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Review of  Language, Body, and Health


Reviewer: Simone C. Bacchini
Book Title: Language, Body, and Health
Book Author: Paul McPherron Vaidehi Ramanathan
Publisher: De Gruyter Mouton
Linguistic Field(s): Discourse Analysis
Pragmatics
Sociolinguistics
Book Announcement: 23.2751

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Review:
EDITORS: McPherron, Paul. and Ramanathan, Vaidehi
TITLE: Language, Body, and Health
SERIES TITLE: Language and Social Processes [LSP] 2
PUBLISHER: De Gruyter Mouton
YEAR: 2011

Simone C. Bacchini, Department of Social Sciences, The British Library, London, UK

SUMMARY

In broad terms, the theme of this edited volume is the relationship between
language and the human body. The term ‘body’ is used here in a very broad sense;
it includes the healthy body and as well as the ailing one. It is concerned with
language about and by individuals experiencing a host of body-related issues,
such as visual impairment, organ transplants, chronic and terminal illnesses,
and mental conditions. Contributions are also concerned with language about and
by those near to those experiencing these issues, such as family members and
carers. They draw on a number of methodologies, disciplinary perspectives, and
theories. The analysed material comprises extant data as well as
ethnographically gathered ones. To use the phrase coined by one of the editors
(Ramanathan 2009), it is concerned with the ways in which bodies ‘get
languaged.’ The authors of the contributions address various aspects of the
terms in which body-related issues can be and are addressed. These include the
social, the cultural, the communicative, and the emotional. Each contribution
focuses on how, through language, “people with ailments or ‘unusual’ bodies’ get
positioned and slotted in certain ways'' (p. 1). Importantly, the volume
addresses the issue of how notions of ‘normalcy’ in relation to body-matters are
constructed and reproduced and the ways in which, through language,
‘dysfunctional’ bodies are publicly framed or hidden from view.

Following an introductory chapter by the editors (pp. 1-14), the volume is
divided into four sections. ''Bodies and communication'' (pp. 15-74) deals with
''abnormal'' or ''malfunctioning'' body-parts. “Bodies and cognitive ‘impairments’”
(pp. 75-144) deals with conditions which affect cognition, such as Alzheimer’s
disease and autism. ''Bodies and chronic ailments'' (pp. 145-171) contains essays
on long-term or chronic conditions, such as diabetes and rheumatoid arthritis.
The final section, ''Bodies and body performances'' (pp. 193-278), deals with ways
in which culture and society structure ''body enactments and performances.''

Section one opens with an essay by David Bolt titled ''Community, controversy,
and compromise: The language of visual impairment'' (pp. 15-36). With reference
to visual impairment, Bolt addresses the various debates that have been taking
place in recent decades within the disability community in relation to
terminological typology. He begins with an overview of the ways terms such as
''blindness'' and ''the blind'' have been used unproblematically until the 1960s.
The discussion is usefully positioned within current and well-established
debates on ''ableist'' discourses on impairment but focuses on what Bolt terms
''ocularcentrism'' in language about visual impairment. The author highlights how
the central role that vision is accorded among human experiences is reflected in
the plethora of phrases, metaphors, and various language usages that equate
unimpaired vision with full cognitive and experiential integrity. A consequence
of this is that, in a language like English, the word ''blindness'' and its
related concepts have almost exclusively negative connotations. This conclusion
is supported by an examination of dictionary entries for terms and expressions
related to blindness. Interestingly, Bold shows that of thirteen definitions of
the adjective ''blind'' twelve are negative and only one pertains to actual visual
impairment. However, even when not referring specifically to visual impairment,
such usages clearly translate in negative evaluations of not only visual
impairment but, crucially, of visually impaired individuals. Observations on how
words derive their meanings ''from the company they keep'' and of the effect this
has on people’s understanding and evaluation of real-world phenomena is not new.
Yet, Bold highlights how this common linguistic encoding of vision-related
phenomena is not only conducive to negative evaluations of visually-impaired
people, it also distorts the reality of the full spectrum of visual impairment.
The world of total darkness that such phrases and metaphors imply is rarely, if
ever, the case. In this reviewer’s opinion, the analysis would benefit further
from usage of large corpora, such as the Bank of English, to lend further
support to the author’s claims. Furthermore, historical corpora could be used to
give sounder grounding to claims relating to the stigma attached to blindness
from a diachronic perspective. Use of the OED would perhaps offered better and
more interesting results than the etymological notes found in the ''Encarta Wold
English Dictionary,'' which Bold uses.

The author than offers a concise and useful overview of the debates on
terminology which have been occurring since the inception of the disability
movement in the 1970s. In particular, he discusses what has come to be known as
the ''radical social model of disability,'' born out of a desire to contrast
medical and essentialist views of disability. He concludes by discussing how
recently, the radical social model has been critiqued but how this critique is
adding diversity to the debate and having empowering effects.

Bold’s analysis illustrates very well how language clearly shapes our
understanding of bodily phenomena. As noted, his observation that reality is not
only reflected but also shaped by language is not new. However, by making the
point with reference to the language of and about visual impairment the point
comes across vividly. In his conclusions, the author states that his analysis
does not intend to be prescriptive but that it aims to provide a rationale for
making particular linguistic choices. This is particularly apparent in Bold’s
critique of the National Federation of the Blind’s opposition to what has come
to be known of ''person-first strategy.''

The second essay (pp. 37-53), by Paul McPherron, is titled: “Rebuilding the
body: Biomedical discourse and the decision to perform a living donor organ
transplant surgery.” It deals with the concurrent and often contrasting
discourses of organ transplant of medicine (transplantation as a medical
miracle), those of society (organ donation as a ''gift,'' signifying generosity
and altruism, as exemplified by donations advertisements), and those of the
patients and their families. Taking an ethnographic approach, the author
concentrates on the discourse of living-donor transplant, based on his
experience of donating part of his liver to his father. Using data derived from
print and internet advertising, family discussions about transplant, and
participant journals, the author shows that behind the medical discourse of
organ donation lies a dominant ideology that, whilst framing donation as an act
of generosity, simultaneously monetises it. McPherson’s analysis problematizes
the prevailing notion of organ donation through metaphors of accounting. His
data show how different from patients’ own metaphors and conceptualisations
these images are. However, he demonstrates that questioning prevailing
discourses of organ donation and transplant creates new spaces where new,
fruitful and empowering discourses, more reflective of the patients’
experiences, can be generated.

The fourth chapter, which concludes section one, is by Vaidehi Ramanathan:
“Reading ‘intentions’: Communication challenges for parents of children with
autism and partial hearing'' (pp. 56-72). This ambitious essay attempts to probe
whether the language we have for our bodies can adequately explain (or
''language,'' in the sense of ''give voice to'') accounts of ''subjectivity and the
psychical inner space'' (p. 55). To answer this question, the author refers to
Lacanian psychoanalytic thought as well as Bakhtinian Vygotskian ideas about
inner speech and tries to explore how intentions operate at a pre-language level
and to what extent such unconscious, pre-language intentions and verbalised
language match. For parents and carers of children with autism and partial
hearing, Ramanathan argues, an appreciation of the possible mismatches of
pre-linguistic intentions and what gets ‘languaged’ is of crucial importance.

Ramanathan’s essays is based on two cases of autism and one of partial hearing.
It is aimed at showing that, in such situations, communicative problems reside
not so much in the children’s problems in reading other people’s intentions.
They reside in the fact that the parents and carers of these children have to
base the socialisation of the children on their (the parents’ and carers’)
“readings of what the ‘normal’ world intends'' (p. 57). Although the essay does
not provide definite answers, it highlights the problematic nature of
communication in general and the ways this is heightened when what we take to be
the ''normal,'' world, with it referents and ways of meaning, and the
''pathological'' meet.

Section two opens with a chapter by Boyd Davis: ''Intentional stance and Lucinda
Greystone: Embodied memory in conversational reminiscence by a speaker with
Alzheimer’s Disease'' (p. 75-104). This chapter focuses on the communicative
challenges faced by individuals with a relatively common communicative
impairment and those who care for them. The author argues that, in spite of
changes in attitudes towards dementia of the Alzheimer’s type (DAT) and in
models of care, negative attitudes and stigma towards DAT persist. Crucially,
the author argues, such attitudes influence not only care outcomes but also
people’s willingness to participate in screening programmes. Davis makes use of
the concept of ''intentionality of insight,'' ''an awareness [on the part of DAT
patients] of how other people might view their having dementia'' (p.76), two
analyse two sets of repeated stories by a woman with DAT in conversation with
students in training. By looking at repeated snapshots of conversation, the
author shows how his informants manage to create and project a sense of self,
with the interlocutor’s co-operation, by using small narrative fragments.

Chapter six (pp. 105-141), ''Body in autism: A view from social interaction'' by
Olga Solomon, concludes the section. Similarly to the previous essay, this
chapter focuses on social interaction in cognitively impaired individuals.
Solomon’s analysis is multimodal; it relies on video-recorded daily (and
mundane) interactions involving high functioning. The section discusses the ways
in which affected individual operate in everyday life. In addition to addressing
the embodied nature of autism, the chapter also argues for more ethnographic
involvement in the study of autistic communication.

Part three, on ''bodies and chronic ailments'' is opened by Hanako Okada’s essay
(pp. 145-170): ''Negotiating the invisible: Two women making sense of chronic
illness through narrative.'' Taking a broadly narrative approach, the author
analyses accounts by two women, one diagnosed with fybromalgia and chronic
fatigue syndrome, the other with rheumatoid arthritis and a herniated disk. All
of these ailments are, to a lesser or greater extent, ''invisible illnesses'' in
the sense that (apart from disc herniation) they can go undiagnosed for a long
time and their symptoms are very often invisible to the onlooker, even the
medical professional. Okada uses Merleau-Ponty’s (1962) embodied phenomenology
as a theoretical framework to investigate how these women narratively construe,
negotiate, and communicate their conditions. Crucially, because of the
aforementioned invisibility of these ailments, narrative becomes essential in
reifying the conditions, lifting them, and the experiencing subject, out of
obscurity.

Another chronic condition, Type 2 diabetes, is addressed in chapter eight,
“Training your taste buds”: The language of success in diabetes ‘Self-efficacy’”
(pp. 171-190), by Evan Davis, Knol, and Turner. The authors combine the
instruments of discourse and narrative analysis to examine the language of
patients who are successfully self-managing their condition and that can then be
used to instruct and encourage newly diagnosed individuals to accept their
condition and take ownership of their treatment regimens. According to the
authors, such stories present the diabetic condition as one that is manageable,
thus allowing patients to better cope with it. In addition, by narrativising
their experiences, these ''successful'' patients are shown to ''discipline'' both
the body and body breakdowns.

The final section of the book moves beyond the mainly North American setting
with an essay by Busi and Sinfree Makoni titled: “The discursive construction of
the female body in family planning pamphlets” (pp. 193-219). This section used a
multimodal approach, by analysing both text and images in family planning
pamphlets in pre and post-Colonial Zimbabwe. The authors’ analysis highlights
the contradicting discourses and perceptions of the female body in the
transition between the colonial and independent period. These differences in the
conceptualisation of the female body, many of which persist to this day, have
resulted in considerable tension between generations and between the sexes. The
chapter also looks at the semiotics of film in female health and child reproduction.

The following chapter, “Blood talk: A discursive perspective on transcultural
identity and mental health” (pp. 221-244), is by Matthew T. Prior. By looking at
the language of a former Vietnamese refugee in the United States, the author
examines how his informant draws on discourses of the body as both object and
resource to construct a present a coherent and believable identity, as well as a
rational self. Several ''strands of identity'' are addressed by the speaker:
ethnicity, masculinity, and sexuality (same-sex orientation). Interestingly, the
author shows how the topos of ''blood'' is invoked to harmonise potentially
conflicting identities (Vietnamese, Chinese, Asian).

The following essay is by Fei Shui: “Body act: Contemporary Chinese body
performance, critical narrative, and somatic writing” (pp. 245-266). This essay
is unique in that it uses as data the performance genre of body art in China.
The author analysed discourse around such performances (the ways in which they
are documented, critiqued, talked about, and written). In so doing, he connects
them with his idea of ''somatic writing'', defined as ''the alternative embodied
practice and linguistic strategy to capture the evasive, the illicit, and the
erotic'' (p. 245) in such performances. The author’s analysis shows how in these
performances the body is eminently political in its interactions with the state,
space, and the evolving organisation and prevailing ideology of Chinese society.
The body is both object and subject and a living metaphor of the wider body-politic.

The last chapter in the volume is an essay by Tim McNamara: “Bodies and applied
linguistics: The challenge of theory” (pp. 267-278). In it, the author
consolidates and brings together the various themes addressed in the volume and
suggest new avenues of research. He focuses on the relationship between applied
research (in the form of applied linguistics) and theory. He advocates a
bringing together of applied work and theory and highlights how not only theory
can inform applied theory but also how applied research can in turn shape
theoretical thinking. Body and language issues, the author argues, cross
disciplines and they ought to be made as central as issues of language and race,
ethnicity, and gender.

EVALUATION

This volume is the second in a series that aims to contribute ''to the
development of promising new approaches to the sociolinguistic, sociohistorical
and linguistic anthropological study of social issues that centrally involve
language'' (2012, Language and Social Processes series: aims and scope). The
approach is thus broad and the volume under review fits very well in the series.
One of the strengths of the volume is provided by the variety of academic
background its contributors come from. The variety of expertises, outlooks, and
theoretical perspectives truly allows the volume to appeal to different
readerships. As stated by the editors (p. 1), the volume “seeks to contribute to
and extend current investigations in applied sociolinguistics.” Because of its
broad perspective and non-dogmatic approach, the volume will be of interest to
different audiences. These include, but are certainly not limited to, applied
linguists, sociolinguists, discourse analysts, health professionals, those
working within the field of the medical humanities as well as those with an
interest in disability issues.
In addition, it is certainly refreshing to come across a work where a
cross-disciplinary approach allows researchers space for intellectual and
methodological cross-fertilisation and inter-disciplinary dialogue. Whilst
scholarly works on the language – illness nexus are not lacking, what this
volume offers is a broader perspective made possible by the idea of ''languaging
the body,'' formulated by Ramathan in this and her previous work (2009). By
''languaging,'' the authors in this volume refer to various meaning-making
processes (verbal and non-verbal; at the production and reception end of the
communicative spectrum) using different modalities. The ''body,'' too, is
understood in a non-restrictive manner and this understanding is therefore
conducive to analysis of various aspects of the embodied experience, ranging
from cognitive impairment to chronic illness. The already-mentioned ethnographic
perspective that many of the essays have is particularly valuable, adding the
value of the personal testimony to that of scholarly research.

At the same time, this broad approach can result, in places, in an apparent
reduction in coherence. For example, from a methodological point of view, the
various authors often employ different transcription conventions for their data.
Although, as Riessman (2008) implies, transcriptions should not be fetishised,
using different transcription methods within the same volume without providing
transcription conventions can be confusing. Similarly, some of the authors
employ terminology without proper definition. In Okada’s otherwise excellent
paper, the term ''narrative'' appears to be used rather loosely, as a more or less
synonym of ''story.'' Although not a major problem per se, in a volume that often
makes reference to sociolinguistics, the reader is bound to expect ''narrative''
to reflect the rather strict Labovian model; the same applies to Evan Davies et
al.’s paper, where reference is also made to ''discourse'' and ''discourse
analysis'' rather ambiguously, as is the term ''agency'' (p. 179).

However, in this reviewer’s opinion, the aforementioned characteristics do not
detract from the overall value of the research that this volume presents and
encourages. But perhaps owing to the reviewer’s own background in
sociolinguistic and discourse studies, it is felt that a certain harmonization
at the editorial level would have made the final product more user-friendly.

In spite of the minor defects pointed out above, ''Language, Body, and Health'' is
a valuable and needed book. Not only does it highlight the ways in which
language (broadly understood) shapes and give visibility to embodied experience,
but it also opens the way for new avenues of research from a variety of angles,
or for the novel exploration of ''old'' problems in relation to the body in its
various states. Usefully, each essay includes, together with list of references,
a short annotated list of recommended readings for anyone interesting in knowing
more about the background and methodology of each essay.

REFERENCES

Ramanathan, Vaidehi. 2009. Bodies and language: health, ailments, disabilities.
Clevedon: Multilingual Matters.

Riessman, Catherine. 2008. Narrative methods for the human sciences. London: Sage.

Language and Social Processes series: aims and scope. Available at:
http://www.degruyter.com/view/serial/179211 (Accessed: 15 June 2012).
 
ABOUT THE REVIEWER:
ABOUT THE REVIEWER I have recently defended my doctoral thesis on the linguistic encoding of the experiences of physical pain and chronic illness through the lexicogrammar of Italian. My research interests include sociolinguistic, Systemic Functional Grammar and discourse analysis. As a result of my doctoral research, I have developed and interest for health communication and the use of language in medicine and medical settings. I am currently researching the encoding of ‘affect’ in doctor-patient communication, with particular attention to the role of the interpreter in situations when medical professional and patient do not speak the same language.

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