Why I've started ParaDoxa
And how you can get involved
Hello folks,
Thank you to everyone who’s already been in touch about this new venture. The response so far has been incredible. And we’re only just getting started.
Before the site gets really moving, though, I thought I’d take a moment to tell you a little about me and explain why this, why now?
At the time of writing this, I’ve been an academic for just on 30 years this year. I’m also a physiotherapist, but I’m unusual in my own field because my work concentrates on history, philosophy, and sociology rather than biomedicine.
Eight years ago I set up the Critical Physiotherapy Network with a few friends. We initially thought it would be a small meeting of colleagues dotted all over the place, but it quickly developed into an international network of over 1,000 people from more than 50 countries. It was proudly free and independent, and it frankly restored my faith in physiotherapy.
But by 2022 I knew I needed a fresh start.
I’ve been a student of postmodernism — especially the writings of Michel Foucault — since starting my Ph.D. nearly 20 years ago. But over the last decade, I’ve been increasingly drawn to post-humanism and the turn away from human-centred research and practice, and towards ‘material’ philosophies like new materialism and object-oriented ontology.
More and more I’ve thought about ways these could be used to transform healthcare.
In 2017 I wrote a Foucauldian history of physiotherapy (The End of Physiotherapy), and last year (2022) published Physiotherapy Otherwise which analysed the physiotherapy profession sociologically. My plan was always to write a third book using philosophy to ‘diagnose’ my profession, and I began work on that last year.
The book will attempt to develop a post-human philosophy of healthcare (probably using physiotherapy as my case study — because that’s what I know best). The work of Gilles Deleuze and Félix Guattari will provide the main thrust of the arguments, with an array of assorted co-conspirators alongside.
But to do this, I felt I needed to close one part of my academic life off, to open up another. So, a few months ago, I resolved to end my time with the CPN and the International Physiotherapy History Association and start down a new path. And that’s what ParaDoxa is.
I’m convinced that:
We’re entering perhaps the most exciting and dynamic period in the century-long history of the healthcare professions, but this is undoubtedly a post-professional era. Future healthcare will look vastly different from the way it’s configured today;
We should not be placing our energy or trust in ‘the state’, or the ‘free’ market as the remedy for what ails us. We have to think beyond the Enlightenment and the legacy of industrial capitalism that has been so advantageous to the orthodox (Western) healthcare professions in the past;
Similarly, we shouldn’t look to revive the anthropocentric (human-centred) project, because there’s too much other ‘stuff’ going on in health and healthcare (never mind what lies beyond it) to focus simply on the bits that we care about;
There is something in the philosophies of Deleuze and Guattari, Irigaray, Spinoza, Nietsche, Bennett, Butler, Liebniz, Manning, Braidotti, Foucault, and others, that might give us a route map into an entirely new way to think about health and healthcare. (And if it doesn’t give us a ‘route map’ exactly, it will at least give us some pointers to much better questions.)
So ParaDoxa is a passion project.
It’s also a way to build a community among clinicians, researchers, students, teachers, and writers, who also want to think more about these things and share some of their ideas.
An example of what I mean
Most of my clinical work as a physiotherapist was centred around children and older adults with chronic lung disease. I had been given really good training in oxygen dissociation and lung anatomy, I knew lots of objective tests for VO2 max, and knew how to spot respiratory failure from an ABG. But I needed to become a qualitative researcher to understand why breathlessness really frightens people. Even then, though, the phenomenological research I was doing fell short, because it didn’t tell me anything about the structural conditions of poverty, social isolation, and stigma that these people experienced. I needed sociology for that. Then Foucault came along and taught me to look into the conditions that made my work as a physiotherapist historically and socially possible. Learning that was life-changing but, even then, there seemed to be something missing.
I was looking for something that was capable of holding all of this together; something deep, philosophically strong; something that wasn’t just naive ‘holism’ (no thank you, biopsychosocial model); something that could cope with the body, the soul, and the social.
And I wanted this for some really quite pragmatic reasons. I wanted a new kind of physical therapy — something that wasn’t bound by the old dogma of biomedicine, interpretivism, or sociology.
I tried to write about this in an article back in 2019. Apologies for the long quote, but hopefully it explains what I was struggling with;
‘How can I reasonably practice as a respiratory physiotherapist and not have a view on the interplay between the ecology of air, the biology of breathing, the lived experience of gas exchange, the spirituality of breathlessness, or the symbiotic relationship between objects that are neither defined by what they are, nor by what they do? How can I not be interested in designer face-masks, and the creative conversion of oxygen, air and breath in works of art; or be concerned for cities like Delhi, where levels of carbon monoxide were 25 times the WHO recommended level at times last year? How can I privilege an anthropocentric view of breathing and ignore breathing as a form of anarchy, air as ‘landscape’, a negative space, and terra infirma? Air as terror and medium of social control? Combat breathing or muscular armor? My practice and thinking, surely, has to embrace the use of breathing in films and role player video games? And if oxygen is the ‘fuel’, how can I understand the role it will play in future robotics and space travel? I have to be interested in breathing as memory and history, in iron-lungs, ventilators and machine- assisted breathing. And I surely must want to understand why the diaphragm is the only skeletal muscle in the body that is both under voluntary control and essential to life? What of the interstitial (liminal) spaces between things – so important for the micro-anatomy of the lungs – but applied elsewhere too?’ (https://openrepository.aut.ac.nz/handle/10292/13056).
I’m sure the same expansiveness applies in whatever area of healthcare you live, work, or study in.
So, finding a philosophy that could be adequate to a more-than-human, post-qualitative, post-structural, post-professional kind of healthcare has been the focus of my work since then, and it’s the basis for everything that you will see in ParaDoxa.
Broadly, I’ve labeled all of this work post-critical. It’s not an ideal label, but it will do for now. If you’d like to know more about the ideas behind ParaDoxa, click on the ‘About’ tab on the website, this link will take you there.
What you get if you subscribe
A regular diet of links, announcements, editorials, digests, podcasts, and assorted other bits-and-bobs, delivered to your email inbox every week.
While the community builds and the site grows all of this will be for free. All you have to do is write in your email address and subscribe.
I should also say I have a fantasy of doing this kind of work full-time and moving to a post-academy life where teaching and writing about post-human healthcare become my full-time work.
So, at some point in the future, I’ll create free and paid subscription arms to the site. But that won’t be for a while yet.
And finally, what can you do?
Firstly, click on the ‘Subscribe now’ button above and sign up;
Tell other people about ParaDoxa. Click the share button below and pass it on;
Chip in. Add comments to the blogposts, send me emails, chat on Zoom… whatever works for you. There are so many people out there doing amazing post-critical work right now, I’d love to hear from you and anyone you think would be interested.
Stay well, and stay in touch.
Touch… now that’s something I should look into…
Dave