Book Review: Reading the Psychosomatic in Medical and Popular Culture, edited by Carol-Ann Farkas (London and New York: Routledge, 2018).
Dr Cris Sarg, University of Glasgow
Reading the Psychosomatic in Medical and Popular Culture (2018) is an edited collection by Carol-Ann Farkas. As is evident from the title this book examines the perceptions/interpretations of the psychosomatic within both medical and lay culture. The essays ‘seek to understand what the psychosomatic does, what uses we put it to, and what work it does for us: medically, socially, and culturally’ (Farkas, 2018, p.2). These essays both complicate and expand the readers understanding of the psychosomatic. This is because the authors do not merely simplify or define the topic but instead examine and explore it from within via multiple disciplinary perspectives, such as the clinical, historical, sociological, textual and cultural.
The first three essays examine the psychosomatic within clinical encounters. Caryn Rubanovich’s essay examines the conflict between clinicians and patients that is the result of the Western construct of biomedicine bringing those that exhibit psychosomatic symptoms into conflict with medical providers in order to gain the status that a definitive diagnosis confers upon them. The second essay by Maria Guilia Marini et al. provides a direct clinical example of the conflict between clinicians and patients affected by syndromes that have historically fallen under the heading of psychosomatic. They examine disease/care narratives compiled by both clinicians and patients who are dealing with fibromyalgia. The premise is that both patients and clinicians can learn from each other via the journals that both groups kept with the eventual hope of improving both the patient and clinician experience within this encounter. Finally, Claire Hooker and Louise Stone’s essay examines the conflict between patients and clinicians when clinicians insist that nothing is wrong, and proceeds to highlight the influence of the wider cultural and social milieu in shaping what we know and how we experience ill health.
Jessica Parr’s essay shifts the conversation from the clinical towards the historical and cultural and looks at the history of emotional eating in America during the twentieth century. She highlights the disconnect in the popular and medical/scientific understandings of excess weight and how twentieth century advancements in research into physiology and metabolism did not have nearly the same level of popular impact when compared to the models that explain overweight individuals that were provided via the psychological and psychoanalytic. These models assume that the act of overeating as a psychosomatic manifestation for unresolved problems of identity and emotion. ‘[T]his idea reinforces social stigmas and continues to endorse a construction of the self that values the belief that the fat body can be understood and regulated through a mind-body framework’ (Parr, 2018, p.66). Further, Amba Sepie’s essay expands on the idea that only certain ideas and theories have social legitimacy over others. Sepie posits that biomedical practices have had a colonizing effect on discourses of “health” and “illness” and have therefore privileged those discourses that have their roots in the “Western” and “scientific”. Sepie further argues that by lessening hierarchies within the biomedical establishment then discourses of health, wellness and illness can in effect be decolonized and the role of the psychosomatic can become more integrated into practice. In short, ‘it is hoped that this chapter may provide encouragement to look more deeply into cosmological constructions that influence how truths are established and power maintained’ (Sepie, 2018, p.83). Seamus Barker and Lorimer Moseley’s essay continues on to challenge the westernized biomedical model, especially as they appear in various editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM). They use rheological and narratological analysis to challenge the implicit power imbalance between clinicians and patients when the psychosomatic is involved in the encounter.
Maria Tutorskaya’s essay shifts the tone towards textual analysis and examines the passage of medical students from lay people to medical students and finally to physicians via what she terms medicalstudentitis, or medical student hypochondria. She explores the phenomena in its depiction in Vikenty Veresaev’s novel The Memoirs of a Physician (1901) and Eric Segal’s novel Doctors (1988). Tutorskaya argues that the psychosomatic experiences of medical students serve as a metaphor for their transition from one internal identity to another, and that ‘the humanizing benefits of literature might not only contribute to students’ cultural niveau but could lead to a more empathic and compassionate practice of medicine’ (Tutorskaya, 2018, p.111).
Olaug Lian, Catherine Robson and Hilde Bondevik’s essay examines how the female body is stigmatized, especially female exhaustion, within society and literature by the largely male medical profession, which has severed to use these medico-moral assumptions particularly about hysteria and neurasthenia from the nineteenth century to the present to essentially enforce gender normative behavior. They conclude that authors have used psychosomatic identities (i.e. hysteria) as a powerful imputes for female characters that cannot, or will not, fit within the prescribed gender normative narrative that society expects of them. In short, ‘[t]he condition has become more medicalized [over time], but instead of removing blame, as medicalization often does, the ailment is now portrayed in a harmfully judgmental manner’ (Lian, Robson et al., 2018, p.125). Then there is Camelia Raghinaru’s essay, which provides a psychoanalytic reading of the television drama The Sopranos (1999-2007). She argues that the “hysterical” symptoms of a number of the characters, particularly Tony Soprano, are the symbolic manifestation of unresolved neurotic conflicts of identity, specifically as they relate to ideas of (hyper)masculinity, ethnicity and class that are a part of American culture of the late twentieth century. Finally, Hannah Tweed’s essay examines the idea of chaos as normal, as seen through Alasdair Gray’s novel Poor Things (1992). Her essay serves to demonstrate the overlap between postmodern aesthetics and ‘the place of controversial mental illnesses and disabilities in twentieth and twenty-first century cultural productions’ (Tweed, 2018, p.142). Tweed concludes that Gray uses ‘the mutability of diagnostic terminology […] [to] challenge the increasingly pervasive stereotypes surrounding representations of cognitive disability and illness in contemporary popular culture’ (Tweed, 2018, p.149).
As a whole the collection spans the full spectrum of the medical humanities, from the clinical to the literary and everything in between. It is somewhat jarring to the reader to move along this spectrum, but this is mitigated by how the essays are grouped thematically. This critique is relatively minor, and can be leveled at most edited collections. Further, each essay forces the reader to re-examine how they understand and what they know about the psychosomatic and its impact in various circumstances, from its origins and perceived validity to the cultural or social background of the participants of an encounter, whether they be clinicians, patients or society as a whole.
Farkas, Carol-Ann, ed. (2018). Reading the Psychosomatic in Medical and Popular Culture: Something. Nothing. Everything. London and New York: Routledge.