Illness as Metaphor by Susan Sontag
"Illness as Metaphor" is a pivotal work by Susan Sontag that emerges from her personal battle with breast cancer and her reflections on the societal interpretations of illness. In the book, Sontag critically examines the tendency to attribute psychological or moral meanings to diseases, arguing against viewing illness as a metaphor for personal or societal flaws. Drawing on historical examples, such as tuberculosis, she highlights how misconceptions about the nature of diseases can hinder understanding and treatment. Sontag asserts that such metaphoric interpretations diminish the lived experiences of those suffering from illnesses and can lead to fatalistic attitudes.
Furthermore, she critiques the use of disease as a literary or political metaphor, suggesting that this practice distorts reality and misrepresents the experiences of patients. Emphasizing the importance of treating illness as a medical condition rather than a moral failing, Sontag encourages individuals to take an active role in their medical care. Ultimately, she acknowledges the necessity of metaphors in language but warns of their potential to obscure the reality of illness, advocating for a more nuanced understanding that respects the complexities of human health and identity. This work serves as both a personal testimony and a broader critique of cultural attitudes toward illness, promoting a more empathetic and informed approach to health.
On this Page
Illness as Metaphor by Susan Sontag
First published: 1978
The Work
Illness as Metaphor, a groundbreaking book, grew out of Susan Sontag’s own struggle with disease. She was diagnosed with breast cancer and was given only a slim chance of surviving. Her first reaction was fear and self-blame. Perhaps her repressed personality had contributed to her sickness, she surmised. Then she began to take charge of her own therapy—not only deciding on a radical mastectomy but also on a rigorous two-and-a-half-year course of chemotherapy—against the advice of doctors who doubted the efficacy of the experimental drugs she was taking. She attributed her aggressive response to her illness a key factor in her recovery.
Sontag’s experience and her research into the history of disease convinced her to reject psychological explanations of disease. Illness as Metaphor, as she later noted, is against interpretation, in the sense that the book counsels people to treat illness as illness—not as some judgment on their character or as a product of bad behavior. To bolster her case, she presents the history of diseases such as tuberculosis, which were thought to be connected with certain kinds of artistic and sensitive personalities. When the true, physical cause of the disease was discovered, and a treatment with antibiotics was developed, such psychological explanations were abandoned, she concludes. So it will be with the many different manifestations of cancer, Sontag contends.
Illness as Metaphor is also a work of literary criticism in the sense that Sontag attacks writers, including herself, who have used cancer as a metaphor. To compare a country’s actions to the spread of cancer—as she did in her attack on U.S. policy in the Vietnam War—is to demean people who have the real disease and to use language not to reveal reality but to distort it. Such exaggerations, Sontag points out, further neither an understanding of cancer nor of the issues to which cancer is compared.
Thus Sontag cautions against using disease to define personality and to establish identity. To suppose that a certain personality type is susceptible to cancer or other diseases is to take away from the individual his or her ability to fight that disease. Sontag is against fatalistic interpretations and believes that with most diseases people can intelligently use medical advice to ameliorate if not always to cure their illnesses.
Sontag acknowledges that people cannot do without metaphors; they are the staple of language, and they establish human identity. To use metaphors without due caution and understanding of their consequences, however, can actually inhibit, rather than extend, the individual’s control over his or her life.
Bibliography
Brooks, Peter. “Death of/as Metaphor.” Partisan Review 46, no. 3 (1979): 438-444. Compares Sontag’s views on metaphor to those of Alain Robbe-Grillet. Brooks doubts that people can truly free themselves from the need for metaphor and can only hope to expose metaphor for what it is. He hopes that Sontag will explore the subject further in the manner of Michel Foucault’s “archeologies.”
Bruss, Elizabeth. Beautiful Theories: The Spectacle of Discourse in Contemporary Criticism. Baltimore: The Johns Hopkins University Press, 1982.
Clare, Anthony. “The Guilty Sick,” in The Listener. CI (February 22, 1979), pp. 294-295.
DeMott, Benjamin. “Susan Sontag: To Outrage and Back.” Atlantic Monthly 242 (November, 1978): 98-99. DeMott reviews Sontag’s career with open hostility to her modernism, but he finds Illness as Metaphor an encouraging turnabout in her thinking. In fact, he identifies the ideas behind illness metaphor as important to the whole body of thought named modernism. “Her happiest and least conventional book, it’s also immeasurably her shrewdest,” according to DeMott.
Jacobson, Dan. “Sickness and Psyche.” Commentary 66 (October, 1978): 78-82. Argues that the representations of tuberculosis by nineteenth century poets and novelists cannot be compared with the remarks by more recent writers about cancer. Rejects Sontag’s claim of a Romantic “cult” of illness. One of the sharper, more critical reviews.
Kendrick, Walter. “Eminent Victorian,” in The Village Voice. XXV (October 15-21, 1980), pp. 44-46.
Kendrick, Walter. “In a Gulf of Her Own,” in The Nation. CCXXXV (October 23, 1982), pp. 404-406.
Kennedy, Liam. Susan Sontag: Mind as Passion. Manchester, England: Manchester University Press, 1995.
Sayres, Sohnya. Susan Sontag: The Elegaic Modernist. New York: Routledge, 1990. Contains only occasional specific references to Illness as Metaphor, but the introduction and the biographical chapter are informative. The selected bibliography is indispensable.
Scarf, Maggie. “A Message from the Kingdom of the Sick,” in Psychology Today. XII (July, 1978), pp. 111-112.
Sontag, Susan. “Alone Against Illness: Interview.” Interview by C. Kahn. Family Health 10 (November, 1978): 50-53. Sontag reviews the steps that she took before deciding on a radical mastectomy. She chose a Paris doctor who prescribed the largest number of drugs for the longest time, and she had thirty months of chemotherapy at the Sloan-Kettering Institute for Cancer Research in New York City. She also had immunotherapy, which was experimental in the United States at that time. She argues that cancer patients are undertreated.
Sontag, Susan. “Susan Sontag: The Rolling Stone Interview.” Interview by Jonathan Cott. Rolling Stone, October 4, 1979, 46-53. Another excellent interview that covers considerable ground. Sontag talks freely about her encounter with cancer, her resistance to it, and the book that she wrote about her experience. A wide-ranging interview filled with vivid comments.