{"id":43124,"date":"2018-09-28T12:44:01","date_gmt":"2018-09-28T11:44:01","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=43124"},"modified":"2018-10-03T09:51:30","modified_gmt":"2018-10-03T08:51:30","slug":"nick-hopkinson-wellness-meaning-and-control","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2018\/09\/28\/nick-hopkinson-wellness-meaning-and-control\/","title":{"rendered":"Nick Hopkinson: Wellness, meaning, and control"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-38500 \" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2017\/02\/nick_hopkinson_2017-1-244x300.jpg\" width=\"170\" height=\"209\" srcset=\"https:\/\/blogs.bmj.com\/bmj\/files\/2017\/02\/nick_hopkinson_2017-1-244x300.jpg 244w, https:\/\/blogs.bmj.com\/bmj\/files\/2017\/02\/nick_hopkinson_2017-1-768x945.jpg 768w, https:\/\/blogs.bmj.com\/bmj\/files\/2017\/02\/nick_hopkinson_2017-1-832x1024.jpg 832w, https:\/\/blogs.bmj.com\/bmj\/files\/2017\/02\/nick_hopkinson_2017-1-300x369.jpg 300w\" sizes=\"auto, (max-width: 170px) 100vw, 170px\" \/><i><span style=\"font-weight: 400\">\u201cBeing old enough to die is an achievement not a defeat, and the freedom it brings is worth celebrating.<\/span><\/i><span style=\"font-weight: 400\">\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400\">From this striking vantage point, Barbara Ehrenreich, in her recent book <\/span><em><a href=\"https:\/\/www.waterstones.com\/book\/natural-causes\/barbara-ehrenreich\/9781783782413\"><span style=\"font-weight: 400\">Natural Causes: Life, Death and the Illusion of Control<\/span><\/a><\/em><span style=\"font-weight: 400\">, considers the way our perspectives on life, health, our bodies, and our minds are constructed through metaphor and social convention. This is not a passive, neutral, or value free process. Where and what are our bodies and ourselves in these anxious, consumerist times?<\/span><\/p>\n<p><span style=\"font-weight: 400\">Although best known as a writer and campaigner on social and political topics, Ehrenreich began her career as a PhD student working on the immune system, \u201ca magical and for the most part invisible cloak.\u201d She worked on macrophages in particular, which were conceived as \u201cfrontline defenders\u201d against invaders. She notes that military metaphors for the immune system are common: for example, \u201cfighting disease;\u201d \u201cbattling infection;\u201d or guard animals, the \u201cbig eaters\u201d that devour invaders. <\/span><\/p>\n<p><span style=\"font-weight: 400\">So far, so conventional, but what to make of the more recent discovery that macrophages, whose accumulation at the site of tumours had been assumed to be part of the body\u2019s \u201cheroic\u201d resistance, may actually <\/span><a href=\"https:\/\/www.nature.com\/articles\/s41467-017-02481-5\"><span style=\"font-weight: 400\">facilitate<\/span><\/a><span style=\"font-weight: 400\"> the spread of malignancy\u2014themselves, committing \u201ccellular treason.\u201d Macrophages are \u201ccheerleaders on the side of death,\u201d providing tumour cells with access to blood vessels and hence metastasis to distant sites. Researchers are \u201chorrified\u201d by this behaviour.<\/span><\/p>\n<p><span style=\"font-weight: 400\">In this metaphor of treason, who is rebelling against what? Who is in charge? Can we control our minds, bodies, and lives, and if we can, who is controlling what? She argues that, to replace religious belief and the flight of the soul, we have a new model of \u201cthe self,\u201d which centres around the mind controlling the body, a struggle between mind and body, and the body as something to be worked on. This work includes eating the right food and fitness regimes. Witness the rise of\u00a0fitness regimes as a marker of virtue and the elision of health behaviours with class identity.<\/span><\/p>\n<p><span style=\"font-weight: 400\">But now the mind itself has become something to control. Ehrenreich describes how mindfulness is offered as a solution to the developing problem of the distraction caused by technology, and is itself being marketed to us by the tech industry\u2014selling apps as a solution to a problem it has created. \u201cNeuroplasticity\u201d is the advertising tagline replacing the less sophisticated concept of \u201cbrain training.\u201d The mind is to be controlled through disciplined exercise, much as the body should be. <\/span><\/p>\n<p><span style=\"font-weight: 400\">Or not. So keep fit, eat well, and be lucky. Wellbeing may be yours, but be careful of analogies, especially ones of violence and discipline.<\/span><\/p>\n<p><span style=\"font-weight: 400\">From professor of immunology, Sheena Cruickshank, who appeared on <\/span><a href=\"https:\/\/www.bbc.co.uk\/programmes\/b0b50kwx\"><span style=\"font-weight: 400\">The Life Scientific<\/span><\/a><span style=\"font-weight: 400\"> recently, a final and more encouraging metaphor: \u201cthe primary job of the immune system is actually maintaining tolerance.\u201d<\/span><\/p>\n<p><em><strong>Nicholas Hopkinson<\/strong>, reader in Respiratory Medicine, Imperial College London.<\/em><\/p>\n<p><strong>Competing interests<\/strong>: None declared.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u201cBeing old enough to die is an achievement not a defeat, and the freedom it brings is worth celebrating.\u201d From this striking vantage point, Barbara Ehrenreich, in her recent book [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2018\/09\/28\/nick-hopkinson-wellness-meaning-and-control\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":43130,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[18889],"tags":[],"class_list":["post-43124","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-nick-hopkinson"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - 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