the street. Nevertheless, Herrera et al. conclude their article by maintaining that the street youth they interviewed all described how their bodies do not fit neatly the discourses of what bodies should be – the ‘modern’ or ‘normal’ body – and of what street youths bodies should be. The bodies of Mexican street youths are outside of the ‘normal’ body discourse; therefore, Foucault would suggest that these bodies fail to practice self-surveillance. However, Herrera et al. seem to suggest otherwise; their informants were consciously aware of their bodies and were keen enough to strategize and manage their bodies according to various social situations.

           Samira Kawash (1998), Professor Emerita in the department of Women’s and Gender Studies at Rutgers University, wrote about the concept of the “homeless body” in North America. Much like the aesthetically impaired bodies in Botswana and the bodies of street youth in Mexico, Kawash argues that the bodies of homeless people are situated outside of multiple dominant discourses working together to create the productive, docile subject. In fact, Kawash argues that the dominant image of the homeless is North American society is the image of homeless as “victims or parasites outside the pale of society” (1998:321). Because of this view, Kawash maintains, “The aspect that seems most to trouble policy makers is not how to help the homeless, but rather how to control the homeless and especially how to protect the public from them” (1998:320, emphasis added). However, instead of problematizing the homeless body, Kawash problematizes the public by questioning who the public is, of who may inhabit public space, and of how such space will be constituted and controlled (1998:325). She therefore argues that the question of homelessness is always a question of public space. Thus, the aim of vengeful homeless policies is not limited to the immediate goal of solving the problem of homelessness by eliminating the homeless; but, is extended as a mechanism for constituting and securing a public, establishing the boundaries of inclusion, and producing an abject body against which the proper, public body of the citizen can stand (Kawash 1998:325). In other words, Kawash is arguing that the “war on the homeless” is really a strategic political euphemism that is being used by the opportunistic government in order to justify both political and structural violences experienced by the homeless. Moreover, multiple discourses of neoliberalism, governmentality, public safety, and security are operating together to create relational subjects – the “good citizen” and in this case, the homeless. Kawash is arguing that by adopting and perpetuating these multiple, powerful discourses, the state is effectively producing an abject – homeless – body, so that the proper, public body – the good citizen – can exist. In this case, public policies that address the notion of “public safety”, simultaneously address “the war on the homeless”, implicating that the homeless body is a threat to overall society; a threat that must be managed, controlled, and eliminated.

           Foucault’s work on discourse is undoubtedly powerful and influential. Specifically, his work around the notion of subjects has been of particular interest throughout this course. However, in his conceptualization of subjects, Foucault maintains that the docile body practices self-surveillance; indeed, he argues that the practice of self-surveillance is the key characteristic of the docile body. If this is the case, then by contrast, the relational, “deviant” body must not practice self-surveillance. The ethnographic works of Livingston (2008), Herrera et al. (2009), and Kawash (1998) seem to trouble Foucault’s argument. These articles all demonstrate that the deviant, aesthetically impaired (Livingston 2008), differentially marked (Herrera et al. 2009), homeless (Kawash 1998), abject bodies all practice self-surveillance; perhaps, not in the same capacities as their relational oppositions of the “healthy” or “normal” “good citizens”, but under their specific temporal and contextual contexts, the troubled bodies encountered in all of the readings did practice self-surveillance. They were all able to “read” their situation and subsequently, “read” and “control” their bodies in ways that the docile society would find acceptable. In fact, I would go so far as to say that they were all able to navigate their “mindful bodies” through the “violences of everyday life” – that were given to them by the multiple discourses acting against them – because they practiced self-surveillance. Their awareness of their positionality – being situated outside of the discourse – was integral to how each of the types of abject individuals encountered, made sense of their world and of their subjectivities. Essentially, the subjectivities of aesthetically impaired bodies, the bodies of the Mexican street youth, and the homeless bodies allowed them to evaluate and make sense of their world and their situation, and strategize or control their bodies and practice self-surveillance accordingly.

       This, I believe, is an example of Csordas’ concept of embodiment (“perceptual experience and mode of presence and engagement in the world”), as the two key attributes to his conceptualization of embodiment are agency and intentionality; which, arguably, all of the troubled bodies encountered, demonstrated through the strategic control of their bodies in various social situations. Through these readings, and even through transcribing the interviews with street involved youth in Victoria, it has occurred to me that if people really want to know anything real about society – Foucault’s docile subjects or programmed robots – then perhaps people should stop talking to the “good citizens”, and begin focusing their attention on the “troubled bodies”. It has become very apparent to me that “troubled bodies” are often the most knowledgeable about the true botho of the world, as they have experienced the inherent structural violences hidden in the multiple discourses that governments opportunistically use for public doublespeak. I wonder what Foucault would say.