Deleuze and Guattari

Social theorists of health, illness and health care have struggled with a tension between conceptualisations of the body as a biological and as a socially constituted entity, with no end in sight to the capacity of researchers in these two disparate traditions to generate more and more detail about bodies (Fox 2012). The biological sciences have made inroads into the realm of the social, to explain behaviour and social organisation in terms of evolutionary theory and neuroscience (Pitts-Taylor 2010, Tooby and Cosmides 2005). Conversely, social scientists have sometimes regarded biology as irrelevant to the structures and processes of human societies, cultures and economies (Cromby 2004: 798, Turner 1992: 36). A focus on an exclusively biological or social body is not, however, an option

for those whose daily work concerns bodies, amongst others health and social care professionals and the social scientists who research health and illness in the interests of improving patient care and outcomes. Health is an embodied phenomenon that is material, experiential and culturally contextual. For body theorists working to supply a coherent and holistic understanding of embodiment to inform professional health practices and research, it is essential to find a way to explain the dual character of the body, without reducing one or other aspect to a footnote. An intellectually coherent theory that recognises that the body is always both biological and social, and that these aspects of its character together make it what it is, can supply an effective blueprint for the body work of the health and social care professional, and for the experiences of health, illness and care by their patients and clients. Achieving this balance has not proven to be straightforward. Biological and

social scientists start from different places (these days, at the molecular level for the former and at the psychic, cultural or even political level for the latter), and tend to end up with explanations that reflect these starting points. Few academics or professionals have sufficient knowledge and experience of both traditions to move seamlessly between natural and social aspects of embodiment, nor should this be an essential requirement for a holistic insight. In this chapter, I want to introduce a perspective, deriving from the work of Gilles Deleuze, in partnership on occasions with Félix Guattari, which holds substantial promise as a basis for an

analysis that can engage with both the biological and physical aspects of embodiment and health on one hand, and the social and cultural on the other, and be comprehensible to both natural and social science traditions. Relatively ignored in Anglophone sociology until recently, the work of Deleuze

and Guattari concerning the connections between body, self and social world offers some interesting ways of thinking about embodiment, and consequently about illness, health and health care. Intrinsic to Deleuze and Guattari’s position is the recognition of the link between body, subjectivity and culture. Bodies’ physical, psychological and cultural relations, and their capacity to affect and be affected by these relations, are the substrate for embodiment and identity, but also for a radical conception of health as defined by what (else) a body can do. This conception focuses on the body’s capacities for engaging with the world around it: physically, psychologically and socially. Sociologists have used Deleuze and Guattari’s approach to theorise health, illness and human development (Buchanan 1997, Duff 2010, Fox 2002, 2012, Fox and Ward 2008a), and the perspective offers considerable promise as a means both to develop theoretical understanding of health and illness, and to address the practice and delivery of health care and enhance health and well-being. In this chapter, I will proceed by summarising the three key elements in Deleuze

and Guattari’s theoretical position: the body-without-organs (BwO), assemblages and territorialisation. These abstractions will be explored to suggest how Deleuze and Guattari’s conceptions can be used to think creatively about the confluence between the body and the social world, and provide new understanding concerning health and illness. Then, by asking the Deleuzian question ‘what can a body do?’, I examine how bodily relations and affects (meaning here, the capacity to affect and be affected) mediate ‘health’ and ‘illness’, and how these concepts are radicalised by this focus on the body’s capacities and potentiality. Finally I will explore some consequences for health care deriving from Deleuze and Guattari’s approach.