Through the Eyes of a Chinese Doctor - Feminist Theorization of the Bodymind

One of the most highly contested issues in feminist theory today is how to go about the theorization of the body. The debate is generally cast in terms of the distinction between essentialist and constructionist readings of the body. In an essentialist reading, the body is posited in naturalistic terms as having some sort of fixed, unchanging essence. Such a reading of the body is useful for feminists in advocating for and justifying political coalition among women. If "woman" is seen as being a natural kind, on the basis of some "natural" or "biological" essence, then it becomes easy to identify women, and easy also to argue why women should join together in political action to resist the oppression of women as a class.

One problem with such a reading is that defining "woman" in this essentialist way effectively masks (racial, ethnic, age, sexual preference...) differences among women. Another problem is that naturalistic readings of women's biological make-up have often been used in justification of discriminatory practices, for instance when it is argued that women are "naturally" weaker than men, or "naturally" more nurturing than men, so that they "naturally" should be employed as caretakers rather than in positions requiring bodily strength.

In a constructionist reading of the body, on the other hand, women's bodies are theorized as being the always-changing product of social practices. Such readings take different forms. A materialist constructionist analysis, for instance, would describe the body as resulting from the work it performs within feudal, capitalist, or socialist social relations. A poststructuralist reading would likely be more linguistic in orientation, focusing on how the body can be talked about only in terms of the meanings we assign to it, meanings dependent on our position within discursive fields. The problem with constructionist readings of the body, from a feminist perspective, is that theorizing the body as containing no fixed essence makes it difficult to decide on what basis one is to form political coalition. If "woman" is not defined biologically and essentially, but rather is seen as a constantly shifting category, on what basis are we to organize to oppose the oppression of "women" - or can we even talk about such a thing?

Recently there have been attempts by feminist theorists to come to some sort of middle ground on this issue, in the form of what has been called a "strategic essentialism." Such a position often draws on Locke's distinction between real and nominal essence. Feminists advocating a strategic essentialism reject the idea of any real essence defining "woman" as a natural kind, yet do employ nominal essence as an at least provisional ground from which to organize politically. They accept the necessity for having the linguistic category of "woman" as a way of talking about issues important to feminists, but try also to keep in mind the constantly shifting nature of the meaning of this linguistic sign as well as the constantly-shifting (physical and psychological) identities of the individual women whose lived experience is the referent of the sign "woman." Despite this useful recognition of the necessary tension between essentialism and constructionism with respect to feminist political action, questions around experience and the body remain stumbling blocks.

I have argued elsewhere that the problem is much feminist theorizing about the body is its reliance on Cartesian theoretical frameworks - the discussion never gets out of the mind-body split. I have argued that feminists may be well served by Chinese or African philosophical systems, or - within the tradition of western philosophy - by pragmatists like James and Dewey or phenomenologists such as Merlue-Ponty - in other words, by theorists who are self-conscious in their attempts to theorize outside of the mind-body dualism. What I would like to do in this essay is to illustrate this point by presenting some principles of the philosophy underlying the practice of Chinese medicine, and talking about ways in which these principles may be read in ways useful for feminists attempting a theorization of the body which avoids the dangers both of essentialism and constructionism, as these have to date been defined.

The western post-Descartes spiritual/material dichotomy is not relevant to Chinese medical thought. Chinese medicine does not differentiate between matter and energy. Chinese medicine is synthetic, organismic, holistic. No bodily part is ever abstracted from the whole. Health is defined as balance (between Yin and Yang) - a qualitative rather than quantitative judgment. What in a western framework are labeled as "diseases" are in the Chinese framework seen as "patterns of disharmony" which describe imbalances in the body/mind/spirit of the patient. Yet "disease" and "patterns of disharmony" are not equivalents for, again, patterns of disharmony cannot, as diseases can, be isolated from the individual in which they occur. As such, Chinese medicine rarely looks further than the patient. Theory is necessary only to guide the physician's perceptions - the "truth" of ideas lies in the way the physician can use them to treat real people with real complaints.

Chinese and western medical systems constitute two completely different medical perceptual systems - two completely different ways of seeing. While the western physician isolates affected body parts, and analyzes them in terms of theory abstracted from any particular individual, the Chinese physician looks at the whole patient. The "four examinations" in Chinese medicine are: (1) looking, (2) listening and smelling, (3) asking, and (4) touching. Again, the idea is to look at the whole patient, as a way of discerning a pattern of disharmony, a pattern unique to the particular patient.

Underlying this system of medical perception and practice are particular philosophical beliefs about the nature of cause, of knowledge, or truth. The Chinese are not interested in causality but rather in the relationships among bodily events occurring at the same time. As such, the practice of Chinese medicine has a very different temporal character than western medicine. Chinese medicine is more rooted in the present, in the here and now. The western preoccupation with causality necessitates a focus on past and future, in determining a sequence of events. And the abstractions of western medical (and philosophical) categories often seem to exist outside of time and space. They are posited as the view from nowhere and from everywhere, as transhistorical categories that can be uniformly applied to any time or place.

There is no need to search for cause, in the Chinese belief system, because phenomena are believed to occur independently of any external act of creation. When it is appropriate, given the universal pattern, for something to happen, it is produced spontaneously, internally, without an external "cause." What is important for the Chinese physician is the phenomena (the patient's body/mind/spirit) as it is right here and now. What is important for the western physician is the cause, with the phenomena itself seen merely as the reflection of this cause. Again, the western doctor's perceptual system is oriented away from the here and now.

These differences in beliefs about causality are parallel to differences in beliefs about truth and knowledge. In the Chinese view, the truth of things is immanent; in the western view, truth is transcendent. Knowledge in the Chinese framework consists in the accurate perception of the inner movement of the web of phenomena. The desire for knowledge is the desire to understand the interrelationships or patterns within that web, and to become attuned to the unseen dynamic. The "truth" of medical ideas, again, depends on their usefulness in treating actual patients - it is radically context-dependent, and changing.

Since the truth is immanent in everything, since it is the process itself, constantly shifting, no description of reality can ever penetrate to the truth. Such descriptions can only be poetic descriptions of a truth that cannot be grasped. This goes far in explaining the Chinese use of metaphor and visual images in describing medical conditions. The use of metaphor not only evokes the connection of the body to the cosmos - the idea that each person is a cosmos in miniature - but also allows for the kind of flexibility of meaning necessary in a medical system which is at the same time radically qualitative and radically individualistic. Such language allows for, in fact forces, an awareness of the process that exists between linear measurements, of the dynamic functional activity of, say, an organ, rather than any exact description of physical location or any precise conceptualization. Since the only constants in this system are change and transformation (for Yin and Yang necessarily contain within themselves the possibility of opposition and change), the language of the system must allow the kind of flexibility to accommodate these changes, as they manifest themselves in specific patients.

What I would like to suggest is that it may be useful for feminists to look at the body in the way the Chinese physician does - both theoretically (via academic writing) and practically (via pedagogical and political strategy). In the remainder of this essay I will present several examples of how employing the conceptual framework of Chinese medicine could open up ways of seeing the body that could lead to productive feminist theorizing and practice around the body.

The idea that Yin and Yang each contain the other, and that such opposition underlies the dynamic of all change, sound on the surface like feminist theorists who advocate a "strategic essentialism." For such theorists often point out that neither essentialism nor contructionism is free from the influence of the other. Instead, essentialism depends on a sort of constructionism, and constructionism depends in places on the deployment of essentialist concepts. This is pointed out in the service of an argument for the necessity of a tension between essentialist and constructionist notions of the body.

Yet the very word "tension" implies a pulling against, an inherent antagonism that is currently at a balance point but that is in immanent danger of falling to one side or the other, at which time the "balance" maintained by the "tension" will forever be lost. Such is the result of attempting such a combination within a dualistic, mechanistic framework, one whose focus ultimately is on discrete categories, discrete positions, discrete intellectual frameworks. Essentialism and constructionism, within such a framework, can at best be held in this always-tenuous "tension."

Yin-Yang theory is much different in its evocations. Yin and Yang are conceptualized as opposites, and opposites each containing the other. But here the focus is not on the categories themselves, but rather on the process of continual change operating through the ebb and flow of these categories. So yes, there is "tension" between these opposites, and "balance" is the goal, but this is a tension which maintains itself within a framework of constant change. It is a tension free from the sort of danger surrounding the essentialism/constructionism tension, for it includes a recognition that at times Yang will predominate, at times Yin will predominate, but always there will be a return to balance.

The slippery slope worries manifest within western linear thinking are absent within the circular, cyclical thinking of Chinese medicine. In the same way that lines of causation are bent into circles, with our attention focused in the center, in the here and now, rather than thinning in a way approaching zero as a limit as it is stretched into the past and future - in this same way the Chinese system is able to handle opposites without slippery slope worries. So a much easier balance may be struck within a Chinese framework than within a dualistic one, for feminists trying to hold at once the advantages of essentialism and constructionism.

Feminists operating within a poststructuralist framework have adopted, in a way, the Chinese insight that change and transformation are the only constants. Yet they have done this within the context of "discourse" or "meaning" defined in a way which presents real problems for theorizing the body as a material thing. It seems that many feminist poststructuralists have adopted the Chinese notion of constant change but have at the same time held onto the western notion of cause, at least with respect to the body.

When operating solely within the confines of "discourse" their attention is focused squarely on what the meaning is here and now. But when talking about material bodies or experience the idea of cause gets imported: meaning/discourse is the cause, and bodies as phenomena are merely reflections. Truth may be immanent within discourse, but it is never immanent in embodied experience. Looking at the body in the way a Chinese physician does would demand that we take seriously the actual living continuity of bodily experience, as well as our metaphorical descriptions/perceptions of that experience. The Chinese physician's diagnosis is based on careful, specific, in-the-present observation (looking, listening, smelling, touching). Only after such an experiential encounter with a specific patient is s/he able to talk about the patient's body.

Such a reading of Chinese medicine points also to a very practice-oriented, experientially based theorization and pedagogy around question of the body. Talking about the body in any meaningful way requires us to know our body and other's bodies as they are right now. So perhaps a useful way to go about a feminist pedagogy around questions of the body would be to include as part of the classroom experience kinesthetic activities meant to bring students' awareness more fully into their own bodies. Meditation, marshal arts, yoga, dance and theatre all offer practices which could work in this direction. Again, the goal would be to teach - along with conceptual theories about the body - specific physical techniques which would train our feminist theoretical perceptions in the direction of the sort of perceptual skills cultivated by a Chinese physician. Then maybe we can begin to talk about our body, and women's bodies.

And once we begin to talk, how should we talk? Again, the Chinese medical framework reveals a provocative option. Namely, that our language should be metaphorical, poetic. It should have to do with function and quality more than with form and quantity. It should be a soft language, flexible enough to shape itself smoothly around and without damage to whatever bodies it encounters - rather than a hard language, with fixed meanings, which imposes its own, static shape on whatever it encounters. It should be a noninvasive language, one that preserves the phenomena, caresses it long enough for us to be able to speak of it but then leaves, not attaching, not fixing either itself or what it fleetingly spoke of. It should be a language of fluids rather than of solids.

We are talking, ultimately, about two very different ways of seeing the body. I am not in a position (nor do I wish to be) to argue for the all-time all-place "truth" of one over the other. I don't think we should ask "which is true," but maybe instead "what are the implications of each" and "which seems the most appropriate, most humane way of perceiving at this specific place and time in history?" I have suggested in this essay that seeing through the eyes of a Chinese physician may be a useful perceptual strategy for feminists trying to theorize the body in a way that is, at this time and in this place, both theoretically and politically useful and satisfying.