Recently the Minister of Health of Trinidad and Tobago explained the problem of chronic disease in the country: “The population do not listen to the message we are sending out – love yourself, eat right, exercise and decrease your sugar and salt intake.”[i]  The exhortation to “love yourself” in a disciplined approach to health suggests the curious place of the heart—and its love—in contemporary medical logics. This is a heart rooted in long Christian traditions. This figure with a potentially loving heart offers a more ambivalent subject than the autonomous and rational individual of liberalism sometimes imagined to reside at the center of contemporary medical regimes.  The Christian connotations of a heart capable of loving the self crafts a sociality of health around an affective unknown within.

The heart has a storied history in Christian theology as a special interior site of the self.  St. Augustine drew on Peter and Paul in his Confessions to explore the heart as what Eric Jager calls “the innermost self.”[ii] This heart intermingled affect and memory, carrying remembrance.  Medieval writings made the heart also a source of affective piety of devotion and self-sacrifice, “the moral or spiritual core of the individual” (ibid.: 103)  Medieval saints and lovers alike could have words inscribed on their hearts, a secret letter kept within (ibid.).  This was a love not amenable to any easy distinction between the carnal and the spiritual.  Such love turned toward the self was a particularly seductive sin for Jesuits, preventing one from spiritual betterment, as J. Michelle Molina argues.[iii]

With the Reformation, the heart became a site of conscience.  Martin Luther crafted a particular relationship between the heart and the law:

If the law were for the body, it could be satisfied with works.  Because it is spiritual, however, no one can satisfy it—unless all that you do is done from the bottom of your heart.  But such a heart is given only by God’s Spirit, who fashions a person after the law so that such a one acquires a heartfelt desire for the law (doing nothing henceforth out of fear and compulsion but out of a willing heart).  The law is thus spiritual in that it will be loved and fulfilled with such a spiritual heart, and requires such a spirit.[iv]

Luther’s exhortation to listen to your heart crafted a logic in which the law is sought within. For both Luther and Calvin, the heart kept a deeper, hidden you to be discerned. The uneasy journals that 17^th century Calvinist divines kept bespeak an anxious and continual search for signs of grace—an unknowable inner self.  In the Protestant relation to the heart, one learned to love oneself by adopting techniques to recognize a mystery within that was always there.

This inner heart has long been central to Protestant social reform, from attempts to nurture the involuntary poor, to the affective turn of the Second Great Awakening.  American health endeavors have relied on this heart, found in the projects of temperance societies and hospitals: when the Massachusetts Children’s Hospital was founded in 1869, the trustees intended for the regimen to have the effect on children of “quickening their intellects, refining their manners, and encouraging and softening their hearts.”[v] The hope among the trustees was that such pedagogy would “cultivate devotional feelings” (ibid.).  A similar affective emphasis could be found in the Protestant roots of Alcoholics Anonymous, as Trysh Travis has explored.[vi] The New England Protestant churches that AA founders Bill Wilson and Dr. Bob Smith were raised in played a role, as did the evangelical group where they met, a group started by a Lutheran Pietist after hearing a charismatic Pentecostal preacher (ibid.).  Bill Wilson called AA’s method the language of the heart. This was an affective community not based on an authority, but a heartfelt relation between brothers.  Here is a fundamental paradox Weber reads in Protestantism—the truth is sought within an individualism so exclusive that it produces a brotherhood of such seekers.[vii]

Today, this history of the heart resonates in the call for a loving orientation toward the self. Therapeutic regimes in Trinidad and elsewhere bring together aesthetics and ethics in a Protestant notion of inner feelings turned toward health.  As a Trinidadian man with diabetes told me, “When you love your body, you do stuff to enhance your physical output, plus you have to be strong.  And to live strong you have to do right thing.” This is an exalted love in the heart, a generous higher impulse found in Weber’s distinction of Christian brotherly love from eros.  And if today the heart is where one seeks a healthy love, then it is also where one is likely to find this love missing—an absence found in eating and drinking to excess, in failing to care. In Trinidad these techniques of learning to love estrange contrasting religious practices, particularly Muslim and Hindu rituals.

This heart within renders a richer figure than the classic foil of the liberal subject of rational autonomy.  There is a kernel within the subject hidden to himself in the notion of the heart as a site of inner truth. The passions and desires that perpetually run counter to rational plans are also a source of some masked higher law.  The heart knows something that the subject’s self-knowing doesn’t; and this unknown might heal by conferring a (for)giving attitude toward the self.  This subject crafts an affective solidarity around health and the law, one secured through the refusal of other religious traditions, in a “secular” love with longstanding religious significance.

 

Ian Whitmarsh teaches anthropology at the University of California San Francisco. He is the author of Biomedical Ambiguity: Race, Asthma, and the Contested Meaning of Genetic Research in the Caribbean (Cornell University Press, 2008) and co-editor with David Jones of What’s the Use of Race: Modern Governance and the Biology of Difference (MIT Press, 2010). His next book is on the intersections of techniques of achieving health and Protestantism.