Monday, November 4, 2013

The "Health" Concept Is Dangerous Interpersonal Colonialism

The Surgeon Evgueni Vasilievich Pavlov in the Operating Theater, Ilya Repin [Public domain], via Wikimedia Commons

I am so sick of the word "health" being thrown around in normatively complex situations.

Normatively complex situations are those in which, because people are different, it's impossible to universalize what's good and bad for them. Which means normatively complex situations are pretty much, like, everything. When situations are normatively complex, trying to use a universal scale, as "health" does, is wrong: it's like interpersonal colonialism, saying your way just has to be the best way, because it's best. And yet, when it comes to "health," people just can't stop!

Example 1: Sexual health.
When it comes to sex, "health" has about the worst track record you can imagine. We all know the sad sad basic story: vaginal orgasms are "more mature" than clitoral ones, homosexuality is a disease, women are naturally monogamous, etc. etc.

It's easy to say "mistakes were made," but I think the problem goes deeper. News flash: people are different and are fulfilled and pleased by different things! Yet there's this relentless and ongoing attempt to say that some ways of doing it are just wrong. They're not a "healthy" sexuality. "Promiscuity and hook-up culture: good or bad?" Can't things be different for different people?

Example 2: Mental health.
Don't even get me started with mental health. First, duh, not all people are going to be made to feel OK by the same things. But it's worse than that, even, because not all people are even going to find the same kinds of things feel OK-for-them.

These days, it's like, if you find yourself made unhappy by the basic suburban, kids, car, work-life balance life set-up, if you can't make that work for you, everyone's mentally packing you off to the therapist -- or, well, probably now to the psychopharmacologist, but you know what I mean. There's this default of, "have you talked to someone about that"?

And the urge for consensus and universality is relentless. For example, there's this whole debate over whether repression is bad or good. Back in the day: bad. Then it was found that sometimes repression helped people get over things. So now it's like "repression, good or bad?!" Why can't some people need repression and other people need to talk things over?

Plus, why does everyone have to have the same kind of well-being?  What if you're high-strung, or very shy, a loner, or just a weirdo, and you're good with that? "Health" is like a trick word bringing in immediately that there's some relatively clear and straightforward way things are better and worse. But that's so implausible.

Example 3: Health.
You'd think "health" would be the one area where the use of the health concept would be unassailable, but in fact I think it's been a source of real problems.

Aren't you tired of the once-size-fits-all rhetoric of health? Low-fat or high-protein? What should each person weigh? How much exercise and how much? Why on earth assume there's a single answer that applies to all people? Why can't some people need a low-fat diet to feel good and others need a low-carb one?

And again, the problem goes beyond different means to ends -- important though that is. Because  health health, like sexual health and mental health, is not a unified thing, and so it's possible for people to make different judgments and accept different trade-offs. 

For instance, surely if a drug makes you feel kind of shitty but will make you live longer that is a matter of which people can have multiple reasonable preferences? And same for feeling hungry all the time in pursuit of longevity? Can't a person rationally choose pot smoking or sex with strangers, knowing these things will cause other problems?

Yet the medical establishment makes these trade-offs seem beyond the pale. We're not even allowed to have the conversation. They set out the treatment and the rules, and if you don't follow, you're "non-compliant."

Obviously, the concept of health has some real and important uses and I'm not suggesting doing away with the whole idea of some things being better and worse. I'm just saying that sometimes, what's good is highly relative to the individual.

But it's perfectly possible for someone to register that all is not well without appealing to health. A person whose anxiety is causing them pain and misery can easily express this dissatisfaction whether or not the anxiety is in the "non-healthy" category or range. So why not just go there directly?

That is, in some interactions, instead of a rhetoric of "healthy" and "unhealthy," why can't we just a rhetoric of how-you-doing?  "You doing OK?" "Something on your mind?" "Something not working for you?" "Can I help?"

See? Doesn't require any interpersonal colonialism at all.

1 comment:

Daniel said...


These are huge pet peeves of mine. There is an effort afloat to replace "health" with "wellness," which I simply can't stomach. How is that better? It's funny, though, to imagine conversations with the substitute word / idea: "So, how is your mother's wellness?" And then, for a while, there was talk of "emotional intelligence." Ugh.