The Stigma of Language: a Review of Eleana Vaja’s “Epilepsy Metaphors.”

Works Reviewed. Eleana Vaja. Epilepsy Metaphors. Liminal Spaces of Individuation. 

There is an image, taken from the life of John Hughlings Jackson, that has somehow impressed itself upon my mind as an emblem of the modern era. Hughlings Jackson, the father of modern neurology, would buy a book from the bookshop, tear it in half, and put one half in his right coat pocket and the other in the left. As he read, each leaf would be discarded, and thus he would while away a journey on the train. (Critchley, Macdonald MD “Hughlings Jackson; the man and the early days of the National Hospital. Proceedings of the Royal Medical Society.)

It is difficult to pin down exactly why I find this image so captivating; is it a parable of the instrumentalization of reason? A preview of what the French philosopher Jacques Derrida saw as the “end of the book and the beginning of writing?” Or is there something more – can we see in Hughlings Jackson some sort of neurological messiah who had come to tear apart the bindings of a culture that valued the dogma of books over the dynamics of the brain?

If so, then he is a strange and secular messiah, but perhaps the one needed to begin the work of tearing apart the shrines that at once sacralize and stigmatize, and to inaugurate the process of a more rigorous, more dynamic understanding of neurological stability. And yet, like any messiah, he does not emerge out of the mists of time. There is always a history, and the desacralization of neurological phenomenon can be traced back at least as far as On the Sacred Disease, a work belonging to the Hippocratic Corpus, though of questionable authorship.

We find ourselves, then, still at the crossroads between humans and the metaphors and images which define them, in need of a richer understanding of the relationship between books and the individuals whose lives intersect with those words, with these metaphors. Eleana Vaja’s Epilepsy Metaphors: Liminal Spaces of Individuation in American Literature 1990-2015 contributes to that conversation through the precise literary lens of contemporary American fiction.

“(E)pilepsy,” Vaja tells us, “is intrinsically connected to our understanding of life,” and the documentation supporting this hypothesis stretches from the Egyptian Hieroglyphs in 4000 B.C. through the Code of Hammurabi to the The Sacred Disease, and into our own times. The quantity of evidence supporting the theme of epilepsy as an important area of reflection for human mental life is significant, and has, perhaps, begun to undergo something of a renaissance with the increasing cultural importance that neuroscience and related fields have begun to occupy over the last few decades. Among the first of Vaja’s footnotes is Umair J. Chaudhary’s essay “A Dialogue with Historical Concepts of Epilepsy from the Babylonians to Hughlings Jackson: Persistent Beliefs.” One of the claims this reference supports, even in its title, is that epilepsy has been a persistent question or object of reflection across cultures. It is also suggestive of the dominant modes of interpreting or explaining epilepsy. Vaja articulates these modes as biology and medicine on the one hand, and religion and metaphysics on the other. The brain and the book, in a sense, are the two main corpuses to which those who would explain the phenomenon of epilepsy appeal.

Vaja’s interest, however, is not so much a systematic categorization, or a taxonomy of epilepsy in either the medical or religious register, but a look at how metaphors structure our understanding and experience of the phenomena of epilepsy. Epilepsy metaphors throughout history, she finds, have contributed to a stigmatization. Novel trends in American literature between 1990 and 2015, contends Vaja, have tackled that stigmatization in three key, overlapping, areas – those of society, the body, and language.

The primary lens through which she will address epilepsy is therefore the metaphorical language of literature. How does literature participate in the tendency to perpetuate stereotypes about individuals with epilepsy, and how, conversely does and might literature work out the process of individuation through the liminal spaces named and occupied by epilepsy? Vaja is interested, particularly, in the trope of metaphor, and in how that trope is used in understandings and prejudices surrounding epilepsy.

The timeframe for the literary works she looks at is justified in the surge in interest in brain disorders and diseases in the 1990s, but also by the fact that the “American with Disabilities Act of 1990” secured some economic and social equality for people with disabilities. This act occurred at the same time as the American president of the time, George W. Bush, was declaring 90s the “Decade of the Brain,” and using language to define “disorders” as enemies to be conquered. One need hardly mention the echoes of this combative attitude which the past decade has witnessed.

In effect what was emerging was a consciousness of different ways of being in the world. Ways of being which resisted the highly-militarized us-them paradigm in favour of voices articulating the “multiplicity of bodily and mental varieties.” The literary both reflects, and plays an active role in the changing landscape of understandings around epilepsy.

Vaja contends that the particular subsection of literature to which she attends – American literature between 1990-2015 sees the emergence of “novel approaches to epilepsy metaphors” which promise a “shift away from this fetishazation of ability and the normal.” (14) Through the works of Lauren Slater, Audrey Niffenegger, Dennis Mahagin, Thom Jones, Rodman Philbrick, Reif Larsen and, especially, Siri Hustvedt, Vaja works to define epilepsy as a process of individuation. Several concepts emerge as significant in the process, perhaps chief among them that of metastability. Epilepsy as metastability is the kind of conceptual metaphor that Vaja sees emerging in the literature she has selected.

Epilepsy Metaphors is divided into three main sections. In “The Folklore of Epilepsy,” she traces the historical stigmatization of epilepsy through five motifs; sleep, falling, danger, intelligence, and religiousness. These motifs “define the stigmata of epilepsy by disguising the ephemeral character of scientific truth and, likewise, religious belief.” (21) These motifs also allow Vaja to establish a particular lineage of how the stigmatization of epilepsy functions, moving from the level of an “affective” correlation through linguistic discrimination, socio-cultural implementation of that discrimination, and the rational and spiritual codification of the stigma.

Noting that, whereas psychoanalysis historically focused on hysteria, epilepsy has been the domain of neuroscience. The rise of interest in epilepsy, she writes, “parallels the rise of neuroscience in social popularity.” (40) Historical motifs of epilepsy are, therefore, refracted through a fragmented scientific discourse. To my mind the image of Hughlings Jackson, discarding pages left and right, arises again at this point. Vaja’s work, in a sense, is to regather the scattered pages, but to do so with an eye towards the liminal and towards the process of individuation. Canvassing the American literary corpus, from Thomas Pynchon to Michael Crichton to Lauren Slater, Vaja uncovers a codependent relationship between literature and medicine. The question this poses for representation, says Vaja, is one of breaking this cycle and initiating new metaphors – metaphors capable of sustaining the kind of liminal spaces required for individuation.

Vaja then pivots to disability studies, outlining the emergence, within medical and literary cultures, of an emergent discourse of individuation which challenges the binaries of healthy/sick, able/disable and normal/abnormal through its metaphorical representation of liminal spaces. Metaphors also have the capacity to represent liminal spaces, and therefore to capture a sense of singular existence.

The second part of the book “Liminal Spaces of Individuation,” moves us into the territory of theory, as Vaja seeks to account for the “innovative power of epilepsy metaphors. Through the work of Jurgen Link and Michel Foucault she grapples with the question of ‘who is normal?’ Society is in the background, and Vaja distinguishes between two types or usages of metaphor – protometaphors and flexmetaphors – which respectively reinforce rigid stereotypes or allow for flexibility and ambiguity.

She moves from there to the work of Georges Canguilhem, wherein the focus shifts from social relationship to an understanding of normativity that is understood as the self-regulating process of a singular organism. “For Canguilhem,” she writes, “each living organism has its own norm and acquires norms throughout life though aging, diseases, accidents, social relations, geographical position and psychosomatic effects.” (83) The question, for Canguilhelm is not who can be said to be normal in terms of their relation to a social average, but rather “what is the normal?” In posing this question Canguilhelm abandons an overall notion of health in favour of a radically individual approach focussed on bodily experience.

The third and final part of this section turns to the area of language and the work of Gilbert Simondon. From Simondon she develops the notion of conceptual metaphors, particularly the metaphor EPILEPSY IS METASTABILITY (all caps in the original). The notion of conceptual metaphors was , for me, one of the most intriguing themes explored in the book. It is through conceptual metaphors, Vaja argues, that we either reinforce or challenge stigmatization at the level of language. “Conceptual metaphors structure daily (normal) language and serve as powerful tools for exposing and reingorcing rigid belief systems as well as for challenging them.” (111)

Having laid the theoretical groundwork, the next step is to jump into the epileptic text itself, beginning with a reading of Lauren Slater’s Lying. As a reviewer I will have to say that I was not familiar with all of the works Vaja covered, and in addition to the critical tools she has provided have to thank her for introducing me to a wide body of literature. She deploys her conceptual work through this corpus with grace and vigor – I particularly enjoyed her work on Hustvedt’s poetics as displaying and manifesting metastability through her use of conceptual metaphor and the invitation to understand life through shared experiences of “fragility, vulnerability, and endurance.” (238)

Perhaps, in the end, there is more to learn from the epileptic and the author than from the neurologist who tears at the bindings of book and brain. We share a common humanity that, as part of its singular beauty, is manifested in the process of individuation and constant redefinition. Torn pages, perhaps inscribed with stigmatizing metaphors, may be deployed differently. Eleana Vaja has done a tremendous work in drawing attention to the relational and bodily aspects of metaphor and the use of literature in the process of individuation and de-stigmatization.