Introduction
Having set out my own position among the different schools of posthumanism in Part 3 (link), I thought I should probably now lay down the key principles that follow from this, and then I can try to explain how I apply them to healthcare thinking and practice — my methodology if you will — in the next installment.
Before we begin, I offer you a mea culpa for some of the pretty heavy theory that is littered throughout this post. Condensing controversial arguments and radical alternatives into one readable blog post is never easy. I hope it doesn’t spoil your enjoyment of the piece.
If the philosophy does get too much for you, though, here’s a potted version of the arguments laid out in this post:
Human exceptionalism, notions of identity and ‘being, transcendentalism, and discovery are ubiquitous and hugely problematic both in Western society in general and healthcare in particular. Wherever we find them, we should try to root these out and replace them with Deleuzian posthuman philosophies of becoming, immanence, and creativity. These speak directly to the joyful pandemonium that is life and so are much closer to what’s really going on.
So let’s take each of these in order.
1. Against human exceptionalism
This is perhaps the obvious first principle of posthumanism, and I’ve covered some of its main forms in the last three posts. To briefly summarise, as Christine Daigle and Terrance McDonald recently wrote, ‘The idea that we must overcome humanist thinking, its dualistic stance and concomitant human exceptionalism is at the core of critical posthumanism’ (Daigle & McDonald, 2023).
We are talking here about different forms of de-centering, from contextualising the human within the context of the nonhuman turn (Stark & Roffe, 2015, p. 2), to a more complete and radical nonhumanism (see Brassier below).
Regardless of the outcome of this work, the starting point is often an ‘intense and harsh critique of classical philosophical understandings of the human as separate from nature and other beings, and of the human as superior to other beings in virtue of possessing reason’ (Daigle & McDonald, 2023).
But just as there is a general opening towards the more-than-human in posthumanism, there is, at the same time, an important political critique in play, particularly where some would embrace a worldly pan-humanism as a veiled way to reify the place of humans at the centre of the universe. We see this most often in what Rosi Braidotti called the ‘endangered human’ narrative;
‘The reinvention of a pan-human is explicit in the conservative discourse of the Catholic Church, in corporate pan-humanism, belligerent military interventionism and UN humanitarianism. It is more oblique but equally strong in the progressive Left, where the legacy of socialist humanism provides the tools to re-work anxiety into political rage. In all cases, we see the emergence of a category – the endangered human – both as evanescent and foundational’ (Braidotti, 2019).
So posthumanism is as disparaging about the humanitarianism of socialism, person-centred care, and aid work, as it is about organised religion, venture capital, and transhumanism, when these are covertly underpinned by an ethic of human flourishing.
One way that writers in recent times have tried to make this tendency visible and escape its magnetic pull is through the exploration of nihilism. Chief among these has been Ray Brassier.
Nihilism, since Nietzsche, has offered a powerful critique of dogmatic thought. Some humans, Nietzsche argued, are always looking to the past. Rather than fully engaging in the future, they never allow themselves to forget their pains and old sadnesses; constantly recollecting and dredging the past into the present. Nietzsche called them ‘resentful’ types and ‘slaves’ to their memories.
The seemingly endless rumination drives personal judgment, passivity, identity fixation, and self-blame into the person’s psyche — a force all too easily fed upon by powerful social discourses like science and religion (Nietzsche thought all religions were evil in this regard). Ultimately, the resentful type presents as an outwardly ‘moral’ person, but this person only really ever resents others and yearns to become their ‘hangman’ (Nietzsche, 2001).
The contrast for Nietzsche was the person who acted without resentment: without dragging up the past; always with both eyes fixed on the world to come. They have a lust for life, for becoming; they are ‘masters’, always open to disruption, ambiguity, possibility, emergence, and spontaneity. In Nietzsche’s famous allegory of the demon in the eternal recurrence, it is the übermensch — the joyous, free spirit — that would be happy to live their life over and over again just as it has been lived till now.
Following Nietzsche, Brassier sees Enlightenment science as a powerful force of nihilism. Our four-century-long search to map and measure every facet of human existence, to know the world and bend it to our will, is a project doomed to bring about our psychic and physical destruction (Brassier, 2007). Far from bringing untold social benefits, our modern fetish for reason and logic, taxonomy and diagnosis, and human cures for ‘man’-made problems, will be our undoing.
But Brassier takes a surprising turn here. Rather than siding with Nietzsche, Spinoza, Deleuze, and others in arguing for the possibility of a radical new posthuman view of ‘life’, Brassier argues for death: specifically the possibilities of understanding creation and thought beyond human imagining. Only by embracing our inevitable demise in life will we be able to grasp the other-than-human world more fully.
One of the problems of a lot of posthumanist writing is that it all-too-often struggles to fully escape human ‘being’. It is, as Jane Bennett says, very hard to rid ourselves of our anthropocentrism (Bennett, 2009). But if posthumanism is going to offer something fundamentally different than, say, critical theory has offered in the past, it must work out how to do this. So, perhaps Brassier’s approach is worth considering.
2. Becoming not being
‘nothing in man — not even his body — is sufficiently stable to serve as the basis for self-recognition or for understanding other men’ (Foucault, 1977).
‘Being’ is almost so ubiquitous in Western thinking that it’s hard to imagine a philosophy working in any other way. But posthumanism attempts to do exactly this, by ‘fractur((ing)) the assumed coherence’ of the world (Brown, 2020). Posthumanism takes to task all of those places where ‘being’ is taken for granted, and many of these areas form the very backbone of our work in healthcare:
In science, with its passion for giving names to things through its objective taxonomic, diagnostic clarity, such that we take for granted seemingly ‘solid’ forms of being like ‘the body’, ‘the mind’, and ‘disease’, and with them, the necessary correlates of ‘reason’, ‘logic’, ‘objectivity’, and ‘truth’;
In phenomenology and its (inter)subjective ‘being-in-the-world’, which leads to the over-used qualitative question of what it means to ‘be’ someone with Parkinson’s disease, and what being disabled means for you;
In social theory with its socially constructed identities based on ability, ethnicity, gender, and so on; a naming that is necessary to give voice to the marginalised ‘other’;
In the language we use to define concepts and their limits: ‘caring’, ‘therapy’, ‘pain’, ‘nursing’, ‘behaviour’, ‘addiction’, and so on;
And even in recent assemblage theory — a branch of posthumanism associated with Deleuze — with the listing of ‘things’ that can now be brought into consideration when we think about health (air conditioning units, trees, fictional characters in stories, graffiti, etc.), or the hyphenated lists of ‘things’ that now supposedly break with essentialised ideas of ‘being’: the sidewalk-wheelchair-skin assemblage, for instance.
(Of course, the great irony in all of this is my own use of fixed labels to list the disciplines that themselves privilege seemingly fixed identities).
‘Being’ imposes temporal and spatial stability on things. And yet, this is, of course, illusory.
In Deleuzian posthuman theory, being tells us nothing about the boundless, relentless, and unfathomably enormous process of ontogenesis that is at work in the cosmos; a process that expresses the endless repetition of creativity through difference, not sameness, becoming not being.
In keeping with its ethos, becoming may be a harder concept to ‘pin down’ but it comes closer to the reality of constant cosmic creation, conatus, and collapse than fixed identities and endlessly contested labels ever will.
’It’s not a question of being this or that sort of human, but of becoming inhuman, of a universal animal becoming – not seeing yourself as some dumb animal, but unraveling your body’s human organization exploring, this or that zone of bodily intensity, with everyone discovering their own particular zones, and the groups, populations, species that inhabit them’ (Deleuze & Guattari, 1987, p. 11).
3. Immanence, not transcendence
In a similar way to ‘being’, transcendence penetrates modern thought so deeply that it is hard to imagine thinking without it.
Transcendence refers to the present as a ‘projection’ of some greater or higher realm.
Many religions, ancient and indigenous cultures propose ‘higher’ gods, or some form of ‘other place’ where people go beyond this life. Enlightenment science called this superstition but replaced one form of transcendentalism with another when it argued that there are mind-independent truths and natural laws governing the universe. Plato thought that there were ideal ‘forms’ of everything we experienced in the world — us included — that were merely images of the realm of truth. Moral philosophers suggest that there must be something more to life than mere existence; why else would humans have been blessed with the gift of consciousness and self-reflection? And social theory isn’t immune from transcendentalism either, especially those areas that are concerned with the social structures that exist in the world and give the lie to myths about human autonomy and agency (Marxism and linguistics, for example).
Deleuzian posthumanism following Bergson, Leibniz, Nietzsche, Ruyer, Spinoza, and others, rejects the idea that there is somewhere else, or something else, to which life points. Transcendence is rejected in all its forms, in favour of immanence. In immanence, nothing ever has to go outside to fully realise itself. All it needs is right here.
Key here is the primacy Bergson and Deleuze give to intuition and gnosis — or the most direct, unmediated knowledge of the world — that all entities possess (as opposed to intellect, which always seems to lead to epistemic knowledge, the search for transcendental explanations, and nihilism).
But immanence also provides the basis for radically different concepts of duration (or ‘time’ in the Western canon), space (the ‘surplus’ that exists for all things and makes change possible that does not reside outside in some cosmic waiting room, but is folded into this moment, this entity, this relation), and thought (a more-than-human phenomenon).
4. Creation, not discovery
It perhaps follows from the critique of identity and being that posthuman thinking — particularly of a Deleuzian flavour — would dispute the place of discovery as a mode of thought.
Where Western philosophy has largely been a centuries-long project to discover how we should live (meaning the forms of logic and reason that frame the natural and social laws that are, in turn, sufficient to govern our species-being), posthumanism asks how could we live (May, 2005).
So while the Enlightenment project and all of its many offspring (modern healthcare, health professions and disciplines, clinical assessment and treatment, quantitative and qualitative research, etc.), pursue ever greater forms of discovery, posthumanists argue that we are being increasingly locked in the nihilism of instrumental reason.
In discovery, we see the stain of transcendentalism again because discovery is orientated only towards finding the thing that already exists ‘out there’, beyond our current knowledge. It is a mindset that is already prepared to make sense of what it sees.
But this is not what creates the ‘new’ or explains the sheer ceaseless productivity of the universe. It is the shock of the new, the violence of becoming, and the danger inherent in surplus that is the engine of the cosmos.
As Deleuze says, we are inside a thunderstorm, not a watercolour painting (Deleuze, 1993).
What then do these make possible?
It can be hard to know where to start as a posthuman thinker if we have to abandon even our starting points because they are so much the product of Western Enlightenment thinking. I mean, I’m a physiotherapist by training, interested in what a posthuman reading of bodies, movement, touch, and therapy might offer, but these terms are expressions of a flawed philosophy, so surely I should begin by rejecting all of these concepts and starting somewhere else?
This paradox is nothing new to posthumanism, though. As Hannah Stark and Joe Roffe argued, we are ‘simultaneously contextualized as a minuscule entity in relation to nonhuman time scales’ whilst also ‘positioned as the force shaping a new geological era’ (Stark & Roffe, 2015, p. 5).
I think, though, that Deleuzian posthumanism offers some remarkably creative ways to think if we can first uncouple our humanism and see putatively human practices like care and touch as being not just human interventions, but features of the becoming of all things. Understanding ‘therapy’ as a concept that applies as much to dying leaves as it does to human touch, for instance, is an exciting shift in what had become a rather stale, unremarkable field of thought in recent years.
There is surely more to wound care than just caring for human wounds.
There is also a critical project to be done here and posthumanism certainly provides lots of new tools to expose the often understated anthropogenic and professogenic assumptions underpinning healthcare (Burns, 2019). Much of this critique can be found in the posthuman literature, which has, as yet, been largely ignored by health professionals and those who write on the need for reform.
At its heart, though, Deleuzian posthumanism appeals to me because it aims at ‘the production of joyful or affirmative values and projects’ (Braidotti, 2019). It is a playful disengagement.
‘from the rules, conventions and institutional protocols of the academic disciplines. This nomadic exodus from disciplinary ‘homes’ shifts the point of reference away from the authority of the past and onto accountability for the present (as both actual and virtual). This is what Foucault and Deleuze called ‘the philosophy of the outside’: thinking of, in, and for the world – a becoming-world of knowledge production practices’ (ibid).
Postscript
As I was writing this piece, I read about the death of British sculptor Phyllida Barlow. In a lovely interview with Katy Hessel some years earlier, Barlow said this about the work of sculpture;
“I think the relationship of a warm-blooded creature vs an object that is still and silent – which is essentially what I think sculpture is – for me is the sort of fundamentals. Sculpture is in our everyday lives the whole time. Crossing the road with a lorry coming towards you, is, in my opinion, a sculptural experience, where you as a flesh and blood object is up against the thing that isn't. And one’s emotional and psychological assessment of that all happen in a flash” (Hessel, 2021).
I’m increasingly wondering if posthumanism isn’t a term for the act of sculpture that all things, not just human minds, engage in as a fundamental function of their existence; always seeing it as a chance to create something new.
References
Bennett, J. (2009). Vibrant matter: A political ecology of things. Duke University Press.
Braidotti, R. (2019). A Theoretical Framework for the Critical Posthumanities. Theory, Culture & Society, 36(6), 31-61. https://doi.org/10.1177/0263276418771486
Brassier, R. (2007). Nihil Unbound: Enlightenment and Extinction. Palgrave MacMillan.
Brown, J. M. (2020). Performance, Medicine and the Human, by Chris Pak. Link
Burns, E. A. (2019). Theorising professions: A sociological introduction. Palgrave Macmillan.
Daigle, C., & McDonald, T. H. (Eds.). (2023). From Deleuze and Guattari to Posthumanism: Philosophies of Immanence. Bloomsbury Academic.
Deleuze, G., & Guattari, F. (1987). A thousand plateaus — Capitalism and schizophrenia (B. Massumi, Trans.). University of Minnesota Press.
Deleuze, G. (1993). Difference and repetition. Columbia University Press.
Foucault, M. (1977). Nietzsche, Genealogy, History (S. Sherry & D. F. Bouchard, Trans.). In D. F. Bouchard (Ed.), Language, Counter-Memory, Practice. Cornell University Press.
Hessel, K. (2021). Phyllida Barlow. See podcast link below;
May, T. (2005). Gilles Deleuze: An introduction. Cambridge University Press.
Nietzsche, F. (2001). The Gay Science (J. Nauckhoff, Trans.). Cambridge University Press
Stark, H., & Roffe, J. (2015). Deleuze and the Non/Human. Palgrave Macmillan
This last part is just excellent. Employing mainly Deleuzian ideas, we reach the planes of creation, assembly, immanence, chaos and pure freedom. For my part, I believe that Nietzsche's elements must be explored more in-depth in order to deliver a reading that perhaps sticks more closely to his ideas, while being partially compatible with those that have been developed recently by many post humanist authors. It is therefore necessary for Nietzsche to reconsider « what » becomes of the post-human at the limit of the concepts of eternal return and the will to power. However, with Nietzsche, there is a downside to the possibilities of post-human creation because in the majority of these texts: Nietzsche urges us to return to the earth, to our inevitable otherness... to our end – and so live up to the utmost everyday – always becoming metamorphosing. To become post-human in this context means to become to the maximum of what one has received as a "body" in this world - and especially time - which inevitably wears us out.
Well, to the pleasure of submitting for ISIH in the next few days and maybe we will have the chance to discuss it live. Thank you again a thousand times for 4 sublime essays on the posthuman. Pawel.