Arthur Rose – Reorienting Breathlessness: A Case against Symptom Discordance

Here is the latest of our recordings from The British Society for Phenomenology’s 2018 Annual Conference ‘The Theory and Practice of Phenomenology’. Arthur Rose is from Durham University, and his paper is titled ‘Reorienting Breathlessness: A Case against Symptom Discordance’.   Abstract: “In Phenomenology of Illness, Havi Carel identifies a ‘Janus-faced duality’ to breathlessness: ‘it is so real and overwhelming to the person experiencing it and yet so invisible to those around her’ (Carel 2016: 109). The discrepancy between external appearance and internal reality replicates a further discrepancy, known as symptom discordance, between the person’s perception of breathlessness (‘subjective experience’) and the oxygen saturation of their blood (‘objective measurement’). Not only is the breathless person challenged by another’s failure to recognize their experience, their own interoceptive ability may not match what they feel to what medicalised testing shows. Carel usefully relates this mismatch to Merleau-Ponty’s distinction between the objective and the lived body. The affordances of the objective body come to define new limits on the bodily habits that determine the lived body’s engagement with the world. To emphasize the reshaping of world that faces the person with breathlessness, Carel uses geographical metaphors or articulations that demonstrate both forms of discordance. But, Carel does not devote much attention to extremes of symptom discordance: either where a person has objectively low levels of oxygen saturation but does not complain of breathlessness or, conversely, where a person does complain of breathlessness but has no measurable oxygen deficiency. This paper seeks to draw on Carel’s account of breathlessness to consider how it responds to the problems symptom discordance presents for ‘external’ verification, by either casual or medical perception. By shifting the terms of the account, from concordance-discordance to orientation-disorientation, it reframes a continued reliance on the subjective-objective distinction as a matter of cognitive direction. Drawing on Sara Ahmed’s engagement with Merleau-Ponty’s account of orientation, it argues that the experience of breathlessness can be usefully thought of as a series of orientations: to the world, the sensations of breathlessness and their scientific measurement.”   The British Society for Phenomenology’s Annual Conference took place at the University of Kent, in Canterbury, UK during July, 2018. It gathered together philosophers, literary scholars, phenomenologists, and practitioners exploring phenomenological theory and its practical application. It covered a broad range of areas and issues including the arts, ethics, medical humanities, mental health, education, technology, feminism, politics and political governance, with contributions throwing a new light on both traditional phenomenological thinkers and the themes associated with classical phenomenology. More information about the conference can be found at: https://www.britishphenomenology.org.uk/conference-2018/   The British Society for Phenomenology is a not-for-profit organisation set up with the intention of promoting research and awareness in the field of Phenomenology and other cognate arms of philosophical thought. Currently, the society accomplishes these aims through its journal, conferences and other events, and its podcast. You can support the society by becoming a member, for which you will receive a subscription to our journal: https://www.britishphenomenology.org.uk/about/