Illness as Metaphor
Encyclopedia
Illness as Metaphor is a nonfiction work written by Susan Sontag
Susan Sontag
Susan Sontag was an American author, literary theorist, feminist and political activist whose works include On Photography and Against Interpretation.-Life:...

 and published in 1978. She challenged the "blame the victim" mentality behind the language society often uses to describe disease
Disease
A disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs. It may be caused by external factors, such as infectious disease, or it may be caused by internal dysfunctions, such as autoimmune...

s and those who suffer from them.

Drawing out the similarities between public perspectives on cancer
Cancer
Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...

 (the paradigmatic disease of the 20th century before the appearance of AIDS
AIDS
Acquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the human immunodeficiency virus...

), and tuberculosis
Tuberculosis
Tuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...

 (the symbolic illness of the 19th century), Sontag shows that both diseases were associated with personal psychological traits. In particular, she says that the metaphor
Metaphor
A metaphor is a literary figure of speech that uses an image, story or tangible thing to represent a less tangible thing or some intangible quality or idea; e.g., "Her eyes were glistening jewels." Metaphor may also be used for any rhetorical figures of speech that achieve their effects via...

s and terms used to describe both syndromes lead to an association between repressed passion and the physical disease itself. She notes the peculiar reversal that "With the modern diseases (once TB, now cancer), the romantic idea that the disease expresses the character is invariably extended to assert that the character causes the disease–because it has not expressed itself. Passion moves inward, striking and blighting the deepest cellular recesses."

Sontag says that the clearest and most truthful way of thinking about diseases is without recourse to metaphor. The tone of her treatise was angry and combative, and she makes sweeping claims that, while perhaps true to a first approximation, go too far (Donoghue, 1978).

She believed that wrapping disease in metaphors discouraged, silenced, and shamed patients. Other writers have disagreed with her, saying that metaphor
Metaphor
A metaphor is a literary figure of speech that uses an image, story or tangible thing to represent a less tangible thing or some intangible quality or idea; e.g., "Her eyes were glistening jewels." Metaphor may also be used for any rhetorical figures of speech that achieve their effects via...

s and other symbolic language help affected people form meaning out of their experiences (Clow, 2001).

Context

Sontag wrote this treatise
Treatise
A treatise is a formal and systematic written discourse on some subject, generally longer and treating it in greater depth than an essay, and more concerned with investigating or exposing the principles of the subject.-Noteworthy treatises:...

 while being treated for breast cancer
Breast cancer
Breast cancer is cancer originating from breast tissue, most commonly from the inner lining of milk ducts or the lobules that supply the ducts with milk. Cancers originating from ducts are known as ductal carcinomas; those originating from lobules are known as lobular carcinomas...

 (Olson, 2002:167). She does not mention her personal experience with cancer in the work, but she addresses it in her related 1988 work, AIDS and Its Metaphors
AIDS and Its Metaphors
AIDS and Its Metaphors is the companion book to Illness as Metaphor, also by Susan Sontag. While Illness as Metaphor drew on her experiences as a cancer patient and focused on the various metaphors that we attribute to cancer, AIDS and Its Metaphors extends this argument to the AIDS crisis...

.

At the time that Sontag was writing, the current alternative cancer treatment fad was psychotherapy
Psychotherapy
Psychotherapy is a general term referring to any form of therapeutic interaction or treatment contracted between a trained professional and a client or patient; family, couple or group...

 for the patient's supposed "cancer personality". According to these proponents, patients brought cancer upon themselves by having a resigned, repressed, inhibited personality. By undergoing the often blame-filled psychotherapy offered by some groups, such as the Simonton Center, the patient would overcome cancer by consciously choosing to give up the emotional benefits he or she created the cancer for, and be healed (Olson, 2002:160-169).

Publication

The short book was originally published as three long essays in the New York Review of Books (Donoghue, 1978). Some of the more inflammatory language was slightly toned down when it was published as a book. For example, what Sontag originally called the "inimitable looniness" of William Reich's language was softened to the "inimitable coherence" (Donoghue, 1978).
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