Being Ill: On Sickness, Care and Abandonment

[Neil Vickers]

Members of this listserv may be interested in a book that Derek Bolton and I have just published with Reaktion Books in London and which will be available from Chicago University Press from today called Being Ill: On Sickness, Care and Abandonment. 

This book is about what major illness does to social belonging in the WEIRD world (Western, Educated, Industrial, Rich and Democratic). A major diagnosis changes how others see us, in ways that are difficult to control. Few if any relationships remain the same. Relations with intimate others often become closer as we become more dependent on them; more distant contacts become more strained; and, if the illness is visible, even relations with complete strangers may become fraught. These transformations in social identity are seldom discussed. Drawing on social neuroscience, group psychology, psychoanalysis, infant research, disability theory and microsociology, Vickers and Bolton offer a psychobiological account of relations between the healthy and the ill in contemporary Western societies that highlights the creative power of care and the devastation of abandonment. Highly individualistic societies are bad at supporting the supporters of the ill. Vickers and Bolton show how a sense of connectedness and group belonging can not only improve care but also make societies more resilient to illness.

This book draws attention to a major social problem in much of Northern Europe and North America today: the largely-hidden social isolation of those with major physical illnesses. Very little sustained inquiry has been made into this subject – we are unaware of any previous book-length study of it – and what there is tends to stay at the level of description. 

In the same way that Atul Gawande in Being Mortal (2014) sought to change the way we think about the relationship between medicine and ageing, we want to get people to see that illness is not simply a medical problem or a personal problem. It is a group problem. Illness transforms our relation to our groups, mostly for the worse. We want to explain why this happens, how it happens and what can be done about it.

We argue that illness interferes with the forms of recognition humans give each other by default. Drawing on neuroscience, group psychology, psychoanalysis, infant research, disability theory and microsociology, we put forward an original account of how those forms of recognition work. We believe our model, or something like it, is essential if illness is to be understood in social terms.