Thoughts on ‘Illness’ by Havi Carel

Christmas has always been for me an opportunity to catch up on some reading that I have been too busy for in the year and this year I have been lucky enough to discover a book called Illness by the philosophy lecturer Havi Carel.

Carel combines insights from her own experience of living with a fatal lung condition called LAM (lymphangioleiomyomatosis) with her learnings from Western philosophers such as Heidegger and Merleau-Ponti. It is the latter’s emphasis on a phenomenological approach that appeals to Carel and to me, as I see in it an echo of Chinese medicine’s approach to illness.

Carel explores the phenomenological approach, which is essentially the lived experience of an illness, as opposed to the naturalistic approach whereby people are viewed on purely physical terms. This means that a patient’s emotional reaction to illness, their ability to adapt to the changes brought about by ill health, and the social impact of illness is also considered.

Acupuncture incorporates this phenomenological approach, in that the energies we work with are regarded as the source of our physical being, but also bring into existence our emotions and individual ways of thinking. For example, the energies stored in the Stomach and Spleen meridians concentrate to form the physical organs but also give us the ability to take things in and process them on a broader level. These energies govern our ability to take in ideas and process situations, and when out of balance they can lead to over-thinking and worry. Treatment of these energies with acupuncture will see improvements of both physical and emotional aspects.

The energies treated with acupuncture also govern our relationships to others and an imbalance many show itself as dysfunction on this social level. A person with an imbalance of Stomach and Spleen energies may find that they give too much to others, are caring for them to an extreme degree and quite possibly to their own detriment. Alternatively, they may behave in a self-centred way and so full of worry about themselves that they cannot offer any attention or care to another.

Carel’s book presents philosophy as therapy. She explains the importance of healthcare professionals respecting the impact of illness beyond the physical and into the social and emotional. She discusses the fear of death at length; presents the arguments to counteract this fear and encourages us all to grasp our mortality as an essential element in living an authentic life. Overall she advocates fostering the ability to live in the present as medicine for fearing the future and the grieving what is lost to the past.

She concludes ‘Illness can be a journey. Like some journeys, you do not always know where it will take you. This particular journey moved from personal experiences of illness to a philosophical exploration of their meaning. With the aid of phenomenology, it linked the personal-subjective and the philosophical-objective. It ends, or rather stops, here, in the middle. In the present. Where I am now. I do not know what the future will bring; no one does. But being here, now, is enough.’

It was interesting and reassuring to see how the Western philosophers approach to illness resonates with their counterparts in the East. I hope that in my acupuncture practice I acknowledge the lived experience of illness in every one of my patients and can help to move them towards a place where they can live their lives in an authentic and fulfilling way.

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