Illness as Metaphor
|Publisher||Farrar, Straus & Giroux|
Illness as Metaphor is a nonfiction work written by Susan Sontag and published in 1978. She challenged the "blame the victim" mentality behind the language society often uses to describe diseases and those who suffer from them.
Drawing out the similarities between public perspectives on cancer (the paradigmatic disease of the 20th century before the appearance of AIDS), and tuberculosis (the symbolic illness of the 19th century), Sontag shows that both diseases were associated with personal psychological traits. In particular, she says that the metaphors and terms used to describe both syndromes lead to an association between repressed passion and the physical disease itself. She notes the peculiar reversal that "With the modern diseases (once TB, now cancer), the romantic idea that the disease expresses the character is invariably extended to assert that the character causes the disease–because it has not expressed itself. Passion moves inward, striking and blighting the deepest cellular recesses."
Sontag says that the clearest and most truthful way of thinking about diseases is without recourse to metaphor. The tone of her treatise was angry and combative, and she makes sweeping claims that, while perhaps true to a first approximation, may go too far (Donoghue, 1978).
She believed that wrapping disease in metaphors discouraged, silenced, and shamed patients. Other writers have disagreed with her, saying that metaphors and other symbolic language help affected people form meaning out of their experiences (Clow, 2001).
Sontag wrote this treatise while being treated for breast cancer (Olson, 2002:167). She does not mention her personal experience with cancer in the work, but she addresses it in her related 1988 work, AIDS and Its Metaphors.
At the time that Sontag was writing, the current alternative cancer treatment fad was psychotherapy for the patient's supposed "cancer personality". According to these proponents, patients brought cancer upon themselves by having a resigned, repressed, inhibited personality. By undergoing the often blame-filled psychotherapy offered by some groups, such as the Simonton Center, the patient would overcome cancer by consciously choosing to give up the emotional benefits he or she created the cancer for, and be healed (Olson, 2002:160-169). Others have taken her idea further, showing not that there is a real "cancer" behind the metaphors, but that all we have is metaphor—even in science—to understand the behavior of a disease that remains mysterious (Jain, 2013).
The short book was originally published as three long essays in the New York Review of Books (Donoghue, 1978). Some of the more inflammatory language was slightly toned down when it was published as a book. For example, what Sontag originally called the "inimitable looniness" of William Reich's language was softened to the "inimitable coherence" (Donoghue, 1978).
- Clow, Barbara (2001). "Who's Afraid of Susan Sontag? or, the Myths and Metaphors of Cancer Reconsidered". Social History of Medicine 14 (2): 293–312. doi:10.1093/shm/14.2.293.
- Donoghue, Denis (16 July 1978). "'Illness as Metaphor'". The New York Times.
- Olson, James Stuart (2002). Bathsheba's Breast: Women, Cancer and History. Baltimore: The Johns Hopkins University Press. ISBN 0-8018-6936-6.
- Jain, S. Lochlann (2013). Malignant: How Cancer Becomes Us. Berkeley: The University of California Press.