Healthy self-care may be healthy, but is it good?

March 16, 2020

Written by guest blogger Talia Welsh.

Many years ago now, the health care insurance that covers the state of Tennessee (USA) employees developed the lowest cost program to include wellness monitoring. I chose this program for the cost and found myself in a room in our university student center being weighed and having a variety of other tests (blood pressure, blood sugar, heart pressure) done along with other faculty and staff. After the tests, we were to sit in some metal chairs in the middle of the room and then, based on our scores, counselled. I watched a middle-aged man being told patiently by some very young health counselors to eat more vegetables since some test was not favorable. He looked extremely uncomfortable and I wasn’t too sure if I could maintain my composure if I was lectured in such a condescending fashion about vegetable consumption. The entire apparatus seemed completely out of proportion. I ended up not being told to eat more vegetables, but I did end up having to be remotely “health coached” once a month. What was critical from the coaching perspective was that I have health “goals” and I track my behavior accordingly. I do some things for my health—I work out, I mostly eat well. But, I work full-time and I have a young son and I can’t really see obsessively monitoring my diet or exercise since I’m able to do the things I want and need to. My first love in philosophy, the work of Friedrich Nietzsche installed in me a strong inclination to question authoritative voices that speak from a moral high-ground. While I’ve largely departed from Nietzsche’s central issues in my own work, the idea that morality is very often a tool for other means, rather than a conclusion or truly held belief, still colors my work.

During one session, a health coach said—but you could be healthier! Yes, I admitted, I could. But I didn’t seem obvious to me that I should since it would mean I couldn’t do other things. It just seemed silly as a reasonably healthy busy person to spend more time tracking whether I ate this or that or exercised 10 minutes more. During this time, the Affordable Care Act (also known as Obamacare) was being debated and eventually enacted. What intrigued me was that despite the fact that overall, the ACA was a public health benefit to many uninsured Americans, it actually enshrined the capacity of insurance agencies to promote such “wellness” programs—even to the degree of “fining” bad actors—such as smokers. This led to some more reading and considering of the way in which wellness operates as a politically neutral (although the right and left tend to weaponize it differently) and morally beneficial pursuit.

As a feminist, the practices and rituals, and the attendant shaming of not being healthy enough reminded me strongly of the work women are encouraged to do to look a certain way—through attention to self-care work such as skin care, hair care, body modification, and dress. These demands are wildly asymmetrical in their extensiveness between men and women even if surely men too feel pressure to look a certain way. They too require an objectification of one’s own body, like one would need to alter one’s diet or typical activity level, and can include complex means of tracking and documenting good performances (especially in our digital age).

However, feminist work also often uses health as a means to argue against certain practices and policies and often argues strongly for self-care as a kind of means to obtain time, resources, and attention to the self instead of the more traditional view of good women as endlessly sacrificing for others. And, certainly wanting to be healthier, avoid sickness, and prolong life seems to be something profoundly human, not merely something constructed by society. I’ve been trying to since my “health coaching” experience, to figure out ways in which to embrace the critical means to disentangle moralism around health, but still provide spaces for those who wish to spend time in healthy self-care.

Talia Welsh is a UC Foundation Professor of Philosophy and Interim Director of Women, Gender, and Sexuality Studies at University of Tennessee at Chattanooga. She translated Merleau-Ponty’s lectures in child psychology and pedagogy in the volume Child Psychology & Pedagogy: Maurice Merleau-Ponty at the Sorbonne (Northwestern UniversityPress, 2010) and wrote a book on Merleau-Ponty entitled The Child as Natural Phenomenologist: Primal and Primary Experience in Merleau-Ponty’s Psychology (Northwestern University Press, 2013). She has also published extensively in feminist theory, particularly on parenting, pregnancy, and the way in which female bodies are normalized in health care practices.

Her latest article in IJFAB: International Journal of Feminist Approaches to Bioethics entitled “The Affirmative Culture of Healthy Self-Care: A Feminist Critique of the Good Health Imperative” is free to read for a limited time here.

The UTP Journals blog features guest posts from our authors. The opinions expressed in these posts may not necessarily represent those of UTP Journals and their clients.

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