On Illness and Value: Biopolitics, Psychosomatics, Participating Bodies

Article Summary by Monica Greco

In its heyday, around the mid-twentieth century, psychosomatic medicine was heralded as a new science of body/mind relations that held the promise of transforming medicine as a whole. Sixty years on, the field has achieved no more than a respectable position as a research specialism within a model of practice still dominated by biomedicine, and many of its more ambitious propositions are now dismissed as obsolete, or forgotten. In this article I invite readers to revisit some of these propositions, and I show how they continue to be relevant and challenging today. Taking the failure of the ambition of psychosomatics as my starting point, I suggest a different approach to the problem of mind/body dualism. Instead of pointing to the epistemological and clinical shortcomings of dualism, as has often been done, I propose it is important to acknowledge the resilience of dualism, and to ask what value dualism represents for modern industrial and post-industrial societies. Modern dualism, as A. N. Whitehead argued in Science and the Modern World, involves the assumption that nature, matter, and bodies are objective entities that do not, in themselves, express values. This assumption, in turn, is involved in producing value in the form of technoscientific and economic development. Some early proponents of psychosomatic medicine – most notably Viktor von Weizsäcker – understood clearly that overcoming dualism in practice would involve more than investigating ‘mind/body correlations’.  Weizsäcker placed the question of value – and what values might be at stake in renouncing the dualist solution – at the centre of the problematic of psychosomatics. The ambition of psychosomatics, he claimed, should be not to establish ‘correlations’ but to ask, of all events of illness, the type of questions that can only be asked of a subject: questions concerning motives, values, and aims. From this vantage point, in the last section of the paper I invite readers to reflect on the limitations of contemporary discourses of ‘participatory medicine’, where the importance of value is typically articulated in relation to the conscious expression of preferences, and not to bodily events.

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