The Function of Illness
Updated: Aug 26, 2020
To understand the healing process we must first identify what it is that needs to be healed.
The typical method for identifying illness or injury is known as the “medical model.” The medical model is “the traditional approach to the diagnosis and treatment of illness as practiced by physicians in the Western world since the time of Koch and Pasteur. The physician focuses on the defect, or dysfunction, within the patient, using a problem-solving approach (source).” Under this construct, a person is assessed, diagnosed, and treated, most often in isolation, and returned to the fold when they are cured. (Laing, 1971).
As I researched what the actual process is, I came across many descriptions that although are different from each other, had common elements which basically resembled the medical model. First there is an identification process of the injury or illness, then a course of treatment is considered, and assuming that these first two steps are accurate, wounds heal and health is restored.
This sounds simple enough, right? So what complicates this journey?
In John Russon’s book, Human Experience: Philosophy, Neurosis and the Elements of Everyday Life (2010) the formation of personality through family and social experience is explored. He concludes that neurosis and mental illness are the result of habits developed within the family interaction and social construct. “The sphere of intersubjective life is the sphere of co-creation… In this sphere, therefore, our identity is not something given to us but rather something we must create for ourselves (Russon, 2010, p. 177).” Russon explains neurosis through the logic of habituation that is created by the relationships we have in life. Our identity is co-created with those who offer feedback to us in our lives; dependent upon the feedback received. Each in turn affecting the other in carefully constructed ways that help serve each other’s purpose and form each other’s identity.
Considering this relational aspect of illness, how can we accurately identify what illness is and where it resides? Wouldn't this change with differing points of views and depend on whose purpose the illness serves?
Illness functions in our identity formation which is co-created by the ones who need to identify as afflicted and the ones who need to be identified as healthy. This suggests that there is something else driving one to these identifying terms in this dynamic. Do we need the sick so we can maintain our present version of health that we are not willing to compromise? For instance, when a member of a family is identified as "sick," they draw attention away from other members who may be harboring an affliction they do not want noticed. The identified patient serves as a distraction, and members of the family may have a vested interest in maintaining the facade. Affliction serves a purpose and plays a significant role in our personal and community relationships, and this directly impacts the ability to overcome illness and be cured.
In Veena Das’ book, Affliction, she explores illness as a function serving a purpose that is intrinsically woven into the very fabric of personal relationships and communities. Das, an anthropologist, demonstrates how healing and cure is determined by the relationships of those involved by their reaction and response to the function of affliction. The afflicted become a gravitational point by which the people in their lives find definition. Her case studies of illness and healing reveal the different trajectories possible that are complicated not only by available resources but by these changing relationships and how this impacts illness narratives within families and communities.
Veena Das’ fieldwork in this area also draws our attention to another, less popular, need to perpetuate affliction. She illustrates how affliction is not only used to control members of a family and community but how it is used to define and control the poor. It is a definition that results in oppression rather than ameliorating illness. Through her exploration of affliction at the personal, community and global level, she suggests a need to bridge the local experiences of the people to the global actors who create and define policy. She illustrates the difficulties involved in this as the multifaceted aspects of illness are continually redefined to suit the varying needs of those involved at all levels, which leads one to wonder if affliction could ever be eradicated in a way that could benefit us all, or is it needed in some measure for others to enjoy health?
Can there be wellness without illness?