Illness as Metaphor
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''Illness as Metaphor'' is a 1978 work of critical theory by Susan Sontag, in which she challenged the
victim-blaming Victim blaming occurs when the victim of a crime or any wrongful act is held entirely or partially at fault for the harm that befell them. There is historical and current prejudice against the victims of domestic violence and sex crimes, such as ...
in the language that is often used to describe
disease A disease is a particular abnormal condition that negatively affects the structure or function of all or part of an organism, and that is not immediately due to any external injury. Diseases are often known to be medical conditions that a ...
s and the people affected by them. Teasing out the similarities between public perspectives on
cancer Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal b ...
(the paradigmatic disease of the 20th century before the appearance of AIDS), and
tuberculosis Tuberculosis (TB) is an infectious disease usually caused by '' Mycobacterium tuberculosis'' (MTB) bacteria. Tuberculosis generally affects the lungs, but it can also affect other parts of the body. Most infections show no symptoms, i ...
(the symbolic illness of the 19th century), Sontag showed that both diseases were popularly associated with personal
psychological trait In psychology, trait theory (also called dispositional theory) is an approach to the study of human personality. Trait theorists are primarily interested in the measurement of ''traits'', which can be defined as habitual patterns of behaviour, tho ...
s. In particular, she said that the
metaphor A metaphor is a figure of speech that, for rhetorical effect, directly refers to one thing by mentioning another. It may provide (or obscure) clarity or identify hidden similarities between two different ideas. Metaphors are often compared wi ...
s and terms used to describe both syndromes lead to an association between repressed passion and the physical disease itself. She wrote about the peculiar reversal that "With the modern diseases (once TB, now cancer), the romantic idea that the disease expresses the character is invariably extended to assert that the character causes the disease—because it has not expressed itself. Passion moves inward, striking and blighting the deepest cellular recesses." Sontag said that the clearest and most truthful way of thinking about diseases is without recourse to metaphor. She believed that wrapping disease in metaphors discouraged, silenced, and
shame Shame is an unpleasant self-conscious emotion often associated with negative self-evaluation; motivation to quit; and feelings of pain, exposure, distrust, powerlessness, and worthlessness. Definition Shame is a discrete, basic emotion, d ...
d patients. Some other writers have disagreed with her, saying that
metaphor A metaphor is a figure of speech that, for rhetorical effect, directly refers to one thing by mentioning another. It may provide (or obscure) clarity or identify hidden similarities between two different ideas. Metaphors are often compared wi ...
s and other symbolic language help some affected people form meaning out of their experiences.


Synopsis

''Illness as Metaphor'' served as a way for Susan Sontag to express her opinions on the use of metaphors in order to refer to illnesses, with her main focuses being tuberculosis and cancer. The book contrasts the viewpoints and metaphors associated with each disease. At one point,
tuberculosis Tuberculosis (TB) is an infectious disease usually caused by '' Mycobacterium tuberculosis'' (MTB) bacteria. Tuberculosis generally affects the lungs, but it can also affect other parts of the body. Most infections show no symptoms, i ...
was seen as a creative disease, leading to healthy people wanting to look as if they were ill with the disease. However, lack of improvement from tuberculosis was usually seen as lack of passion in the individual. Tuberculosis was even seen as a sign of punishment by some religions, such as
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, leading the afflicted to believe that they deserved their ailment. Sontag then made the comparison between the metaphors used to describe tuberculosis and cancer, with cancer being seen in the 1970s as a disease that afflicted people who lacked passion and sensuality, and those who repressed their feelings. Sontag wrote that multiple studies found a link between depression and cancer, which she argued was just a sign of the times and not a reason for the disease, since in previous times physicians found that cancer patients suffered from
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and
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, which were signs of their times. In the last chapter, Sontag argued that society's disease metaphors cause patients to feel as if society were against them. Her final argument was that metaphors are not useful for patients, since metaphors make patients feel as if their illness was due to their feelings, rather than lack of effective treatment. The most effective way of thinking about illness would be to avoid metaphorical thinking, and to focus on only the physical components and treatment.


Context

Sontag wrote the
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while being treated for
breast cancer Breast cancer is cancer that develops from breast tissue. Signs of breast cancer may include a lump in the breast, a change in breast shape, dimpling of the skin, milk rejection, fluid coming from the nipple, a newly inverted nipple, or a r ...
. She does not mention her personal experience with cancer in the work, but she addresses it in her related 1988 work, ''
AIDS and Its Metaphors ''AIDS and Its Metaphors'' is a 1989 work of critical theory by Susan Sontag. In this companion book to her ''Illness as Metaphor'' (1978), Sontag extends her arguments about the metaphors attributed to cancer to the AIDS crisis. Sontag explores ...
''. At the time that Sontag was writing, the fad in
alternative cancer treatment Alternative cancer treatment describes any cancer treatment or practice that is not part of the conventional standard of cancer care. These include special diets and exercises, chemicals, herbs, devices, and manual procedures. Most alternative ...
was psychotherapy for the patient's supposed "cancer personality". According to these proponents, patients brought cancer upon themselves by having a resigned, repressed, inhibited personality. By undergoing the often blame-filled psychotherapy offered by some groups, such as the Simonton Center, the patient would overcome cancer by consciously choosing to give up the emotional benefits he or she created the cancer for, and be healed. Others have taken her idea further, showing not that there is a real "cancer" behind the metaphors, but that all we have is metaphor—even in science—to understand the behavior of a disease that remains mysterious.


Publication

The work was originally published as three long essays in the ''
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''. Some of the more inflammatory language was slightly toned down for republication. For example, what Sontag originally called the "inimitable looniness" of
Wilhelm Reich Wilhelm Reich ( , ; 24 March 1897 – 3 November 1957) was an Austrian doctor of medicine and a psychoanalyst, along with being a member of the second generation of analysts after Sigmund Freud. The author of several influential books, most ...
's language was softened to the "inimitable coherence".


Reception

While one of Sontag's widest read and most celebrated works, ''Illness as Metaphor'' has received several negative reviews. '' Kirkus Reviews'' called it "a small, liberating book that could become the cancer patient's Common Sense." The literary critic Denis Donoghue of ''
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'' gave the book a negative review, describing it as "a deeply personal book pretending for the sake of decency to be a thesis." He added: Despite this criticism, Donoghue also writes, "If I wanted to see a fine discrimination made, with precisely the right degree of allowance for and against, I wouldn't ask Miss Sontag to supply it. She would be bored by the request. But if I badly wanted to win, at nearly any cost, I would do anything to have Miss Sontag on my side." It is not clear, then, whether Donoghue is disdainful, admiring, or merely jealous of Sontag's persuasive writing. The literary critic and frequent Sontag detractor
Camille Paglia Camille Anna Paglia (; born April 2, 1947) is an American feminist academic and social critic. Paglia has been a professor at the University of the Arts in Philadelphia, Pennsylvania, since 1984. She is critical of many aspects of modern cultu ...
described the book as "clumsy and ponderous, like a graduate-school seminar paper."Paglia, Camille. ''Vamps and Tramps: New Essays''. Penguin Books, 1995, p. 353. Additionally, critics also brought up the argument that metaphoric thinking about diseases hasn't stopped research about diseases from taking place and that humans deal with the reality of their lives through the help of metaphors.


References


Sources

* {{DEFAULTSORT:Illness As Metaphor 1978 non-fiction books Works by Susan Sontag Books about metaphors Books about cancer Tuberculosis Social problems in medicine