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Body in time - timeless body.
A patchwork of thoughts.

Published in: Annual Review of Health Social Sciences, 1994, Vol. 4, 121-151

Last updated:  26 April 2000

A man who says that men are machines may be a great scientist. A man who says he is a machine is 'depersonalized' in psychiatric jargon.
Ronald D. Laing (1965, 12)

When time grows short, self-serving wins out over others-serving.
Lee Burns (1993, 332)

But man is so addicted to systems and to abstract conclusions that he is prepared deliberately to distort the truth, to close his eyes and ears, but to justify his logic at all cost.
Fyodor Dostoevsky (1981, 25)

"The important thing," Castel replied, "isn't the soundness or otherwise of the argument, but for it to make you think."
Albert Camus (1991, 48)

This piece of work reflects my theoretical interest in the concept of body and time. There is no other interest in this paper than the pleasure to think, to speculate, to assume or to suppose whatever comes to mind in the given context. This is not what reviewers call a "scientific paper" because I am trying to explore something of which I do not yet know what it is all about. The paper contains subjective, sometimes even personal thoughts.


Forever young, was the paradoxical, but perfectly appropriate message sent out by Bob Dylan at the end of the 60s. He meant it in a common sense way, he did not think about techniques of the prolongation of life, cosmetical surgery or the negation of biological processes. He simply mirrored what he saw in his environments. Mick Jagger and Keith Richards of The Rolling Stones will be 51 years of age in 1994 and on a world tour promoting their latest album Voodoo Lounge; although Jagger said in the 60s, he could not imagine singing Satisfaction after the age of 50, he is still up there, alive, well and kicking. Keith Richards is even wilder; he simply lives the rock & roll life as he has done for the past 30 years; medics would call him a drug addict, others name him one of the best rock & roll guitarists of the world.

Paul McCartney of The Beatles will be 52 years of age by the end of 1994. He lives together with his wife and kids on a farm in the northern parts of England; he has become a vegetarian and environmentalist donating parts of his shows and income to environmentalists' causes. He is still pursuing his pop-music career. He never doubts that his music has brought pleasure to hundreds of millions of people. And there is certainly no doubt about it.

US-President Bill Clinton is the first national leader of a developed country being younger than those being charged for the rock revolution of the 60s. He will be 48 years of age by the end of 1994. Well, he was born in the town called Hope. No kidding.

Have we entered an era of time- and culture-related confusion?


The Rolling Stones' I can't get no satisfaction was not just a rock song and has never been, but has become the hymn of affluent societies of the northern hemisphere because it reflects the unrealizable need for MORE. More of health, more of sex, more of pleasure, more of speed, more of sunshine - in short: more of everything is good and less of everything is bad.

The good are young, healthy, professionally successful and extremely mobile with regard to everything. The bad are relatively poor, narrow-minded and certainly not mobile. Who wants to be narrow-minded? Who wants to be poor? Who wants to be immobile? We are told that humans are flexible in almost any aspect of their existence, particular as far as their body is concerned. Is fashion not a good example for this flexibility?

In the age of The Rolling Stones, organ transplantations, cosmetic surgery, and all kinds of body-building have become ordinary events. The living body has become subject of repair- and style-shops - gender-distinguished, expertise-based and pseudo-rationally used. We bring our body to the market-place and look what we can do for it to enhance its quality and value regarding social interaction and psycho-physical investments in social relations.


Our body, ourselves has become a desperately inadequate formula. Neither have we had "our" body, nor have we been "ourselves". Have we been ourselves at all? Or have we not always been the self of others, too? Have we not learned we are socialized people, only partly responsible of what we have become, however almost always made responsible for what we do? Do we not explain to each other our background, and do we not want to know the background of the other person before we make further decisions whether we want to continue relations?

Some may say we have never been ourselves at all because we belong to an universe of living beings. We live in a global eco-system, interconnected with billions of other beings, depending upon numerous sub-systems. We are certainly not alone. The cats, for example, are not here in my house because I decided so on my own; they have had their active involvement, too. The domestication of beings is not a one-way street (Budiansky 1992). The same is true regarding our ways in dealing with other relations and therefore with our body.

Artificial insemination and gentherapy are only the latest techniques to intervene in the body. We assume that we are able to set aside biology and replace it with man-made technology. This is not just a spin-off of science or technology. This is rather the intended outcome of publicly and privately funded research aiming at the discovery of new areas of potential and profitable businesses. When all kinds of gadgets are available in the market to ease our daily life, business needs to look for some new areas to penetrate. In societies of great affluence, the body presents the ultimate area of intervention.

We are witnessing nothing less than a commercial invasion into our blood, organs, and fetuses, our gametes and children, our genes and cells. As body parts and materials are sold and patented, manipulated and engineered, we also are seeing an unprecedented change in many of our most basic social and legal definitions. Traditional understandings of life, birth, disease, death, mother, father, and person begin to waver and then fall (Kimbrell 1993, 228).

When basic needs are satisfied, needs of different kinds will be defined, felt and nurtured. Humans have never been without needs. If people have not defined their needs themselves, they have been defined by those in power; consequently they offer opportunities to realize these "needs". This is what Kimbrell's book The human body shop is all about.


The human potential is realized, so it seems, in its performance and in the manipulation of it. We are what we perform, respectively performed for. That sounds strange only at first glance. We are not aware of what is done to our body because we are not aware of our body in the first place; we do not use it, it is used and we go along with it. Even if we are involved, we tend to perform according to the model of rational action, i.e. we tend to adjust our performance to what we think is reasonable rather than to what we feel emotionally satisfactory. There are so many cases during the day in which we do things although we do not like them to do. And there are several other occasions in which we do things even so we do not realize why we are doing them; we perform habitualized behavior.

As humans, we seem to need the feeling of timelessness particularly when we are in need of time for ourselves. Timelessness makes us feel strong. It gives us the impression that we own past, presence and future. We tend to imagine that only lack of time is preventing us from doing the things we want to do. Of course, this impression is wrong. Time is too abstract a concept that it would be able to interfere in our daily routines. Societal rules and regulations impinged on us serve as monitors of our performance in a much stronger way than time will ever be able to do.

On the other side, time is the concept permitting us to organize our days along its compartmentalized segments. Because of its representation of structure, time seems to be a matter of rhythm. This certainly is true as far as individual circumstances are concerned. Ironically, time is a structural means in this respect, while it becomes functional as far as societies is concerned.

While time is rhythmic, society follows melodies. Social systems fashion themselves daily because of the changes in their internal and external relations, i.e. in their functions rather than in their structures. Revolution and reform are concepts terrorizing social systems because they call for a change of melodies (functions) and probably also for a change of rhythm (structures). Perhaps, they call for changes when social systems have felt well and at ease for a longer period of time.

No, that is not true. Social systems do not feel anything. They present a concept agglomerating social interaction under specific circumstances. They represent even more: they have become the buzzword for excuse, accusation and blame. As human beings, we tend to attribute to social systems qualities being substantial only for our existence. We also tend to attribute to them those qualities which we are ashamed and/or afraid of attributing to ourselves. We love to blame because blaming gives us a break in coming to terms with ourselves. Coming to terms with ourselves - is that the purpose of life; is that what we are occupied with in the course of time?


We never really think about time - we only think about appointments. We love to structure our lives along an appointment calendar. We do not wish to think about the chronology of life. This would be a far too abstract concept when we are enjoying life. We do not dare to think about the future because the future is uncontrollable. Future is a wild ocean of time. It rejects our approaches of rational management. We may dream about the future, about sailing this ocean, but we do not seriously deal with the future in a constructive way. The only time when future becomes an issue of daily life is the day when we sign an insurance policy.

We treat our life as a commodity (Burns 1993). We seem to believe that monetary investment results in biological outcomes; think about body-building, jogging or any other physical activity currently being promoted as fashionable and/or health-promotive. The investment in genetechnology, for example, reflects our wish to stay alive as long as we can. We do not even recognize that genetechnology, i.e. the combination of biological research and economics, combines different spheres, put into the same format of thought by us: we tend to think in terms of market-economy, although there is probably no such economy anywhere in the world, and we think of longevity, although we know that there is no such perfect cure that would give us what we want. But we have internalized the thoughts of this model, i.e. that everything may become a commodity in the market place. In other words, the human body in particular, and life in general have become commodities, so it seems:

... we are now in the early stages of adding the human body, its parts and processes, to the list of commodities that are subject to the laws of supply, demand, and price. The body is not a commodity. It is not a manufactured product intended for consumption. However, just as the new techniques in industrial technology led to the commodification of noncommodities such as human work and nature, the new techniques in biotechnology, including transplantation, reproductive technology, and genetic engineering, are now leading to the commodification of the body (Kimbrell 1993, 272-293)

It seems we want to stay alive as long as possible because we are afraid of losing something. Death has become the ultimate threat to wealth, irrespective of how much we own because it will always be much more than the other people in the southern hemisphere have access to. We fear death because we fear the loss of commodities and persons supposedly belonging to us. Our collective existence seems to be connected to the defeat of death. At least for human beings in developed countries, life has always had this character. As self-styled conscious beings, we are probably aware of the end of our individual life in some point of time and simultaneously we may know that our collective life will continue. The latter thought supposes that we have an idea of spiritual domains intervening in our lives. It supposes that there are spiritual qualities and dimensions of our life irrespective of our own rationale.

However, as we have lost our spirituality due to the acceptance of the paradigm of rationality, we are now fighting for the spiritual dimension of life with rationality, i.e. with the specific rationality that guides us through bureaucratic formulas, departmental regulations and helps us to obey traffic signs. We do not realize, so it seems, that rationality on the level of philosophical discourse does not necessarily result in rationality on the level of social action. Thought and action have always been distinguished - not only in philosophical terms, but specially in terms of action. We do not understand that spirituality is not an issue to be fought for rationally in order to get it back into one's life. Spirituality is a matter of time, furthermore, it is a matter of body, mind and soul in the context of time.


When I was in Germany in the summer of '94, I had a hard time because after unification, the Germans have become enemies of themselves. The body politics have gone back to the fifties and early sixties. People mistrust each other in unexpected ways. The differences between West and East are no more easily detectable in terms of economics or urban planning but in the opinions that people voice. There is dissatisfaction all over. The reason, again, is time. They have been promised to be as wealthy as their Western "brothers and sisters" within three to, at least, five years. Of course, that did not happen. It has been a specific information policy helping the government staying in power thereby neglecting all survey data pointing to a much more difficult time integrating East Germany into West Germany and vice versa.

While we have better insight, we seem to have worse action. The other way around: the more information we have, the less we trust our senses and subsequently our bodies. In difficult times we tend to become periodically bodiless. Although we (bodily) know that there is no existence without bodily struggle, we enhance our minds to take over control. Mind over matters, sang Dire Straits. Mark Knopfler, the mastermind behind this group, clearly spoke out what was going on in northern societies. Fundamentalists of southern and northern countries have picked up the issue without hesitation. They defined the body a timeless one. If you sacrifice it, you will be honored in this and the other world. Time has become eternal time, ironically in both worlds.

While the northern countries are on the path to technological reproduction of the body, the southern ones are about to sacrifice the body to superior forces. The body has become a nothing, at least a nothing concerning societal, cultural and political fora; it is only something to be manipulated. Or maybe it is the other way around: the body has become everything. It is treated like a commodity, even though the term commodity does not apply to the body:

The body is not a commodity. It is not a manufactured product intended for consumption. However, just as the new techniques in industrial technology led to the commodification of noncommodities such as human work and nature, the new techniques in biotechnology, including transplantation, reproductive technology, and genetic engineering are now leading to the commodification of the body (Kimbrell 1993, 272-273).

The body has been secularized to the degree that it has become an object of different technologies. Perhaps humans are seen as commodities providing storage of organs, health and disease thereby giving a lot of people employment. Diseases are determined via checks similar as in the case of automobiles. In the latter case the check is determined by the amount of kilometers or miles the car has passed; in the former case it is years of age and/or gender and/or occupation defining the criteria for regular check-ups. The body is increasingly seen as a machine, as Kimbrell (1993, 249) states:

Our association of the body with "efficient machines" has crept into our culture in ways other than work. It has created a modern body type in the machine's image - what one commentator has called "techno-body". The techno-body ideal, for men, and increasingly for women, is the "lean, mean machine": a hairless, overly muscled body, occasionally oiled, which very much resembles a machine. For many body zealots, the healthy body is one that functions and looks like an "efficient machine", not a body that is functioning in a natural and holistic fashion.


Why have we gone so far and putting mind over matter (i.e. body)? Why do we conceive of the body as a machine? How much are we afraid of the body? How much are we sure of mind? Do we really believe that there is just matter and mind? No spirituality? No religion, beliefs, superstitions? Do we believe we would be more rational than our ancestors, and if yes, why can we hold to that belief?

There are no simple answers to these questions. I do not have answers resolving the questions. I do know there has been some time when our thoughts were redesigned towards what we now call reason or rationality. It is the era of enlightenment, back in the 17th century. Descartes and later on Galilei, Locke, Newton, Kant and Humboldt among others substantiated the idea of mind over matter, or of reason over material. This type of philosophy has survived until today. It has become the major philosophy of developed countries. Rationality, they say, is the essence of the state, of the government, of organizations.

Others may describe and label our mainstream philosophy differently. I go along with the critical remarks made by Amitai Etzioni (1988, 15):

individuals are found to be much more limited in their ability to reason than is often suggested; typically, we shall see, they are sub-rational at best.

Of course, this is not a scientific statement but one which is loaded with insight. There is more critical insight in the development of industrialized countries and their subsequent degradation of mind to a psychological commodity. Michel Foucault and Jürgen Habermas have been brilliant examinators in this respect; they found that the concept of society does not bear the kind of consensus being suggested by conservative politicians. They demonstrated that reason was just another whore of those in power. They have not, however, enlightened us about ways and means how to overcome the irrationality of this type of "rational culture".

The de-reasoning in a culture of rationality is extremely ironic. While emphasis is put on functionality, the rationality of its subjects is almost neglected. All of the latest technological "break-throughs" are more related to the increase of functions and less to reason, let alone the enhancement of individual and collective living conditions. Our belief system has been shaped towards the calculable and manageable. It is probably Ronald Reagan who represents this approach to the ultimate extent. Star Wars is the perfect concept in relation to what our minds have become; we are on the outlook for ultimate control. Reagan and his advisers thought, control of each and everything on earth and in the galaxies would result in security. They never understood total security would result in death because total security presents the state of entropy in which nothing is happening at all because no risks are taken any more (Rifkin 1985).

Living beings need risks to exercise their potential for surviving. The concept of security which aims at "total security" or at total prevention of any hazards is actually denying some of the basic facts of life. As someone so eloquently stated:

Life without risk would be like chili without heat - edible but bland (Egger, Spark & Lawson 1990, 17).

I would even go one step further and state that this kind of chili is not chili anymore. It is something else.


Our current understanding of risk refers to threats caused by individual or collective action and/or its projected outcomes. In daily life, we define risk as the probability that something negative will happen when we realize a specific action. We are looking for safety and for secure ways of reaching the goals we have set or that have been set for us. We believe there should be technologically safe ways guarding us to the goals we want to attain. If we have to select from options, we assess the risks they may contain - either by listening to experts telling us about them or by referring to our own understanding and common knowledge concerning the experience others have had.

This understanding of risk reflects the belief that there are technically safe solutions for fundamentally social problems. This applies particularly with regard to health and health-related behaviors being basically social issues. They are embedded in the cultural patterns and social settings of any given society. The meaning of health - as well as the meaning of life in general - is subject of a social discourse. Discourses are potentially colliding because there may be as many different views on the subject as there are participants in the discourse. The notion of consensus regarding social discourse is not realistic. Perhaps there may be a consensus about an issue for a certain, mostly short period of time. However, as life goes on, people will again develop in different directions leading to different perceptions of the world and the beliefs and values held by them. Thus, there will always be dissent about issues and, ultimately, about risks related to certain actions.

Some may consider an action as risky; however, to them it seems worthwhile to take the risk. Others disagree with them. On the societal level, the debate about risk is related to institutions and, subsequently, to the power they have to decide which action is considered to be risky. It is an organizational setting in which risks are assessed and the outcome of the assessment is presented to the public in different forms as:

  • recommendations,
  • warnings,
  • regulations,
  • laws.

While recommendations are the weakest form of policy interfering in daily life of individuals, groups, and organizations, warnings already bear concrete threats to them, at least on the behavioral level in terms of negative effects their behavior may result in. Regulations and laws, finally, decide upon the correctness/incorrectness of behavior and action and define - more or less clearly - which sanctions are to be taken if people and/or organizations are identified of non-compliance.

Regulations and laws do not necessarily lead to their enforcement. As William Greider demonstrates, environmental laws and regulations in the USA among others have not been enforced as intended but have become subject of deal making:

The high art of governing - making laws for the nation and upholding them - has been reduced to a busy commerce in deal making. Thousands and thousands of deals are transacted every day in diffuse corners of the city. The rare skills required for politics at the highest level are trivialized as petty haggling, done with the style and swagger of rug merchants (Greider 1992, 105).

Organized special interest influences national agencies to consider specific regulations helping to avoid the intended effects of laws related to their interest. While laws and regulations are meant to reduce risks concerning the public, special interest is concerned to reduce risks regarding its business by imposing risks on the public. While risks are considered to be negative, the risk taking has to be covered up as soon as business and economy is involved (Bryner 1987, Reagan 1987, Landy et al. 1990). At the same time, individual risk behavior such as smoking, drug abuse, or excessive alcohol consumption, is blamed to be responsible for the huge increase in health care costs. Individual action is interpreted as threat to an institution which is held alive, for example, by the medical industrial complex profiting from the criticized behaviors.

The assessment of risks is not unequivocal. It depends on interests, beliefs, and values of the assessors. They may base their assessment on research data; however, research data from social sciences are not unequivocal either. Study designs, methods, and statistical analyses and concepts of explanation may differ considerably depending on the frame of reference and the interpretation of data. As long as these are not taken in account, data have no value at all. Besides the technical discussion on research reflecting the increasing importance "experts" play in the domain of scientification of daily life, the feelings of people are mainly considered as non-technical - as if one had to graduate from university to lead a reasonable, technically sound life. Often, self-styled scientific debates are targeted to cover up the issue rather than to enlighten the people and the decision-makers with regard to the subject in question.

The negative connotation of the word risk creates a fundamental problem in the notion of 'risk taking', namely differences in perception regarding the inherent value or worth of some action or behaviour between the 'risk taker' and the risk assessor. Risk taking implies intent on the part of the actor, but the intentions of the action are not fully appreciated or acknowledged with this one-sided view of risk. The risk assessor judges the actions of another individual to be harmful (or bad?). The (real or perceived) benefits to the individual of smoking, eating, drinking, driving, flying, or whatever, are not considered. The health-enhancing aspects of the benefit of some action to the individual may more than compensate for its health-threatening aspects (rational behaviour?). The notion of risk as wager - assessing both losses and gains - would seem a more appropriate conception of risk in relation to 'risk taking'. Analysis of both positive and negative aspects of behaviour would provide the 'risk taker' an opportunity to play an active role in labelling and evaluating 'risk', thereby wresting exclusive power to determine 'risk' away from an external 'expert' (Hayes 1992, 404).

Risk is a concept directly linked to life; that is, it is linked to the living conditions and lifestyles of the people. Aldous Huxley holds human life is mostly prohibited to blossom fully due to restrictions of the social and economic conditions:

Most men and women lead lives at the worst so painful, at the best so monotonous, poor and limited that the urge to escape, the longing to transcend themselves if only for a few moments, is and has always been one of the principal appetites of the soul (Huxley 1977, 50)

Beyond the structural risks of evolution and, thus life, individuals and groups develop behavioral patterns and strategies helping them to cope with the requirements and contradictions inherent in their ecological and economic living conditions. These not only involve health-promotive behaviors; people also practice health-hazardous behaviors for different reasons. Within the framework of the lifestyles approach (Wenzel 1983), the concept of risk behavior has been used to reflect upon those living conditions and social situations in which people might carry out certain behaviors for a specific period of time which may be considered by others as health-hazardous; however, the individuals involved may not feel the hazards being important as long as the positive effects of the behaviors are qualified as superior, both individually and collectively.

  • The function of risk behaviors is to help individuals and groups manage the difficulties and problems of daily life. It would be a misconception to view risk behaviors per se as deviant behaviors. They are well-accepted by social groups performing them irrespective of what other social groups may think of them. Several risk behaviors are socially more or less accepted such as drinking alcohol, smoking cigarettes, sun-bathing, taking pills, having sex with multiple partners in the life course, driving fast, etc., while others are viewed as unacceptable by society-at-large, such as train-surfing (a practice in Latin American countries where youths ride atop high speed trains standing upright). Some are presented in the context of sports such as freestyle mountain climbing (in the USA, the slogan is: if life gets boring, risk it), deep-sea diving, high-speed skiing, high-speed motorboat driving, bull-fighting etc.; they communicate the message that those who carry out these sports are somewhat like heroes (at least for one day).
  • The outcomes of risk behaviors are mainly relaxation, pleasure, fun, i.e., well-being for a short period of time. Risk behaviors involve only a short-term time perspective. They are always oriented towards a specific social situation and are characterized by a desire to achieve well-being as quickly as possible; Huxley (1977, 52) uses the term frequent chemical vacations from intolerable selfhood and repulsive surroundings. In most cases, therefore, risk behaviors are related to leisure because in this temporal context people have more individual and collective opportunities to decide upon what they want to do. This particular social sector has been developed in developed countries according to commercial and industrialized patterns. Numerous facilities offer services meeting peoples' desire to achieve relaxation, pleasure and fun. From a sociological point of view, one can argue there is an industry offering facilities for risk behaviors - and it meets peoples' needs to get away from daily life for a certain amount of time. This short-term time perspective of risk behaviors is an important factor with regard to health promotion. Health-related behaviors rather frequently are time-consuming and also bear some amount of uncertainty regarding their benefits, while risk behaviors relate to alternatives offering immediate gratification regardless of their potentially health-hazardous effects. For example, after a day full of stress, an individual may decide to unwind by practicing meditation, taking a nap or doing relaxation exercises, all of which may be beneficial health-wise. However, the alternative of visiting a bar to have a drink is often more attractive, though it might be damaging to health depending on how much the person drinks. Living in the fast lane, as a popular rock-song stated some years ago, or living in computime (Rifkin 1989) does not seem to allow for long-term considerations concerning well-being. Risk behaviors thus tend to become an integral part of every lifestyle. The question is whether we will be able to reduce the potentially health-hazardous effects of these behaviors.
  • Risk behaviors are perceived as individual and/or collective attempts to gain control over certain situations in terms of well-being. The functionality underlying risk behaviors does not necessarily follow rational criteria. The term control is used in a subjective way, i.e., as far as the individual perceives a situation as being under his/her control, a certain risk behavior is considered an appropriate way to contribute to well-being. This represents the deeply in-routed irrationality of our system of reason. It permits to be rationally irrational. For example, taking a pill may help one to fall asleep in a situation of constant stress; drinking several glasses of beer may help one get away from the strains of the workplace. By pursuing these risk behaviors, the individual pretends to control the past and future: the past because the behavior enables him/her to escape from a situation so that it no longer serves as a stressor; the future because the behavior contributes to future well-being, i.e., the individual will once again attain a position in which he/she can face reality and to try to cope with it the next day. The problem with risk behaviors lies in the fact that this kind of control is only of subjective relevance; it does not affect the causes of the stress perceived nor does it contribute to an individual and/or collective study of possibilities of overcoming the difficulties involved in certain situations and experiences. The main objective is just to achieve well-being irrespective of the past and future circumstances of one's life.


Health has become a fashionable word. Health food, health club, health shop, you name it. While becoming a fashionable word, it has also become a product - or, maybe the other way around? There were products which entered the market labeled health products? It is probably difficult to decide which came first. It is not important for our argument. It is, however, important that health entered the marketplace. Health shops sell health? It seems this is their message. The concept behind it is, that we can buy health if we buy the products from the health shop. Until recently, we have bought milk, vegetables, meat, eggs and seafood in the supermarket around the corner; on Saturdays we may have gone to the market and we looked for vegetables and eggs fresh from the farmer. Now, there is the health shop, telling us just by its existence that other shops do not seem to be selling healthy products. When buying at the health shop, everything will be fine concerning our individual health and the health of our families. We do not have to worry about toxicated fruits and vegetables, chicken from the chicken industry fed with artificial fodder, meat from animals pumped up with all kinds of chemical fertilizers. We just go to the health shop, buy the amount of health for us and our family - and we will be happily healthy. Correct? Well.

Health has entered the market. It has become an ordinary product, sold to ordinary people, sometimes paying not so ordinary prices for it. As we know, however, quality has its price - and health is certainly supposed to be a high quality per se. One thing amazes me: as there is virtually nothing one can say against health because it is thought of being the product making life comfortable, easy, pleasing, enjoyable, why do we need "social marketing for health" as an approach to sell the message to the people that they ought to lead healthy lives - as if the people were interested to lead unhealthy lives. What is so bad about health that we have to enlighten people so that they buy health? Or is it so difficult to understand what health means? And if so, why is it so difficult? Has health been covered up during the past decades? Is it therefore, that people do not know anymore what health is all about? Have they lost their senses concerning health? And if so, when and why did it happen? Has health to be put on the list of endangered values/products/goods because many people have exploited their health?

I suppose that the public discourse about health reflects several problems crucial to the development of industrialized societies:

  • as the exploitation of natural resources has reached a degree which already has led to the extinction of thousands of species, and which has deforested millions of hectares of land crucial for the global climate, and thus, for keeping an ecological balance of Planet Earth, people increasingly become aware something might have gone wrong with industrialization;
  • as people recognized that affluent societies pay a high price for their kind of living conditions and lifestyles, that is, as there is more and more wealth, and much less health or: as there is more health to the wealthy and less health to the poor, people seem to feel that inequalities of this kind are unbearable for any society in terms of morale, values, beliefs, and political constitution;
  • as governments and those in power have recognized that the costs of industrialized development turn out to be unpayable in the future, i.e. as they recognize that the predominant pattern of development seems to destroy the basic fundaments of its existence, that is: the ecological system and the health of people, they are forced to take action - to prevent this pattern to be rejected by the people; they have initiated the public discourse about health, thereby meaning any behavior of the individual which can be considered unhealthy; strong alliances have been built having access to mass media and other channels of communication to direct people to living healthy lives - as far as the developing countries at least is concerned: in an increasingly unhealthy environment;
  • as the "solutions" proposed by those in power tend to be technical solutions to basically social problems, they will fall short of solving the problems at all; health is a concept involving long-term time perspectives, communication, social action, and involvement of people in developing living conditions and lifestyles conducive to health;
  • improving health needs organized people who are involved in the pursue of common goals/goods which is almost the perfect contradiction to what the economic term market means.

The presentation of these problems leads to three different meanings of health at least:

  • health being a medically defined state of body, mind and soul,
  • health being related to certain types of behavior,
  • health being an inherent quality of life.

The meanings are communicated in political programs and decisions, in mass media campaigns, in health education leaflets, and of course in the marketplace. There is no consensus about what health means; the term is utilized for different purposes and has, thus, become part of the policy process. Sometimes it is used to cover up political decisions aiming at an increase of social control of individual and collective behavior; sometimes it is used to present a vision of society in balance; sometimes it mystifies human needs and behavior; and sometimes it is plainly used to educate people to conform to expert's advice.

Marshall H. Becker (1986), the late American health educator, deals with these difficulties in his paper The tyranny of health promotion in which he states:

reasonably content people have had their fears aroused and fell compelled to attempt significant behavioral changes, attempts at which many (if not most) will fail; some advice is subsequently considered to have already been harmful; and the public has become confused, and even skeptical, about public health advice, perhaps especially because we offer our contradictory advice sequentially (15-16) ... to turn our attention beyond the individual - to recognize the social and economic determinants of disease, health and "wellness" - is complex and threatening (19) ... the individual-responsibility approach has helped to establish "health" as the New Morality by which character and moral worth are judged. "Being ill" is redefined as "being guilty". The obese are stigmatized as "letting themselves go". Smokers "have no will power". Nonaerobics are "lazy" (19).

People are stigmatized, when they are considered by certain people as behaving or being unhealthy. Who are these people executing the power of stigmatization? Certainly, they are not the majority because the majority never stigmatizes itself. Thus, there is a minority of people telling the majority not only what is right and what is wrong, but also blaming those who do not follow their verdict as being "lazy", "guilty", "ill", "having no will-power", etc. This minority consists of representatives of the medical professions, self-styled experts in health matters, priest of a good life, politicians of some kind, and just normal people. What they are doing is to define a morale concerning health as they understand the term health. They are in the business of political correctness, as it is called in these days. In other words: what they are doing is defining a certain kind of policy aiming at the regulation of daily social life. There is nothing correct with political correctness. It presents the structural approach to push individuals to conformity within set standards.


Freud and subsequently all of his disciples have been wrong. Identity is an abstract concept with no relation to the daily life of humans. Body, mind and soul are separated immediately as they are perceived prenatally, natally and postnatally. As soon as we perceive, we are differentiated in the one who perceives and the one who is perceived. Perception as well as experience are human domains which are fundamentally linked to something else beyond the individual; the same is true regarding action and behavior. Without counterparts, no perception and experience is possible. We are what we are, because there are others. Instead of saying "I", we should always say "we", because the "I" does not exist. It is fictional, a theoretical construct which gives us the impression of being a whole person which we have never been. Again, this seems strange at first glance. If one realizes the interdependence of individual development and social, economic, cultural, and ecological conditions, however, it becomes clear that the idea of the "individual" is perfectly inappropriate. The individual presents always the ensemble of these conditions shaped by his/her personal interpretation. Individuality is dependent upon and performed in the context of social, economic, cultural, and ecological conditions.

Psychological development makes us beings of different qualities at the same point in time. We will never be whole, perhaps we will only be able to perform as someone who respects body, mind and soul. There will always be the difference between the suggested timelessness of mind and soul and the real timeliness of the body.

In many aspects, the body is independent from the mind. Why should we have education, even health education or smoking cessation? We have established agencies of body control with regard to these and other domains because we are aware of the incompatibility of mind and body, at least that is what we believe. We feel that the body has to be controlled in order to make it functional according to values and norms of our social systems. Controlling the body is the ultimate function of mind over matter.

Descartes, in the 17th century, recognized the difficulties of bringing mind and body into one concept, that is, he stated their incompatibility. He wrote:

I am thinking, therefore I exist. (...) I was a substance whose whole essence or nature is solely to think, and which does not require any place, or depend on any material thing, in order to exist. Accordingly this 'I' - that is, the soul by which I am what I am - is entirely distinct from the body, and indeed is easier to know than the body, and would not fail to be whatever it is, even if the body did not exist (Descartes 1988, 36).

Descartes felt the carnal aspects of human existence are harder to understand than the mental. One can feel some anxiety shining through his statement as far as the body is concerned. The body seems to represent the wild, while the mind the "civilized". Unfortunately, there have been too many who have agreed with Descartes. Some in these days, who have their doubts about Descartes' concept, are insurance companies. They know very well that people tend to mix mind and matter for whatever reasons; rationality may not be the overall and most important characteristic of human beings. As humans are an entity of body, mind and soul, they are hardly in a position to split the complexity of their bodily, emotional and intellectual experience into different domains of distinctive relevance. Every human action encompasses body, mind and soul. We are never able to perform only one of these aspects, which is the reason why we are truly unique as individuals because each of us performs a typical mixture of body, mind and soul. If we were rational or even logic, we would behave in very similar ways because logic, for example, is a clearly defined method of dealing with intellectual topics. Computers perform excellently in this domain - and this makes them look very much the same. Humans mix it all up - and this makes them look very differently.


Carl F. Rogers argues there is the opportunity to merge mind and body. He goes so far as to state life may be incomplete without the merge. In one of his last publications he wrote:

Most of us consist of two separated parts, trying desperately to bring themselves together into an integrated soma, where the distinctions between mind and body, feelings and intellect, would be obliterated (Rogers 1980, 252)

I am not quite sure whether we are "desperate" to bring mind and body together. I am, however, rather sure, that we think about this antagonism without mostly finding a solution to the problem. In the end, I feel we tend to believe that body and mind are completely separated from each other. We do think this way because we hardly experience the suggested entity of body, mind and soul consciously.

All this new age frenzy contaminating mainly middle and upper class people of developed countries is nothing less but an indicator for the manifest belief there may be more than just carnal aspects of life. In this context, the carnal, however, gets degraded to the extent of not being substantial for human existence. Emphasis is put on mental and spiritual encounters. Specific exercises are suggested to reach a level of "consciousness" enabling the individual to go beyond the limits of the body. It is again mind over matter.

The basic concept of training of new age groups resembles the master-apprentice relationship of traditional guilds in pre-industrial centuries. It reflects an hierarchical approach of education, i.e. it creates dependence during the training period while simultaneously instilling feelings of superiority among the students thereby enabling them to perform successfully after "graduation". We seem to have a strong need to become technicians of body, mind and soul.


In the Bible it is written:

The light of the body is the eye if therefore thine eye be single, thy whole body shall be full of light (Matthew 6:22).

The Koran says:

Enjoin believing man to turn their eyes away from temptation and to restrain their carnal desires. This will make their lives purer (Al-Nur 24:30).

The Bhagavad-Gita comments:

Among all kinds of killers, time is the ultimate because time kills everything (Chapter10, Text 33).


Body feelings may be defined as the ultimate and unconditioned process of communication between psyche and soma. That is, we can never be sure what these processes are all about because psyche and soma are equally involved in shaping the perception, if not producing it. When talking about the body, we are actually talking about psyche-soma-psyche-communication. All ends up in the brain - even the deadliest disease. We know of patients fighting terminal disease with unconventional measures - more of them survived than we imagine (Cousins 1981, Kaplun 1992).

Of course, they did not survive because of knowing the ultimate formula. They survived because of what they were doing was just the right thing for them in the right environment. The power of the mind is indisputable. However, since it is a matter of living conditions, and subsequently education and lifestyles, the power of the mind is based on social class. New age is not a matter of insight alone but of being in a position to create this type of insight. It is a matter of the material conditions someone enjoys.


Our life has become a matter of organization. Management of time and appointments determines our daily behavior. We have become obsessed with time management to an extent being contraproductive (Burns 1993). And those who are not organized, like unemployed people or welfare clients, but also those who do not affiliate themselves to any particular organization, are disrespected in many ways, as William Greider observed in the USA:

The problem of modern democracy is rooted in its neglect of unorganized people (Greider 1992, 104).

They seem to be "outlaws", and do not seem to "fit in". It is one of the spectacular contradictions of Western democracy that it stands for freedom albeit simultaneously requesting loyalty and personal commitment regarding community- and other organizations.

Freedom gets spoiled when people are too much organized or when they are forced into organizations. Individual and collective opportunism may be the likely result. On the other side, unorganized people have difficulties to get heard. We are facing a dilemma which cannot be solved. In our general values, we promote individual liberty. All of the democratic constitutions put emphasis on this issue thereby intending to protect the individual from collective and organizational threats. Minorities, as it is often stated, are to be protected by all means. On the other side, we almost only listen to organized people, i.e. minorities have to organize themselves to get a foot into the door to political respect.

As far as individuals are concerned, we only offer them a rather problematic idea. According to the prevailing ideology of capitalistic societies, everyone has the chance to develop his/her potential to the fullest extent. The ideology of the self-made man has psychological consequences as Romanyshyn & Whalen (1987) state:

This dream embodies the promise that one can create oneself, fashion one's personality in whatever way one wishes. In effect, the self-made man is the creator of his own home, the one who 'makes his own place' in the world (Romanyshyn & Whalen 1987, 203-204)

The self-made man breaks free from the bonds of tradition and home only for the sake of creating an ideal home and thus weaving his own history. This figure denies the very thing he strives for, fleeing his historical roots in order to give birth to his own conception of himself. This soul's flight from home, from its origins and its past, characterizes the depressive soul (Romanyshyn & Whalen 1987, 207)

The side-effects of becoming a self-made man or a self-made woman seem to be serious, not only in terms of mental and physical health but particularly with regard to collective aspects of human life. The self-made man represents one type of busy bodies (Kimbrell 1993). He runs into the trap of becoming increasingly unable to sustain his concept of life without major shifts in his psychological perspectives which would unfortunately result in the demolition of the self-made man's dream:

... the cognizance of death humiliates the self-made man. In destroying his project of self-creation it asks him to search beyond himself for another reason for his being. In a quite literal way it returns him to the earth, to the soil of the land, for men are dust and to dust they shall return. Death reconnects man to the earth (Romanyshyn & Whalen 1987, 210-211).

In other words, what is offered to the individual is the dream of becoming a truly unique self-made man; however, while pursuing the dream, he/she will find out that it is impossible to live the dream to the end. With the cognizance of the timeliness of the body, i.e. by recognizing the limits of material existence, the dream becomes obsolete. After having been set on the track in earlier years of life, the track seems to be set aside before one's eyes in later years. Is that not a pretty dirty trick?


In many cultures, people tend to perceive themselves and others as social beings rather than as embodied persons. The body seems to be a rather difficult issue in social communication except in terms of illness, disease and sports. However, as Bryan S. Turner states in his book The body and society: "...human beings are embodied, just as they are enselved" (Turner 1984, 1), and he continues:

The body is the most proximate and immediate feature of my social self, a necessary feature of my social location and of my personal enselfment and at the same time an aspect of my personal alienation in the natural environment (Turner 1984, 8)

The body is the bearer of the human being and at the same time the expression of his/her existential, i.e., economic, political, social, cultural and environmental situation. Individual and social biography are represented in the body, as are the social and cultural circumstances in which it developed; moreover, economic and ecological living conditions also find their expression in the human body. Therefore, body awareness, bodily experiences and bodily expressions are not only subject to individual choices of one lifestyle over another; they are primarily structured by social communication and interaction, both of which are dependent upon the symbolic structure of the social system, i.e., the value system, normative expectations and symbolic categories such as health, wealth, happiness, satisfaction, power, etc. Relationships between the individual and collective, between personal and social development, between economic and ecological processes are both directly sensed and expressed by the body.

Each culture has its own characteristic manner of locomotion, sitting, standing, reclining, and gesturing. (Hall 1977, 75).

Certain bodily behaviors are directly related to well-being or illness. People who suffer move differently than those who feel healthy and energetic. People who feel socially accepted and supported move differently than those who do not. Someone who feels self-assured, positive and mentally strong communicates with a different body language than someone who feels depressed, oppressed or simply of low mood. All of these expressions are socially and culturally shaped. As Crawford states:

The body is a cultural object. As our most immediate natural symbol it provides us with a powerful medium through which we interpret and give expression to our individual and social experience. 'Human nature', the category of the inevitable (and often the desirable), finds its truth in the body. We live within a nature/culture opposition and the 'natural body' confirms our place within a more 'authentic' order. It is a vital foundation upon which behavior and values are predicated. Conversely, as a symbol of nature the body must be contained and transformed by culture. We invest the body with culture, thereby distinguishing ourselves from the rest of nature. Moreover, our biological being, always mediated by culture, delimits many of our most important social roles. It defines us in relation to others in kinship, sex, age groups, and larger social units such as race or caste. Bodily states are key markers in which are invested the social definitions of the self - not only regarding role, but normality and abnormality. The body also supplies a universally experienced model of a living and dynamic unit, an organic whole, a prototype from which we can draw in our attempts to explain and give meaning to larger social units and experiences. It is our richest source for metonymy and metaphor (Crawford 1984, 60-61).

However, these different aspects of the body are rarely perceived consciously. We almost always make our way through this world without realizing that we use our body in manifold ways at every moment in time. We may be engaged in selecting clothes to underline our body shape; we may take care of our body in terms of health care and cosmetics; we may realize that we have a body when we feel ill. But on a day-to-day basis, we rarely experience our body language, our bodily behavior at all. This is one of the reasons why we are often surprised when we see ourselves in videos or listen to our recorded voice, both of which seem rather strange because we are not experienced to see ourselves the same way as we are seen by others. Our "manners of locomotion" are surprising for us, even more so when we follow Hall's statement:

Viewing movies in very slow motion, looking for synchrony, one realizes that what we know as dance is really a slowed-down, stylized version of what human beings do whenever they interact (Hall, 1977, 72)

This is an amazing perspective on body behavior and interaction.

Our body concept has been shaped by what society and/or culture considers to be relevant. As society provides fashion, it fashions our material conditions.


The body is difficult to understand. It refers at least to

  • a physiological system,
  • a substrate of psychological processes,
  • a composition of psyche and soma,
  • a social and cultural domain of experience and action,
  • an economically defined commodity.

In other words, the body is multidimensional, it is contrary to the occidental type of logic, it is something for which we hardly have any analytical tool. While we may measure certain bodily performances, we cannot be sure that this type of measure really relates to what we suppose to measure. In many cases of epidemiology, we have become aware that physiological indicators not necessarily relate to health or the quality of life. Other than physiological categories seem to be more important to analyze and predict morbidity and mortality (Blaxter 1990, Phillimore, Beattie & Townsend 1994).

Body is a complex domain - in almost every aspect imaginable. Time related to body matches this kind of complexity:

Body time is a multicomponent, multimedia affair. It is put together from a conglomerate of clocks, some clearly important, others not so important and still others occupying an ambiguous rung on the ladder of temporal status. But the clocks are not isolated units, each one responsible for driving a particular rhythm independently of all the rest; clocks interact, influence and are influenced, modulate, entrain, couple and uncouple, in a highly mobile set of relationships, which are mediated by messages encoded as chemistry and as electrical impulses in the nervous system. Some clocks are strong, some are weak, some are more independent than others, some are tuned to environmental time cues to which other clocks turn a blind eye. We cannot really talk about the "regulation" of biological time, although people often do, because that is the language of the master clock hypothesis. We must speak rather about the coordination of a multiplicity which under the right conditions can become a unity (Campell 1989, 113).

The complexity of body and time refers to the complexity of life itself. As humans, we deal both with natural and social factors of ourselves and our environments. We simply cannot reduce the effects of this complexity by building organizations and institutions, and developing values and norms designed for the regulation of our daily life. Although they represent examples of reduced complexity, they nevertheless cannot circumnavigate the fundamental complexity of life and its effects on each and everyone of us. In principle, we are not able to get away with biology, physics, nature and whatever has been here on this planet before we arrived. We are shaped by nature although we have gone a long way in shaping it as much as we can.

Beyond our relation to nature, we have gone similarly far concerning the social organization of bodily behaviors. Social systems introduce values and norms by which the effectiveness of their functions is measured. A micro-analysis of social interaction demonstrates that our daily interactions are to a vast extent ritualized. Societies claiming to be rational, organize many of their social situations as rituals. Rituals, however, have the peculiar connotation of being sets of interaction in which people participate without questioning the meaning of their participation because the meaning is represented by the ritual as such. Rituals are sets of interaction in which no individual input is required - just attendance and obedience to the rules, i.e. bodies in time become timeless bodies because they do not count given the transcendent quality of rituals.


We are living on Planet Earth, but we can hardly understand the reasons why this planet impinges these kinds of lifestyles and living and working conditions on us or why we have been able to develop them this way. We dance through the neatly fenced universe of our societies without realizing their randomness. We are made believe and we proactively believe that this environment shall be the human environment, i.e. the environment humans made and are made for. Why are we so sure that we are what we (most often) pretend to be? We have developed social systems to which numerous social scientists devote their working life and still, we do not come up with a consistent understanding of our circumstances. Of course, there are these cultural, social, economic, political, and historical differences. However, is it really only a matter of these differences that we do not understand the world we are living in?

Let me reduce complexity to a superficially easy issue: we do not recognize that there are limits for our understanding of what body and time may mean. The English psychiatrist Ronald D. Laing takes a rather pragmatic position when stating:

I, for instance, regard any particular man as finite, as one who has had a beginning and who will have an end. He has been born, and he is going to die. In the meantime, he has a body that roots him to this time and this place (Laing 1965, 25-26).

Contrary to Laing, although not contradicting his conception basically, we may find other body-concepts anywhere else in this world. Fortunately, as I would say, and unfortunately, as others would say, it is difficult to find the truth. Maybe the truth of the body lies in the few seconds everyone may perceive shortly before dying. Wouldn't that be the perfect irony of human bodily existence?


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Copyright © by Eberhard Wenzel, 1997-2001