Social Science & Medicine xxx (2014) 1e3

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Commentary

Commentary: Doing health geography with feeling Neil Hanlon Geography Program, University of Northern British Columbia, 3333 University Way, Prince George, BC, V2N 4Z9, Canada

Gavin Andrews, Sandra Chen and Samantha Myers are to be commended for inviting a deeper engagement by health geographers with non-representational approaches. Originally outlined as a theory in the 1990s by Nigel Thrift, non-representation has more recently emerged as a conceptual approach to human geography, thanks largely to contributions from geographers such as Ben Anderson (2006), Alan Latham (2003) and Hayden Lorimer (2008), to name a few. While non-representation has made its greatest impact in the field of cultural geography, the approach warrants serious consideration across the discipline, especially as it challenges us to rethink relationships of mutual dependence between people and the environments they inhabit. Rather than heralding non-representational thinking as the next big thing in health geography, however, I am more excited at the prospect that its adoption in health geography might help re-invigorate our now decades-old interest in health and place interrelationships. Two insights from non-representational approaches, in particular, stand out for me as most promising for advancing scholarship in health geography. The first is the notion that we should widen our accounts of place to consider ways in which bodies not only interact, but co-evolve with things (e.g., physical infrastructure, technologies) and other beings (i.e., not simply other people, but pets, livestock, wildlife, insects, and so on) that co-occupy environments of daily living. The second, and related, critical contribution is the idea that feelings and emotions make a difference in the co-evolution of people and their lived environments. Many contemporary approaches to social inquiry, which Thrift (2004) and others lump together as ‘representational’ approaches (e.g., social constructivism), tend to overlook or else undervalue such feelings and affects in seeking to explain social and spatial phenomena. I briefly examine each of these promising insights below. I then challenge the authors' conceptualization of wellbeing as an affective environment, arguing that such a notion conflates the idea of affect, which I understand to mean pre-cognitive impulses and ambient energies, with the feeling-state of wellbeing which, while clearly influenced by environmental and social relationships, is nevertheless a condition possessed by individuals. This one caveat notwithstanding, I conclude by echoing the authors' contention that non-representation offers a critical means to re-consider

DOI of original article: http://dx.doi.org/10.1016/j.socscimed.2014.02.037. E-mail address: [email protected].

established theoretical and conceptual approaches to health geography.

1. The co-evolution of people and place Given the inherent materiality of notions such as place and landscape, it is ironic that there would be strong calls from within the discipline for more attention to the importance of materiality in accounting for the influence of place on our lives (e.g., Duff, 2010; MacPherson, 2010). Yet these and other critics appear to raise a good point. Consider the notion of place effect, which presently enjoys widespread interest in health geography and beyond. Here, the importance of place is derived almost exclusively from what it signifies about the nature of inter-subjective social relations (e.g., levels of inequality, social capital). Little about the materiality of neighbourhoods and places actually enters into the analysis of this literature as anything other than the outcome or product of uneven social relations (e.g., Macintyre et al., 1993). While we like to tell ourselves, as health geographers, that we treat place (and landscape) as more than simply the backdrop on which social relations play out, much of our work continues to consign place to this role. Even if we are set on the notion that social relations are paramount, there does seem to be an opportunity for geographers to make a stronger case to take the materiality of place and landscape seriously. The work of Hannah MacPherson may be particularly helpful for re-imagining the interdependence and mutual constitution of health and place. MacPherson (2008, 2009, 2010) has made great strides in articulating the value of non-representative approaches in understanding human-landscape interdependencies. She asserts that humans and the landscapes they occupy are not fixed, independent entities awaiting discovery and re-presentation by academics. Rather, people and places are continually evolving in and through performance with each other. Co-evolution operates in even the most mundane and routine of daily routines, or in the minutest of instances (e.g., a fleeting impulse or feeling). That is, individual bodies are constantly taking shape through interactions with other bodies and objects, and likewise the objects that bodies come into contact with (e.g., the very stuff of landscape and place) co-evolve by intersecting with bodies. MacPherson's insights have much to offer the conceptualization of health and place relationships. The nearest we presently have to such a position is work employing theories of embodiment which,

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N. Hanlon / Social Science & Medicine xxx (2014) 1e3

for instance, explore the ways in which the homes and neighbourhoods occupied by persons living with particular physical conditions represent material aspects of social marginalization processes operating on individuals who do not conform to socially constructed ideals of health and normalcy (e.g., Craddock and Brown, 2010; Moss and Dyck, 2002). Embodiment scholarship has done much to highlight the ways in which the materiality of daily living helps reinforce social stigmas and demarcations of ‘otherness’, but a wider engagement with the influence that material things exert may well yield broader insights about the hybridity, permeability and mutuality of places and identities. 2. Feelings, emotions and affect The second insight I argue we can draw from nonrepresentation is to look beyond a narrow consideration of rational interpretation to take a wider account of the co-evolution of people and place. Non-representation challenges the impulse to rationalize experience as a post-hoc analytical exercise. Representational approaches are argued to reduce the world out there to rationalizations that impose an order and structure to lived experience at the expense of impulse, emotion and other non-rationalist modes of thought and action. Dewsbury et al. (2002) liken this to a kind of academic vampirism, whereby researchers drain the lifeblood of interactions by reducing these to pre-established interpretive categories that are argued to reinforce particular rationalities and reproduce social norms and power structures. Non-representational thinking, by contrast, pays attention to impulses, feelings and instinctive responses that are said to offer a more nuanced account of social reality (Anderson, 2006). The promise of non-representational health geography is to invite more-than-conscious consideration of a wider set of wellbeingenvironmental relations, including those involving even the most ephemeral encounters between subjects and the objects that ‘take place.’ If we accept the critique that representational modes of thinking encourage us to impose post-hoc rationality on observed or expressed behaviour, then a concern for feeling, emotion and affect will encourage us to problematize our interpretation of events and call into question our standard explanations for the empirical world around us (e.g., behaviour, action, value). For instance, a teenager participating in a study about smoking may be asked to explain why she or he chose not to take up smoking. A typical response might be that they purposely wished to avoid becoming addicted to nicotine so as not to risk long-term exposure to tobacco smoke. This would be a reasonable explanation, but what if the teenager was in fact simply saying these things because they were unable or unwilling to comment on the role that feelings, hunches and instincts played, for example in not accepting cigarettes when offered or avoiding particular social situations that may have encouraged them to take up smoking? Health geographers and others would do well to make room for non-rational considerations of the way in which people respond to, and act in, the world around them. Moving beyond representational, and hence over-rationalized, thinking encourages us to consider emotions and feelings, which are still readily identified and communicated through cognitive processes. Non-representational scholars, however, encourage us to take things a step further to consider the notion of affect, which appears to occupy a position beyond cognition and attached to no particular subject or object (e.g., Anderson, 2006). There is little consensus in the literature about how affect is defined (e.g., is it an impulse, an energy?), but this has not stopped, and in fact may have enabled, the spread of interest in affect to fields and pursuits as disparate as psychology, anthropology, sociology, geography, literature, communications, film, fine art, gender and queer studies (e.g., Gregg and Seigworth, 2010). Like many avenues of insight, the

idea of affect has been taken up as a way to overcome dualisms and other conceptual impasses that tend to creep into established literatures (e.g., nature and nurture, object and subject, structure and agency). It remains to be seen where considerations of affect will take us in health geography, but we can certainly look forward to lively debate in years to come as scholars step forward to take up the challenge that affect presents. 3. Wellbeing is an affective environment? For all of the insights the paper by Andrews et al. has to offer, I take exception to the idea that wellbeing should be regarded as an affective environment. The authors do not help their cause in how they describe wellbeing; that is, they expressly defined it as a state with a ‘fundamental nature’ that is clearly and cognitively felt by individuals, although clearly this state of feeling is malleable and influenced by interactions with our social and physical environments. The authors assert that it is important to pay attention to the full context of affective moments in which wellbeing is revealed to us, including attention to the routines, movements and interactions we happen to find ourselves ‘performing’ at moments when an awareness of wellbeing is present (e.g., driving a car down a busy highway, watching children at play on a warm day). This is all well and good, but an individual's state of wellbeing and the affective environment in which individuals experience a sense of wellbeing appear, at least to me, to be two distinct things. I argue it would be more helpful to regard wellbeing as a feeling state rather than an affective environment. Wellbeing may be a concept that defies precise and unambiguous definition, but it is familiar enough that people feel they recognize it and are comfortable talking about it in a general sense. Affect, however, is a much more slippery and less apparent concept. This raises questions about the method of “witnessing” used in the paper by Andrews et al., which entailed the authors recognizing a brief experience of their sense of wellbeing and recording a detailed description of this affective moment, complete with details about the relationship of their bodies to material objects and sensory impressions of their environmental surroundings. Does this not amount to a post-hoc effort to recall affects which, by definition, occur at some instant prior to cognition? If so, there appears to be a problem here, as the authors acknowledge, but do not address in the paper. That is, how does one recognize their own pre-cognitive responses if not by means of post-hoc cognitive reasoning? I think the authors are on more secure ground to regard wellbeing as a somewhat stable and cognitively realized state of feeling that people are fully capable of recognizing and describing. This caveat notwithstanding, the notion that the routines of daily living, including the full range of material, emotional and interpersonal conditions a body encounters, matter to the production of wellbeing as a feeling state, deserves serious consideration. 4. Concluding thoughts For all that is refreshing about non-representation, there is much that is familiar. In particular, non-representation draws on relational and situational modes of thought that have been central concerns in human geography for some time (e.g., Gregory, 1989; Massey, 1994). I also do not see how non-representational approaches can escape interpretation as the primary means by which to interrogate emotion, feeling and affect. That being said, health geographers would do well to be more observant of lived daily environments and more mindful of feelings and emotions in our interpretations of empirical reality. We should find ways to incorporate performance in our work; that is, to reflect on the ways in which routines and practices of daily living reveal

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our interrelatedness and co-evolution with the world. I expect this may entail a greater engagement with techniques of observation, but we should not overlook considerations of context, emotions and feelings when making sense of interview transcripts and other forms of narrative data that have become the mainstream in health geography scholarship in recent years. Health geographers should be open at all times to consider fresh perspectives and approaches that enable us to re-consider central questions and concerns. To integrate non-representational thinking is to challenge ourselves as researchers not to dismiss feeling and emotion as background noise, not to confine the materiality of place and landscape to an afterthought or outcome of social activity, and not to reduce human action simply to rational selfinterest or any other pre-conceived conceptual category. At the same time, the onus is also on a scholarly community to hold new ideas and approaches up to critical scrutiny and interrogation. References Anderson, B., 2006. Becoming and being hopeful: towards a theory of affect. Environ. Plan. D Soc. Space 24, 733e752. Craddock, S., Brown, T., 2010. Representing the un/healthy body. In: Brown, McLafferty, Moon (Eds.), A Companion to Health and Medical Geography. Wiley-Blackwell, Chichester, pp. 301e321.

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Dewsbury, J.D., Harrison, P., Rose, M., Wylie, J., 2002. Enacting geographies. Geoforum 33 (4), 437e440. Duff, C., 2010. On the role of affect and practice in the production of place. Environ. Plan. D Soc. Space 28 (5), 881e895. Gregg, M., Seigworth, G.J. (Eds.), 2010. The Affect Theory Reader. Duke University Press, Durham and London. Gregory, D., 1989. The crisis of modernity? Human geography and critical social theory. In: Peet, R., Thrift, N. (Eds.), New Models in Geography, vol. II. Unwin Hyman, London, pp. 348e385. Latham, A., 2003. Research, performance, and doing human geography: some reflections on the diary-photograph, diary-interview method. Environ. Plan. A 35 (11), 1993e2018. Lorimer, H., 2008. Cultural geography: nonrepresentational conditions and concerns. Prog. Hum. Geogr. 32 (4), 551e559. Macintyre, S., Maciver, S., Sooman, A., 1993. Area, class and health: should we be focussing on places or people? J. Soc. Policy 22, 213e234. MacPherson, H., 2008. Between landscape and blindness: some paintings of an artist with macular degeneration. Cult. Geogr. 15, 261e269. MacPherson, H., 2009. The incorporeal emergence of landscape: negotiating sight, blindness and ideas of landscape in the British countryside. Environ. Plan. D Soc. Space 6, 1080e1095. MacPherson, H., 2010. Non-representational approaches to body-landscape relations. Geogr. Compass 4 (1), 1e13. Massey, D., 1994. Space, Place and Gender. University of Minnesota Press, Minneapolis. Moss, P., Dyck, I., 2002. Women, Body, Illness: Space and Identity in the Everyday Lives of Women with Chronic Illness. Rowman and Littlefield, Oxford. Thrift, N., 2004. Intensities of feeling: towards a spatial politics of affect. Geogr. Ann. B 86, 57e78.

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