Ilsia Vinalay-Carrillo,1 María de los Ángeles Torres-Lagunes,2 Elsy Guadalupe Vega-Morales3
1Facultad de Enfermería, Universidad Veracruzana, Minatitlán, Veracruz; 2División de Estudios de Posgrado en Enfermería, Unidad de Posgrado, Universidad Nacional Autónoma de México, Distrito Federal; 3Coordinación de Guías de Práctica Clínica, Hospital General “Agustín O`Horán”, Secretaría de Salud, Mérida, Yucatán. México
Correspondence: María de los Ángeles Torres-Lagunes
Keywords: Human body; Medical antropology; Medical sociology
Talking about the body makes us think of a space, a being, an entity that feels and expresses itself. Nursing as a generator of care maintains close contact with the body that takes care of itself, that needs to be cared for as a being, and that expresses itself with body language, gestures, movements, and expressions with which the word is not necessary to express its feelings, its pain, and its needs. The nurse needs her senses to understand what the patient's body needs. The theme of the body as a classification system has been central to Mary Douglas’s anthropological vision, in which the primary means of classification has historically been the human body itself. The idea of the body as a central metaphor of political and social order is a general theme in sociology and history. Anthropology mentions that in premodern societies the body is an important area on which marks of social status, family status, tribal affiliation, age, sex, and religious condition can be easily and publicly exposed. The use of symbolism of the body can also be associated with the fact that in premodern societies the differences attributed to condition and nature were more rigid and obvious. In certain theoretical and philosophical traditions, the importance of human incarnation has been forgotten; in other traditions of social theory, the human body was submerged as a powerful and somehow disguised subject.
... at this point, Douglas’s anthropology is not only about "them" but also about "us", it opens the door to the explanation of a multitude of phenomena in contemporary society
Various studies define the body as something objective, concrete, which can be measured with precise boundaries; however, the "body schema" is the idea we have of it, i.e., something subjective and subject to change. Corporeality constitutes an instrument of expression of our own personality; it allows us to have contact with the outside.1 Our bodies not only allow us to experience the world, but through them we come to be seen in it. Sometimes we are aware of our bodies as objects to be seen in specific social spaces, while in others, like at home, our bodies are contemplated.
Based on structural linguistics and the cybernetic theory of interaction (feedback), Birdwhistell proposes a new theoretical approach to body "micro-movements". This cultural and communicational study of body movements is called kinesis. Spoken language can be broken down into sounds, words, or sentences; in kinesia there are units called kine (barely perceptible movements), and larger and more significant movements called kinemas. The body has fifty to sixty kinemas, and 33% are concentrated in the face.1
When we introduce ourselves through verbal cues, the so-called body gloss influences individuals’ perceptions and reactions generally and each particularly. Therefore, when in contact with the nurse, the body emits expressions and signals as a symbol of the care needs required. Consequently, nurses use their senses in order to identify those needs and generate the care process. The body is the first mediator sign in the social relationship, as it is that with which we present ourselves. The body speaks for itself and the word goes mute. And it has become part of a project on which we must work. This project links the person’s self with identity. Care for the body refers not only to health, but to feeling good, our happiness, and personal fulfillment, which are subject to the way our bodies adjust to contemporary standards. Feathertone distinguishes two types of demands on the body: the inner body must work well (when it is healthy and fit), and the appearance (outer body) must be maintained. Feeling good is not enough, rather the projection that others have of oneself.
During the care process, the nurse sees the person’s emotional and physical needs, what exists in their environment, and how this affects their recovery. On this basis they formulate strategies that favor the individual, without forgetting family involvement, which affects their health.
In the new culture, the body is a sign that links, separates, and hides the forms and conditions in which each individual is assigned to and belongs to a social class, an age, a sex, a profession, an activity, a certain context, and a space.
Previously, thinking about the body referred to biomedical knowledge: viscera, functions, and physiological and biochemical processes were the first references when thinking about the body, which was considered an object when looked at this way. And when the nurse sees the person as an object and not as a subject the care process is interrupted, and they become just the healthcare provider that meets the needs that present themselves; however, they do not perceive what is behind that body: an individual who feels and who can agree or disagree with the care that is provided.
Since the seventies, several disciplines have agreed that talking about the body involves going beyond its physical referents, i.e., the body naturally underlies its social construction. This has allowed the consolidation of the body as an object of study pertaining to the social sciences. Since the eighties, various studies have been devoted to showing that the body, its meaning, and its representation change throughout history, and that these are different according to people’s different allegiances.
For methodological study the body has two levels: the order of interaction and the order of disposition; the first relates to the sociological part, to the simultaneous presence of two or more people: the body always says something, that is, it is a source of information and at the same time a vehicle of emotional displays, and dispositions are the inclinations and tendencies that are perceived: to feel, to do, and to think in a certain way. The phenomenological point of view on the body has been central in sociology, to the extent that it underscores how even though the body has physiological characteristics, it is never just a physical object; so, it is not just a passive object, but an agent, as it interprets the world and establishes courses of action.2 In this sense, the heart, lungs, or brain are not mere physical units, but even more, they are units that execute a function. So, the eyes serve to see and the hands to grab or touch something.
The body is not something one has, but something one is. For Pierre Bourdieu, social existence always happens in a relational sense with the social space in which people have developed, and the subject is conditioned by the experiences of the whole group and all its traditions, but also by its own experiences.3
... The conception of the person from phenomenology invites us to stake our very existence as a person in the world because, unlike the classical dualisms, it says that each person’s being is not comparable to the being of a thing, an animal, or a spirit. A person’s being is an original reality; their being is human in all its integrity.4
At present, the body is subject to social forces of a different nature in traditional communities. Contemporary discourses of health and image link the body to identity to promote body care practices typical of contemporary society. The other theoretical part of modernity that focuses on the body is fragmented to provide knowledge related to science and technology.
Existing research on the body as lived experience shows that the lived and not the theoretical are perceptions that depend on self-knowledge of the potentialities of the human condition. The nurse’s own body is attributed the meaning of being an instrument of care, which is offered because there is a body: the body that dominates care. Everything in the body comes into action at the moment the care process happens, because the nurse presents and perceives the individual’s physical and psychodynamic changes. The body itself as an instrument of care transcends while performing a procedure or technique. This presence of care has a spiritual meaning by remaining available to interrelate with others and touch others.5
The body as corporeality involves entering the universe of the being that perceives the space of the body in its various perspectives. Part of the human being, felt and feeling, touches and can be touched in the process of coexistence of the human dimension, since it is not something objective and finished; corporeality is the existence of man himself and his history.6
The nurse and the client in corporeality intertwine in the action of sharing knowledge and expressing their values and feelings.7 The body as lived experience facilitates the coexistence of rationality because it allows the caregiver’s body to stop being one and transforms into us at the time of providing care by establishing a relationship of intercorporeality in which the cared-for body becomes subject of the care process.8 When nurses face a real and natural body, they are aware of care with sensibility and aesthetics, so based on this consciousness, the coexistence of aesthetic and technical care happens, where knowledge meets care with the emotions and conscience of the body’s feeling.9
The body is a whole; it is the object that is transformed during the process of care as a subject, who speaks through expressions and signals, says that it needs to be attended to and heard; the subject is the one who asks the nurse for care so that they will let them highlight their needs, generating a relationship that favors their recovery. Where both bodies (cared-for/caregiver) develop their own codes of communication, the nurse should use their senses to carry out this process of interaction; the eyes let them discover changes that happen to the individual, like a gesture of pain; smell lets one recognize odors that reveal some disorder; the hands will comfort the person being cared for, but also entrench the relationship; the ears may also perceive strange sounds that are the sign of a disorder; each of the expressions that the cared-for body manifests will be significant for nurses to consider in the care plan they will give, without forgetting that family involvement is important, as well as the surrounding environment. Therefore, the nursing staff has a strong commitment to provide care to a body that feels, listens, speaks, that needs to be understood and respected as a subject and not an object.