244 Michael p. Kelly and David Field

significance of bodily changes for the phylogenetic development of human

sodality can scarcely be disputed even though it is not possible to specify

confidently the detailed reciprocal mechanisms involved (Richards 1987)

and there is considerable controversy and dispute about explanations

(Megarry 1995, Midgely 1985, Wilson 1975, Sahlins 1976). As we understand

the literature, human sociality and social organisation developed in

an evolutionary set of interactions involving changing relationships

between the physical environment, physiological changes, the development

of symbolic cognitive capacities and changes in emotional control

and expression (Becker 1962, Richards 1987). During this process,

humans developed the ability to construct their world both physically and

emotionally. In particular, humans acquired the capacity for symbolic

representation (Lennenberg 1967, Mead 1934). Another profound change

was the replacement of biologically determined pattems of response

(reflexive and instinctual) by a more adaptable pattem under cerebral

control resulting in the greater fiexibility, precision, discrimination and

control found in human responses as compared to other animals. One

consequence is that human emotions are both socially shaped and biologically

founded (Averill 1982, Hoschschild 1983), as are the experiences

and responses to pain (Melzack and Wall 1982).

Ontogenetically, the importance of the body in social life can be seen in

a number of areas. We begin from the observation that a central prerequisite

for the development of the human {i.e. social) being is the control

of the physical body and its capacities. Such control and the knowledge it

brings provide a sense of constancy of the embodied self and the ability

to plan and predict future actions. Our position has been articulated most

clearly by writers from the symbolic interactionist perspective, especially

Mead (1934) and Stone (1962). In particular, the concepts of self and

identity as developed in symbolic interaction are central to our argument.

Both social identity and self-conception are central to human social

conduct and both are related to the body. The experience of self derives

from mundane everyday life during which individuals note and witness

their own subjectivity (Brittan 1973). Bodily sensations provide the initial

way of knowing and learning about the world and provide the first experiences

from which self-awareness develops. This was argued in Piaget's

influential (although now contested) account of how the infant's perceptual

and cognitive skills begin to develop through its physical interactions

with its immediate environment (Flavell et al. 1968, Piaget 1959, 1969).

Mead (1934) argues that the awareness of the body as a separate object

which the infant can control is an essential prerequisite to the development

of the social self. The persistence of bodies through time provides

the 'physical thread' to which the sometimes disparate actions of the

social self can be connected. The sense of being a causal agent is also

seen as crucial. To use Dewey's formulation (Dewey 1963) the infant

moves from being primarily an 'undergoing' object to which things hap-

© Blackwell Publishers Ltd/Editorial Board 1996

Chronic Illness and the Body 245

pen, to being a 'doing' actor who makes things happen. White (1959)

places this sense of efficacy at the centre of human life, while others have

seen the ability to control the world as central to the development of selfesteem

(Coopersmith 1967, Rosenberg 1979). Without the belief in and

sense of being causal agents who can shape and influence their environment

humans would merely respond to what happened to them rather

than actively shaping the outcomes of their behaviour.

We are not arguing that self is the same as body, nor that self exists in

some reductionist psychologistic sense. Self is a cognitive construct that is

constantly being reconstructed and which is expressed in the various narrative

and autobiographical accounts which are offered by the individual

in self-presentation. Self is linked to body in so far as common-sensically

self and body are experienced as one and the same thing. However, when

bodily demands conflict with desired self-presentation the individual

becomes acutely aware of the divergence between body and self.

Perhaps the most obvious way in which the physicality of the body

influences social life is that bodily appearance mobilises social identity

(Stone 1962). However, unlike selves, identities are public and shared

aspects of individuals. Identity establishes what and where the person is

within social structures, thereby linking self to social structure. Within

any macro or micro social configuration, people occupy positions, statuses

and social roles. These placements signify certain things to other

people and they are the markers by which the person is identified by others.

Identity defines a person as a social object locked into group memberships

and social relationships (Kelly 1992a).

The attribution of identity is very evident at the start of life. When the

human infant is born it is incapable of doing anything other than reacting

to immediate internal and external demands. At this point it has no

sense of self and, to use Stone's terminology, is a social object invested

with meaning by others (Stone 1962). Initially meanings are imputed by

others upon the basis of appearance, e.g. in the social construction of

gender identities. Thus the building up of the social self comes 'from the

outside' through the investiture of social meanings upon the basis of the

child's appearance and apparent behaviour, with little capacity by the

infant to affect such attributions. Stone observes that core identities such

as gender, age and ethnicity are typically embodied. The importance of

these core identities is that they place individuals as particular types of

himian beings, and provide the often unquestioned assumptions about

people which underpin social encounters. Other identities reflecting personal

qualities or primary role activities are a matter of construction in

interactions. Many, although not all, identities are 'read off" and imputed

by others on the basis of physical appearance (Goffman 1959, 1963,

Stone 1962). It is partly for this reason that others involved in constructing

identity (labelling or stereotyping for example) may do so in ways

over which the individual being identified has only limited control

© Blackwell Publishers Ltd/Editonal Board 1996

246 Michael P. Kelly and David Field

(Weinstein and Deutschberger 1963, Gergen 1971, Goffinan 1963, Jones

et al. 1984).

The bodily basis of social capacities and social behaviour is less apparent

once the social self has been established. However, that bodily basis is

not in any sense fixed. Human bodies grow, age and change through

time, and therefore impinge on social capacities in varying ways. The

body is therefore an important although changing element in human life.

Transitions in identity such as the movement from child to adolescent

and entry to 'old age' are all accompanied by changes in both the physiology

and appearance of the body. The onset of puberty with its dramatic

physical changes and feelings marks the entry to adolescence in a

way that is difficult for young people to ignore and the social uncertainties

and awkwardness of many adolescents refiect the very real difficulties

they have in coming to terms with their changed and changing bodies

and their control of them. For women, the changes in physiology and

appearance associated with menstruation, pregnancy and childbirth are

even harder to ignore. In this regard some feminist literature has been

concemed with the effects of the linkages between biological and social

factors in the construction of gender (e.g. Crowley and Himmelweit 1992,

Kaplan and Rogers 1990, Martin 1987). In old age, although physical

and social aspects may be less firmly linked, physiological changes affecting

bio-rhythms such as the wake-sleep cycle and energy levels are

significant, as is the increasing level of background impairment which

typically accompanies the later years of life. 'Disengagement' and the

social construction of dependency both reflect the reality of diminished

physical capacity. Of course, none of these physical changes impacts on

social life in a direct mono-causal way. Rather, the degree of biological