‘Health Humanities’ by Paul Crawford, Brian Brown, Charley Baker, Victoria Tischler, and Brian Abrams (Palgrave Macmillan, 2015).
Visions for the future of the field(s): Review of Health Humanities
Evolution and emergence, the subsumed and the superordinate, death and genetic adaptation: nowhere is Health Humanities more animated than in its discussion of its relationship to the medical humanities. In 2010, Paul Crawford, Brian Brown, Victoria Tischler and Charley Baker published a discussion paper in Mental Health Review entitled ‘Health Humanities: the future of medical humanities?’ Five years later, and joined by Brian Adams as fifth co-author, their “slim manifesto volume” answers that question in the affirmative.
Questions of temporality lead directly on to questions of territory (and even territoriality): situated at the intersection of the arts, humanities and healthcare, the health humanities, according to Crawford and colleagues, arises from and supersedes the field of medical humanities simply by expanding its boundaries on multiple fronts. Decentring the privileged pas-de-deux of doctor and patient, the health humanities has a broader, more inclusive cast list of nurses, allied health professionals, informal carers, non-specialist health workers and ‘the self-caring public’; it claims a more international reach and encompasses disciplines, such as anthropology and linguistics, less prominent in the medical humanities; and it also seeks to ‘extend “appliedness” in relation to how arts and humanities knowledge and practices can inform and transform healthcare, health and well-being’ (p. 1).
Health Humanities outlines this programme of expansion in its opening chapter and elaborates it through subsequent discussions entitled ‘Anthropology,’ ‘Applied Literature,’ ‘Narrative and Applied Linguistics,’ the ‘Performing Arts and the Aesthetics of Health,’ and ‘Visual Art and Transformation.’ With considerable variations in style, each chapter draws on a range of brief case studies to offer a broad account of the different ways in which particular ideas, texts, methods or practices from the arts and humanities can be applied in a range of contemporary healthcare contexts. It is difficult to determine the audience addressed by this approach. Readers with a background in the arts and humanities will find large sections of the book take them back to basics (‘Examining the history or genealogy of illnesses, disorders and complaints is often instructive’ (p. 27); ‘…as any book-lover will attest, reading is an activity that is relaxing, stimulating, educative, enjoyable and soothing (The Telegraph, 2009)’ (p. 56). Healthcare workers, policy makers and health humanities sceptics may be frustrated that the problems and limitations of existing approaches to health, illness and wellbeing, and the role of the arts and humanities in addressing these, are assumed rather than robustly demonstrated. Readers whose interests are piqued by the promise of a more genuinely international approach might be disappointed to realise that US and particularly UK programmes and projects remain the central focus of the text. And readers from the ‘self-caring public’ would be forgiven for wondering what they might usefully do with their new knowledge of a field that, despite claims towards expanded domains of engagement, is still predominantly focussed on healthcare located in or administrated through professional and institutional settings. The Routledge collection Medicine Health and the Arts: Approaches to the Medical Humanities (published in 2014, edited by Victoria Bates, Alan Bleakley and Sam Goodman, and reviewed here) tackled the challenge of engaging such a diverse audience by inviting three distinct kinds of contribution (a historically grounded overview followed by two more practically oriented chapters examining medicine’s influence upon the arts and the role of the arts in medical and therapeutic practice). Health Humanities achieves something more integrative but its theoretical and practical conception of interdisciplinarity struggles to engage directly with, let alone intervene decisively in, many of the existing debates that dominate more specialist fields of knowledge.
It’s not until the two concluding chapters that a really novel agenda for the Health Humanities emerges. ‘Practice Based Evidence: Delivering Humanities into Healthcare’ evokes feminist methodologist Patti Lather’s notion of ‘transgressive validity’ to question existing hierarchies of evidence and their fit for arts and humanities based approaches to health; it also calls for emancipatory research practices that ‘involve the participants in the research helping to define problems, identify research questions and implement research activities, as well as trying to find ways of using the research to bring about social change’ (pp. 128-9). These are more fully outlined in the final chapter ‘Creative Practice as Mutual Recovery,’ which argues for a change in emphasis from professional-led arts therapies focussed on recovery in the context of particular conditions or patient groups, to empowering forms of creative practice that locate recovery as belonging equally and reciprocally to communities of individuals with diverse mental and physical health needs and expertise (pp. 137-140). There are interesting conversations to be had about how ideas of transgressive validity, creative practice and mutual recovery can and should refocus work at the crossroads of the arts, health and humanities, especially when, as the authors argue, they engage all potential stakeholders (professional, public and academic).
What I find puzzling and, if I am frank, objectionable about this book is the way that Crawford and colleagues characterise the medical humanities, and position medical humanities researchers as variously ignorant of, defensive towards, or uncritically opposed to the health humanities. In my experience this is simply not the case: there is far more common ground between these initiatives than fierce branding exercises would suggest, and it feels rather disingenuous to historicise, characterise and then dismiss the field of medical humanities in less than two pages. Citing nothing published or produced from this dynamic and growing area of scholarship and practice since 2009, Health Humanities seems simply to ignore the last five years of insight and innovation in the medical humanities, at intellectual, organisational, and institutional levels.
In other contexts, however, Crawford has appeared acutely aware of recent developments in the medical humanities, but only insofar as they represent a hostile response to ‘the discipline [he] helped to found’:
Some centres with a focus on medical humanities have tried to react to the challenge they plainly feel health humanities represents.
Renamed programmes, tweaked websites and forays into notions such as ‘critical medical humanities’ underline their desire to pop the new kid on the block into the blender.
This is not a desire I recognise, nor do I see the medical humanities in its current and emerging forms as being “beholden to hierarchical or elitist thinking” or constricted by ‘innately narrower arteries‘ when it comes to the circulation of ideas. Of course I can only speak from my own vantage point, but my experiences of working at one of the major UK medical humanities research centres, co-editing a recent special issue on Critical Medical Humanities and contributing to this blog, have led me to the conclusion that contemporary medical humanities is a far more inclusive, intellectually ambitious, impactful, and above all less antagonistic field than Crawford and colleagues imply.
Why does this matter? It matters because territoriality gets us nowhere, and saying so does not put any one or any thing ‘into the blender,’ nor does it seek to take back turf in an imagined war. Bluntly discrediting the work of others or misrepresenting their intentions runs contrary to the collaborative and inclusive spirit that the authors of this book seek to champion, and it also closes down the kind of detailed, critical dialogue that should be expected from scholars in a position of leadership, authority and privilege.
Despite rehearsing counterproductive rivalries, Health Humanities offers an accessible introduction to what Crawford and colleagues think the field is and can achieve. However, if ‘health humanities’ is ‘set to become the superordinate term for the application of arts and humanities to healthcare, health and well-being’ (p. 156) then this will have to be a merit earned rather than asserted.
Reviewed by Dr Angela Woods, who is a Senior Lecturer in Medical Humanities at Durham University. She is Deputy Director of the Centre for Medical Humanities and Co-Director of the Hearing the Voice project.
Correspondence to Dr Angela Woods.