The Invisible Kingdom: Reimagining Chronic Illness

by Meghan O'Rourke

While this confusion has roots in immunology’s early vocabulary of selfhood, the idea that disease is a physical expression of a metaphysical condition is not new. It is deeply embedded in Western Judeo-Christian thinking, going back at least to the Christian notion that illness is entangled with sin: “Confess your faults one to another, and pray for one another, that ye may be healed,” we read in James 5:16. Christianity saw illness as a sign of spiritual taint—a metaphor for sin. In the Gospel, the sick are healed when they accept faith. Our word “pain” is from the Latin poena, or “penalty,” later the Old French peine, or “suffering,” as punishment. In the twentieth century, Freud and his descendants updated this framework by psychologizing illness: the body’s symptoms were now not a sign of sin but a sign of taboo or repressed emotions. Still a metaphor. What is new is that today, in our secular, individualistic nation, an amorphous illness is seen inevitably as an opportunity to uncover the authentic nature of the self and improve it, a project squarely in line with other obsessions of our neoliberal society. The focus on personal realization obscures the fact that it is not our selves that are wrong but the very structure of our society, with its failing support systems, its poor chemical regulation, its food deserts, its patchwork health care delivery.