Neil Vickers and Derek Bolton, "Being Ill: On Sickness, Care and Abandonment" (Reaktion Books, 2024)
Oct 5, 2024
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Neil Vickers, a Professor of English literature with a keen focus on medicine, and Derek Bolton delve into the complexities of illness, care, and social dynamics. They explore how serious health challenges can reshape interpersonal relationships, emphasizing the isolation felt by both the ill and their caregivers. Drawing on neuroscience and personal narratives, they advocate for communal support systems over individualistic approaches. The conversation highlights the critical role of empathy and connection in fostering resilience during illness.
The experience of illness significantly alters relationships, often leading to feelings of abandonment and social isolation for the sick.
Generous support systems in non-WEIRD cultures highlight the importance of communal care in contrast to individualistic perspectives on health.
Deep dives
The Intersection of Illness and Relationships
Serious illness encompasses not just medical treatment but also the vital role of relationships in the experience of being unwell. The authors emphasize that narratives of illness often reveal how friendships can diminish, with many individuals encountering feelings of abandonment from those around them. This highlights an important societal issue: as individuals face health challenges, they often feel pushed to the margins of society, which contrasts sharply with experiences in collectivist cultures where support systems remain robust. The book suggests that understanding the relational dynamics during illness is critical to addressing the stigma and social isolation often experienced by the ill.
Understanding WEIRD Societies
The concept of WEIRD (Western, Educated, Industrialized, Rich, and Democratic) societies exemplifies the individualistic perspective prevalent in the West regarding health and illness. In such contexts, illness is typically perceived as personal responsibility, often leading to social withdrawal and stigmatization for those affected. The authors contrast this with perspectives from non-WEIRD cultures, where communal support remains strong, even in the face of serious health issues. The narrative asserts that we need to shift back toward recognizing the social aspects of illness, advocating for a collective approach that emphasizes group support rather than isolation.
The Biopsychosocial Model of Health
The biopsychosocial model reinforces the understanding that health outcomes are influenced by biological, psychological, and social factors, challenging the traditional solely biomedical narrative. This conceptual framework suggests that psychosocial elements, such as social determinants of health, significantly impact the prevalence and experience of illness. Research demonstrates that individuals from lower socioeconomic backgrounds face disproportionately poorer health outcomes, underscoring the need for a broader perspective on health. By exploring these dynamics, the authors aim to foster a greater understanding of how social experiences can amplify health disparities.
The Importance of Intersubjectivity and Care
The authors delve into the intersubjective dimensions of care, emphasizing that meaningful relationships are fundamental during illness. They introduce the concept of 'holding,' where individuals share emotional and physical support, fostering an environment of care that transcends mere transactional relationships. Drawing insights from infant research, the authors highlight how the nuances of human interaction play a vital role in providing comfort and recognition in times of crisis. This focus on care as a communal process illuminates the transformative potential of strong social bonds and underscores the importance of nurturing these connections to mitigate the isolation often experienced by the ill.
A serious illness often changes the way others see us. Few, if any, relationships remain the same. The sick become more dependent on partners and family members, while more distant contacts become strained. The carers of the ill are also often isolated. This book focuses on our sense of self when ill and how infirmity plays out in our relationships with others.
In Being Ill: On Sickness, Care and Abandonment (Reaktion, 2024) Dr. Neil Vickers and Dr. Derek Bolton offer an original perspective, drawing on neuroscience, psychology and psychoanalysis, as well as memoirs of the ill or their carers, to reveal how a sense of connectedness and group belonging can not only improve care, but make societies more resilient to illness. This is an essential book on the experience of major illness.
This interview was conducted by Dr. Miranda Melcher whose new book focuses on post-conflict military integration, understanding treaty negotiation and implementation in civil war contexts, with qualitative analysis of the Angolan and Mozambican civil wars.