Jenny Slatman

In her chapter ‘Pragmatism in the Fray’, Monica Greco convincingly argues that ‘somatization’ is the iatrogenic product of Western medicine (Greco, Chap. 17, this volume). The term somatization is used for the phenomenon that people still suffer from physical complaints even after doctors have been unable to find pathology. For example, you have suffered from pain in your joints for a long time, but all diagnostic tests are negative (the blood values are good, nothing shows up on scans). When somatization occurs, there is an illness without a disease. Because no underlying pathology is found in the biological body, it is assumed that the reason for, or cause of the complaints must be psychological. After all, within Western medicine we assume a distinction between body and mind. If there is not something wrong in the body, there must be something wrong in the mind. People who somatize are then said to be unable to psychologize—they resist a psychological explanation. Greco shows that this somatization is systemic within Western medicine. Doctors are trained to search for pathology in the biological body with the purpose of providing a pathological explanation for every condition. Physicians are not well prepared for situations where pathological explanations are not so obvious. Uncertainty is no part of the doctor’s habitus.

By drawing on Jean-Luc Nancy’s philosophy of ontological relationality, this article explores what it means to be a ‘we’ in breast cancer. What are the characteristics—the extent and diversity—of couples’ relationally lived experiences of bodily changes in breast cancer? Through analyzing duo interviews with diagnosed women and their partners, four ways of sharing an embodied life are identified. (1) While ‘being different together’, partners have different, albeit connected kinds of experiences of breast cancer. (2) While ‘being there for you’, partners take care of each other in mutually dependent ways. (3) While ‘being reconnected to you’, partners (re-)relate to each other through intimacy and sexuality. (4) While ‘being like you’, partners synchronize their embodied daily lives to one another, sometimes up to the point that the self cannot be distinguished from the other anymore. These ways reveal that being a ‘we’ involves complex affective, bodily encounters in which the many fault lines that both separate partners into individual selves and join them together as a unity are continuously reshaped and negotiated. Being a ‘we’ may be understood as something we have to do. Therefore, in being true to the legacy of Nancy, we argue at the end of this article for a sensible praxis of sharing a life and body, particularly in breast cancer.

Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS) is a highly contested illness. This paper analyzes the discursive production of knowledge about, and recognition of ME/CFS. By mobilizing insights from social epistemology and epistemic injustice studies, this paper reveals how actors, through their social-discursive practices, attribute to establishing, sustaining, and disregarding their own and others’ epistemological position. In focusing on the case of the Dutch newspaper reporting about ME/CFS, this paper shows that the debate about this condition predominantly revolves around the ways in which people who make truth claims are represented. In being portrayed as gendered, affectatious, formerly very able, fanatical, or benevolent, people with ME/CFS are constructed as non-/credible. In the debate about what causes ME/CFS, by contrast, the production of non-/credible knowledge focuses more on the content of epistemic positions. Actors in this debate argue that they know the (clear) causes for the illness, something which functions as a discursive strategy to establish and enhance their credibility. This paper contends, however, that since this discursive demarcation of causes is consistently infused with uncertainty – with multi-interpretability, with diffuse explanations, and absence of current knowledge – the credibility of these actors’ epistemic position is undercut rather than established.

“You need to listen better to your body!” is a common prescription in contemporary health discourse. From a phenomenological perspective, we can say that the ability to hear your body implies body awareness. In this paper, I will provide a phenomenological analysis of the different ways in which the “audible body” can appear, and how this is related to health, drawing on the work of Merleau-Ponty, Shusterman, Leder, and Nancy. In Merleau-Ponty’s early work, so I explain, the “lived body” emerges as an “audible” body, but it is only faintly audible and only so on the surface. Moreover, we find no explicit clues in his work for the injunction to learn to listen to the audible body. Shusterman, on the other hand, claims that we should train and increase somatic attention, and thus better listen to our bodies in order to cure bad bodily habits such as poor bodily posture. Subsequently, I describe how Leder argues that phenomenological analyses of the body should not only involve the surface body and its motor-sensory capacities. They should also involve the recessive, inner body. According to him it is healthy to increase one’s capacity for introception in order to increase “inside insights.” In the final part of this paper, I explain, on the basis of Nancy’s work, that listening to one’s body might become unhealthy when this listening goes hand in hand with amplifying the strangeness of one’s own body.

This article is based on an online ethnographic study of Dutch women who use YouTube as a medium to document their contested illness experiences. During 13 months of observations between 2017 and 2019, we followed a sample of 16 YouTubers, and conducted an in-depth analysis of 30 YouTube videos and of 7 interviews. By adopting a ‘praxiographic’ approach to social media, and by utilising insights from phenomenological theory, this study teases out how bodies are ‘done’ in (the making of) these YouTube videos. We describe three types of bodies: (1) inert bodies, (2) experienced bodies, and (3) authentic bodies. Ultimately, this study shows how vlogging about contested illness is a practice in which bodies are continually (re)configured, and through which the ‘invisibility’ of a sufferer’s condition can obtain social visibility.

This paper aims to mobilize the way we think and write about fat bodies while drawing on Jean-Luc Nancy’s philosophy of the body. I introduce Nancy’s approach to the body as an addition to contemporary new materialism. His philosophy, so I argue, offers a form of materialism that allows for a phenomenological exploration of the body. As such, it can help us to understand the lived experiences of fat embodiment. Additionally, Nancy’s idea of the body in terms of a “corpus”—a collection of pieces without a unity—together with his idea of corpus-writing—fragmentary writing, without head and tail—can help us to mobilize fixed meanings of fat. To apply Nancy’s conceptual frame to a concrete manifestation of fat embodiment, I provide a reading of Roxane Gay’s memoir Hunger. In my analysis, I identify how the materiality of fat engenders the meaning of embodiment, and how it shapes how a fat body can and cannot be a body. Moreover, I propose that Gay’s writing style—hesitating and circling – involves an example of corpus-writing. The corpus of corpulence that Gay has created gives voice to the precariousness of a fat body's materialization.

Phenomenology of illness and abnormality Habitually, illness or disease is considered as something abnormal. Therefore, the distinction between health/illness is often conflated with the distinction normal/abnormal. Inspired by Kurt Goldstein’s work, Merleau-Ponty makes clear, however, that abnormality does not automatically coincide with pathology. It is also interesting to note that Merleau-Ponty nowhere uses the term “abnormal” to indicate the opposite of the normal person. Similar to Georges Canguilhem he uses the pair “the normal (person)” (le normal) – “the sick person”, “the pathological” (le malade, le pathologique). As Goldstein and Canguilhem make more explicit than Merleau-Ponty, the abnormal person or “deviant” is very often not sick. Instead of approaching physical symptoms from an external or statistical view (which might lead to the conclusion that something is abnormal), they claim that sickness should be defined by the patient’s own lived experience. Merleau-Ponty shares this view, but for different reasons. Goldstein and Canghuilhem, both trained clinicians, believe that patients’ own experiences should be central in clinical practice instead of objectifying measurements and tests. For Merleau-Ponty, the phenomenologist, objective physical features have no place within his phenomenology of lived bodily experience. Bracketing positivist scientific insights, phenomenology also excludes biomedical statistics from its analysis. If we assume that abnormality is a result from a comparison with what is statistically seen as normal, this means that a phenomenology of abnormal embodiment might seem a contradiction in terms. In this paper, however, I would like to show that abnormal embodiment can also be approached from a phenomenological perspective. While drawing on some ideas by Hacking on the history of statistical reasoning, I demonstrate how the statistics of abnormality directly interconnects with lived experience. Hacking explains how the descriptive “average” or “mean” has become the normative “normal”. Because our world is in many ways determined by averages, it is an illusion to think that phenomenology can just bracket statistics. The one who appears physically as abnormal can, comparable to the one who is ill, experience that his or her embodied possibilities to deal with the world dwindle. What I show in this article is that even though a clear distinction can be made between illness and abnormality, both can be accompanied by a reduction or disruption of the “I can”.

In this article, we present an analysis of bodily integrity in hand transplants from a phenomenological narrative perspective, while drawing on two contrasting case stories. We consider bodily integrity as the subjective bodily experience of wholeness which, instead of referring to actual bodily intactness, involves a positive identification with one’s physical body. Bodily mutilations, such as the loss of a hand, may severely affect one’s bodily integrity. A possible restoration of one’s experience of wholeness requires a process of re-identification. Medical interventions, such as a hand transplant, may improve the possibility of a successful re-identification. However, since the experience of wholeness does not refer simply to physical intactness or impairment, the choice for medical intervention should not be based merely upon the degree of physical mutilation. It should also be based upon the degree to which a person fails in re-identifying with his or her mutilated body. We argue that a normalizing operation is only ethically justifiable if the intervention enables the person to be the body he or she has.

Women intimately interact with various medical technologies and prosthetic artifacts in the context of breast cancer. While extensive work has been done on the agency of technological artifacts and how they affect users’ perceptions and experiences, the agency of users is largely taken for granted hitherto. In this article, we explore the agency of four women who engage with breast cancer technologies and artifacts by analyzing their narrative accounts of such engagements. This empirical discussion is framed within the tradition of science and technology studies, philosophy of technological mediation and phenomenology of embodied agency as ‘I can/not’. This approach leads to the conclusions that women’s technologically mediated agencies range from being restricted to extended, take place on different bodily levels, within complex temporal structures, and are determined by certain socio-cultural contexts. Furthermore, it reveals that such agency shaping does not imply a one-way conditioning relationship between technologies and users, but rather involves a reciprocal relationship in which both subject and object are co-constituted. We therefore suggest that the ‘material turn’ in philosophy of technology also needs to take into account technologically mediated, material human beings in order to gain a better understanding of human existence.

The person with dementia: A plea for a (non-metaphysical) relational notion of personhood In this article we explore the notions of personal identity and personhood, using concrete descriptions of the experiences of people living with dementia as a case study. From an analytical point of view we argue against memory or psychological-continuity criteria of personal identity as too cognitive. Instead we focus on embodiment. The person with dementia, as an embodied human being, is numerically the very same person (s)he was before. Moreover, we argue against a metaphysical notion of personhood. Personhood is constituted by the reactive attitudes of other persons: someone becomes a person and remains a person by being received, and almost literally incorporated, in a community of persons. From a phenomenological point of view we show that embodied intersubjectivity is crucial for the recognition of one person by another. We use Merleau-Ponty’s notion of intercorporality to show that there are ways of keeping people with dementia within this community of persons, of keeping in touch with them, even when many of their cognitive capacities are gone, for instance by singing or dancing together. As long as there is still a shared world, it is up to us to keep recognising someone with dementia as a person, and not as ‘an empty shell’.

Philosophizing on Scars: Plea for a Material Turn in PhenomonologyIn this paper, I provide a philosophical reflection on the meaning of scars while drawing on phenomenological studies of the body. According to Husserl and Merleau-Ponty, the body as Leib or corps vécu functions as a transcendental condition for world disclosure. Because of this transcendental reasoning, phenomenological studies concerning embodiment often prioritize a form of embodied subjectivity that is virtually immaterial. Endowing meaning to one’s world by becoming engaged in actions and projects is most successful when one’s body is ‘absent,’ ‘transparent,’ or, at least, if it is not in the center of one’s attention. This taken-for-granted nature can be disturbed by discomfort, disability, and disfigurement. Habituation to these kinds of disturbances aims at maintaining or restoring the body’s taken-for-grantedness. Successful restoration of this taken-for-grantedness is mostly understood in terms of incorporation. My analysis of the case of a woman who successfully habituated to her mastectomy scar demonstrates, however, that habituation to a perceptible scar can be understood only partly in terms of incorporation. Next to a decrease of explicit attention for the scar and the discomfort it produces, the scar should also stop being a sign that refers to something else than itself. This is only possible, I argue, by taking the body’s materiality seriously, rather than it being wiped out as a result of transcendental reasoning.

In recent years, facial difference is increasingly on the public and academic agenda. This is evidenced by the growing public presence of individuals with an atypical face, and the simultaneous emergence of research investigating the issues associated with facial variance. The scholarship on facial difference approaches this topic either through a medical and rehabilitation perspective, or a psycho-social one. However, having a different face also encompasses an embodied dimension. In this paper, we explore this embodied dimension by interpreting the stories of individuals with facial limb absence against the background of phenomenological theories of the body, illness and disability. Our findings suggest that the atypical face disrupts these individuals’ engagement with everyday projects when it gives rise to disruptive perceptions, sensations, and observations. The face then ceases to be the absent background to perception, and becomes foregrounded in awareness. The disruptions evoked by facial difference call for adjustments: as they come to terms with their altered face, the participants in our study gradually develop various new bodily habits that re-establish their face’s absence, or relate to its disruptive presence. It is through these emergent habits that facial difference comes to be embodied. By analyzing the everyday experiences of individuals with facial limb absence, this article provides a much-needed exploration of the embodied aspects of facial difference. It also exemplifies how a phenomenological account of illness and disability can do justice both to the impairments and appearance issues associated with atypical embodiment.

The ever increasing ability of medical technology to reshape the human body in fundamental ways—from organ and tissue transplants to reconstructive surgery and prosthetics—is something now largely taken for granted. But for a philosopher, such interventions raise fundamental and fascinating questions about our sense of individual identity and its relationship to the physical body. Drawing on and engaging with philosophers from across the centuries, Jenny Slatman here develops a novel argument: that our own body always entails a strange dimension, a strangeness that enables us to incorporate radical physical changes

Although scars never disappear completely, in time most people will basically get used to them. In this paper I explore what it means to habituate to scars against the background of the phenomenological concept of incorporation. In phenomenology the body as Leib or corps vécu functions as a transcendental condition for world disclosure. Because of this transcendental reasoning, phenomenology prioritizes a form of embodied subjectivity that is virtually dis-embodied. Endowing meaning to one’s world through getting engaged in actions and projects is most successful indeed when one’s body is “absent,” “transparent,” or, at least, if it is not in the center of one’s attention. This taken-for-granted nature can be disturbed by discomfort, disability, and disfigurement. Incorporation, so I explain, aims at maintaining or restoring the body’s taken-for-grantedness. My analysis of the case of a woman who successfully habituated to her mastectomy scar demonstrates, however, that habituation to a perceptible scar can only be understood partly in terms of incorporation. Next to a decrease of explicit attention for the scar and the discomfort it produces, the scar should also stop being a sign that refers to something else than itself. This is only possible, I argue, by taking the body’s materiality seriously, rather than it being wiped out as a result of transcendental reasoning.

In this paper, I explore the meaning of bodily integrity in disfiguring breast cancer. Bodily integrity is a normative principle precisely because it does not simply refer to actual physical or functional intactness. It rather indicates what should be regarded and respected as inviolable in vulnerable and damageable bodies. I will argue that this normative inviolability or wholeness can be based upon a person's embodied experience of wholeness. This phenomenological stance differs from the liberal view that identifies respect for integrity with respect for autonomy (resulting in an invalidation of bodily integrity's proper normative meaning), as well as from the view that bodily integrity is based upon ideologies of wholeness (which runs the risk of being disadvantageous to women). I propose that bodily integrity involves a process of identification between the experience of one's body as “Leib” and the experience of one's body as “Körper.” If identification fails or is not possible, one's integrity is threatened. This idea of bodily integrity can support breast cancer patients and survivors in making decisions about possible corrective interventions. To implement this idea in oncology care, empirical-phenomenological research needs to establish how breast cancer patients express their embodied self-experiences