The Wiley Blackwell Companion to Medical Sociology. Группа авторов
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The social body constrains the way the physical body is perceived. The physical experience of the body, always modified by the social categories through which it is known, sustains a particular view of society. There is a continual exchange of meanings between the two kinds of bodily experience so that each reinforces the categories of the other. As a result of this interaction the body itself is a highly restricted medium of expression. (Douglas 1970: xiii)
Thus, according to Douglas (1966), the body forms a central component of any classificatory system. Working within a Durkheimian tradition she maintains that all societies have elements of both the sacred and the profane, and that demarcation between the two is fundamental to the functioning of social systems. Thus, societies respond to disorder by developing classificatory systems which can designate certain phenomena as matter out of place. “Where there is dirt there is system … This idea of dirt takes us straight into the field of symbolism and promises a link-up with more obviously symbolic systems of purity” (Douglas 1966: 35). Anything which transcends social, or bodily, boundaries will be regarded as pollution. Ideas, therefore, about bodily hygiene tell us as much about our cultural assumptions as they do about the “real” body and our medical knowledge of it. Furthermore, any boundaries that are perceived to be vulnerable or permeable will need to be carefully regulated or monitored to prevent transgressions (Nettleton 1988; Longhurst 2001). Bodies that transcend boundaries can be politically vulnerable, most especially where politicians invoke symbolic and cultural representations of bodies deemed as “out of place” as we see in the politics of migration, borders and popular nationalism.
Boundaries and classificatory systems play into discrimination that is both enacted (Shields 2017) and lived. For instance, a qualitative study of Arab Canadian immigrant women found that living in a new country, experiencing isolation and alienation of the body and bodily practices such as infant feeding, eating exercising and so on became sites of frustration (Oleschuk and Vallianatos 2019). The authors found that women talked in terms of embodied boundaries in two ways. One, they framed their bodies in relation to their own bodies when living in their home country and/or in relation to Arab women still living there which portrayed ways of living or a former sense of themselves now lost. Two they also framed their bodies in relation to the dominant images of Canadian women from whom they felt alienated and wanted to resist. The authors suggest that this embodied boundary talk reveals both the structural pressures of immigration, while it also enables them “to reframe the impact of those pressures (i.e. their weight gain and poor eating and exercise habits) into a narrative of immigration based on dignity.”
Social changes have bodily correlates in that what bodies are permitted to do, and how people use their bodies, is contingent upon social context. The work of Elias (1978, 1982) demonstrates this on a grand scale. Elias is concerned with the link between the state and state formations and the behaviors and manners of the sociology of the body the individual. He offers a figurational sociology; this means that he works at the level of social configurations, rather than societies. In fact, for Elias, societies are the outcome of the interactions of individuals. In his studies of “The Civilizing Process” (first published in 1939 in German), Elias (1978) examines in detail changes in manners, etiquette, codes of conduct, ways of dressing, ways of sleeping, ways of eating, and changing ideas about shame and decency associated with bodies. According to Elias, the civilizing process began in the Middle Ages within court societies where social mobility became more fluid and people’s futures could be determined not only by their birthrights, as had been the case under the feudal system, but also by the extent to which they were in favor with the sovereign or their advisors. In short, people were more inclined to be on their best behavior. Medieval personalities were characteristically unpredictable and emotional, they were inclined to be indulgent, and there were virtually no codes surrounding bodily functions.
However, within court societies, codes of body management were developed and copious manuals were written on how to and where to sleep and with whom, how to behave at meals, appropriate locations for defecation, and so on. Changes in behavior impacted on social relations and, as social relations transformed, so the compulsions exerted over others became internalized. This process, according to Elias, was accelerated in the sixteenth century. His analysis reveals how greater self-control over behaviors was associated with the body and a heightened sense of shame and delicacy:
The individual is compelled to regulate his [sic] conduct in an increasingly differentiated, more even and more stable manner … The more complex and stable control of conduct is increasingly instilled in the individual from his earliest years as an automatism, a self-compulsion that he cannot resist. (Elias 1982: 232–233)
This civilizing process involves three key progressive processes (Shilling 2012): socialization, rationalization, and individualization. Socialization refers to the way in which people are encouraged to hide away their natural functions. Thus, the body comes to be regarded more in social rather than natural terms. In fact, we find many natural functions offensive or distasteful; for example, if someone sitting next to us on a bus vomits over our clothes or if someone willingly urinates in an “inappropriate” part of our house. Rationalization implies that we have become more rational as opposed to emotional and are able to control our feelings. Finally, individualization highlights the extent to which we have come to see our bodies as encasing ourselves as separate from others. It is important, therefore, that we maintain a socially acceptable distance between ourselves and others. Furthermore, how we “manage” and “present” our bodies (Butler 1990; Goffman 1959) has become especially salient in a late modern context. Some argue that this is because the body has become a prime site for the formation and maintenance of the modern self and identity.
BODIES IN LATE MODERN SOCIETIES
Sociological theorists have argued that a key feature of such late modern societies is risk (Beck 1992; Douglas 1986; Giddens 1991). Doubt, Giddens argues, is a pervasive feature which permeates into everyday life. Our self and identity are a continuous embodied reflexive process (Crossley 2006) where we continually revise our biographical narratives. The reflexive self is one that relies on a vast array of advice and information provided by a myriad of sources.
What has all this got to do with the body? Well, a number of theorists have suggested that the body has come to form one of the main sites through which people develop their social identities. Whilst the environment and the social world seem to be “out of control,” the body becomes something of an anchor. Giddens points out that the self is embodied and so the regularized control of the body is a fundamental means whereby a biography of self – identity is maintained. Giddens (1991: 218) states:
The body used to be one aspect of nature, governed in a fundamental way by processes only marginally subject to human intervention. The body was a “given,” the often inconvenient and inadequate seat of the self. With the increasing invasion of the body by abstract systems all this becomes altered. The body, like the self, becomes a site of interaction, appropriation and re-appropriation, linking reflexively organised processes and systematically ordered expert knowledge. […] Once thought to be the locus of the soul … the body has become fully available to be “worked upon by the influences of high modernity” […]. In the conceptual space between these, we find more and more guidebooks and practical manuals to do with health, diet, appearance, exercise, lovemaking and many other things.
According to this thesis, therefore, we are more uncertain about our bodies; we perceive them to be more pliable and are actively seeking to alter, improve, and refine them.
Flexible Immunity Bodies
The idea that contemporary societies are characterized by change