29 August 2017

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So summer is nearly over,  and a new academic term about to begin. I have spent the summer travelling (above, from California, where my heart is) and writing. I’ve been thinking about my new book, which will be completed at the end of this year: a history of loneliness. This work explores loneliness as a medical and philosophical condition, and I will be delivering an excerpt in Madrid next month – to be published here shortly afterwards. In the meantime I want to leave you with the following teasers:

When does solitude become loneliness?

How does loneliness change according to age, gender and ethnicity?

Does the digital world help or hinder the lonely?

And what kind of idea about our ‘selves’ must we have to experience loneliness at all?

If you have any thoughts, do get in touch. I would love to hear from you.

3 July 2017

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On Thursday 29 June I gave a keynote at the Geoffrey Flavell symposium, held at the Worshipful Society of Apothecaries. Flavell was a highly respected cardio-thoracic surgeon. Born in New Zealand, he completed his training at Bart’s in London. In 1939, he became the resident surgical officer at the Brompton Hospital. And he worked, during the Second World War with Sir Archibald Mcindoe, of Guinea Pig fame, in treating severely burned patients. Flavell was appointed consultant at the London Hospital in 1950, where he worked for 30 years.

The title of the Geoffrey Flavell Symposium was ‘The Heart, Health and Culture: An Exploration in Medicine and the Humanities’. It gave me a chance to revisit my earlier work on the history of the heart, in health and disease. My book Matters of the Heart: History, Medicine and Emotion (Oxford University Press, 2010) explored the meanings of the heart as both symbol and organ. It looked at why we have two very different ideas about the heart in our culture: the heart as a Hallmark symbol sold on millions of cards every year and the heart as a pump, responsible for the circulation of the blood.

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In my book, and in my paper, my theme was this: for centuries, medical practitioners in the West held the heart to be the centre of emotion, thought and feeling. Before the rise of the brain qua mind, the heart was the most important organ of the body, which was frequently viewed in cardiocentric ways: the heart was all that mattered in the end. With the rise of scientific medicine and neuroscience, the decline of religious explanations for our existence (and the decline of the soul in the material tradition), the heart became a material object. It might beat excitedly when we see a loved one, but not because our soul was moving through the heart. It might feel like our hearts would break, but not because our hearts were overwhelmed by the melancholic humours of the ancient world. Hormones began to offer a new explanation; hormones produced by the new emotional centre of the body: the brain.

Of course, the heart still continues to thrive at the level of popular culture. The brain governs emotions in name only. Nor is the brain the only contender for the title of emotional organ par excellence, as my book This Mortal Coil: The Human Body in History and Culture (Oxford University Press, 2016) argues. Other organs – notably the gut – are coming into their own. Like the heart, they are seen as sites of hormone production (and even, more controversially as systems of cellular memory). We are listening to the body more and more, though as we do, we must acknowledge the gaps in scientific medicine; the ways in which narratives of healing are leaving holism behind.

These are the themes I talked about at the symposium, reflecting my enduring interests in the history of the body and the history of emotion. How do we explain what we feel, and how has that changed over the centuries? Why are some organs given more importance than others? Why do heartfelt emotions and gut feelings have so much sway? Or perhaps: why shouldn’t they? We feel with our gut and our heart, after all.

One of the most fascinating aspects of the symposium for me – a day that brought together historians and theologians, surgeons, cardiologists, ethicists and more – was how emotional our attitudes towards the body are. The ways we abstract the body in medicine, talk about it, take it apart physically and metaphorically, doesn’t take away from the fact that we exist and experience the world, for good and ill, in our bodies. We feel emotional about what happens to our bodies now as in the past, albeit for different reasons. We might talk about the word ‘soul’ (and most of us believe we have one), though there is no agreement on what it is, or what it does.

In Descartes’ time it was simpler: the soul lurked behind the eyebrows. It was the space where the physical body met the emotional and spiritual body. It was also why so many emotional expressions involved the raising or furrowing of the brows. Today the soul is often placed in the brain (and sometimes seen as synonymous with the mind and consciousness). Far more often it exists as a nebulous, free-floating entity that is, and yet is not, linked to our religious beliefs.

Sometimes, the soul is still placed in the heart. When I ask audiences to point to their minds, more often than not they point at their heads. When I ask them to point to their ‘selves’, they point to their heart. The heart remains an emotional centre, then, and not just in language. The heart remains a symbol of our inner selves, of truth, of passion. Outside the narrow confines of medical textbooks, it can’t ever be reduced to a pump.

23 June 2017

I am delighted to be one of the History Girls, a group of writers of historical fiction and non-fiction that blogs regularly on all aspects of history. I blog for the History Girls on the 15th of alternate months, and thoroughly enjoy reading other people’s posts. No matter what the period, the theme or the angle, there is always something new to think about. I will be posting much more on my own blog soon, but for now I want to link to my History Girls blog for 15 June: an account of A Trip to Eyam, the Plague Village. 

 

21 March 2017

Faces that Matter: Writing the History of Face Transplants

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Faces matter. They tell the world who we are and where we come from. They reveal our individuality, our genetics, emotions and ethnicity. But faces are also ‘matter,’ a composite of tissues, muscles and nerves that can be changed by cosmetics, art and surgery.  Face transplants are no longer science fiction, as they were in 1997 when Face/Off hit the cinemas, starring John Travolta and Nicholas Cage and directed by John Woo. Since 2005, it has been possible to perform face transplants, in which the face of a dead donor is overlaid on the body of a recipient. That recipient will more than likely have undergone some traumatic event or accident, and multiple reconstructive surgeries before receiving a new face. What must it be like to wake up as someone else? To have to learn to speak, eat, smile and inhabit a totally different visage? What would it be like for your family? Or for the family of the donor, constantly looking for and hoping to find (or not to find) an essence of their loved one.

I have been thinking a lot about these kinds of questions lately. I’m writing a book about face transplants, focusing on the period post 2005, when the 38-year old French woman Isabelle Dinoire became the first face transplant recipient. Hers was a partial transplant; her nose, chin and lips had been lost when she was savaged by her pet dog. Dinoire was unconscious at the time, having argued with her daughter and taken an overdose of sleeping tablets. Whether or not it was a deliberate overdose has proved contentious: could she have given true, informed consent for a face transplant when she was depressed enough to commit suicide? When she couldn’t possibly have known what the world had in store for her?

As it turned out, the world was very interested. Immediately the transplant had taken place, the hospital released photos of Dinoire to a world intrigued and repulsed in equal measure. Her life was never the same again as she became subject to relentless and devastating media attention. Dinoire remained dependent on her doctors and did not return to full time work. When she died of cancer in 2016, her doctors denied it was in any way connected to the cocktail of immunosuppressant drugs she had been taking – though those drugs are known to increase the risk of cancer. I have written in detail about Dinoire elsewhere, for her case draws attention not only to public attitudes to what has been called ‘Frankenstein science’, but also to the context in which medical firsts take place. There are numerous problems with Dinoire’s recorded treatment by the medical profession, the media and the public, which have particular resonance because of the lens they are viewed through in our increasingly global, digital world.

I have not included images of Isabelle Dinoire in this blog post, since some readers might find them upsetting. But they are widely available online. So, too, are images of her surgeons, Bernard Devauchelle and Jean-Michel Dubernard, who also performed the first hand transplant. The hand transplant was not ultimately a success, though it was hailed as such at the time, because Clint Hallam, the recipient, could not bear living with it or dealing with the tissue rejection that occurred. For transplants to hold, massive amounts of immunosuppressants have to be taken. Doctors are experimenting with alternative methods, but to date these have been unsuccessful. In a very real sense, the boundaries medicine are being tested out and explored in cutting-edge cases because of their visibility and their status as public spectacle. All too often, ethics lag behind, constantly playing catch up to new discoveries. This argument can be made in the case of Dinoire, who has since been regarded as a less than ‘ideal patient’, given her emotional condition at the time of her accident.

Yet who could be an ideal candidate in such a case? People with a recognised need for a face transplant will typically have undergone multiple reconstructive surgeries before a face transplant is decided upon. This was not the case with Dinoire, which is one of the reasons the hospital that treated her has come under criticism.Leaving aside the medical complexities, elaborate psychological protocols are needed to come to terms with a face transplant. People with transplanted faces do not, at present, gain full mobility of the face, so in addition to belonging to the realms of both the living and the dead, they are both healed and not healed. Isabelle Dinoire said that she felt like a ‘monster’ before her operation, when her wounds were visible and like a ‘circus freak’ afterwards, when everybody knew that she was the first face transplant recipient.

I came to this project sometime after publishing a book about the history and meanings of the heart: Matters of the Heart: History, Medicine, Emotion. More recently, my book This Mortal Coil explores, amongst other things, the rise of cosmetic surgery and the drive for bodily perfection. It turns out that hearts and faces have a lot in common. I became interested in the history of transplants because of what they tell us about our bodies – and how we feel about them. Heart transplant patients often claim they have received more than a stranger’s heart; stories abound of people’s personality or even their cravings and abilities changing as a result. Transplants are gifts, from one person to another (at least in the UK where donors are not paid). As such they invoke a wide range of responses from the recipient: fear of having a new organ, disgust that organ is assimilated into their own bodies, gratitude to the donor, guilt that s/he has died while the recipient lives on, and so on. In the case of Dinoire, she expressed both revulsion that her tongue touched the dead lips of her donor as well as gratitude. There is an added poignancy to the fact that Dinoire’s donor was a young woman who committed suicide. In life as in death, the two were linked together forever.

Face transplants involve a degree of social contract then, of belonging in the world, even as a ‘hybrid person’, in the words of one scholar. Unlike heart transplants, faces are visible. we are judged every day on our faces (just as women who hide their faces with burkas are judged, for different reasons). Our attitudes towards faces are complex. And research shows we are increasingly focused on external appearances, on beauty. The rise of cosmetic surgery after the end of World War 2 was a direct result of consumers having more money and surgeons having more skills. People had to feel the need for cosmetic surgery of course – to feel that their faces were too wrinkly and their breasts too saggy. For the first time psychiatrists linked imperfect bodies and faces with depression and anxiety. The very act of getting older drives some of us into a tailspin, and little wonder given the relentless pressure, especially on women, on looking good. For people suffering disfigurement, it is social stigma that is said to be worse than anything else; not fitting in or being accepted, being stared at, ridiculed or even treated as less than human. In understanding what it is to face the future as someone else then, perhaps it is society as much as surgery that needs to come under the spotlight.

 

21 February 2017

The following post is reproduced from The History Girls daily blog: http://the-history-girls.blogspot.co.uk/2017/02/arts-and-crafts-in-walthamstow-william.html

Arts and Crafts in Walthamstow: William Morris and Feminism

My youngest is studying the Arts and Crafts movement at secondary, so I took him to visit the William Morris Gallery.  The Gallery is housed in a gorgeous Georgian house, built in the 1740s and set in Lloyd Park in Walthamstow, north-east London.  This was William Morris’ family home from 1848 to 1856, when he lived with his widowed mother and eight brothers and sisters from the age of 14 to 22 years old. The Gallery is the only public space devoted to the work of William Morris.

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The Arts and Crafts movement brought together politics, life and art in a way that seems so relevant to today’s challenging political climate. William Morris (1834-1896) was a designer, craftsman, writer, conservationist and socialist. He is probably best known as a designer and artists, designing simple yet beautiful furniture and fabrics. His hand-printed textile designs in the 1880s revived the old and difficult indigo print method. Against the backdrop of industrialising Britain embedded in chintz, Morris favoured nature dyes and patterns found in nature, creating patterns that are instantly recognisable today.

William Morris was also a radical poet, thinker and socialist, seeing art as essential to a fulfilling life and not merely a decorative pursuit for the elite. Like other socialists of his time he was angered by the poverty, pollution and working conditions of the factory movement, and sought to recapture the beauty and satisfaction of traditional crafts. He believed that there was ‘no square mile of earth’s inhabitable surface that is no beautiful in its own way, if we men will only abstain from wilfully destroying that beauty.’ The William Morris Gallery brings together these connected aspects of William Morris’ life, his art and his political views, with different sections focusing on art, design and politics.

Although Morris came to socialism quite late in his life, the William Morris Gallery holds selections of his political pamphlets and books as well as editions of the Socialist League paper Commonweal. Morris led the Arts and Crafts movement, a group of like-minded artists who saw traditional skills as an alternative to the mass production, consumerism and division of the pride of labour – as discussed by Karl Marx – by industrial production. Some of these artists are also represented at the William Morris Gallery, including paintings by Edward Coley Burne-Jones and stained glass panels by William de Morgan. For kids, hands-on activities included reproducing the techniques of the Arts and Crafts movement in brass rubbing, weaving and architectural planning.

What of the bigger story of social change presented here? The lack of feminist credentials of much socialist activity in Morris’ time is well known. Debates about the role of women (the ‘Woman question’) were rife in the 1880s. Ideals of the male breadwinner wage norm and codes of femininity and masculinity meant that women were often excluded from debates about equality. Feminism is curiously absent from the William Morris Gallery, but Morris’ News From Nowhere offered some response to socialist-feminist debates, projecting the value of sexual equality and exploring the historical nature of male and female roles. In News From Nowhere, a near perfect economic, social and environmental world is envisaged, in which household structures are flexible but overwhelmingly heterosexual. Women are implicitly given sexual power over men, but the book is ultimately rather conventional in terms of gender roles.

What then of the lack of discussion of female artists as part of the Arts and Crafts movement? The Arts and Crafts movement peaked between 1880 and 1910 in Western Europe and the United States, spreading to Japan in the 1920s. We know far less about the position of women workers in the movement; although there were many female artisans like Frances and Margaret MacDonald, their artwork remains under-recognised by contrast with their male peers. This largely reflects the lack of political and economic freedom and power given to women in the Victorian period, even within most socialist utopias. One of the impacts of the factory movement was to deskill women; tasks which were traditionally undertaken by women, like spinning, entered factories as mechanised and male activities. Women were encouraged to participate in the Arts and Crafts movement. After all, it employed traditional female skills around domesticity and home making – all in keeping with the ‘Angel of the Home’ ideal. But, women’s work was largely recognised because they were considered executors of male designs in the main, rather than talented creators. And two influential Arts and Crafts guilds, Guild of Handicraft and Art Workers’ Guild, excluded women from membership. Paradoxically, the Arts and Crafts movement, like socialism, was both dependent on female involvement and hostile towards their work.

When my son and I visited the William Morris Gallery, there was an excellent temporary exhibition given over to political demonstrations and imagery through history. Here, the rhetoric of 1980s socialism was set against posters from all around the world decrying inequality and oppression and injustice. I was interested in how these two different perspectives on economic and political equality – the history of posters and the history of the Arts and Crafts movement – had a hidden truth at their core: gender inequality remains overlooked. The History curriculum in 2016 is apparently no more concerned by this absence than the founders of the Arts and Craft movement and early socialism had been.

 

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16 January 2017

The following blog post is reproduced in part from The History Girls daily blog: http://the-history-girls.blogspot.co.uk/2017/01/why-western-world-loves-extrovert-by.html

Why the (Western) World Loves an Extrovert 

On New Year’s Eve my friend and I sat in a busy venue, gently grumbling at all the bonhomie involved in the celebrations: strangers hugging, singing and optimistically making predictions for 2017. We were the obligatory introverts – the spectres at the feast, commenting on the party that was erupting around us, rather like Statler and Waldorf, those grumpy old men from the Muppets.

I thought a lot about introversion and extroversion over the festive period, and its social history. The overwhelming narrative of the season is the good humour and geniality of friends and family, and yes, strangers, in the spirit of man’s humanity to man – though it always seems to be women who are landed with the practicalities. Those who are not swept up in the spirit are the Scrooges and the Grinches of the world, preferring their own company to that of others. The pressure on all of us to grab the hands of strangers for a rousing rendition of Auld Lang Syne is considerable.

So where does it come from, this association of introversion with hostility and unfriendliness? What got me thinking about this is the history of loneliness, a subject that I am researching for a forthcoming book. Today, loneliness seems to be an ever growing concern, variously linked to adolescent depression, middle-age suicide and elderly dementia. To be separated from society, the story goes, is to fail to function in it. Loneliness has become shorthand for a pathological isolation from the outside world, made all the more challenging by the rise of social media. Sites like FaceBook are said to encourage isolation at the same time as they make us more ‘social’ – lurking on social media websites and seeing everyone else leading apparently ‘perfect’ lives, leads to introspection and depression.

It is introverts who most commonly report, or are more willing to report being lonely, but the term introvert is itself a modern one, coined by the Swiss psychiatrist and psychoanalyst Carl Jung in 1921. At the time of Jung’s research, many of our current working ideas about the self and society, emotions, the mind and the role of the individual were being formulated with the rise of the mind sciences. Scientific explanations for human personality and behaviour were being discussed, especially in relation to the structuring and working of the brain.

In the new mind sciences, extroversion was characteristic of talkative, outward-facing personalities who were energetic and enlivened by being around other people. By contrast, introversion was associated with isolation and reserve, and by the need to spend time alone. Most personality models in history since Jung have worked with this basic understanding of differences between extroverts and introverts. In 1962 Myers-Briggs created a workable model of Jung’s theories (the Myers-Briggs Type Indicator or MBTI) which is still in common usage. Curious? There is even a free online test, adapted from Myers-Briggs that you can take at home.

The MBTI ‘personality inventory’ uses Extroversion and Introversion as one of its main categories of analysis. Despite changing models of psychology since the 1960s, concepts of introversion and extroversion continue to dominate, and have acquired a moral loading. Extroverts are generally seen to be open and agreeable, and introverts thoughtful as well as neurotic. The basic idea of personality (or temperament) types is not new; it has been around since the classical period. Following Galen, men and women were divided into melancholic, phlegmatic, choleric or sanguine individuals, depending on how much of a particular humour they possessed within their bodies.

Today, there is more moral loading about different personalities, and the value of introversion and extroversion. In the Western world we place higher stock on being extroverted, as identified by Susan Cain in Quiet: The Power of Introverts in a World that Can’t Stop Talking  Many organisations and institutions celebrate noise and activity over quietness and consideration. Introversion, despite its necessity in many of the creative arts, has acquired something of a pathology; shyness a failing. Why is this?

Part of this association (extroversion = good and introversion = bad) can be rooted in the social context of the psychological models that emerged after Jung. In the early twentieth century, European and American models of psychology valued self-help, self-reliance, hard work and the rise of the individual. Being able to stand out, being willing to be vocal and outward-facing, being able to demonstrably lead others was a measure of success in presenting the self, as in business. On 21st century social media, vloggers like Zoella sell not only books and make up but a particularly modern form of aspirational extroversion that would have been unthinkable in an earlier time.

There are global differences in the desirability of extroversion. While it is taken as the norm in the UK and US, it has been argued, extroversion is less acceptable in traditionally social-orientated traditions of Japan and Buddhist cultures. Of course these are stereotypes, and differences are often surface, rather than core. But part of the reason for introversion in Buddhist cultures is the emphasis on looking inwards, in stillness and mindfulness, characteristics that arguably retain a different value in the West.

In the real world, of course, we need introverts just as much as extroverts. And most of us are neither entirely one thing or the other. It is common for each of us to feel introverted or extroverted at different times depending on our mood, company and environment. Extroversion is just one of the ‘big five’ that psychologists now use to measure personality and aptitudes. In addition to extroversion, the characteristics that matter are neuroticism (emotional stability); conscientiousness, agreeableness, and openness. The vast majority of people fit somewhere in the middle on most of these rankings. There are always exceptions. In a recent study, The Atlantic magazine found that Donald Trump, America’s new President, scored extremely low on agreeableness and unusually high on extroversion: a ‘combustible’ combination whose effects have yet to be seen.

 

5 December 2016

Guts and Brains: Why Connecting the Two is Crucial to Mental and Physical Health

This week the scientific journal Cell reported a major scientific breakthrough in understanding the cause of Parkinson’s disease. Parkinson’s is long term, degenerative neurological condition in which individual nerve cells in the brain die off, principally because of a lack of dopamine. It is estimated that one person in every 500 has Parkinson’s – that’s approximately 127,000 people in the UK.  The main symptoms of Parkinson’s are tremors and slowness of movement, though people with the condition often suffer depression and tiredness and constipation. This link with constipation is important because, as Cell reports, there are clear associations between the condition of gut bacteria and the health of brain cells. While scientific research into Parkinson’s has been largely confined to the brain, this new scientific finding has provided a clear path for research into the bacteria in the gut and how it might affect the rest of the human body.

This is great news for Parkinson’s sufferers, but it’s hardly a breakthrough. As I have argued in This Mortal Coil, an association has been made between gut health and brain health for decades. In the 1990s Michael D. Gershon argued that the Enteric Nervous System (ENS) was effectively a ‘second brain’, based on the size, complexity and similarity in neurotransmitters and signalling molecules between the brain and the gut. The ENS contains between 200 and 600 million neurons, the same number of neurones as have been identified in the spinal cord. The intestinal surface is also the body’s largest surface area, and approximately 100 times larger than the skin. Like the skin, the gut has a considerable role to play in receiving information and communicating that information to the rest of the body. The gut speaks to the mind through mechanical pressure, hormones and the immune system; indeed the gut contains more than two-thirds of the body’s immune cells.

This association of the ENS with the brain was not new in the 1990s. As early as 1907 Byron Robinson identified the ENS in The Abdominal and Pelvic Brain. He argued that the abdominal viscera contained a vast, complex network influencing and regulating many of the body’s systems. The body had two brains, according to Robinson – the mental and moral cranial brain where consciousness resides and the abdominal brain, which carries out routine vascular and visceral functions. These findings gave credibility to a range of well-established relationships between psychological and physical conditions like irritable bowel syndrome (IBS) as well as a range of psychiatric disorders. It also allowed for the possibility for a two-way system to be operating between brain and gut; given that ninety-five per cent of the body’s serotonin (a neurotransmitter linked to happiness, appetite, sexual behaviour and happiness) is found in the gut, there is ample evidence that gut health helps to shape brain health and function. Since neurotransmitters from the gut can influence the brain in happy as well as unhappy states, stimulation of the vagus nerve has been suggestion as a treatment for depression.  The existence of these gut–brain signals can also help explain why fatty foods are so addictive and why they make us feel good. Fatty acids are detected by cell receptors in the gut lining that send positive nerve signals to the brain.  By contrast, too few fatty acids link low-fat diets and depression. Moreover, a lack of healthy fats (found in foods like coconut oil and avocados and even butter) is potentially damaging to the brain.

Building on this work into the relationship between brain and gut, a 2011 study in the journal Neurogastroenterology and Motility showed that much of the work in generating information from the gut is carried out by the intestinal microbiota, or germs. There are approximately 100 trillion bacteria in the intestines, and their presence is often accompanied by neurochemical changes in the brain. Is it thus possible that depression and anxiety might ultimately be reframed as bacteriological conditions, rather than neurological ones. The development of the ‘gut brain’ as a site of knowledge, intuition, and feeling, and the relationship of gut flora and hormones with obesity, depression and now Parkinson’s indicates a more holistic understanding of the mind–brain relationship than is found in conventional Western medicine. Poor gut flora is a result of many different factors including the over-consumption of processed foods that contain no healthy bacteria. Over-use of pasteurisation, like over-use of antibiotics, is starting to bite. There is widespread belief now that healthy gut bacteria means a healthy mind, even in the tabloids. There are not, however, government guidelines about how to make sure ‘good’ bacteria is good enough or what diet changes might promote gut health naturally.

My book This Mortal Coil explores the history behind the division of the body into different systems, and therefore the reasons why it has taken so long for the scientific community to look properly at the question of microbes and their link to brain health. Since the early twentieth century the segregation of modern medicine into specialisms – psychiatry, neurology, gastroenterology and so on – means that it is hard to look for connections that indicate holism. Hospital departments, funding and research structures are based on viewing parts of the body in isolation rather than an integral whole. The move towards viewing mind and body together through bacterial health is an indication of a move away from this segregation and a transition back towards holism. It is interesting that the latest publication of findings in Cell has received a lot of media coverage. Far more than previous scientific publications that connect gut flora and mental health.

Does this mean that the tide is changing in our understanding of neurological degeneration and that we are perhaps ready for a more holistic approach? For the sake of the nation’s health, I hope so. Future research into Parkinson’s and related conditions can go even further by exploring how we can promote beneficial gut flora and the lifestyle changes that needed in the pursuit of optimum mental and physical health.  Earlier this year it was announced that seven major pharmaceutical companies were working together on clinical trials for new medications to treat Parkinson’s. But what if the future of Parkinson’s were in our own hands? Everyday decisions about the food we consume, the exercise we take, the alcohol we consume, the sleep we get and the stresses we place on our own bodies might make more difference, in the end, than any number of medications. This is a fairly radical step, since it gives power back to individual patients, and relies on disease prevention rather than cure. It is radical because scientific medicine is not set up this way, and because pharmaceutical companies make their profits by treating disease. It is radical because demolishing the boundaries between the brain and gut will mean rethinking established scientific specialisms. And it is difficult to suggest flaws in the system without being accused of airy-fairy thinking and a love of leeches. But most of all it is radical because we need to find new ways of proving what we know about the mind, the body and the complex relationship between the two, rather than relying on established yet flawed systems of belief that carve us up into ever decreasing parts.

10 October 2016

The Monster Within: Donald Trump and the Institutionalisation of Rape Culture  

Two days ago a recording of Donald Trump making ‘lewd’ comments about women hit the headlines. Except the classification of Trump’s comments as merely ‘lewd’ is part of the problem. Trump talked about sexual assault; about how he could kiss any woman he wanted and grab their ‘pussy’ because he was a star. How did Trump respond when the news was leaked? It was ‘locker room’ behaviour, he said. It happened a long time ago. When he was 59 years old, by all accounts a mere slip of a boy. This is a man who is running for President of the United States, and staggeringly, still claims around forty per cent of the vote.

Even before this recent example of Trump’s misogyny, Eve Ensler described the ways in which Trump and his election team demonstrated a deep-rooted contempt for and abuse of women. This is a man who has claimed women should be ‘punished’ for having abortions, who refers to his wife as a ‘beautiful piece of ass,’ who says he would date his own daughter, and calls breastfeeding women ‘disgusting.’ What I find disgusting is that a man who has demonstrated time and again racist and misogynistic attitudes and whose entire campaign is based on fear and resentment, could still be running for President.

Trump’s  strategy is based on the idea of ‘taking our country back’. From whom? Mexicans? Black people? Muslims? He repeatedly suggests that America is under attack; peddling fabricated stories about how muslims celebrated 9/11 in the streets of New Jersey, and that ‘grossly incompetent’ President Obama is somehow in league with Isis. Trump sees the ‘enemy’ as outside white America, infiltrating the country in crowds of Syrian refugees, or maybe lurking in black neighbourhoods. Trump uses the language of terror; latching on the worst and lowest common denominator emotional responses. (His campaign is after all nothing but emotional rhetoric – them versus us, a frightening picture in which we are the only innocent party. It was a campaign that resulted in the chaos that is Brexit, and why should we be surprised that Farage has come out as one of trumps most vocal supporters?)

So terror is out there somewhere, and Trump is America’s best defence? Trump isn’t big on facts – indeed an entire website has been built around his lies. But let’s look at some statistics. The BBC news reported that a Trump presidency is believed to be one of the ten greatest global threats in existence. What of Trump’s claims about terrorism and the dangers to US citizens since 9/11? Between 2004 and 2013, it has been estimated that 80 Americans were killed as a result of terrorism, excluding deaths in Afghanistan and Iraq. 36 of those people were killed in the United States. Of course none of those deaths should have happened, and if we want to look for causes, we do need to consider the failings of American and British foreign policy. 

Nevertheless, the rhetoric of terrorism should not allow us to overlook a monumental and insidious form of terror within the United States itself, one which has had, and continues to have far more impact on the lives of its citizens than Isis.  The Department of Justice estimates that there were more than 1,600 women murdered by men in the United States in 2013 alone.  Leaving aside colour, creed, religion and age, it is suggested that one out of every six American woman has been raped or sexually assaulted. Around the world, systematised rape has become a global weapon of war. Where, then, is a real threat to human life and security in the US? What is the greatest challenge to decency and civilisation? Men like Donald Trump, who use the language of terror to further their own careers while perpetuating an institutionalised and ubiquitous rape culture. Men who treat women like objects to be graded out of ten. Who call women ‘disgusting’, ‘pigs’ and ‘dogs’. Who belittle and undermine women while referring to their own children as ‘hot’. Men who seek to deny a woman rights over her own body while claiming his right to ‘grab her pussy’.  Women’s rights are human rights and it is time for that statement to be realised.

While significant missions like the Everyday Sexism project catalogue the millions of insidious examples of sexism and harassment faced by more than half the planet, women and young girls around the globe are violated, abused, raped, harassed, oppressed and murdered on a sickening scale.  It is women who have borne the brunt of the Tory austerity cuts in the UK, just as it will be women who would bear the brunt of Republican reproductive rights legislation. By contrast, as a member of privileged white social group, men like Trump are allowed to get away with misogynistic words and deeds because the odds are always stacked in their favour. Consider the Stanford rape case and the heart-rending letter written by the victim of a ‘star swimmer’ whose ‘20 minutes of action’ cost him jail time. The powerful letter written by the victim of Brock Allan Turner (a white middle class man) leaves no doubt whose side the law is on. Most women know this – and that’s why they don’t come forward when they are raped. Only around 15% of victims of rape in the UK report that rape to the police. Sadly this reflects the attitudes of men (and women) who are quick to point the finger at victims rather than consider the ways in which we talk about sexual violence and male responsibility. Sexual violence by men is by and large attributed to testosterone and the provocative (drunken, unfeminine, loose, insert-your-own-adjective) behaviour of women and young girls. Boys will be boys and girls will be garbage.

Nor are there enough places for women to report the everyday harassment heaped upon them at work and in the street. Rape and sexual violence and street harassment and ‘men’s talk’ are not different things, or ‘words compared to deeds’ as Trump unconvincingly tried to defend his own behaviour. They are part of the same spectrum of misogyny. I recently reported to the EveryDay Sexism project how my child was harassed on her way home from a coffee shop and was immediately trolled by critics saying ‘it didn’t happen’ and that I had made it up. Why our our voices silenced? Because to step into the light is to be called ‘shrill’ or to take ourselves too seriously.  Clearly we can’t take a joke. Or understand the sophisticated humour of the locker room.  Women are encouraged to compete against rather than supporting one another. Is this just a form of internalised misogyny? And amid the realities of sexual violence, our media is filled with conflicting images of sexist and offensive reporting about women’s bodies, looks and lifestyles. Many young girls suffer from poor mental health as a result of the diverse pressures heaped upon them. Not only the pressure to be perfect (for men like Trump to give them a high score?) but also because of the immense sexual, social and psychological traumas that many girls endure during their path to adulthood. And then for the rest of their lives.

There are many challenges confronting the world today. But Donald Trump is not the saviour of America. He is a symptom of its illness. His words depict a racist, misogynistic and hate-filled caricature of the monster that lives within, and that thrives on the language of the locker room. There is no wall big enough to keep out that terror.

 

12 September 2016

Last month I agreed to become one of the ‘History Girls,’ – ‘a group of best-selling, award-winning writers of historical fiction and non-fiction’: http://the-history-girls.blogspot.co.uk/2016/08/this-mortal-coil-by-fay-bound-alberti.html. I will be blogging on 15th of each month, starting January 2017. The following is my first blog, which I was asked to write to mark the publication of This Mortal Coil. You can win a copy of the book by entering a competition on the History Girls website: http://the-history-girls.blogspot.co.uk/2016/08/august-competitition.html

I’ve always been interested in the body, and how we talk about it. When I was eight my mother explained to my brother how they had been connected in her womb through their combined umbilical cords: ‘mine attached to yours’, she said, which didn’t sound quite right to me. I could sense the determination in her words though, the sense of ownership involved in explaining their physical bond. At secondary school my sex education lessons, brutally indifferent to feelings, resolved that physical conundrum, but not the sense of wonder by which we – wriggling in embarrassment on high wooden stools – tried to imagine what lurked beneath our skin. At university, I learned how long men and women had been trying to understand the human body; to account for the gift of life as well as the those ‘thousand natural shocks that flesh is heir to.’ (Hamlet, III, I, 1755) To this end Shakespeare was our ‘contemporary,’ at least according to Jan Kott; his characters experiencing their physical and emotional worlds as dramatically as we do.

But there’s the rub. We experience the world differently from Hamlet. Our bodies are not viewed the same today as they were in Shakespeare’s time. Across seventeenth-century Europe came the arrival of tools like the microscope by which people could know the workings of the body through the only sense that came to matter: sight. The four humours that had explained health, disease and even personality for thousands of years fell from grace, though humoral treatments like ‘bleeding’ continued into the nineteenth century. The ‘mortal coil’ described by Hamlet, the political and social world we inhabit, was also transformed – the rise of democracy and secularism in the West and the end of the ‘great chain of being’ (a hierarchy that kept us all in check) giving rise to individualism and the modern, introspective self. Today it is the brain, not the heart, that is the centre of our feelings, memories and identities, though the symbolism of the heart survives.

How did the brain come to dominate? Here as elsewhere, philosophical change accompanied technological and scientific change. The French philosopher René Descartes moved the soul from the heart, which had recently been confirmed as a pump by the English physician William Harvey, to the pineal gland, located behind the eyebrows. Mind and body were torn asunder; in time, ‘mind’ (which once described soul), simply meant brain. From the nineteenth century, scientific medicine gave rise to new ways of viewing the body through measurement and comparison. New norms were created. Gender and racial differences were etched into the fabric of our bodies – into the shape of our skulls, the structure of our skeletons, the thickness of our skins. Scientific medicine provided new rules to follow, new versions of the truth that were not driven by the imagination, folklore or symbols. But like any other narrative, it was a product of its time, creating stories that rationalised racism and sexism.

Through a series of case studies into the history and meanings of the skin, fatness, the female breasts and genitals, the tongue and the skeleton, This Mortal Coil considers how we have invested each of our body parts with meanings that reveal the needs of culture, politics and society. Thus seventeenth-century women’s tongues were so dangerous in an age of political uncertainty that the ‘scold’s bridle’ was needed to keep them in check. From the nineteenth century, when the industrial age privileged efficiency, being ‘fat’ represented waste and inefficiency, heaping moral outrage on the (increasingly lower-class) obese. In the 1950s the possession of small breasts was redefined as a psychiatric problem, easily fixed by a new type of medical practitioner: the cosmetic surgeon. Today the threat of the female genitals, a source of terrifying power for Shakespeare as for Freud, is contained by language: how much safer is it to see the vagina as a ‘birth canal’ rather than a source of untamed physical pleasure?

Metaphors matter because they shape our worlds, whether depicting the brain as a computer or the pubic hair as a lady garden. Illness is a battle we fight against invaders: we win or we lose, we live or we die. In conventional medicine we are divisible into separate systems and organs. There is no soul or immaterial essence. Yet many of us still believe in one. The heart might be a pump that beats 120,000 times a day, sending blood, nutrients and oxygen around the body. But some people maintain heart transplants move more than an organ, transferring the personality, habits and memoriesof the donors. Today the separation of mind and body suggests we can take control of our physical shell, disciplining it through exercise or cosmetic surgery in search of that perfect ideal. We regard our bodies objectively, as though distinct from the self that lives in our brains. Yet the incidence of mental illness is increasing. As is the demand for whole-body treatment. We are arguably more dis-eased about our bodies than ever before.

Ultimately, This Mortal Coil explores the stories we tell about the body. It does not demonise modern medicine. Nor does it suggest that we were all better off when we lived, like my mother, in a pre-modern world of imagination where we could each lay claim to our bodies without the intervention of science. But this book does ask whether the decline of holistic views of the body, that saw our minds, bodies and emotional worlds as part of a functioning, social whole, has done us a disservice. For surely we are more than the sum of our parts.

 

8 August 2016

Thoughtful review of This Mortal Coil in the Canadian magazine Macleans.

A look at Western notions of the perfect body

This Mortal Coil takes a provocative look at the problem with medical reductionism

MAC33_BOOKS_POST02

THIS MORTAL COIL

By Fay Bound Alberti

Timmie Jean Lindsey is one of medical history’s footnotes, the sort of Patient Zero whose individual story starts a mass medical development. In 1962, the 29-year-old divorced mother of six received the first silicone-gel breast implants. It wasn’t her idea: Lindsey had gone to a pro bono clinic in Houston to remove breast tattoos she regretted. No problem there, responded surgeon Frank Gerow, who had been working with chemical company Dow Corning on crafting something better than what surgeons had been up to for decades—injecting liquid fat, polyethylene or silicone directly into breasts. Would Lindsey also like some free (experimental) implants?

Actually, she told Gerow, “I’d rather have my ears fixed,” confessing she was self-conscious about how they “stuck out.” Surgeon and patient made a deal: Gerow implanted two silicone sacs, upping Lindsey’s breast size from B to C cup, and pinned back her ears at the same time.

Lindsey isn’t exactly the star of This Mortal Coil, but she is emblematic of much of what is covered in Alberti’s provocative look at the evolution of Western notions of the perfect body, and the way medical science has come to focus on individual pieces of it even while humans maintain an intuitive sense of its interconnectedness. Many, perhaps most, Westerners have beliefs incompatible with materialistic medicine, notes the British historian, concepts that emerge most strongly in regards to transplantation. Lindsey woke up from her operation, she later recalled, feeling like “an elephant was sitting on my chest,” and spent decades coming to terms with the notion the implants were part of her. Likewise, Alberti’s teenaged daughter, who has metal rods in her back to correct scoliosis, is still feeling her way to accepting the rods as of her body, rather than simply in it.

This Mortal Coil follows, with deliberate irony, the kind of medical reductionism Alberti rejects, dissecting bodies into parts that are of interest to her. It’s an organizing principle that allows her to show conceptual change over time regarding the organs we most associate with feeling (heart, gut and brain), the mutual influence of gendered medical and social thinking (breast, genitalia, skin and, more surprisingly, tongue), and how current thinking about fat stigmatizes some bodies.

But the approach also allows Alberti to bolster her case that reductionism is counter to human instinct. We speak of our bodies and organs in metaphor, she points out, using terminology that sticks with us even after new medical concepts arise. Thus we still speak of hearts as warm or cold, full or empty, long past the era when we thought hearts pumped emotions as well as blood. Just as the language of the Industrial Revolution formed images of the emotional body (with its need to “let off steam”), it also crafted brain metaphors: according to one 19th-century scientist, the brain was an “enchanted loom, where millions of flashing shuttles weave.”

No more, of course. Our lasting linkage of hearts and pumps is equaled by our instant identification of brains with digital technology—first as computers, machines hard-wired to “process” or “file away” experiences, more recently as a kind of Internet search engine, part of a worldwide cloud. A turn for the good, suggests Alberti: we should think of ourselves as more than the sum of our parts.

 

4 August 2016

I spoke to Julie Beck at the magazine The Atlantic about This Mortal Coil. The interview is reproduced below:

In a Brainy Age, the Heart Retains its Symbolic Power

http://www.theatlantic.com/health/archive/2016/08/the-enduring-metaphors-of-the-heart-this-mortal-coil-fay-bound-alberti/494375/

Scientists no longer believe that the soul lives in the heart—but we continue to use it as a metaphor for far more than just its physical function.

Julie Beck Aug 4, 2016 Health

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These days, the brain is where it’s at. “It” being our minds, our personalities, our behaviors, our memories, our consciousness. The lumpy chunk of grey between our ears is the part of the human body scientists are most excited to study. When President Obama announced his BRAIN Initiative, to map the human brain, the New York Times called the brain “the next frontier.”

But the pedestal the brain currently occupies used to belong to the heart. For much of history, the heart was the seat of what made humans human, as Fay Bound Alberti, an honorary senior research fellow at Queen Mary University of London, writes in her new book This Mortal Coil, a history of how culture has treated the body. And as the focus shifted to the brain, and scientists began to think of the heart purely in terms of its physical function, the heart nonetheless retained a glimmer of its former emotional, spiritual aura. The English language is full of metaphors invoking the heart. People wear their hearts on their sleeve; they have hearts of stone, or hearts of gold; they have heart-to-heart conversations. Other languages have many similar metaphors.

I spoke with Bound Alberti about how the poetry and metaphor of the heart has helped the physical heart hold onto a psychological significance, even in this, the era of the brain. A lightly edited and condensed transcript of our conversation is below.

Julie Beck: You write that, for much of history, the heart was the most important organ for selfhood. Why did people think that your self was something that physically resided in your heart?

Fay Bound Alberti: So the ancient Greeks had what we call a cardiocentric view of the body. I suppose because it’s the first part of the body that demonstrates life through beating, they saw the heart as the center of the human body. The organ was imbued with psychological characteristics, but also was the space where the soul moved through the body, bringing together the mind and the body with the divine. That was also evident in those physiological feelings that we have in our chest that are linked to our emotional state. So for 2000 years we have this image of the body as being entirely driven by the heart, and the heart lies at the center of our psychological well-being and character as well as our relationship with God.

Beck: Was this part and parcel with the four humors? Since blood was one of the humors and the heart pumps blood?

Bound Alberti: There were four different humors in the body. Each one was responsible for a different emotion. And if the soul moved through the body and determined that an event was negative and disturbing, then the heart would summon the appropriate humors. Either choler, so that the body could run fast away from the threatening object, or melancholy, in which case the heart would feel down, sunken, and the body would retreat into itself. So the heart was responsible for summoning these humors that were made in the liver.

Beck: It was also a heating/cooling thing, right? Which also kind of had to do with personality. Could you explain that a bit?

Bound Alberti: In the early modern period you have the heart, which is responsible for the heat of the body, and the brain, which is basically the body’s refrigerator. Under humoral medicine what you have is a balance of heat in the body. Men were hotter than women for instance, who were wet. And the reason was that the heat was supposedly burning up the hair on the men’s head, which is why women’s hair is longer, and it burns up flesh which is why women’s bodies are fatter. So you have an incredible gendering of the body around the heat that operates through the heart. At this point the brain is just a cooling organ and has no importance to most physiological interpretations. It’s all about the heart.

Beck: When did we start to shift away from that?

Bound Alberti: Well, it’s a fascinating aspect of the history of physiology really. On the one hand, for the first time in the 17th century people can cut open human bodies and look inside, do vivisection and dissection in a way you weren’t allowed to legally in the earlier period, for religious reasons. So you have the heart, increasingly from the 17th century but specifically in the 19th century, being regarded as this organ that you could compare and classify and contrast with other organs. And you also have the removal of the soul from the body in medicine generally. So the heart becomes an automated organ.

And the second big shift is you have philosophical ideas about the self, starting really from Rene Descartes in the 16th century, who talked about that disjuncture between mind and body. He introduced notions of the reflex and so on, which gave organs like the heart these integral properties—they could pump on their own. So Rene Descartes separated the passions from reason, and this coincides with work like physicians like William Harvey who talk about the circulation of the blood. Once you have the circulation of the blood, then the humoral model cannot survive. We can’t be composed of these different humors that move around the body when actually the blood is being circulated all the time. So you have this convergence of philosophical, medical, and scientific belief that ultimately makes the heart less significant in relation to our mental selves and our spiritual selves, and prioritizes the brain. That’s how we’ve ended up now in a very neuroscientific age where we’re all about the brain.

Beck: Did they think the soul was something that no longer had any physical component?

Bound Alberti: Interestingly not. Rene Descartes wanted to view the body as still having a soul, but what he did was he moved the soul from the heart to the brain. He put it in the pineal gland, which is just behind the eyebrows. One of the reasons he did that was that facial expressions are very important in showing emotion. And he figured that actually, if you’ve got the soul working behind the eyebrows, that makes sense.

Beck: Scientists were thinking of the heart more as just part of the body, just another organ, but the poets were not having it, right?

Bound Alberti: That’s right. So in the late 18th, early 19th century, the peak of the process by which the heart was becoming objectified, you’ve got the rise of the Romantic poets who reinforced the idea that there was something very heartfelt about what lurks in our chest. Those languages of emotions being heartfelt, hearts rising and sinking, being heavy-hearted, light-hearted, having the heart of a lion and so on—those metaphors and the language in which we talk about the heart, show that we still, even at the very peak of scientific medicine, have those associations of the heart being psychologically and emotionally, even spiritually important.

Beck: It seems like that period of poetry had a really big influence. We still use the heart to describe personality, you mentioned that in the book, like you could be cold-hearted, or tender-hearted, or empty-hearted. The poets kind of won, didn’t they?

Bound Alberti: I see there being a really strong and problematic disjuncture in modern medicine, as a result of these changes. On the one hand you’ve got the surgeons who do really important valuable work on the heart, transplantations and so on. But when I’ve spoken to the surgeons, they don’t want to imagine that the heart has any more significance than being a pump that sends the blood around the body and beats 100,000 times a day because they couldn’t bear to do their job.

But then you also have people who continue to view the heart as something that is symbolic and psychological. There’s some evidence of this in heart transplants, where you have people who’ve received a heart from another person and claim that they have all kinds of personality changes, like they’re craving different food as a result. That isn’t to say that demonstrates that there’s anything more fundamentally real, if you like, about the heart as opposed to the brain as a way of talking about the self. But what’s interesting to me is you’ve got these different narratives of understanding behavior.

And actually the medical community, through work like that done at the HeartMath Institute are slowly moving toward a cellular memory being located in the heart. Which actually, gives a very modern scientific explanation for the kinds of phenomena we’re seeing in people who identify a heart transplant as being psychologically changing.

Beck: That’s like, very fringe though, isn’t it?

Bound Alberti: Yes, yes. But with something so dramatic and life-changing as heart surgery or heart transplantation, you can understand why all these different cultural ideas might come into play.

Beck: I wonder about the cellular memory stuff, I’m not sure how… legit that is.

Bound Alberti: It’s not mainstream and it’s absolutely not that I wish to say that it is the way ahead. But what I have found in looking at different ways the body’s been interpreted, is it becomes another story that we tell about the body. So in a sense whether it’s true or not is not as important to me as the fact that people use it as a way of explaining their world.

Beck: That is interesting because I think you do see this with a lot of alternative medicine stuff where people are suffering from a disease that’s not well understood yet like chronic fatigue, or something like that. And because we believe in science so much, it’s much more comforting or you just want to have a scientific narrative even if the actual science isn’t there yet.

Bound Alberti: I think that’s true. We are basically products of the 19th century scientific revolution that redefined how we view our bodies. I think it’s the same in America as it is in most of Europe. We want to be able to objectify things, we want to name them, we want to classify them, and that gives a degree of comfort. But I think in a sense it also makes us question the medical framework that we live by. So when you have medical students dissecting bodies, they talk about the fact that actually it feels both frightening and privileged to cut open the heart and look at it. Because they, like everybody else, are imbued with these cultural ideas that just exist in the ether. So we’re trying to be very objective, very materialistic in how we view the human body, but of course even the practitioners don’t always see things that way.

Beck: And they felt that way more even about the heart than the brain, right?

Bound Alberti: Yeah. I think what you find in medical students—and I feel this really takes us to the heart of the matter—they tend to view cutting up the brain as problematic in the same way that cutting up the heart is problematic. But when they cut open the brain they tend to talk more about thoughts and memories, and whether or not they’re cutting through those immaterial processes. But when they talk about dissecting the heart it’s much more about love and feeling.

Beck: One thing that’s interesting to me is how we ascribe an agency, or a sort of separateness, to the heart. Like, you “listen to your heart”—as though it’s not a part of you. Like it’s talking to you, or you’re not totally in touch with it. And people do that with the brain, but it’s much more detached like, “Oh when the brain wants this, you behave this way.” Which is a little different. And I don’t think there’s any other body parts that we really do that with. Why do you think we talk about the heart that way?

Bound Alberti: I think you’re absolutely right. Nowadays we think of our selves as residing in our heads so we are crainiological beings rather than cardiological beings. Part of it I think is that division between reason and emotion, which is also a product of the 19th century. We’re locked in this battle sometimes between our minds and our passions—head over heart and which do we follow. There are interesting gender theory issues around that, because you have the brain which traditionally was associated with reason and very male and very objective, and the heart really becomes female and problematic and all about feelings. That head-heart divide is something that I think is very much built into modern medical structures. We don’t tend think of ourselves anymore as a holistic whole, so we think about our hearts as very separate from our heads.

Beck: I’m wondering about not just contrasting the heart with your head, but thinking of it as not even totally connected to who you are, because you have to listen to it, like “Oh what is your heart telling you?” If it was like “Oh what is your brain telling you?”, you would know. It’s like a separate thing that you have to kind of seek out and listen to.

Bound Alberti: To expand on the head and the heart analogy, I think the reason that we do this is that we are used to thinking of our thoughts and our brains as being the rational way we could do something. What we’re doing when we live our lives that way is actually distancing ourselves from our bodies. Our hearts are beating in our chests, and they are a very visceral reminder that our bodies have feelings and our bodies have reactions. But we have learned as crainiological beings to separate ourselves out from our bodies. So sometimes we might be trying to rationalize something, to feel okay about something, but our body, our heartbeat, is telling us there’s a disconnect. I think that’s why we have a rise in body memory work and in body therapies, that focus on the senses that are locked into the body and particularly the heart, that are telling us something different than the rational brain that tries to reason with the world.

Beck: Could you give me an example of what kind of therapies you’re talking about?

Bound Alberti: There’s quite a lot of body work that’s on trauma. There’s work by people like Peter Levine who does somatic experiencing, which focuses on the physical experiences, we have a sinking feeling we associate with fear and so on. People who do body work and somatic forms of therapy, their argument is that we need to bypass this rational brain which talking therapy has focused on, to try to get to what is making us feel lacking in ease within our own bodies. Body work has been most particularly useful for survivors of trauma and sexual abuse. There’s different ways of understanding mental and physical health that either relate to what’s happening in the brain or what’s happening in the heart. Integrated medicine, I think, is finding ways to draw them together. But change is always slow, largely because we’re locked into our original metaphors and our very traditional ways of seeing the body.

Beck: It’s interesting because we have such advanced technology now that we can look at genes and neurons and get really computery with it if we want to. Even with all that, is there still something that remains mystical to us about the heart?

Bound Alberti: I think that there is. I think a lot of people still regard their heart as having an essence of self which cannot be read in material terms. There’s metaphors about the heart that are enduring in the language that we discussed, about feeling that something is heartfelt, you’re being true to your heart and so on. So the organ carries on that meaning above and beyond any scientific explanation.

And if you think about the iconography as well, there is nothing more iconic than “I heart…” whatever it is, New York, or you. Those sorts of images, of what I call the Hallmark heart, that wonderfully symmetric beautiful blood red sign, have been found throughout the world since the 14th century, and it’s relentlessly the same across cultures, which is fascinating because it has no comparison to the bloodied slab on the butcher’s block. This is a fantastical heart, which represents unity, it represents sex, it represents love, in a way that the brain can never visually represent, because it’s not such a beautiful aesthetically pleasing symbol, is it?

 

25 July 2016

The following is an excerpt published by LitHub. http://lithub.com/lithub-daily-july-25-2016/

‘A Darke and Vicious Place: Conceptualizing the Vagina: How Female Sex Organs have been Understood, in Art and in History’.

hamlet                 Lady, shall I lie in your lap?
ophelia                No, my lord.
hamlet                 I mean, my head upon your lap?
ophelia                Ay, my lord.
hamlet                 Do you think I meant country matters?
ophelia                I think nothing, my lord.
hamlet                 That’s a fair thought to lie between maids’ legs.
ophelia                What is, my lord?
hamlet                 No thing.

(Hamlet, III. ii. 107–115)

Hamlet’s exchange with Ophelia is a ribald one. Elizabethan audiences would have understood the sexual puns in Hamlet’s words—lie (to have sex with), head (penis or oral sex), country matters (allusion to “cunt”) and “no thing” (a slang term for a vagina which reveals its definition by absence, i.e. no penis). Much has been written about Shakespeare’s frequent references to sex and sex organs, and there are perhaps 700 puns about sex in the plays alone. There is also a considerable body of analysis on the troubling nature of female sexuality and desire in Shakespeare’s work. Women arguably feature most often in Shakespeare principally in terms of their sex, and not as a focus for social criticism or observation but as a source of mythical power that arouses both love and loathing in their male counterparts.

Historians of the so-called “one-sex model” of gender difference argue that early modern men and women viewed sexed difference on a continuum; that the female body was essentially an imperfect version of the male. Thus some anatomists wrote about the vagina as an internal penis, the labia as the foreskin, the uterus as scrotum and the ovaries as testicles, an inversion made possible by the physical imperfection of women; unlike men they lacked the sufficient heat for the sex organs to be drawn outside of the body and to become male. This is an interesting historical hypothesis, as is the suggestion that the Enlightenment saw a complete separation of male and female into our modern “two-sex model” of binary biological difference. But it also depends on a rather simplistic interpretation of a few select anatomical texts. Not all early modern writers were wedded to the idea of the one-sex model, and there were many anatomists who viewed male and female organs as entirely different. Additionally, there was a degree of animosity towards the vagina in the early modern period, as indicated by Shakespeare’s prose. The vagina was a troubling space, an organ of creative power and maternity, but also of sexual manipulation and control.

One of the most striking aspects of Shakespeare’s references to female genitalia is the range of words used to describe them: the vagina is not merely a no thing (Hamlet), but a “vallie-fountain” (Sonnet 153), a “deep Pit” into which one might stumble and be lost (Titus Andronicus), a bracelet (Cymberline) and a “darke and vicious place” (King Lear). The vagina has many names but no name; it is an object of euphemistic discourse in the past as in the present, as testified by Eve Ensler’s Vagina Monologues and its contributors, many of whom identify with what Ensler calls the “‘down there’ generation.”

Even today, a study of dictionary definitions of “vagina” reveals that the organ is seldom described in relation to sex (unlike the penis), but overwhelmingly in terms of its physical location. Similarly, while “penis” is almost always described as an organ, the vagina is not; it is pictured as a “canal” or a “passage” that by implication leads somewhere else. Moreover the clitoris is often missing from those dictionaries; where it has been included that is principally in relation to the penis. The possession of a vagina, or the absence of a penis, is what has historically defined female against male bodies. This binary difference is not only problematic for women (whose bodies are defined by that absence), but also for representatives of the LGBT+ movement, especially in relation to transgender identity. There is ample literature to show that women have been delimited by, and reduced to their vaginas for centuries, which raises the question whether the equation of womanhood to the vagina in Ensler’s monologues is just another way of reducing women to their sexed existence.

Leaving behind the one-sex model, this chapter explores the ways women’s sex organs have been understood in history: most notably the vagina, the vulva, the clitoris, and the hymen. Since Shakespeare’s time female genitalia have been written about in a number of different ways, anatomical explorers laying claim to specific body parts much as their seafaring counterparts colonized new geographical lands. In the process the mapping of the female body became a powerful social and political metaphor for gendered discussions about the dominance of reason over passion, of civilization over nature. Female genitalia are often the subject of multiple anxieties over the control of women’s bodies and their reproductive function. The reasons have been theological and ideological as well as purely economic, such as primogeniture, the passing down of property through the male heir, and religious ideals of female chastity.

In the twenty-first century, governments, pressure groups, feminists, educationalists, and religious organizations express concerns about female sexuality, linked both to reactions to the so-called “sexual revolution” and the ever-present double standards of sexual morality. Control over female sexuality is embedded in broader political debates and specific human rights abuses like female genital mutilation and sexual slavery.

The words used to describe women’s sex organs also remain controversial, whether that is the profoundly provocative “cunt” or deliberately demure “lady garden.” Political and linguistic anxieties reflect not only cultural concerns about women’s bodies as sexually active or sexually reproductive, but also political values about women’s sexual and socioeconomic function. There is more, then, to “the woman’s part” than meets the eye.

Passivity and the “Woman’s Part(s)”

Female sexual organs are more physically complex than indicated in the generalized diagrams of reproduction found in school teaching; the two-dimensional sketches that highlight the fallopian tubes, the ovaries, the womb, and the vaginal passage that can stretch to accommodate a penis as well as a baby’s head. The “facts of life” are ordinarily explained in the most rudimentary biological terms. The language in which reproductive sex is described is also important, because it sets up and confirms the social relationships in which it takes place. The vagina is figured as a passive recipient that is “penetrated” by the penis, which deposits sperm that must race to the patiently waiting egg. This version of the physical process denies any active agency on the part of the uterus, most notably through orgasm, in dipping to pick up the sperm and help conception to take place. In 1999 the feminist Germaine Greer explored the idea of a “different version of female receptivity by speaking of the vagina as if it were active, as if it sucked on the penis and emptied it out, rather than simply receiving the ejaculate.”

The language in which reproductive sex is described is also important, because it sets up and confirms the social relationships in which it takes place. To date there has been no scientific evidence confirming that the vagina, or the uterus (through hormones released at orgasm that cause muscle spasms), has an active role in propelling sperm up the vagina. It is highly relevant that evidence-based work is undertaken in women who are not sexually aroused. There is not, moreover, much financial incentive for research in this area. Yet the evolutionary function of the female orgasm is a subject that has aroused much public and academic interest, especially since the 2005 publication of Elisabeth Lloyd’s The Case of the Female Orgasm. The briefest consideration of the history of the female orgasm makes clear that Greer’s observations are not new. The association of female orgasm with pregnancy has a long history. Since the ancient Greeks a prerequisite to pregnancy has been orgasm in both parties. Unfortunately, agency is a double-edged sword: this belief has been used to deny rape: from the advice of a seventeenth-century midwife, Jane Sharp, that “extream hatred is the reason why women seldom or never conceive when ravished” to the Republican Senate nominee Todd Aitken’s farcical distinction between rape and “legitimate rape” in 2012.

The language of female genitalia has changed. In early modern writing, the term “womb” was sometimes used to describe both the womb and the vagina, treating them as one distinct unit. Sometimes the term “bottom” is used for womb, and “womb” for vagina. Today there is a similar slippage of terms from one part of the female anatomy to another. When most people use the term “vagina” they are usually not speaking precisely about the internal, muscular tube that connects the uterus to the fallopian tube and the ovaries, but its visible outer layer and opening (sometimes called the vestibule in medical textbooks), as well as the labia majora (outer lips), labia minora (inner lips) and the clitoris. There is seldom any mention of the vulva in diagrams of the female reproductive system. Yet the vulva has a sexual function; it is not a merely a gateway to the vagina. The external organs are filled with nerves that provide pleasure when properly stimulated. How strange then, that the vulva is ignored in discussions of reproduction, along with the clitoris and the hymen, despite the fact the former is crucial in enabling women to reach climax, as discussed below, and the latter in “proving” virginity.

The Vulva Monologues

Looking at the vulva became particularly fashionable at the end of the twentieth century, with its clinical reconstruction for aesthetic reasons. It  has been suggested that women who request vulvar reconstruction overwhelmingly base their aesthetic ideals on their childlike rather than their adult appearance. And this trend has its roots, somewhat alarmingly, in both the sexualization of young bodies and the fashion for the so-called “Barbie doll” aesthetic found in pornography, in which women’s external genitalia are dainty, pink, soft, even-textured, and hairless. Labiaplasty, the reduction and cutting away of the inner labia, is one of the fastest growing forms of cosmetic surgery in the West. In 2008, in reference to this troublesome cultural trend, the Brighton-based artist Jamie McCartney created The Great Wall of Vagina; a sculpture comprising plaster casts of 400 women’s genitals to show how varied vulvas might be. The artist describes the work as “art with a social conscience.”

It seems churlish to point out that McCartney has actually created a Great Wall of Vulva, since the geographical allusion would be lost. On the one hand, the declared intent of McCartney, to celebrate the diversity of  womanhood, to make women “feel better” about their differences is laudable. And yet on the other, there is something oddly jarring about a male sculptor exhibiting female body parts so explicitly; for art or for profit, such a mass display is somehow objectifying (the very opposite of McCartney’s claim, in fact, that the multitude somehow makes the depiction less so). There is, moreover, a subtle allusion in McCartney’s work to the writings of the Renaissance scholar and humanist François Rabelais, though this may be accidental. In Gargantua and Pantagruel, Rabelais imagines a wall of vulvas protecting Paris, being “cheaper than stone,” given how much women’s private parts sell for on the city streets.

There are disturbing parallels between the rise of cosmetic surgery as an aesthetic choice and the incidence of female genital mutilation (FGM), also known as “cutting” or “female circumcision.” It could even be defined as such, if we use the definition given by the World Health Organization (WHO) as “all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons.” Of course, not all forms of cultural compliance involve surgical alteration. Another example where female genital appearance has developed a strong visual aesthetic is in the case of pubic hair.

To Bare or Not to Bare

Female body hair removal has become ubiquitous in the modern West, especially in the UK and North America. One psychologist has called hairlessness, especially of the underarms and legs “a major component of ‘femininity’; a norm that has developed in the United Stated since the early twentieth century.”  The fashion for shaved or waxed pudenda is more recent. In 2002 commentators began to discuss the ubiquity of the “Brazilian,” the removal of all hair from women’s genital area that was the subject of considerable media attention from HBO’s Sex and the City to popular magazines and websites.  How did we get to a place where the almost complete removal of public hair, a process that is painful, inconvenient, expensive, and repetitive, is not only fashionable but also the idealized ‘norm’, female body hair being seen, at least in most of Europe and the United States as unattractive, unfeminine, and even dirty?

In the same way that small breasts became abnormal in the nineteenth century, excessive body hair was pathologized and associated with excessive masculinity, and with animalism and primitivism in the context of evolutionary theory. A series of high-profile case studies from the 1850s, from bearded ladies to human zoos to the ‘hairy family of Burma’, meant that excessive hairiness was medically and socially linked to a new condition—hypertrichosis—and women with superfluous hair on their bodies or faces were regarded as non-women. The following century, moreover, saw first the rise of feminism and the rejection of beauty ideals around the removal of body hair, before a backlash against that movement and the imposition of even stricter ideals of femininity and hairlessness.

18 July 2016

The Page 99 Test

This Mortal Coil is a cultural history of the human body. It considers how beliefs about the body have been structured by, and reinforce, ideas about gender, race and sexual identity. Though we often consider Shakespeare ‘our contemporary,’ – as seen by commemorations in the 400th year since his death – the ways we view the body have changed.  My title is taken from one of Shakespeare’s most famous Hamlet soliloques: ‘To be or not to be’, in which ‘this mortal coil’ that we ‘shuffle off’ after death refers to the social, political and cultural turmoil in which the body is situated.

In Shakespeare’s time a humoral model of the body predominated, in which the body was composed of blood, yellow bile or choler, black bile and phlegm. The proportion of each humor influenced one’s health and psychological state. The soul, which moved through the heart, summoned black bile for sadness and blood and choler for anger, producing the physical effects of emotion: the hair standing up on end, the flushed face, even the gnashing of the teeth. On page 99 of This Mortal Coil I describe how early modern writers invoked these physiological processes when explaining anger’s effects. Thus John Downame’s Treatise on Anger (1609), explained how the passion:

Maketh the haire to stand on end, shewing the obdurate inflexiblenesse of the minde. The eyes to stare and candle, as though with the Cockatrice they would kill with their lookes. The teeth to gnash like a furious Bore. The face now red, and soon after pale, as if either it blushed for shame of the mind’s follie, or envied others good. The tongue to stammer, as being not able to expresse the rage of the hart. The bloud ready to burst out of the vaines, as though it were a raide to stay in so furious a body. The brest to swell, as being not large enough to containe their anger, and therefore seeketh to ease it selfe, by sending out hot-breathing sighes. The hands to beate the tables and walles, which never offended them. The joyntes to tremble and shake, as if they were afraid of the mines furie. The feete to stamp the guiltlesse earth, as though there were not room enough for it in the whole element of the aire, and therefore sought entrance into the earth also. So that anger deformeth the body from the hayre of the head to the soale of the foote.

Between the seventeenth and nineteenth centuries, medical understandings of the body were transformed. In the West, writers moved from a humoral and holistic understanding of our selves to one in which the material body was a series of parts, systems and organs. The location of our ‘selves’ moved from the heart to the brain and the soul became irrelevant. Ideas about body parts also changed: from the skin to the bones, from fat to the tongue, new narratives evolved to explain the workings of this complex material structure. These were invested with a series of beliefs about race, gender and sexuality that continue to have impact.

One of the challenges of this broad development, I suggest, is that our psychic selves are more distanced than ever from our bodies at the same time as medical understandings are more specialised. Rates of depression are increasing and our drive for perfect bodies has given rise to dangerous and unregulated cosmetic practices. The ‘modern body’ therefore presents philosophical as well as scientific challenges. Through a series of historical case studies, This Mortal Coil asks: are we really more than the sum of our parts?

For more information on the page 99 test, see: https://www.theguardian.com/books/2010/sep/27/page-99-test-book

7 July 2016

Emotional Health and the ‘Toxic’ Family.

We choose our friends but not our relatives, and a ‘toxic’ family of origin takes its toll on the body as well as the mind.  This term describes an environment and a system of relationships that is unhealthy to an individual who is usually a survivor of abuse: physical, mental or sexual.  Toxic families do not define themselves as such; it is often one person, scapegoated and alienated from the others, who identifies that which has been hidden or denied. The damage to the self-esteem of the individual concerned can be profound. Unlike those from healthy, loving families, survivors of abuse may go on to form relationships that are equally abusive and unequal, that reinforce the feelings of neglect and unworthiness they have experienced as children. A high proportion of adult survivors are diagnosed with complex post traumatic stress disorder (PTSD), especially if that trauma is continually denied.  And the toxic environment is self-perpetuating as long as the family members continue to participate in it. Roles become fixed and the dynamic ensures that family members play their parts, willingly or otherwise. Those roles can even, like red hair or a favourite teddy, be passed on through the family, replicating old inequalities and established favourites.

For abuse survivors, the feelings that accompany family events, such as a wedding, a funeral, a birthday, can be intolerable. Having spent months and years trying to overcome those original wounds, to make oneself ‘whole’ again, reintegration into a toxic environment causes physical and psychological harm. People in negative social relationships – at work, at home or in their families of origin – are far more likely to suffer cardiac problems, for instance, than those with healthy relationships and boundaries. Trying to ‘fix’ those relationships – the typical and self-defeating attitude of the survivor – does more harm than good. Unless abusers are willing to acknowledge their role and to act to change the dynamic (usually through difficult and sustained family therapy), the survivor is likely to find the same wounds reopened time and again. The survivor’s existence is a reminder that all is not as it seems. That the narrative (and the centre) of the family cannot hold.

The psychological and bodily experiences encountered by the abuse survivor are varied but generally include problems with anxiety, interpersonal relationships and trouble with self-acceptance and reality.  Of course broader and more complex psychological difficulties can include bipolar disorder, borderline personality disorder and post traumatic stress syndrome (PTSD).  One of the most challenging issues for the abuse survivor is maintaining the patterns of secrecy on which the toxic family depends. Nobody speaks of the physical violence, the name calling, the neglect or the regular and sustained belittling of the survivor’s experience. All too often siblings are encouraged to treat the scapegoated child as mentally deficient or ‘difficult,’ compounding the survivor’s sense of isolation and alienation that continues into adulthood. This is particularly difficult when it means that the survivor cannot make and sustain relationships with the children of their siblings. Again, the dynamic is woven onto the next generation.

For many adult survivors, it is impossible to sustain select relationships within a family dynamic; it is all or nothing. This can be problematic for those who have spent years trying to fit, somehow, into the existing dynamic; to swallow their experiences and join in a conspiracy of silence that devalues their memories, mental and physical, of abuse and neglect. Especially when there is ‘re-wounding’: those original hurts are inflicted time and again in a myriad of ways that seem meaningless to the abusers. The goal for the survivor, therefore, is often to remain part of something, however painful and traumatizing it might be to be overlooked, ignored or excluded and to have family memories redrafted in ways that don’t include a survivor’s pain, hurt and distress. We are all members of the collective after all and the alternative – to walk away – can seem a kind of social suicide. Sometimes, however, it is the only way to survive.

 

23 June 2016

Emotions, Hamlet and the Body. Or, Why I wrote This Mortal Coil

The following is reproduced from Queen Mary History of Emotions blog: https://emotionsblog.history.qmul.ac.uk/

Cj4Pas1WUAACIWk-1 (1)This is a guest post by Fay Bound Alberti. Fay is an Honorary Senior Research Fellow in History at Queen Mary University of London, having taught previously at universities throughout the UK, including Manchester, UCL, and Lancaster. A founding member of the Centre for the History of Emotions, she has written extensively in the fields of history, medical history, and women’s history, including Matters of the Heart: Locating Emotions in Medical and Cultural History (2010), also published by Oxford University Press, which was shortlisted for the Longman History Today book of the year award. She is also an experienced philanthropy advisor who has worked as Head of Philanthropy for the Arcadia foundation and Head of Medical Humanities Grants for the Wellcome Trust. Fay also publishes posts on her website www.fayboundalberti.com . Her new book, This Mortal Coil, is published today.

 

To be or not to be-that is the question:

Whether ’tis nobler in the mind to suffer
The slings and arrows of outrageous fortune,
Or to take arms against a sea of troubles,
And, by opposing, end them. To die, to sleep

[…]

To sleep, perchance to dream. Aye, there’s the rub,
For in that sleep of death what dreams may come,
When we have shuffled off this mortal coil.

 William Shakespeare, Hamlet (1603)

 

References to Shakespeare are ubiquitous in 2016, which marks 400 years since the playwright’s death. But that’s not why I chose to quote from Hamlet for the title of my new book, This Mortal Coil: The Human Body in History and Culture (Oxford University Press). By referencing Shakespeare, I am drawing attention to key presumptions that have been made about the body in history. For centuries Hamlet’s body has been seen as our body, his emotions, our emotions, most notably for those writers who see passions like fear and anger as unchanging across times and cultures.[1] This slippage is understandable: like Hamlet we each inhabit a physical body, a mass of flesh, bones and blood that takes us through this ‘mortal coil’ that is the bustle and turmoil of everyday life. Like Hamlet too, we are tied to the world by our bodies and by all the concerns that ‘flesh is heir to’. Hamlet thus becomes our Everyman (or woman), representing existential angst in the modern age as readily Lady Macbeth’s archetype of female manipulation or Othello’s male sexual jealousy.

9780199793396And yet Hamlet’s body is not our own, any more than ‘our’ emotions are stable and unchanging entities across times and cultures. Drawing on religious, medical and scientific texts from the classical world to the present day, This Mortal Coil explores the myriad meanings we have placed on the body’s parts – from the spine, the skin and the heart to the brain, the genitals, tongue and guts. The book’s geographical focus is Britain and North America, with a specific focus on women’s bodies, since gender finds its way through the narrowest of gaps and ‘thrusting manhood’ is everywhere. Each chapter uses a case study to consider both the contemporary relevance of a body part according to medical, religious and scientific writings and the social and political functions that it carries in its wake – whether that be the unruly tongue of a seventeenth-century ‘nag’, the pockmarked face of a nineteenth-century poor boy, the well-padded rear of an eighteenth-century jail keeper, or the pumped-up breast of a twentieth-century factory worker.

The history of emotions runs through each chapter – whether in terms of literal embodiment, such as the skin’s display of emotional experience in blushing or blanching, or the emotive significance given to particular body parts, or even the emotionally-charged rhetoric used to describe the body itself. The siting of emotions in the body has shifted throughout history as the heart and the brain have competed as the centre of our emotional selves. Despite the fact that we live in an age dominated by the neurosciences, the brain has not necessarily ‘won out’ in the battle for supremacy.[2] The heart and more recently the gut has been framed as a ‘second brain,’ responsible for retaining memories, emotions and lived experiences. The very structure of the body, its nerves and fibres, its cells and tissues, have also been used at varying times, to ‘prove’ difference. Thus the brain and the skull and even the hips have reinforced ideologies of race and gender that underscore social and political hierarchies. Today’s body politic might run on hormones rather than humours, but the effects are no less powerful.[3]

The languages of the body are also rich with metaphor. Hamlet’s Denmark is ‘rotten’ and rancid. Mind and body alike are corrupted by a poison that spreads through the king’s body and across the land. There was no easy division in Shakespeare’s time between mind and body, and the soul mediated between both. Today, even if we don’t believe in the soul, few of us see reason and emotion absolutely distinct, though the mind and the body are separated in both philosophical thought and modern healthcare systems.[4] Historians often root that separation in the French philosopher Rene Descartes’ famous division between the material body and the immaterial mind, first published less than forty years after Hamlet.[5] Indeed, the mechanistic body of Descartes (and of William Harvey, popularizer of blood circulation), gave rise to a range of hydraulic metaphors about emotions as well as the image of the heart as a pump with which we are all familiar. Metaphors matter because they reinforce conventions and ideas about the body and – by extension – the roles and responsibilities of men and women in society. This language is often highly moralistic: the ‘incompetent cervix’ of a woman destined to be a productive baby maker, for instance, or the visible wastefulness of a fat body in an ‘epidemic of obesity.’

Medicine is filled with metaphors, especially relating to battles between health and disease, which is structured as an invader.[6] From the mid nineteenth century this language formed part of the rise of scientific medicine, which was based on the classifying gaze of reason and a series of increasingly narrow specialisms through which each body part (and ailment) was compared, catalogued and scrutinized. Today that medically pathologized body has arguably been turned into a socially pathologized body. We worry that we are too fat, too thin, too old. Some of us spend hours in the gym in search of a more socially acceptable ‘look.’ This shift towards seeing our bodies as consumer objects – changeable, perfectible extensions to the ‘real’ selves that live in our heads – is arguably only possible in our compartmentalized, brain-centred age.

To understand this process of distancing and objectification, and the subtle ways that beliefs about the body impact on our experience, This Mortal Coil unravels the differences between Hamlet’s body and our own. For this ever-unfolding pursuit of physical perfection, no matter what that does to the mind (or the soul), is a relatively new phenomenon, made possible only by the development of cosmetic surgery since World War I. Yet it looks set to have a long-term impact on our individual self-image and collective well-being. Those people (usually women) who do go ‘under the knife’ in pursuit of some narrowly prescribed bodily ideal, do so in the hope that it will improve their emotional lives and make them happier. All the evidence suggests that it will not. Like the Prince of Denmark, we have our own existential crises, then, and they also centre on the limits of the human body. This mortal coil is ever binding.


References

[1] For Gail Kern Paster, for instance, ‘many important emotions are both transhistorical and transcultural’. Humoring the Body: Emotions and the Shakespearean Stage (Chicago: The University of Chicago press, 2014), 245.

[2] Fernando Vidal, Brainhood, anthropological figure of modernity.” History of the Human Sciences 22.1 (2009): 5-36. The imagery I am using here is deliberate, reflecting the militaristic tone in which the ‘battle’ between hearts and minds (or minds and bodies) is typically framed.

[3] Emilia Sanabria, ‘From Sub-to Super-Citizenship: Sex Hormones and the Body Politic in Brazil,’ Ethnos 75 (2010), 377-401.

[4] Antonia R. Damasio, Descartes’ Error: Emotion, Reason and the Human Brain (London: Picador, 1994).

[5] René Descartes (1641) Meditations on First Philosophy, in The Philosophical Writings of René Descartes, trans. by J. Cottingham, R. Stoothoff and D. Murdoch, Cambridge: Cambridge University Press, 1984, vol. 2, pp. 1-62.

[6] A classic work on this subject is Susan Sontag, Illness as Metaphor, and AIDS and its Metaphors (New York: Picador USA, 2001, c1989).

 

17 June 2016

Shame and the Body

I’ve been thinking a lot about shame and the body. Especially as it relates to women. Partly my thoughts have been sparked by the Nuffield’s Council on Bioethics’ working party on cosmetic surgery, which is taking place as the demand for breast implants, butt lifts and fillers grows exponentially. Partly by responses to my last blog, in which I talked about the ways violence becomes encoded in the body. And partly by public reaction to the posthumous revelation that Clement Freud was a paedophile. I listened to one of his victims, Sylvia Woosley, now in her 70s, talking on Radio 4’s Today programme  this morning and could feel the pain in her voice, as well as the shame of feeling ‘unclean and soiled’. Aged fourteen, the woman had been sent to live with the grandson of Sigmund Freud when her parents’ marriage broke down. She found herself the unwilling subject of Freud’s sexual affections, describing her feelings of distress about his subsequent abuse. And the shame that she has carried ever since.

Shame is everywhere these days. In the digital age it is perhaps, as Jon Ronson has argued, more ‘public’ than ever before. But shame has long featured as a means of social and patriarchal control. Consider the charivari of the seventeenth century – a French folk custom in which an unmarried couple’s community would urge them to wed through a noisy and very public serenade. In early modern Europe men were shamed for being cuckolds, women were shamed for having sex, for being ‘nags’ and for wearing the breeches, as well as a myriad of social offences that were policed by neighbours, friends and family. There is a growing historiography of shame as a social emotion. Publicly shaming  spectacles were physical and centred on the body of the offender, who might be stripped naked and paraded through the streets – a la the rather ahistorical Game of Thrones’ Cersei – or whipped and beaten, perhaps, depending on the nature of the offence. These forms of public censure became less prominent from the nineteenth century – along with other public spectacles like the torture of Damiens the Regicide. More subtle means of control including litigation and policing became more formal ways to monitor the behaviour of members of a community. Following the logic of Michel Foucault, the Enlightenment saw the focus of punishment (and we can argue shame), moved from the body to the mind. Prisoners were moved out of sight and subject to continual surveillance, the principle being Jeremy Bentham’s panopticon revolution; the mind sciences (psychology, psychiatry and so on), developing new codes of immoral or unnatural behaviour that were rooted in the brain.

According to this trajectory, it can be argued that shame became a mental rather than a physical experience; one internalised into the individual subconscious that lives in the brain. thus ‘in the field of mental health,’ one commentator observes, ‘guilt and shame are transdiagnostic problems.’ I have talked elsewhere about the rise of the brain as a way to articulate selfhood. As this statement suggests, guilt and shame are often linked in the field of emotions. But they are also regarded as opposites: Western societies focus on the individual exhibit internalised shame or guilt (specifically as part of the process by which shame was internalised), it has been argued, whereas in the East, shame is everywhere. Another extrapolation associates religion with shame and guilt, so that ‘shame cultures’ exist in the Far East and Middle East, while ‘guilt cultures’ dominate in Christianised Europe, especially north-west Europe.  This division is overly simplistic. It also ignores the ways in which shame is a bodily as well as a psychological phenomenon.

The word ‘shame’ derives from the Proto-Indo-European word ‘skem’ , meaning ‘to cover,’ the act of hiding one’s face and literally covering one’s shame being a common gestural expression. In chapter thirteen of The Expression of the Emotions in Man and Animals, Charles Darwin described the physical effects of shame in ways that included blushing, confusion, looking down at the ground with a slack posture and lowered head. Distinguishing shame from guilt, the psychoanalyst Helen B. Lewis has argued that shame is about the self and the way the self has failed; by contrast, guilt focuses on a deed that has been committed. It is the act, rather than the person that is the object of guilt, while the opposite is true of shame. Thomas Fuchs, a philosopher and psychiatrist who has written extensively on the subject of embodied or lived emotions, argues that shame takes us out of our bodies at the same time that is makes us more profoundly aware of them. Like extremes of illness and fatigue, the experience of shame makes us all too aware of our bodies as corporeal objects. While most of the time, as we go about our everyday lives, we might become engrossed in something outside of ourselves, allowing our bodies to breathe and move and function independently of conscious thought. Shame brings us back to ourselves, with a catch in our breath and a flush in our cheeks. It makes us suddenly aware of our physicality; a physicality that is magnified in the case of sexual, physical or emotional abuse.

Abuse survivors like Sylvia Woosley often take responsibility for what happened to them. Perhaps feeling that had they behaved differently, if they hadn’t been attractive (and possibly even attracted to) their abusers, the abuse would not have happened.  Physical and emotional abuse also leaves adult survivors with a strong sense of shame that impacts on every aspect of their lives and self-worth. Had they not made their abusers – most often parents or guardians – so angry, had they not had such pronounced needs or been so difficult, the abuse would not have happened. They take responsibility for the behaviour of the abuser – the raised hand, the cutting remark, the inappropriate touch. As adults, abuse survivors commonly put up with or even seek out similarly abusive situations because they seem familiar. And deserved.

The gendering of childhood abuse is a subject that has received little attention. Boys and girls alike are vulnerable, but abuse is more commonly recorded on the bodies of girls. Adults abused in childhood, male and female, describe strong feelings of shame. In the case of male survivors, the emotion of shame might encompass feelings of being ‘un-manned’ by the abuse, and question their own masculinity as well as sense of responsibility. In the case of female survivors, shame arguably forms part of a broader system of shame in which women are habitually positioned and which centres on the body.

The deliberate shaming of women’s bodies in particular has become so commonplace in today’s appearance-obsessed culture that the term ‘body shaming’ has entered common usage. It has been argued that male body shaming is on the rise.  Most commonly, however, men’s shame is reported in relation to accusations of ‘weakness’; ideals of masculine strength being incompatible with the often competing needs of real life and relationships. Gendered expectations about behaviour are damaging to women and men alike. Nevertheless, women are shamed in particular ways that centre on their body, whether framed in terms of their reproductive capacities, sexual attractiveness, emotions or sexual conduct. 

It could be argued that through most women’s upbringing shame is ‘hard-wired’ into women’s thinking, especially about their bodies, and even as adults. Consider the match.com rapist, who preyed on the apparent unwillingness of women to report rape – and the unwillingness of match.com to listen. It is not just older women who are encouraged to feel self-conscious and ashamed of their own sexuality. Younger women and girls are continually subjected to shame about how much skin they show and what messages this might send to men. This is an extremely problematic trend, as suggestions that women and girls change their behaviour to prevent attack suggests that their behaviour somehow makes them culpable, for their own rape and sexual assault – an extension of the shame that is heaped upon child abuse survivors. The ways we talk about personal responsibility and rape divvies up blame depending on how much alcohol a woman has drunk, how short her skirt is, how flirtatious her behaviour. It doesn’t place responsibility firmly back on men’s shoulders by telling them not to rape. The Thames Valley Police’s video on sex and consent that uses tea as a metaphor for sex is a refreshing counterbalance to this trend.

Additionally, most cultural dictates, even in the relatively liberal West, suggest that women’s bodies are relevant for particular chunks of their lives – arguably between the ages of 16 and 35, when women’s fertility, and therefore sexual relevance, enters a swift decline. The so-called liberatory yet offensive term ‘cougar’ to describe a predatory woman who has sex with a younger man has no male equivalent.  Medical language – which is filled with terms like ‘cervical incompetence’ and ‘elderly primigravida’ (to describe a woman over 35 having her first pregnancy) makes it clear that women’s bodies are defined by their reproductive capabilities. That does not mean that women and girls do not feel predated upon under the age of 16. More than thirty per cent of young women aged 18-24 have reported sexual abuse in their childhood.  We are ambivalent as a culture towards young girls. The same newspapers that bay for blood when paedophiles are convicted (but, like the BBC remained silent on Jimmy Saville), frequently contain salacious images of young girls. The Sun and the Sunday Sport notoriously featured a ‘count-down’ to the sweet sixteen birthdays of actor Emma Watson and singer Charlotte Church.

Women’s bodies function as public spaces; it is widely considered socially acceptable to comment on how much a woman eats, what her body looks like, how she dresses and inhabits the world. This trend is most clear in the case of motherhood; every woman who has experienced pregnancy will have experienced a stranger’s hand patting at her belly as well as constant moralising about what she should be doing with her body while she is pregnant. Women’s bodies remain, as they were for Renaissance anatomists, lands to be explored, mapped and conquered. In the 1970s the feminist film theorist coined the phrase the ‘male gaze’ to denote the ways women’s bodies are reduced to objects to be looked at and consumed by male observers. Her criticism is as relevant as it ever was. Under the watch of such constant scrutiny, with aesthetic and moralizing judgements being internalised by men as well as by women, is it any wonder that women’s bodies have become so shame-filled? Sylvia Woosley described her body and her self as feeling ‘unclean and soiled’. Sadly, it is common for abused people to feel ‘tarnished’, for their experiences to feel marked on their bodies. And of course it’s not just celebrities like Jimmy Saville and Clement Freud that are the abusers. The National Society for the Protection of Children (NSPCC) suggests that a quarter of all children are subjected to abuse. Evidence suggests that taking responsibility for the abuse – and of the corresponding shame – compounds this physically and emotionally distressing feeling of being dirty. Used. Unworthy. Speaking out about the abuse and refusing to keep the secret is said to be crucial to absolving oneself of that responsibility and letting go of shame.

This is why it is so important for women like Sylvia Woosley to tell her story. And for us to listen.

 

8 June 2016

Embodied memory, or violence and madeleines.

He was teaching me to box. Or more precisely at that moment, to block. I went first, moving my hands towards him before he batted them away. Then he raised his left hand and brought it down towards me. Slowly. Deliberately. He did not intend to hurt me. But that’s when it happened: the flashback. Uncalled for, unremembered in the conscious memory of my mind. But locked into the tissues of my body, my nerves, my muscles, the fibre of my being. When his hand came towards me I was transported, unthinking, back there. To every time that I didn’t run quickly enough. That I couldn’t hide fast enough; that the door didn’t hold. I could taste fear, feel the ringing in my head that happened afterwards, when his rage was spent.

Body memory is like that. It returns to you at the weirdest times. In the case of violent memory, rather like an unsavoury version of Marcel Proust with his famous madeleine.  It is an overwhelming sensory experience that brings to the present sounds, colours, smells and a feeling that you recognise all too well. Body memory simply means that it is not merely the brain but also the body that remembers. It is a concept with no mainstream validity; like concepts of cellular memory, it sits at the edges of science. Scepticism about body memory is often associated with the memories of sexual abuse survivors, and so-called ‘false memory syndrome’.  This easy dismissal of body memory is problematic since it is the memories of women and young people that are most often hystericized. And when we don’t listen to the experiences of the vulnerable, we end up with a society that allows men like Jimmy Saville to rape and molest at will, protected by the gilt of celebrity in a male-dominated culture.

Academics and therapists who do support the idea of body memory argue that ‘the body keeps the score’. The psychiatrist Bessel van der Kolk suggests that the trauma caused by childhood neglect, physical and psychological abuse and war impacts on our physiological processes.  Damaging childhood experiences prime individuals to be on high alert, ever tuned to the possibility of violent attack. They inform the whole way that survivors view the world, impacting on their social relationships as well as their sense of self-worth. Positive memories, like negative ones, can become self-fulfilling, securing or limiting our future happiness.

Memories make us who we are, that much is undisputed. And yet embodied memories are difficult to access, in the past and in the present. I have studied, for instance, the language used by domestic violence victims in the seventeenth century, and found remarkable parallels in their situation and emotional suffering with women in the twentieth century. The language of ‘trauma’ may not have been around in the seventeenth century, but tears and bruises and fear and a great ‘trouble of mind’ was. Whether or not that experience is the same is impossible to determine. All we have is the language in which feelings have been expressed; we can’t inhabit the bodies of seventeenth-century women any more than we can know for certain how it feels to be our friend, our lover.

Language is limited and historically contingent. And so is science, though in the modern age many of its principles are taken for granted and naturalised. Science has a profound truth-value. The scientific basis of emotional trauma is relatively new. Since the work of Sigmund Freud it has been broadly accepted that there is a psyche that can be damaged just like the body. (In earlier times psyche just meant ‘soul’). It took time for the US and the UK governments to accept the invention of ‘shell-shock’ to explain the myriad of mental and physical disorders that affected soldiers in World War I. By the end of the war, 80,000 cases had been diagnosed in the UK alone. In the twenty-first century ‘Gulf-War syndrome’ was termed to explain the many unexplained illnesses from conflict that included mental and physical conditions.

How remarkable, given the military’s past acknowledgement of the broad impact of emotional trauma that – in the wake of 9/11, ‘torture’ has been redefined in the US to mean only measurable, physical wounds. Those who study domestic violence and child abuse note parallels, moreover, between these privatised forms of violence and those endured by survivors of war. Post-traumatic stress disorder (PTSD) is common across the board –  and defined as both a physiological and psychological disorder.

And yet, as seen by the US military’s redefinition of torture, and our own division of healthcare into the mental and physical realms, we compartmentalize mind and body in a truly unproductive, Cartesian manner. This is a subject I deal with in detail in This Mortal Coil.  For centuries, under the Galenic or humoral model of health, our minds and bodies were linked by fluids and humours that moved between the two. Emotional distress could be a produce of many different forces including the manner in which a person slept, ate and lived as well as their treatment at the hands of others. Physical health mirrored psychological health and vice versa. Today, when a different kind of fluids are at work – hormones – our physicality is seen to impact on our mind in a myriad of physical ways, through the the production of hormones like dopamine and adrenaline, for instance. We signal emotional experiences through the body – blushing, goosebumps, a raised heart-rate.

Our minds and bodies are constantly communicating with one another. And in one form or another, body memory has always been seen as fundamental to our human development. How else can we ride a bike, put one foot in front of the other or play a musical instrument?  Moreover, the focus on the physical pathways of body memory clouds the issue somewhat. Rather than being a cluster of cells that retain and transmit memories (the perspective that is most controversial), we need a broader understanding of body memory – something akin to embodied memory. For body memory brings together a gestural memory (a raised hand, a set jaw), and combines them with a set of visual and aural cues to produce a kinaesthetic experience based on movement. This holistic understanding of memory marks a move away from the focus on visual, brain-led remembering, which has been privileged since the nineteenth century. We live in an age of neurocentric tyranny, when the (gendered) brain is used to explain all aspects of human behaviour. The association of the brain with reason is historically another reason why body memory is not taken seriously in scientific medicine. It is more female-centred than-based logic; it is about the body as much as the mind, and about the emotions and intuition – forms of knowledge that are traditionally female and undervalued.

We might argue, in this vein, that the emotions that run deepest in our bodies are also gendered. Fear. An emotion that women have learned to internalise and to suppress because even leaving aside the perpetration of rape as a tactic in war, all women live in fear of violence. Shame – because there is an ever-growing gap between how women’s bodies are expected to be, and how they actually are.  Anger, which women are not supposed to feel, let alone express in a civilized culture. It topples over, so easily after all, into ‘hysteria’.

Finding a way out of our emotions is supposed to mark our idealized, intellectual, rational self. But what if those emotions, embodied and physical, serve a function? What if we need to experience them fully in order to overcome them? Grief, which shakes us to the core, or at least it ought if we are to recover fully. This is the argument put forward by Peter Levine in his work on healing. Thus the bodies of animals shake when they are frightened, an act that ‘discharges’ the emotion, unlike humans, who try to rationalise and reason their way out of fear.

I am not advocating Levine’s work, or any other model of therapy. As a historian of emotion and the body I am merely highlighting what I consider to be important and neglected themes in our understanding of trauma, violence and the gendered body, and that is that we are leaving the body itself behind. There are profound consequences in the present if we do not come to terms with the physical effects of PTSD. The most common treatment offered on the NHS – for many mental health problems since it is short-term and cost-effective – is Cognitive Behavioural Therapy. Yet in talking therapies there is an ongoing fear that we will have to live and relive the trauma over and over again, without actually moving forward. That seems somewhat inevitable if we view trauma as a mental rather than a bodily experience. We are not engaging with the physical, lived and kinaesthetic experience of the trauma, just the ways we have tried to intellectually engage with them. For victims of trauma, it may be just as important to find physical ways of addressing the embodied memories. There are, for instance, body-centred forms of psychotherapy  that encourage survivors to listen to the language of the body in order to ‘speak’ to it directly.  There are also a range of mind-body practices that can, it is claimed, promote healing from PTSD. These include yoga, tai chi, qigong, mindfulness-based stress reduction, meditation, and deep breathing. The success of these forms of intervention are largely anecdotal, however; complimentary medicines are not quantifiable by conventional scientific means.

Being aware of the different ways that trauma might manifest in the body, however, is perhaps half of the battle. Finding the pathway and the narratives that work for us as individuals, with our own complex sets of memories, beliefs and experiences, is arguably the only way forward. One constant seems to be physical activity. Psychologists agree that exercise is critical in overcoming PTSD, as well as many other mental health disorders. For women, and for those who need to retrieve ownership over their bodies as a result of abuse, this recommendation seems particularly important. It is not just about releasing those ‘happy hormones.’ We know that trauma can lead to obesity, whether as a result of compulsive eating or because survivors subconsciously try to make themselves larger in order to feel safer. Controlling your physical and psychical boundaries is key in recovery from trauma. After all, what is abuse but an over-riding of those boundaries? Building physical stamina, improving one’s reflexes, feeling stronger and able to fight back – these are all ways of releasing pent up aggression in a controlled way, according to our hydraulic model of emotions. Maybe we could all use a punch-bag.

 

24 May 2016

Overweight women are not supposed to be happy

So Facebook has apologised again, this time for banning an image of an overweight model. The Australian group Cherchez la Femme said Facebook rejected an advert featuring Tess Holliday, a plus-sized model wearing a bikini, because it depicted “body parts in an undesirable manner”. Co-producer of the group, Jessamy Gleeson, was articulate in pointing out a problem that lies at the heart of representing women in the media: there are few images of fat women being happy. Overweight women are not supposed to be happy; they are supposed to weep alone into a plate of doughnuts, broken-hearted about not being able to do up their jeans/snag a man/be desirable to others.

Shame is the emotion that fat is supposed to elicit: women who do not conform to the impossible ideals set by society are meant to feel too ashamed to appear in polite society, let alone expose their bodies proudly in the way that Tess Holliday does. Fatness causes moral panics – a fear of global obesity (“globesity”) associated with inactivity, over-indulgence in the wrong kind of food and a lack of self regulation. In my book This Mortal Coil I have traced the ways contempt towards the obese has become commonplace in a post-industrial society, where the languages of the body are all about consumption and efficiency and waste. Yes there is also body-shaming towards thin women. And fat men can be targets too. But the ‘dad bod’ trend of 2015, in which pudgy, rounded bodies of middle-aged men were celebrated in the media, had no female equivalent. Fat- shaming women has become a national sport, cameras at the ready to detect an inch of flab hanging over a women’s bikini bottoms. Especially if she is a celebrity.

Tess Holliday doesn’t fit into this world of intense self-scrutiny and self-hatred. She shouldn’t even be in a bikini (and smiling too!) is the moral undertone to Facebook’s censorship. She should be hiding in her bedroom, eating in secret and gaining absolutely no emotional or sensual gratification from her physical being.  Images of Holliday eating cause distress among the nay-sayers. She is promoting the wrong kind of lifestyle, they protest; celebrating obesity is celebrating disease. She owes it to the world to diet.

Of course. Because women, let’s face it, owe it to the world to take responsibiity for every single aspect of our lives: for when kids turn out wrong (because mothers are working or not working), for when men stray, for women’s abilities (and choices) around reproduction and even for inciting violence against their own bodies. In a culture where prepubescent bodies are sexualised, where rape culture is ubiquitous, where domestic violence is common and underreported, where women continue to make less money than men and where they bear the brunt of economic cuts, yes – let’s target women for making people fat. That way we don’t have to look at the real crimes that are perpetuated on women’s bodies every single day.

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