Talia Welsh, Feminist Existentialism, Biopolitics, and Critical Phenomenology in a Time of Bad Health. New York: Routledge, 2022; 201 pages. ISBN: 9781003168676, available as a paperback and an ebook, published under a Creative Commons Attribution-Non Commercial-No Derivatives 4.0 license. Open access available through Taylor & Francis https://doi.org/10.4324/9781003168676 

Anna Mudde, Campion College at the University of Regina and Kristin Rodier, Athabasca University

Talia Welsh’s monograph intervenes at the intersection of critical phenomenology and critical health studies. It does this from within a specific area of theorizing that has not yet approached these topics in depth—feminist existential-phenomenology. The work is an extended critical theoretical engagement with conceptions of “health” that redirects towards the constitutive existential problems that are often covered over, centrally, “birth, development, suffering, and death” (34). This analysis follows a specifically feminist tack, focusing on reproduction, reproductive labour, and gendered self-fashioning in addition to areas of health work such as smoking, body size, cardiac illnesses, and so on. Welsh builds on critiques of the normativity of health but refocuses on how health has been made meaningful from within lived experience. Welsh asks, can health be a project within a situation—notably with a frustrating and finite biological body habituated into a social world of oppressions? In response to this question, the good health imperative points us inward, shaping essentially existential problems into problems of individual body management (151). 

Welsh’s core concept, “the good health imperative,” points to an imperative for individuals that holds that “it is both rational and moral to better one’s health when one can” (viii). Acting as a critical standard in the work as a whole, Welsh shows that the good health imperative contains many supporting premises, e.g., that our body naturally tends towards or desires health (x); that healthy self-care is always good; that children’s health is entirely a result of visibly good parental practices; that health is an ahistorical good; that health is a certain kind of consumption; that health is a true or moral pleasure; and lastly, that the good health imperative necessitates that we also work to make others take on the good health imperative (17). Even many excellent critiques of normative health maintain the value of health in accordance with the good health imperative. One of Welsh’s important critiques demonstrates the clash between an existential-phenomenology and public health disciplines: the idea that we ought to impose health mandates to shape individual behaviour. Instead, Welsh approaches the good health imperative by bracketing “health” to reveal its contingency and bring our attention to our embodied situation, guiding us towards our bodies as constant projects of embodied ambiguities (72). 

As the title suggests, this work is located in critical phenomenology because it grounds analysis in intersections of oppression, since, as Welsh notes, under the good health imperative, “those most vulnerable to their situation [are] most responsible for their work and health” (97). The question for a critical phenomenology is then, “How do we experience the good health imperative?” (20) and from the position of lived experiences within intersectional systems of oppression, this varies widely. Welsh takes on this question directly at the same time as she works to retrieve the larger question of how health is or could be embodied outside of medical, capitalist, neoliberal discourses of responsibility. Drawing on Gadamer, Welsh describes how health and illness are experienced phenomenologically. It is not easy to divorce health from its social and moral imperatives, but Welsh tries to loosen the threads on these imperatives to outline what embodied health is like and what it does. Welsh develops health as a background against which experiences of illness stand out in diverse ways, drawing attention to the variability of meaning making in lived experiences (32). Within this understanding of lived health, what kind of sense does it make to compel behavioral conformity to induce health in populations? Her hypothesis is that the good health imperative is more concerned with creating and maintaining a certain kind of self-relation, rather than an embodied experience of health. 

A valuable focus in the work concerns childhood as a site of coming to understand and care for our bodies. Welsh focuses on childhood because it highlights how the good health imperative is both inappropriate to its object and fails at its outcomes. Specifically, she describes the pre-personal body and motor intentionality as ontologically prior to our personal knowledge of health or cognitive formulations of health norms. Centering childhood development is so fruitful because how children learn their bodies is characteristically non-voluntary and non-rational. Drawing on Merleau-Ponty, Welsh describes children as not having fully learned how to be, and as still “spontaneous” about what certain objects are for (and not for—e.g., handrails are not for licking (58)), which actions are possible, and how to complete them (55-58). This also reveals the constitutive relationality of bodies, since learning our bodies occurs through learning other people’s bodies. She writes, “[t]he demand to eat differently, move in another fashion, or alter how I care for my body can be hard to reconcile with a long history of living in a certain manner” (59). That “certain manner” is precisely cultural. Thus, the good health imperative cannot (re)mandate “spontaneity” in response to “bad” health, which explains the deeply disciplining practices that we are regularly called upon to enact. Rather, its mandate calls on us to non-spontaneously “work against sedimented behavior toward conscious and deliberate new behaviors” (59). 

Shifting her focus to Foucault, Welsh develops the good health imperative as an apparatus of biopolitics, in which varieties of human bodies render the goal of a “well-managed population” an “impossible task” (86). Welsh’s inclusion of biopolitics and personal responsibility complicate this picture even more, specifically by noting how good health is mandated through personal and parental control of children’s bodies (86-97). She argues that the current apparatus of good health has made children’s bodies a corollary to “parental power” (95). Parental action offers another fraught site of trying to act on the body, revealing the pressure to begin curbing human spontaneity in childhood. Social fears around the “childhood obesity epidemic” intensify parental and state responsibility for children’s health and legitimize the belief that we ought to control children, specifically their bodily spontaneity and normalize bodily variation. As such, “[w]hat biopower needs is the capacity for bodies to be carefully distinguished and each fostered in relative comparison to alleviate their disparities and to motivate better performance” (86-87). That is, “[d]iversity is not eliminated; rather it is reorganized as ‘distributions around the norm’” (87), such that we can compare ourselves with others (83). Welsh’s argument is not that normalizing health has as its aim homogeneous healthy bodies, but instead identifying the good health imperative’s function as producing “the right kind of identity in relation to one’s body” (82). Thus, the panic around childhood obesity is about normalizing self-controlling and self-responsible subjects. This downloads the responsibility to normalize health(y self-relations) onto parental responsibility for a good “child product” (96), including a future “healthy” adult, thus highlighting how the good health imperative is inextricable from the functioning of late capitalism, especially in making subjects who self-control and expect to be controlled for the good of their health. Welsh’s consideration of gendering in this context provides a pivotal conceptual shift in the book: the apparatus behind gender normalization like that of the good health imperative relies on a move to curb our past production as cultural objects.             

Welsh also shifts focus to the self-relation behind the good health imperative to discuss feminist approaches to self-regulating bodies. Beauty, like health, is a primary domain of work on the self and as such feminist philosophers work in this area offers tools for critiquing self-regulation, specifically body normalization. The good health imperative claims we can work on ourselves to shift our embodied experiences and in this way mirror compelled female beautification. Welsh is sceptical that we can retrieve embodied spontaneity through (feminist) beautification, drawing on the frustratingly non-rational and non-voluntary nature of learning our bodies in childhood. This exploration converses with feminist phenomenologies of feminine embodiment and compelled self-relations within gender oppression, and involves a close engagement with Cressida Heyes’ work, Self-Transformations (2007). Welsh reads Heyes as saying there is valuable working on the self within normalizing power—for example, in the case of attention to the self in dieting—but argues instead that this is not appropriate because it presupposes a unitary self and because of the frustrations of embodied spontaneities. Welsh is more focused on the gendered nature of the self-relation, explaining how gender oppression compels women to “do the most with what they’ve got” crafting a self-managed self with a specific self-relation, which is harder to resist than any one specific aesthetic or health norm. 

What seems to be at issue throughout the book, and in this discussion of feminine self-regulation, is a theory of freedom within habitually embodied oppressions. A Beauvoirian approach demands freedom outside of and against gender normalization whereas a Foucauldian feminist theory of agency within gender oppression will find the constitution of the subject through normalization as a condition of possibility of freedom itself. In Heyes’s work, dieting is primarily and for the most part restrictive and oppressive, but she argues it affords some possibilities for relief from some aspects of feminine training. However, this comes down to the question of constrained choice versus spontaneity—relating to Welsh’s developed notion of health as one’s capacity to engage with the world in a variety of ways (72). Relatedly, Welsh takes issue with overlapping assumptions connecting the good health imperative and feminist somaesthetics in the sense that they both require a “self-same subject who works on her body” and who would very likely “continue to place health on the front burner,” again refocusing her argument around the fundamental unpredictability of our bodies (134) and the futility of direct access to managing it. Drawing on Arendt and Beauvoir on the collective nature of political and ethical freedom and action, Welsh argues for less attention to one’s individual work on the self as it is never individually owned but is a matter of our “shared ambiguous condition” (168).

In work that is critically oriented toward healthism, the good health imperative, and a more general understanding of individualism, health, and the “good life,” we note for potential readers that the first chapters of this book engage with medical models of health in ways that have implications for Welsh’s language (e.g., 43-44). The considerations of the routine arguments and ways of approaching fat bodies, fat people, and “obesity,” ground the more critically engaged chapters later in the book. We note, however, that this book uses terms like “the obese,” and “obesity”, and “childhood obesity,” as well as phrases like “maintain[ing] a healthy weight” (115), in ways that—in keeping with common, well-criticized medical and popular practice—are not consistently or overtly problematized (though they are far from uncritically adopted). The term “the fat,” in the subheadings of chapter one, “Smokers, drinkers, and the fat” (fat is on par with addictions here, even if in a critical way) arises without noting discussions among fat people about language—“obesity” and cognates are often understood as slurs. Welsh draws on a piece by Donald McKenna Moss (1982) that discusses the experiences of fat patients’ bariatric surgeries that predates and precludes the critical fat studies lens on “obesity” medicine. This work, “Distortion in Human Embodiment: A Study of Surgically Treated Obesity,” does not include an intersectional account of the effects of fat oppression on lived experiences, but uncritically treats this as a contained issue of space/size/health. Given that critical phenomenology is attuned to matters of oppression, this use without engagement of current discussions among fat studies and critical race scholars and activists distorts the root causes of their lived experiences of oppression. This source also predates and precludes contemporary research on health outcomes for bariatric surgery, including psycho-social ones like disordered eating, and increases in self-harm, suicidal ideation, and suicide. Given the emphasis on both lived experience and the use of body size as a recurrent example in the text, a more nuanced and consistent approach towards fat experiences within structures of oppression would be important for an accurate picture of the terrain upon which Welsh is working. 

Welsh’s book includes engaging analyses of first personal experiences in an existential-phenomenal framework, such as meetings with a health coach, parenting dilemmas, and experiences of injury. The ambitious central argument has many dimensions, and readers will find that chapters focused on particular topics can move a bit adjacent to health at times. These moves away and back to health are a matter of method, it seems, moving between critical and constructive work that engages figures in canonical philosophy without close adherence to any particular thinker (e.g., thinking with Merleau-Ponty, Camus, Nietzsche, and Gadamer). Welsh’s careful work makes interesting and new connections while grappling with critical approaches to the existential and experiential dimensions of health and the social structures and meanings that constitute our possibilities for action, sticking with the thorniness of the topic rather than smoothing over its constitutive ambiguities.