When Sontag criticizes those people who theorize that some forms of cancer may be caused by an unhealthy state of mind, it should be noted that her position against such theories is—until the exact cause of the disease and its various forms is conclusively determined—as moot a stance as those she attacks. Besides the fact that she avoids discussing specific cases in which patients have been reportedly cured of cancer through hypnosis, positive thinking, or prayer, the author herself reveals she has contradictory thoughts on the matter. For example, throughout her inquiry Sontag argues against the belief held by some that an individual’s thinking and self-image can cause illness; yet in her prefatory remarks she herself binds thinking and illness together by suggesting that her intentions are to help the ill by changing their thinking about illness and thereby permitting them to discover “the healthiest way of being ill.” In other words, while Sontag is unwilling to accept that one’s thinking may be a cause of illness, she evidently does believe that one’s thinking has the power to exacerbate it.
While Sontag seems to believe that ultimately there will be discovered one cause and one cure for cancer in its various forms and that patients’ thinking will not be connected to either, her major goal in this book is to elucidate and change the way people think about diseases:The notion that a disease can be explained only by a variety of causes is precisely characteristic of thinking about diseases whose causation is not understood. And it is diseases thought to be multi-determined (that is, mysterious) that have the widest possibilities as metaphors for what is felt to be socially or morally wrong.
One of Sontag’s major contentions throughout Illness as Metaphor is, in fact, that a society’s collective thinking is both shaped and expressed by how a given illness is perceived and discussed; she believes that changes in a people’s mode of discourse about diseases will gradually change their sociopolitical thinking. For example, she suggests breaking completely away from the plethora of military metaphors used to discuss diseases (replacing the body’s “immunodefensive system” with the body’s “immune competence”). According to Sontag, this matter of changing language to change thinking is of the utmost importance, for historically, when illness has been used metaphorically it has frequently been for the acquisition, expression, or continuance of human power over other humans.
Citing Niccolo Machiavelli, Thomas Hobbes, and the first Earl of Shaftesbury, Sontag shows that there is a tradition of equating sociopolitical problems to physical diseases which can be cured; she also shows that, as a preventive against such diseases and a means of maintaining political power, Machiavelli stressed foresight, Hobbes reason, and Shaftesbury tolerance:These are all ideas of how proper statecraft, conceived on a medical analogy, can prevent a fatal disorder. Society is presumed [by such men] to be in basically good health; disease (disorder) is, in principle, always manageable.
In the modern period, however, Sontag contends that the relatively optimistic uses of disease metaphors have been shattered, and cures are usually seen as only possible—in a political sense—by way of revolutions. The author supports her contention in part by noting how noticeably inclined modern totalitarian movements have been to use disease imagery. For example, the Nazis declared that a person of mixed racial origin was like a syphilitic, and European Jewry was repeatedly analogized to syphilis as well as to a cancer that had to be excised; Bolshevik polemics used disease metaphors; and Leon Trotsky used such metaphors with the greatest profusion, calling Stalinism a cholera, a...
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