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The body and disability: Prosthetics, proxemics and pratfalls
Gary Easthope
Department of Sociology University of Tasmania, Hobart TAS
Abstract
The focus of this paper is the social construction of the disabled body and the role of prostheses in that construction. Before discussing how that is achieved it is necessary to look at the body in general terms.
We can (following Turner, 1984, and Lock and Scheper-Hughes, 1990) distinguish three bodies:
- the lived experience of the body-self which includes within it notions of self, identity, mind and matter.
- the social body - the body as a symbol to think with
- the politic body - the surveillance and control of bodies.
In this paper I am not dealing with the social body or the body politic, leaving the body politic of disability to another paper, but concentrate on the first of the three bodies: the body-self.
Since Descartes the body has been conceived as a "natural" organic object separate from the mind and separate from the social (Lock and Scheper-Hughes, 1990). This makes the social invisible when we talk of the body. Medical discourse in particular has this effect; it "can describe events in a value-neutral language that makes them appear to be part of the natural world and thus neutralize what are, in reality, social problems" (Rhodes, 1990: 168). However medicine is just an extreme example of the fact that modern western discourses in general, disengage the body from its social context.
This is however not the only way to conceive of the body, self, identity and the social.
First, there are different cultural patterns relating self and identity:
- the Protestant derived Western notion that the authentic self remains despite identity changes. An essentialist notion.
- the Japanese notion that the authentic self acts correctly by acting according to the identity provided by the social context (Lock and Scheper-Hughes, 1990 )
- the post-modern western notion that identity can be constructed by the self creating itself (Giddens, 1991)
Second, the relationship between the body, self, identity and the social is historically, culturally and empirically variable:
- Historically, the body, self and the physical and social environment have been seen as all interrelated and this is still true in many non-western cultures today: a change in the body is a function of a change in the harmony of the cosmos (see for example Thomas', 1973, account of early modern England and Fabrega's, 1974, discussion of ethnomedicine).
- Empirically, the body is connected to the social such that social relationships affect physiological health and illness. The evidence of a relationship between social support and physiological health is stronger than the relationship between smoking and cancer (House et al, 1988 ).
- Empirically, the physiological body is connected to body image such that different body images expose people to different disease patterns ( Fisher and Cleveland, 1968).
- Empirically, the physiological body is disconnected from. body image such that a skeletal physiological body is perceived as obese (Muus, 1985).
- Empirically, the physiological body is connected to self-identity such that changes in the body lead to identity changes as data from amputees demonstrates (Lipowski, 1969).
From this empirical work I draw the conclusion that the body is not independent of social context. It is socially created.
The strong form of this argument is that the physical body is socially created. Illness and health are a function of the social world. This argument, which comes out of the tradition of Durkheim's work on suicide is currently the focus of much research effort and not just among sociologists. The discipline of psychoneuroimmunology (pni) is busy developing a medical body that can be conceptualised as psycho-biological (see Easthope, 1986, Freund and McGuire, 1991, and Suter, 1986 for a development of this argument).
The weak form of this argument is that what is defined as the body is socially created. This is one of the themes of recent sociological writings on post modernity (Crook et al, 1992) or high modernity (tiiddens, 1991). Authors writing within the post modern tradition have argued that the bodies of individuals have become "reflexively organised projects." Lacking the meta narratives provided in modernity by religion or socialism people use their bodies as a basis of meaning creation (Shilling, 1993). This concern with the body produces the large body industry of health clubs, jogging shoes and alternative medical regimens (see Fox, 1993, for a development of this argument; he writes of the body without organs).
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