The first issue of Medical Anthropology in 2017 is a special issue, “Between Biopolitical Governance and Care: Rethinking Health, Self, and Social Welfare in East Asia.” Enjoy!
Between Biopolitical Governance and Care: Rethinking Health, Selfhood, and Social Welfare in East Asia (open access)
Amy Borovoy & Li Zhang
(There is a video abstract, too.)
In East Asia, health has historically been entwined with notions of morality and broader social ideals. But can the state and other institutions legitimate their involvement in everyday life habits that contribute to poor health outcomes? For example, food consumption, smoking, or cancer—issues that can be conceived as a matter of
‘individual choice’ and personal responsibility. In this issue, we explore the fine lines between exercises of social power that are repressive and controlling, and those that are productive, caring, or supportive. We examine intersections of individual desires and self-work with statism and the public good—for instance, drug addiction care and the use of psychological counseling in China, understanding cancer and stress in South Korea, and the containment of harmful behavior in Japan.
In this article, I explore how and why psychological intervention, often in the name of guanai (care), has gradually become a critical tool of managing the population and governing society in postsocialist China. Psychological counselors and experts are becoming a new form of authority, an indispensable part of creating and managing knowable, stable, and governable subjects for the military, the police, schools, and enterprises. ‘Therapeutic governing’ refers to the adoption of the therapeutic ethos, techniques, and care to improve the management of the work force and to help individuals cope with life in a rapidly changing society. I examine what drives local authorities to pursue this change, and how therapeutic governing takes on a different character and significance given China’s unique path. I suggest that incorporating psychotherapeutic intervention into postsocialist governing can simultaneously produce disciplining and nurturing, repressive and unfettering effects in everyday life.
Cancer incidence has been rising in South Korea, coincident with industrialization and with increased longevity. This has opened the way to a presentation of cancer as a symptom of prosperity and social advancement. Cancer care for older South Koreans is marketed widely as a way of giving back to the older generation, and is often portrayed as an opportunity to mobilize technological achievement alongside family care work to honor aging parents. Because breast cancer tends to affect a younger cohort, however, breast cancer patients seek more specific explanations for their illness in order to prevent recurrence. Many breast cancer patients identify ‘stress’ as the cause of their cancer, reflecting endemic stress in the lives of ordinary South Korean women. While this implies a critique of society and, specifically, of gender constructs, the emphasis on interpersonal ‘stress’ situates cancer causality in family relationships rather than in social, political, or environmental contexts. Cancer management and stress explanations together mute inquiry into causality.
In this essay, I revisit the politics of social control in the context of contemporary public health discussions, touching on the management of obesity and chronic illness. Foucault’s cautionary observations regarding the infiltration of normative social values into the terrain of healing offer a productive framework for considering the politics of public health in the industrialized world. I explore Japan’s public health paradigm and its key features of bureaucratic reform and health interventions through screening, socialization, education, and aggressive lifestyle training, and I consider the close proximity between health and socio-cultural values in the management of chronic conditions in Japan.
Seen through the prism of public health, the cigarette industry is an apparatus of death. To those who run it, however, it is something more prosaic: a workplace comprised of people whose morale is to be shepherded. Provisioning employees of the cigarette industry with psychic scaffolding to carry out effective daily work is a prime purpose of the China Tobacco Museum. This multistoried exhibition space in Shanghai is a technology of self, offering a carefully curated history of cigarette production thematized around tropes such as employee exaltation. Designed to anchor and vitalize the ethical outlook of those working for the world’s most prolific cigarette conglomerate, the museum is a striking illustration that industrial strongholds of ‘slow violence’ produce their own forms of self-care.
In this article, I explore a Chinese residential therapeutic community I call Sunlight in order to understand its quotidian therapies, its fraught nature binding China’s past with its future, and the to care for the self under postsocialism. Reviewing Sunlight ethnographically allows for broader theoretical exploration into how China’s economic transition created tensions between capitalism, socialism, and communism; between individual and community, care and coercion, and discipline and freedom. Sunlight blended democratic, communal, and communist values that in several ways transition drug addicts into a market-socialist society. In focusing on the socialist transition to capitalism much work concentrates on the neoliberal transition as the only path out of communism rather than exploring its exceptions. In exploring China as an exception, I ask: What do the residents, peer-educators and administrators reveal in their stories and reactions to community-based therapeutics of care and what happens when their notions of care clash?
Technologies of the Self and Ethnographic Praxis
The authors contributing to this special issue draw on Foucault’s notion of technologies of the self: the means by which people operate on their own bodies and souls in pursuit of self-transformation, always according to particular regimes of value. Foucault’s notion remains attractive to anthropology: the technologies are ethnographically visible, and they illustrate how power affects the intimate realms of social life. The authors in this issue take up three problems: (1) the process by which people craft new subjectivities, (2) the genealogy of the new technologies of the self now circulating in East Asia, and (3) the forms of governance and political rationality that they justify. The articles as a whole testify to the fruitful encounter between ethnographic praxis and Foucault’s philosophical project. They also show how transnational movement and hybrid cultural forms inflect the strategies of governance associated with modern technologies of the self, especially those allied with biomedicine.