chapter  7
Subjectivities of care – a case history
Alienating identities
ByOwen Dempsey
Pages 18

Individual subjectivity is, in part, dependent on the way capitalism creates social relations and means of survival that a) alienate us from the real source of the creation of profit and b) lead to commodity fetishism, where it is as if just by being a commodity, market exchange creates apparent surplus wealth, and for anticipatory healthcare, surplus life.

This chapter uses Lacan’s psychoanalytic theory to develop insights into why individuals are susceptible to such an ideological structure and the psychoanalytic mechanisms for subjectivity formation. A case history is used, based on breast cancer screening, to illustrate the potential subjectivities formed for: a) enthusiastic screening administrators (care-identifiers) that recruit patients in a master structure; b) a doubtful potential patient (care-labourer) in a hysteric structure; and c) a compliant surgeon (care-provider) in a university structure.

Then, Lacan’s Graph of Desire is used to illustrate the formation of subjectivity through demand, need and desire of the care-provider, using an ‘ideal’ breast surgeon. This shows how the individual is incited by symbolic discourse (guidelines) to form a particular subjectivity in relation to an imagined authority (medical expertise), though the operation of jouissance, fantasy and castration, that produces a subjectivity that feels free to act out a role that she feels is hers, and that provides meaning for her life.