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Sot. Sci. Med. Vol. 36, No. I, pp. 7-14, 1993 0277-9536/93 55.00 + 0.00 Printed in Great Britain. All rights resewed Copyright 0 1993 Pergamon Press Ltd

HEALTHY BODIES, SOCIAL BODIES: MEN’S AND WOMEN’S CONCEPTS AND PRACTICES OF

HEALTH IN EVERYDAY LIFE

ROBIN SALTONSTALL Center for Biomedical Ethics, Stanford University, Stanford, CA 94305, U.S.A.

Abstract-Using interview data from white, middle-class men and women, ages 35-55, the research explores the phenomenological, embodied aspects of health. Health is found to be grounded in a sense of self and a sense of body, both of which are tied to conceptions of past and future actions. Gender is a leitmotif. The body, as the focal point of self-construction as well as health construction, implicates gender in the everyday experience of health. The interplay between health, self, body, and gender at the individual level is linked to the creation of a sense of healthiness in the body politic of society. If social psychological theories of health are to reflect adequately the everyday experience of health, they must begin to take into account the body as individually and socially problematic.

Key words-self/body-concept, gender, embodiment, health concept

INTRODUCTION

Sociologists and anthropologists of medicine have largely focused their research on sickness and illness, thus obscuring social scientific investigations of health and healthiness. Analyses which have taken health as their focus have examined the structural, cultural, and material aspects of health, and not the phenomenological elements, especially those related to the body [l].

The body as problematic is beginning to be more evident in some sociological investigations. Recent analyses of fitness have begun to address embodiment, health, and self [2]. Espeland [3] and Kotarba [4] examine the explicit role played by the body in the construction of self in their studies of giving blood and experiencing chronic pain. Olesen et al., in their research on the mundane ailment, have proposed a new concept of self, “a physical self’ [5]. This new perspective on the body is due in part to the recog- nition that sociological theory has tended to cast human beings as primarily cognitive and rational actors, while neglecting to account for nondeliberate actions (habits), for affective phenomena (emotions), and for the body as more than simply a surface upon which social and cultural meanings are bestowed [6-M].

I argue in this paper that the experience of ‘being healthy’ is another-instance in which the phenomenological body is explicitly salient. No longer can the body be considered theoretically as an abstract universal concept, but must be considered in its concreteness as a lived experience of socially and historically situated men and women. This lived experience en- tails simultaneous processes of interpretation and communication: interpretation of one’s own and other’s particular bodies and communication of one’s

self as healthy and as member of a social group. Gender is an underlying theme.

I propose that social psychological theories of health need to take account of the body as personal and socially situated in the construction of self (and other selves) as healthy. This requires bringing into the theoretical foreground the processes and practices of everyday life through which the body is constructed and known in its concreteness and particu- larity.

Methodology

This research is based on open-ended, unstructured interviews with 9 white, middle-class men and 12 white, middle-class women, ages 35-55. The sample of convenience was limited in size due to financial considerations. None of the respondents had children and all had significant others. The selection of respondents for the research who were partnered and without children alleviated having to address the effects of parenthood and single-hood on health behavior. Interviewees were informed that the interview could be as long as necessary or convenient for them. Typical questions included: Do you consider yourself a healthy person? How do you account for your healthiness? What kinds of things do you do for the sake of health? How do you know if someone else is healthy? and so forth. To analyze interview data, I used the grounded theory method of iteratively coding and categorizing data to uncover thematic categories [ 161.

Findings related to respondents abstract concepts of health are presented first, followed by related findings concerning the body and self in health, the reflexivity of self and body in health, and gendered differences in the phenomenological experience of self

8 ROBIN SALTONSTALL

and body. Findings related to health practices are then presented and include discussions of body maintenance, ‘body insignia,’ and the interplay between gender norms and health practices. The concluding section draws out implications of the research for social psychological theories of health.

MEN’S AND WOMEN’S CONCEPTS OF HEALTH

In general, men and women shared similar ideas about what constitutes health. The cosmos of health depicted in definitions included most aspects of being human: physicality, consciousness, emotions, spiritu- ality, and social situation (family, work, and income level). The idea of health was closely associated with the idea of ‘well being;’ that is, abstract notions of health and healthiness were identified with the posi- tive aspects of ‘being’ in the world and were grounded in lived experience. Some definitions were so encom- passing that they approached amorphousness, but their grandness indicated the degree to which contemporary men’s and women’s ideas of ‘health’ have become synonymous with a particular condition or state of ‘life’ itself. As is discussed below, the homogeneity between men’s and women’s abstract conceptions of health dissipated into gender specific forms when everyday actions were considered.

Many men and women defined ‘health’ compre- hensively, referring to it as a state or condition of being, and often relating this condition to capacity, performance, and function:

My definition of health would be physical, mental and emotional well being (male).

(Health is) being balanced in the things you do (female).

One striking variation was that women frequently alluded to friends or family in their definitions of health (while men rarely did so):

A really healthy person is a well person, they take care of themselves and their family and friends,

Its also being loved and being able to love.

Body and serf in health

Without exception, men and women cited the actuality of being bodied in their concepts of health. Some references to the body were explicit, as in:

I’m a healthy person because I’m in shape physically, I’m not overweight,. I have good muscle tone, (male).

(Health is) . . when I’m in shape, I feel energetic, and I’ve got good color in my cheeks (female).

Others were implicit:

. . . The bottom line is that I am able to go through my day and accomplish what I have to do without any physical or mental encumbrances (male).

Both men and women conceptualized healthiness as flickering in nature, and health as a transitory state

and a process related to the lived body. As one man phrased it:

Health is living. You’re alive and you’re healthy or you’re not healthy as you go along. It’s like a living through.

The body’s history was also seen as contributing to the temporality and transiency of health [17-201:

I guess health is a relative term anyway. I don’t exercise that much I want to but its a time problem and I have allergies. They’re only slightly debilitating, but I have them (male).

Definitions of health often referred to deliberate, intentional action involving the body. Each person was seen as having a biological base, a body, and what one did with that body resulted in various states of health. Both men and women mentioned body-oriented protocols such as avoiding smoking, abstaining from drinking, eating ‘good’ foods, getting sleep, and exercising as being essential to health. In short, health was conceptualized as creation [22,23] and accomplishment [24,25] of a bodied, thinking individual.

The concept of self was implicit in concepts of health, either as the intentional actor making decisions about health actions, or as the consciousness interpreting bodily signs and signals, or as the being performing an action. The self as healthy had both physical and metaphysical dimensions. When asked to describe health and being healthy, respondents moved back and forth between references to themselves as physical bodies and as sentient beings. “I’m in good shape”, “ I have good muscle tone”, “I’ve got good color”, and “I feel energetic”, “I feel good”, “I feel challenged”.

Respondents’ catalogued a kind of ‘health inventory’ which encompassed internal and external, vis- ible and invisible, physical and metaphysical dimensions of themselves. The health inventory included things one’s self was believed to ‘have’ and things one’s self was expected ‘to do’. The former included one’s own particular stock of corporeal and incorporeal health-related items such as body size and shape, strength, capacity to do, genetic endow- ment, and friends. The latter included one’s health-related activities and practices, as in:

I get enough sleep, I don’t over exercise and I don’t starve myself.

These ‘have’s’ and ‘doings’ were often intermixed in responses:

Health to me is the food you eat, how you carry yourself, from the clothes you wear, to the size you are, body fat, skin tone, and whether you’re sick. I feel if you take care of yourself by working out and eating right,. . you will be stronger and healthier (male).

I know I’m healthy. I’m in good shape. I exercise regularly, I eat a very good diet. I know how to avoid getting colds and flus. I get enough sleep. I don’t party and abuse my body. I guess, in a nutshell, I take care of myself (female).

As these remarks suggest, judging one’s self as healthy involved a taking stock of one’s health

Healthy bodies, social bodies 9

inventory--of one’s self as both material body and interaction, that each self is individual because of its conscious actor. unique sociality and complement of interactions [28].

Respondents’ regarded the balance of items in the health inventory as fluctuating with time and action. Individuals would refer to themselves as having been healthier at a former time, or as becoming healthier through certain activities. In sum, the sense of being healthy involved both a sense of self and a sense of body (a body self), both of which were tied to a conception of past and future actions.

I’d say it’s a feeling. Either you feel it or you don’t on any given day for me it’s how I feel and for someone else how they feel (female).

If a person feels that he or she has physical, mental and emotional well-being, then I would say that that person is healthy from that person’s point of view. (Health is) very individual (male).

The rejexivity of self and body

Berger and Luckmann refer to the ‘eccentric’ human relationship between organism and self in which the experience of self involves both being and having a body [26]. In this study, when interviewees took stock of themselves as healthy, body and self were not experienced as divided into two parts; that is, as dichotomous ‘mind’ and ‘body’ in the Cartesian positivist sense. Nor, as in the Cartesian fashion, was the body described as a vacuum which had been filled up with a mind and a soul [27]. Rather, body and self were described as reflexive aspects of one wholeness, one ‘being’; neither complete without the other. The material, or somatic, and immaterial, or asomatic, represented different dimensions of the same self engaged in action in the world. I referred to this reflexive process as ‘the self-soma process’.

Respondents’ characterizations of the reflexive, contingent, and unique nature of the experience of self and body in health dramatically demonstrates the integral nature of embodiment and self-hood. The experience of self as body and body as self constitutes the human experience, and as such, is saturated with notions of moral action and responsibility.

Gendered differences

While both women and men referred to the reflex- iveness, contingentness, and uniqueness of self and body with respect to being healthy, there were nu- ances of difference between men and women in their descriptions of the interactive relationship between self and body. Men frequently referred to healthiness as ‘keeping’ or ‘being in control’ and ‘minding’ one’s body. Men seemed to imagine themselves as having ‘power over’ relationship to their bodies.

The reflexivity of self and body could be heard in the alternating grammatical referents used by men and women to describe health. Due to the linearity of language, respondents had to separate references to bodied self and minded self grammatically into subject and direct object. However, the referent of the ‘I’ continually vacillated such that in one sentence the subject would be the bodied self, and in the next sentence, the subject would be the minded self. This reflected the disjuncture between lived experience and linguistic rules, for in lived experience body and self are related to and contingent on one another. The changing referent is evident in the following example:

Taking control of your health. is the key to an overall sense of well-being (male).

Men spoke about their bodies as though they ‘belonged’ to them (in the same way that an object belongs to one). Women, on the other hand, generally did not use the language of ownership when talking about their bodies, but rather referred to their bodies as though their bodies had a momentum or subject- ness of their own [29-311.

A lot of times I keep on eating even though I know its not good for me. It’s like my body just wants those things right then. .

when I wake up I reflect immediately on how I feel- whether I’m tight from the workout the day before and whether I feel like getting up at all. and whether I can’t face the day and what I have to do.. (female).

These gender differences became even more appar- ent when respondents described their health practices.

The relationship of self and body also had elements of contingency. That is, the state of one was seen as having the potential to affect the state of the other:

MEN’S AND WOMEN’S HEALTH PRACTICES IN EVERYDAY LIFE

I know I’m healthy by the way I feel. . when I go on a binge of junk food . I feel rotten as a person (male).

The experience of being situated in a particular social and cultural circumstance was conspicuous when comparing men’s and women’s descriptions of their everyday health practices with their abstract definitions of heath and being healthy. The homogeneity between men’s and women’s abstract conceptions of health dissipated into gender specific forms when translated into action in the everyday world.

It’s (being healthy) all those things I said. It’s really a body feeling, but it’s also my head. I can take on the world if my body feels good (female).

Healthiness was considered to be a product of a personal and particular self and body. That is, the experience of being bodied, of the intrasubjective pattern of interplay between self and body, was regarded as unique to the individual. This notion was reminiscent of Mead’s theory of the self and social

Men and women unanimously cited biological and physiological ‘needs of the human body’ for rest, exercise, and food in their definitions of health. The prevalence of references to food, rest, and exercise as being essential to being healthy suggested that these

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10 ROBIN SALTONSTALL

have become staples in the commonsense understand- ing of healthiness. There were degrees of difference, however, in ideas about how much and what type of exercise, food, and rest men and women ‘needed’. In these cases, the ideas of the ‘healthy’ body as a social phenomenon infused with social meaning and of health practices as instances of the social construction of bodies as gendered, began to be evident in the data.

In my interviews, women usually listed food first in response to the question, ‘What kinds of things do you do to be healthy?’ They then mentioned exercise and rest. All of my male respondents mentioned exercise first, then sleep and food usually tagged along as the last item of importance. When men did mention food, the nutrient quality was what was important. For women, the caloric value was also, if not equally, as important as the nutrient value. When I asked women about what men should do to be healthy, they still listed food as most important, sleep as next in importance, and exercise as least important (but not to be ignored by any means). When I asked men about what women should do to be healthy, most deferred, saying they didn’t know or that the woman would have to decide for herself. One man responded with “the same thing (as I do), I guess, but less.”

These responses referenced cultural notions of there being two kinds of human bodies, male and female [32]. Human bodies (one’s own and other’s) were seen as having similar needs, but different combinations and degrees of these needs depending upon whether they were male or female. These lay ideas about the healthy body are at odds with medical notions of a universal human body which only varies in its repro- ductive aspects. Furthermore, the conceptualization of the body in the commonsense world of my respondents as dichotomized into male body and female body (with further variations based on particular self as male body or female body within the gross categories of male and female) refutes the idea of a generic and universal body and underscores my theoretical contention that the body is continually and multiply differentiated in the process of constructing self as healthy.

Body maintenance

Respondents’ comments showed that the pro- duction of health for the self involves ‘body maintenance’ [33]. This conceptualization refers to the contemporary notion that the body is like a machine and must be maintained because it is believed to be subject to aging, deterioration, disease, and abuse by oneself and others. Respondents’ references to health practices were rife with mechanistic metaphors. For example, ‘food’ was referred to as ‘fuel’; exercise concerned ‘biomechanics’ and ‘improving the oxygen uptake’ of the heart, the body’s ‘pump’; and being healthy was a matter of routinized ‘workouts’ de- signed to produce ‘fitness’. These references reflected a mechanistic, industrial, work-oriented approach to being healthy.

Men and women often cited ‘body maintenance’ activities as essential to producing health for one’s self. Body maintenance conceptions were undergirded by a notion of the body as protean, potentially vulner- able, and alterable [34].

I exercise regularly. I eat a very good diet. I know how to avoid getting colds and flus. I get enough sleep. I don’t party and abuse my body. I guess, in a nutshell, I take care of myself.

Men’s and women’s approaches to and notions of body maintenance were different, however. Men emphasized sports and outdoor activities--one specifically excluded aerobics because it was woman- ish, “for girls,” as he put it. Eating well was also considered to be important, but was usually mentioned as a corollary to being able to do well in sports. Most men also mentioned tooth-brushing and flossing.

A lot of days I don’t feel like working out, but I do anyway. I push a little harder because I know that when I get through my workout, I’ll feel better (male).

Women also mentioned physical activities, but the emphasis was not on sport activities but on exercise activities (many mentioned aerobics). Food consump- tion was important for women, but interestingly, they often referred to it using the verb “to diet” rather than, as did men, the verb “to eat well”. (I read this as a linguistic reflection of men’s and women’s different relationship to food and the body.) Unlike men, most women mentioned caring for their skin, shaving their legs, getting their hair cut, and other appearance-related items as being basic to body maintenance.

(To stay healthy) I try to keep things balanced. I don’t over workout, I don’t slug it; I try not to overeat, and I take care of all my personal needs, . I use sunblock, shave my legs, keep my hair looking nice (female).

These differences in emphasis and approach to body maintenance practices suggested that men were concerned with the body as the medium of action; function and capacity of the body were of paramount importance. Implicit in men’s orientation was a concern with potentiality, with being able to act in the world. Women were also concerned with maintaining function and capacity, especially with respect to ‘doing for others’, but they were equally concerned with the appearance of their bodies and with keeping their bodies in a ‘presentable’ condition.

The concept of body maintenance reflects a conceptualization of the body as having ‘inner’ and ‘outer’ aspects [35,p. 181. Inner aspects refer to optimal functioning, performance, capacity to do things, and the potential for breakdown (lack of capacity) while outer aspects refer to appearance, movement within social space, and the potential to be touched and heard.

Considering respondents’ comments in light of the concept of the inner and outer body, men and women differed in their emphasis on inner and outer aspects of the body. Men tended to emphasize the inner body


phenomena of function and capacity more than the outer body phenomena of appearance, while women focussed more or less equally on both inner and outer phenomena.

The concepts of the inner and outer body invoke phenomenological conceptualizations of ‘my body’ as a ‘subject’ (or ‘agent’ body) and as ‘object’ body. In her analysis of the effects on body identity of Cartesian dualism which divides the world into dichotomies of active/passive, subject/object, and mind/body, Young points out that body identities have been dichotomized into woman-body-as- passive/man-body-as-active [35-371. Male interviewees comments more frequently referenced the subject body: “being able to go through my day and accomplish things”, “being in shape physically so I can do things”, and “having good muscle tone”. Female respondents, on the other hand, more frequently referenced the object body, as in: “looking agile”, “having good color and skin tone”. This suggested that these men and women each maintained a unique phenomenological stance toward their bodies.

Estimating health in other selves: body insignia

Up to this point I have addressed men’s and women’s self-constructions of being healthy. The analysis now turns to the issue of the construction of others as healthy. As in the case of the construction of self as healthy, the perceived physical body and body practices play a prominent role in the construction of other selves as healthy.

Male and female interviewees used aspects of the body and body practices as indicators of the dimensions of another persons physical as well as ontological state of health. I referred to these cues as ‘body insignia’:

If they have good skin color and glow, then I know they must know what they’re doing with their life (female).

Well, it’s pretty easy. I just look at them, if they’re not in shape, I say, ‘Those people are not healthy’ (male).

Even though, healthiness was not necessarily a point of observation for most respondents (as hair color or height would be), certain body insignia brought healthiness to the fore as an observation point. A person’s skin color-either ‘paleness’ or ‘glow’ was referenced frequently as provoking questions about another’s health. In addition, individuals associated certain body insignia with individuals, and if there were changes, the question of healthiness arose. For example:

I can tell when J. (a dancer). has cramps-she doesn’t move her usual way (female).

Gender norms

Gender norms often informed the interpreting of body insignia. Respondents used body insignia as indicators of the health of self’s and other’s state of womanhood or manhood, that is, as indicators of the

degree to which self or other was ‘correctly’ gendered and followed gender norms.

My mother always said you’re a lazy person if you don’t take care of your face and wear make-up. . . (female).

I see a lot of girls in the weight room these days and it’s too much. I mean I like how some of them look, but the real bulked up ones. that’s not right (male).

Gender was also a recurrent theme in respondents’ comments about their health practices. Even though they made similar general recommendations for themselves regarding what was required in order to be healthy (exercise, rest, ‘good’ food, and so forth), when they came to act on their recommendations in the everyday world, they were guided and constrained by social norms and situations. Some constraints related to ‘appropriate’ sites for health activities. As one man said regarding where he could exercise: “I can’t do aerobics with all those girls.” Or, as one woman remarked: “I can’t run at night anymore now that we live in the city. .”

The issue of public safety (and danger) and being femaled-bodied was a recurrent topic in women’s narratives. Women often cited concern about being safe while exercising. Men did not cite public safety as a health-related issue for themselves personally or for men in general. When men and women who identified themselves as runners and cyclists were asked directly about safety and exercise, most responded that women risked bodily harm if they went out in the dark (unless accompanied by a man), and that men, too, were taking risks by exercising at night; however, the ‘risks’ for men referred to ‘trip- ping and falling down’ and/or ‘hitting something’ and not to personal bodily harm. In short, there were particular structural conditions related to female and male bodies; moreover, male and female bodies were each seen as having their own specific set of concerns regarding public safety and danger.

Other constraints related to norms of behavior for men and women. One man said:

I’d do more (to be healthy), but I can’t with my job hours. My boss at the lab would kill me.

The conflict between work and health activities was a common theme for men. Many mentioned time conflicts (between work and health activities) while others cited the ‘unhealthiness’ of ‘normal’ work- related practices such as frequent traveling, eating restaurant foods, and spending hours sitting in planes and meetings. A few men mentioned routines they followed in order to minimize the unhealthy aspects of their jobs, such as “walking around the building at least three times a day” or taking vitamins and sticking to their home time zone sleep and eating times when traveling. Despite acknowledgements of the ‘unhealthiness’ of occupational practices, work demands usually took precedence over health demands when making decisions about allocating one’s time and efforts. For these respondents, the social

12 ROBIN SALTONSTALL

norms of making a living and using ones body for economically productive (economic) labor were paramount, even if such activities meant not ‘being healthy’.

One woman referenced norms of behavior for women when she said:

My mother always said that women who eat small meals arc more feminine.

Female respondents regularly linked healthiness, eating, exercise, and being thin in their responses. Three women stated directly that their exercise and eating activities were motivated as much by a desire to ‘not be fat’ as by a desire to be healthy. Another respon- dent, expressing a common view among women about health and ‘not being fat’, fortified her response with a comment that ‘being thin really is healthier for you’. There were a number of references to ideas about amounts of food required by men and women; amounts required by women were generally considered to be smaller than those required by men, irrespective of what the man or the women did. Two women respondents said that they often ate less (for weight control purposes) even when they knew it might be healthier to eat more. In these cases, activities related to ‘being healthy’ were influenced by social norms related to gender and the body, which in American culture locate woman as object of the male gaze [38]. Moreover, that a culturally saturated health-seeking activity such as eating can verge into non-healthy behavior is exemplified by such states as anorexia and bulemia [39].

Some of my respondents were acutely aware of the relationship between healthiness, the body, and gender and regarded their health actions as challenges to

existing gender norms:

Masters (swimmers) women are special because they have instituted change into their lives and have been willing to be somewhat unconventional in doing it. (We) have had to unlearn that early socialization and grow comfortable with (our) physical selves.. . (we) open the door for other women.

In sum, gender was emergent in health doings in that specific ideas about what male and female healthy bodies ‘do’ were legitimated and reinforced through the taking of certain actions and not others by either men or women.

Implications of the research

This research suggests that the body is problematic in the lived experience of health. Selfhood, embodiment, and health are intertwined. If social psychological theories of health are to reflect this experience of health adequately, they must begin to take into account not only the body as individually and socially problematic, but also the practices and processes through which the body is constructed and known as personal, concrete, and particular.

In the commonsense world of my respondents, the body as concrete and particular was evident in re-

spondents use of their own and other person’s bodily signs and signals, or ‘body insignia,’ as indicators not only of physical health, but also of ontological health, or the healthiness of the self. Bodies were seen to bear personal and particular self-inflections.

Gender played a key role in interpreting and constructing one’s own and other’s bodies as con- cretely and particularly healthy. Respondents cited different bodily symbols of health for males and females, differentiating between male and female bodies and the needs and ‘appropriate’ health activities for each. The healthy body was rarely referenced in universal, non-gendered terms (except in comments referring to the human need for sleep, food, and rest); rather, the healthy body was considered in its context of who and where. That gender was a significant aspect of the lived experience of health follows from the view that gender is a fundamental social construction of self which has a biological base [30, p. 441. The body, as the focal point of self-construction as well as health construction, implicates gender in the everyday lived experience of health.

As residents of a commonsense world, respondents health practices were instances in which self and body as gendered were constructed. The sense of self as healthy, as gendered, and as body, were intertwined, and were realized simultaneously in concrete habits and practices of daily life. Decisions about what actions to take to be healthy or ‘health doings’ were colored by ideas about appropriate masculine and feminine behavior. From a theoretical point of view, this suggests that the doing of health is a form of doing gender [40]. This is not because there is an essential difference between male and female body healthiness, but because of social and cultural interpretations of masculine and feminine selves- selves which are attached to biological male and female bodies. Health activities can be seen as a form of practice which constructs the subject (the ‘person’) in the same way that other social and cultural activities do 141,421. Health actions are social acts, in interactionist terms, and the social objects pertinent to the experience of being healthy are the self and the body. Social order is negotiated, produced, and re- produced through interpretation and construction of selves as healthy and as bodies.

Health an the phenomenological body

Thus, health is not a universal fact, but is a constituted social reality, constructed through the medium of the body using the raw materials of social meaning and symbol. This contrasts with other views of health which regard health as a material issue [43], an objective state in policy analysis [44], or the absence of illness [45]. Even though health is seen as an organic and inherent reality independent of selves, it is a creation of those selves. It is one classificatory system for mapping self and others. Health actions are political actions enacted via the body which legitimate or challenge norms and ideas of the social


body. Put differently, the interplay between health, self, body, and gender at the individual level is linked to the creation and recreation of a sense of healthiness in the social body, the body politic of society.

In sum, I have argued that health is a lived experience of being bodied which involves action (practical activity) in the world. Gender is an integral aspect of this process. With respect to social psychological theory development, this raises the body to a position of explicit saliency and refocuses analytic attention on the array of everyday ways and means that ideas are enacted and the social order is sustained by socially situated, bodied selves.

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Glaser B. and Strauss A. The Discovery of Grounded Theory: Strategies for Qualitative Research. Aldine, New York 1967. See Herzlich’s concept of the ‘reserve of health.’ Her- zlich C. Health and Illness. Academic Press. London, 1973. Pill R. and Stott N. Concepts of illness causation and responsibility: some preliminary data from a sample of workina class mothers. Sot. Sci. Med. 16, 43352, 1982. - Blaxter M. The causes of disease: women talking. Sot. Sci. Med. 17, 59969, 1983. Herzlich C. and Pierret J. Illness and Self in Sociefy. Johns Hopkins Press, Baltimore, MD, 1984. Blaxter M. Health and Lifesryies. Routledge, London, 1990. Turner [6, p. 2361 has suggested that each disease has an organic grammar, but the speech of the sick patient is “highly variable, creative, and idiosyncratic.” Sacks has noted a similar phenomenon with migraines: “If the foundations of migraine are based on universal adaptive reations, its superstructure may be constructed differently by every patient, in accordance with his needs and symbols. Migraine. starts as a reflex, but can become a creation,” Sacks 0. Migraine. Summit, New York, 1981. The idea of health as an accomplishment leads to the notions that the responsibility for health resides with the individual and that the etiology of both health and illness can be traced to the habits and practives of the individual. See Crawford R. You are dangerous to your health: the ideology and politics of victim-blaming: Int. J. Hlfh Services 7. 663-680, 1978. Crawford R. Healthism and the medicalization of everyday life. Inf. J. Hlth Services 10, 365-388, 1980. Berger P. and Luckmann T. The Social Construction of Reality, p. 50. Anchor Doubleday, Garden City, NY, 1967. Butler notes that in Cartesian, positivist thinking “The soul is what the body lacks; hence, the body presents itself as a signifying lack. That lack which is the body signifies the soul as that which it cannot show.” Butler J. Gender Trouble, p. 135. Routledge, London, 1990. Morris C. W. (Ed.) Mind, Self, and Society, George Herbert Mead. University of Chicago Press, Chicago, IL, 1967. The concept of control and mastery which was prevalent in men’s references to their bodies was less evident in the language of my female respondents. The relationship between self and body was experienced as more colateral than hierarchical. This mirrors some of the feminist theories that women’s relationships are characterized more by affiliation and cooperation than are men’s, See Gilligan C. In a Diffrenl Voice. Harvard University Press, Cambridge, MA, 1982; Jordan J., Kaplan A., Miller J., Stive I. and Surrey J. Women’s Growth in Connection. Guilford, New York, 1991. Dinnerstein D. The Mermaid and the Minotaur: Sexual Arrangements and Human Malaise. Harper, New York, 1976. Diamond and Quinby have noted the prevalence of the language of ‘control over one’s body’ in contemporary discourse, arguing that such language blinds us to other more nurturant and aesthetic conceptions of bodies. Diamond I. and Quinby L. American feminism in the aae of the body. Signs 10. 119-125. 1984. Kessler S. and McKenna W. Gender: An Erhnomethod- ological Approach. University of Chicago Press, Chicago, IL, 1978. Featherstone M. The body in consumer culture. Theory Culture Society 1, 18-33, 1982.

14 ROBIN SALT~NSTALL

34. Featherstone [3 1, p. 221 suggests that body maintenance is tied to a concept of plasticity of the body, such that, if we work hard enough we can alter our bodies.

35. Young I. The exclusion of women from sport: conceptual and existential dimensions. Phil. Context 9,4453, 1979.

36. See Duquin M. Fashion and fitness: images in women’s magazines advertisements. Arena Rev. 13,97-109,1989, and [35] for discussions of women as body objects in the context of sport.

37. Rintala J. The gendered body: a synthesis and more paradox. Arena Rev. 13, 134-145, 1989.

38. Young I. M. Breasted experience, the look and the feeling. In Throwing Like A Girl and Other Essays in Fem- inirt Philosophy and Social Theory (Edited by Young I. M.). University of Indiana Press, Bloomington, IN, 1990.

39.

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Boskind-Lodahl M. Cindarellas stepsisters: A feminist perspective on anorexia nervosa and bulemia. Signs 2, 342-356, 1976. West C. and Zimmerman P. Doing Gender. Gender Society 1, 125-151, 1988. Blacking J. The Anthropology of the Body. Academic Press, London, 1977. Douglas M. Natural Symbols. Vintage Press, New York, 1970. Navarro V. Crisis, Health, and Medicine, A Social Critique. Tavistock-Metheun, London, 1986. Spacapan S. and Oskamp S. The Social Psychology of Health. Sage, Newbury Park, CA, 1988. Calnan M. Health and Illness, The Luy Perspective. Tavistock, London, 1987.