Abstract
By bringing together the Buddhist notion that suffering is intrinsic to all forms of our self-experience with Merleau-Ponty’s phenomenological interpretation of selfhood in terms of the “habit-body,” I show that vulnerability and meaningfulness go hand-in-hand. I then use this developed understanding of the nature of selfhood and suffering as the basis for a critique of various foundational aspects of contemporary, institutionalized healthcare. In particular, I consider ways in which oppressive social and political practices are instituted when the existential dimensions of pain are ignored and a medical model, based on the vision of pain as an alien threat to be eliminated, is adopted instead.
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Notes
- 1.
- 2.
- 3.
For a range of contemporary perspectives on the relationship between Merleau-Ponty’s phenomenology and Buddhism, see Park and Kopf (2009).
- 4.
Compare Saṃyutta Nikāya III.114–15. (Conze 1995, p. 75): “The instructed discipline of the Ariyans does not regard material shape as self, or self as having material shape, or material shape as being in the self, or the self as being in material shape. Nor does he regard feeling, perception, the impulses or consciousness in any of these ways. He comprehends each of the khandas as it really is that it is impermanent, suffering, not-self, compounded, murderous. He does not approach them, grasp after them or determine ‘Self for me [attā me]’ —and this for a long time conduces to welfare and happiness.”
- 5.
See especially II.28 (Davids and Woodward 1917): “That being, this comes to be; from the arising of that, this arises; that being absent, this is not; from the cessation of this, this ceases”; and II.65: “That which we will, and that which we intend to do, and that for which we have a latent tendency, this is an object for the persistence of consciousness. If there is an object, there is a support for consciousness.” See also I.62 and IV.95. See Berman (2004), on the relationship between this notion (which Berman translates as “relational origination”) and Merleau-Ponty’s notion of “reversibility.”
- 6.
One of the best statements of this is Husserl (2001, pp. 39–62). Compare Merleau-Ponty (2012, pp. 378–9): “When I say that I see an ashtray and that it is over there, I presuppose a complete unfolding of the experience that would have to go on indefinitely and I open up an entire perceptual future.” These themes from Husserl and Merleau-Ponty are richly developed in Howell (2015).
- 7.
- 8.
- 9.
In this paper, I write for convenience as if the words and ideas of the sermon are those of Siddhattha Gotama; in fact, of course, these are teachings handed down by tradition, and they may very well be the concentrated insight of generations of Buddhist thought, rather than ideas coming directly from any single individual. See Harvey (1990, pp. 3–4, 15–17).
- 10.
For the five “graspings,” see Harvey (1990, pp. 49–50).
- 11.
See Majjhima Nikāya, III. 203 (Horner 1954–1959). Within the Buddhist tradition, there is a strong emphasis on the theme of our active role in shaping matters even of birth and death; I do not extend my paralleling of Merleau-Ponty and Buddhism to this level. On this divergence with respect to Buddhist soteriology, see Berman (2004, pp. 134–135). I discuss below my understanding of the philosophical importance of the notion of karma.
- 12.
- 13.
- 14.
The core principles of Buddhist practice are found in “the Holy Eightfold Path,” which is “the Middle Way”; see Saṃyutta Nikāya II.43 and Majjhima Nikāya III.71–8. Compare also Krishna’s advice to Arjuna: “Be intent on action, not the the fruits of action; avoid attraction to the fruits and attachment to inaction! Perform actions, firm in discipline, relinquishing attachment; be impartial to failure and success—this equanimity is called discipline” (Bhagavad Gita 1988: Book 2, Verses 47–8). On the resources of Buddhism for dealing with pain in a medical context, see Kabat-Zinn et al. (1985).
- 15.
The notion of karma is in fact inherited by Buddhism from earlier forms of Indian religion, and it is a notion shared with, for example, Hinduism. On this ancient notion, see Doniger (2009, pp. 168–170).
- 16.
For these themes of temporality, see Merleau-Ponty (2012, p. 85).
- 17.
I have given a phenomenological analysis of this “family” inheritence in Russon (2003), especially Chaps. 4 and 5. The stories of “blood-guilt” and its legacy in the classical Greek tragedies offer a particularly powerful reflection on these “karmic” effects. On the psychologically formative effects of families and other institutions, see Leder (2005, pp. 110–112).
- 18.
Compare Pierre Bourdieu ’s notion of the social habitus: “The habitus, a product of history, produces individual and collective practices—more history—in accordance with the schemes generated by history. It ensures the active presence of past experiences, which, deposited in each organism in the form of schemes of perception, thought and action tend to guarantee the ‘correctness’ of practices and their constancy over time, more reliably than all formal rules and explicit norms” (1980, p. 54; emphasis added).
- 19.
On the relevance of traditional Hindu notions of karma for the treatment of pain in medical contexts, see Whitman (2007).
- 20.
- 21.
- 22.
On the strong parallels between Merleau-Ponty’s notion of embodiment and the Buddhist rejection of a substantial notion of self, see especially Mazis (2009; especially, 186–189).
- 23.
Compare Saṃyutta Nikāya, I.135, and II. 66–68 on the inherently “non-self” character of all things.
- 24.
On the theme of intersubjectivity in Merleau-Ponty and Nagarjuna, and on the relation of this to language, see Berman (2004, especially 137–141).
- 25.
On the idea that pain is a meaning, see Honkasalo (2000).
- 26.
I have given a phenomenological analysis of the internal dynamics of “attention” in Russon (forthcoming). See also Casey, “Attending and Glancing,” Chap. 9 (2007; especially 311–335); Vermersch (2004, pp. 52–54); and Bredlau (2006).
- 27.
The International Association for the Study of Pain, for example, defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” On the problems with the “medical model” in dealing with pain and suffering, see Cassel (1982). For a related argument that pain is an “extra-medical” and “biocultural” phenomenon, see Morris (1991). See also Coulehan (2012), and Rawlinson (1986). On problems with the “medical model” in general, compare Goldenberg (2010).
- 28.
On the limitations of this “somatogenic” model of pain, see Okifuji and Turk (1998). As they report: “The psychophysiological bases for many chronic pain syndromes are elusive. For example, no pathology is identified in over 80 % of patients with chronic back pain” (Okifuji and Turk 1998, p. 142). See also Wilde (2003), for the idea that chronic pain does not just “occur in their physical body but also in their embodiments. For such patients, dualistic (mind-body) notions of the body as object and mind as subject can devalue experiences that are necessary for healing and for managing everyday problems related to their illness or injury” (Wilde 2003, p. 170).
- 29.
See Okifuji and Turk (1998, p. 143): “Many patients report that stigmatization associated with the psychogenic [“hysterical”] and motivational [“money-seeking”] models substantially adds to their suffering.”.
- 30.
- 31.
- 32.
On the suffering faced by immigrants due to separation from family, town and homeland, and the problems intrinsic to living in a new land from which one is always “absent,” see Sayad (2004).
- 33.
See Fadiman (2012), for the related issues of the clash of cultures in the experience of a Hmong family’s struggle with the American hospital system following the diagnosis of epilepsy in one of their daughters. On the ambivalent value of the notion of “individual rights” in the context of different religious cultures, see Hoff (forthcoming).
- 34.
For the theme of “home” in the phenomenological interpretation of the person, see Jacobson (2009).
- 35.
- 36.
On the pain of “homesickness,” pertinent as much to interpersonal as to spatial relations, see Russon (2013a).
- 37.
On the experiential implications of hospital architecture, see Adams et al. (2010).
- 38.
On the significance of hospital architecture in general, see especially Ulrich (2000, pp. 49–59). On the stress faced by children and youth in hospital environments, see Pillitter (1987, pp. 567–578), and Korpela (2001). On the theme of permanent institutionalization of the elderly as an undermining of the experience of home and the forms of suffering related to this and to the failure of healthcare practitioners to recognize this, see Young (2005). On the distinctive experience of coming to find oneself at home in the sickbed, see Van den Berg (1966), especially Chap. 1, “The Meaning of Being Ill”.
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Russon, J. (2016). Self and Suffering in Buddhism and Phenomenology: Existential Pain, Compassion and the Problems of Institutional Healthcare. In: George, S., Jung, P. (eds) Cultural Ontology of the Self in Pain. Springer, New Delhi. https://doi.org/10.1007/978-81-322-2601-7_9
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