Mind-body relations in Physical Cultural Studies: Exploring the rise of a new corporeal therapeutics in mental health

This chapter pursues a line of critical questioning concerning how we come to ‘know’ the embodied, discursive and biopolitical dimensions of mental health and illness in the context of physical cultures. In terms of a Physical Cultural Studies (PCS) sensibility I situate my engagement with both epistemic and everyday issues of injustice within a feminist context that understands the personal as political. Over the past decade I have explored questions about the cultural formation of ‘normal and abnormal’ subjectivities in everyday contexts with respect to shifting public discourses about increasing mental health problems. This intellectual inquiry has also been shaped by my family biography that was severely disrupted by the iatrogenic effects of psychiatry in 1950s Australia (Ehrenberg, 2009). My grandmother and uncle (her son) were both diagnosed as ‘paranoid schizophrenics’ and endured therapeutic treatment that was informed by emerging theories of brain dysfunction, failure of maternal bonding and genealogical impurities. Mental illness was a shameful infliction that brought institutional confinement, over medication, electric shock treatment and the violation of basic rights. By the 1980s Australian mental health policies embraced the shift to deinstitutionalisation as the medical model was increasing challenged by advocacy and human rights movements that were gathering momentum in the US, Canada and the UK. Thirty years after his ‘breakdown’ during the pressure of final school exams (he was dux at the time), my uncle moved into a house, learned to cook, manage his own money and began to enjoy the freedom of everyday movement.

Those wasted years of his institutionalised existence offer a stark example of how the minds and bodies of pathologised populations are governed through therapeutic imperatives that seek to restore normality in the pursuit of health. Connecting critical health and sport perspectives Genvieve Rail’s keynote at the recent International Sociology of Sport conference in Paris 2015 examined the “imperative of wellbeing” with respect to how “other” bodies are positioned, erased through normalised thinking or pathologised as unhappy, dissenting or unapologetic. In his critical work Metzl (2010, p.2) has argued argued that “‘health’ is a term replete with value judgments, hierarchies, and blind assumptions that speak as much about power and privilege as they do about wellbeing. Health is a desired state, but it is also a prescribed state and an ideological position”. These points echo the radical contextualism informing my PCS approach to mental heath that situates biomedical, psychotherapeutic and health promotion intervention practices within a genealogy where truth claims about healing, restoring or optimizing mental health are historicized. Such an approach also makes visible the effects of power-knowledge relations on embodied subjects in order to disrupt the normative and open up other ways of knowing and being.

In writing this chapter my aim is twofold, first to consider how the “physical” within Physical Cultural Studies has been theorised with respect to questions of mental (ill) health in the context of an historical dualism of mind and body. Second, I explore how the broader cultural, economic and political context of the United Kingdom (UK) has positioned mind-body relations within mental health policy, research, advocacy and practice. It is now commonplace to read that “exercise is medicine” and I argue that active embodiment has been subsumed within a new corporeal therapeutics (with a nod to Nikolas Rose) aimed at ameliorating mental (ill)health. The physically active self is being mobilised through converging mental health discourses to treat and prevent a growing population ‘problem’.