ABSTRACT
The central question in this chapter is how experience comes to be known as illness, given that what counts as knowledge is produced within a person’s cultural context. The potential for cultural assumptions to over-ride one’s own way of knowing unwellness is shown by the reifying effect of language and the ‘terrible simplifications’ of diagnosis. Medical objectivism tends, as Byron Good says, to render some forms of experience unintelligible. In systemic terms, illness is a particular form of personal, social and biological life, which is how Canguilhem defines pathology. Possible criteria for abnormality are biological (as impairment) or social (as incapacity, or as injustice, in line with the social model of disability). Neither of these perspectives adequately capture what it is to feel ‘wrong’. Judging whether an experience is unnatural or pathological depends on moral and aesthetic values which are personal. A systemic account accommodates all forms of illness, since both illness and disease are ‘punctuations’ of relationships between biological, psychological and social elements.
