Breaking the silence in the kingdom of the sick


Each time I step into my house, I peel off my clothes and throw them in the laundry pile, then I shower, dry off, and layer on fresh ones. This decadent activity is one of my new strategies for coping with hayfever. Other strategies include taking lots of medication, drinking green tea, trying to clock the allocated eight hours of sleep each night, and not going outside frivolously.

I am basically a sweet-smelling recluse right now.

Susan Sontag Illness as Metaphor

I developed hayfever and a host of irritating but not life-threatening food allergies as an adult, and I blame environmental desecration for that. Why else would my immune system randomly start mistaking harmless substances like apples and sunny days as threats to my life?

Allergies are on the rise, with 50 per cent of British children being diagnosed each year, and with this is a rise in generalised and chronic illness across the globe. The causes are thought to be a combination of changing food sources, urbanisation (and with it reduced contact with animals), genetics, and changes in hygiene. So basically, being alive in a town or city puts you at risk of developing allergies.

Susan Sontag wrote, 'Everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick.' And while we prefer to use only one passport, the reality is that every body is precarious, every body will pass through illness, and every body, at some point, will die.

Sontag's thoughts on illness came to her when she was severely ill with breast cancer, which she'd been told would be terminal. In an interview, she said that being very ill had prevented her from thinking about anything else: 'Here you are in a hospital thinking you're going to die, and it would have required an enormous effort of detachment for me to not think about it.' Illness is all consuming, it traps you.

Sontag's analysis is that cancer at the time, much like tuberculosis in the previous century, was shrouded in metaphor, morality, and silence, and that this dishonest language discouraged patients from seeking treatment. As time passed and the AIDS epidemic raged, she expanded her analysis to include that virus, too.

She wrote that 'As long as a particular disease is treated as an evil, invincible predator, not just a disease, most people with the disease will indeed be demoralised by learning what disease they have.' When causes of illness are identified and treatments become available, she says, illnesses lose their immorality and join the ranks of regular afflictions.

What, then, would Sontag think of today's culture around mental illness? In her time, she accused 'madness' of being romanticised, but the language around that has certainly changed. Now, it seems, the host of 'disorders' we call mental illness seem to be understood as a failure of individuals to pull themselves up by the bootstraps.

Like allergies, though, some of the origins of mental illnesses are societal and perhaps, for many, unavoidable. And the social and political conditions which produce illness are not generally a part of the medical project.

At the fundamental level, removing yourself from dangerous or violent situations, situations which immediately impact your health, and seeking out and honing coping strategies, allows people to live with, and eventually recover from, many illnesses. But part of that recovery requires a blinkering of the cultural forces which produce illness in the first place.

When I look into my own life and the lives of those around me, many of us suffer from distress and various mental illnesses. Many of those same people also suffer from financial hardship, unrewarding employment, difficulty keeping up with competitive social expectations, loneliness and bereavement.

I'm not sure it should be surprising that so many are unable to cope. As our social expectations have increased alongside unreasonable financial, gendered, and racialised lines, support networks have disintegrated.

Many people suffering mental illness suffer not because they lack the wherewithal to identify their situation, but because their living conditions are not geared to protect them. Being alive at this point of history presents a high risk of becoming mentally unwell. Increasing awareness of psychological distress in the form of programs like Mental Health Day (which is tomorrow) is critical.

But these initiatives don't necessarily challenge the economic cultures that produce mental illness in the first place.

Is that too dire? I don't think it should be. While I'm sceptical of the overuse of 'illness' to talk about people who are reasonably anguished, identifying that anguish, medically or not, is useful. Finding bold language to talk about distress promotes the idea that systems of care and networks of support are critical, and possible — and that, despite the odds, they do exist.

Ellena Savage

Ellena Savage is the editor at The Lifted Brow, commissioning editor at Spook Magazine, and a graduate student in creative writing.

If you or someone you know is experiencing a crisis, reach out. Lifeline is open 24/7 at 13 11 14.

Topic tags: Ellena Savage, Susan Sontag, allergy, mental illness



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Existing comments

"Challenging the economic cultures that produce mental illness" seems to be a good place to start . Well advised Ellena. If only focus could be placed on the unemployment, financial hardship,loneliness and bereavement of people who suffer from anxiety, depression and other medical illnesses. Thanks for a challenging article , Ellena

Celia | 09 October 2015  

Hang on guys: the concept of "social and political" origins of ill-health is fashionable but largely rubbish. If you are too clean and have the wrong bacteria in your poo, and get allergies, then that is hardly really "cultural". Smoking tobacco if the major cause of anxiety and depression in young people in their 20s to 40s, and illicit drugs is "a" if not "the" main cause of their psychoses. Obesity is now the main cause of general ill-health. All this is preventable and associated with Western affluence but only indirectly so. Certainly many make huge amounts of money out of it all and the tobacco and todd industries have a huge amount to answer for. But we could be affluent and healthy, and this is certainly where political will is imperative.

Eugene | 09 October 2015  

People will always encounter pressures, which if not handled adequately, can give rise to mental illness. There has always been poverty, illness, discrimination and injustice. Some people succumb to these pressures and others rise above them. A helpful insight, foreshadowed in Marcus Aurelius' Meditations and formulated in the Serenity Prayer, is to achieve "the serenity to accept what cannot be changed, The courage to change what can be changed, and the wisdom to know the one from the other". A great help in this is belief in a Personal God who loves and provides for us. Such a belief once meant a superstitious belief that God intervened in the 'Laws' of Nature at the request of admittedly unworthy petitioners, but a more enlightened insight is to realise it is not God's Providence that needs changing, but our response to the Challenges of life, so that they become stepping stones rather than stumbling blocks. Once this is realised much mental stress dissipates.

Robert Liddy | 09 October 2015  

At the risk of sounding glib I attribute a lot of this dis-ease to the socially corrosive neo-liberalism that has pervaded our culture in the service of efficiency and competition. A philosophy that is patently anti-communal places stresses on individuals to remain in a constant state of "brutish warre" with one another, competing in all areas of life and work.

Laurie | 09 October 2015  

Laurie; (9/10); "I attribute this dis-ease to the socially corrosive neo-liberalism that has pervaded our culture in the service of efficiency and competition...". It is not the 'efficiency and competition' that cause the 'corrosion', but rather the cause to which they are employed. Efficiency and competition in themselves are neutral. But they are often employed by some adherents of neo-liberalism to extract money from the pockets of the less well endowed, and to put it in their own pockets. This mind-set is usually dressed up in flowery spin, but basically it comes down to elitist selfishness.

Robert Liddy | 10 October 2015  

i have Foucault's(1967) book in front of me titled "Madness and Civilisation". It is well worth a read in relation to the topic of "mental illness". Social, cultural, economic, and environmental conditions do influence well-being and resilience. Society has always had to wrestle with "unreasonableness" (as Foucault reminds us) ... just look at how the justice (includes the defence force), healthcare, and religious domains seek to either address or ignore people who are "unreasonable", and how they do or don't work together for the benefit of societal well-being and resilience.

mary tehan | 12 October 2015  

As a fity-something female was was diagnosed with colon cancer on Good Friday, I must say, there are better authors who write of their experience with cancer, than Susan Sontag. I respect Jackie Collins for respecting the sacredness in the changed relationship to body symptoms of unwellness, with not writing a cancer memoir.

Grace Darling | 28 November 2015  

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