AIDS, Communication, and Empowerment

Gay Male Identity and the Politics of Public Health Messages

Roger Myrick

• Publisher: Routledge
• Year: 2016
• ISBN:
  9781135904333
• Edition: 1
• Topic: Medicina
• Subtopic: Malattie e allergie

AIDS, Communication, and Empowerment examines the cultural construction of gay men in light of discourse used in the media's messages about HIV/AIDS--messages often represented as educational, scientific, and informational but which are, in fact, politically charged. The book offers a compelling and substantive look at the social consequences of communication about HIV/AIDS and the reasons for the successes and failures of contemporary health communication. This analysis is important because it provides a reading of health communication from a marginal perspective, one that has often been kept silent in mainstream academic research. AIDS, Communication, and Empowerment offers a critical, historical analysis of public health communication about HIV/AIDS; the ways this communication makes sense historically and culturally; and the implications such messages have for the marginal group which has been most stigmatized as a consequence of these messages. It covers such topics as:

• the relationship among gay identity, language, and power
• cultural studies of the historical development of gay identity
• studies in health communication about HIV/AIDS and health risk communication
• the political consequences of public health education about HIV/AIDS on gay men
• the political consequences of media representations of gay identity and its relationship to disease Based primarily on the French scholar Michel Foucault's critical, historical analysis of discourse and sexuality, this book takes a timely and original approach which differs from traditional, quantitative communication studies. It examines the relationship between language and culture using a qualitative, cultural studies approach which places medicalization theories in the broader context of histories of sexuality, the discursive development of contemporary gay identity, and recent public health communication.Author Roger Myrick explains how mainstream communication about HIV/AIDS relentlessly stigmatizes and further marginalizes gay identity. He describes how national health education stigmatizes groups by associating them with images of disease and "otherness." Even communication which originates from marginal groups, particularly those relying on federal funds, often participates in linking gay identities with disease. According to Myrick, government funding, while often necessary for the continuation of community-based health campaigns, poses obvious and direct restrictions on effective marginal education. AIDS, Communication, and Empowerment allows for a rethinking of ways marginal groups can take control of their own education on public health issues. As HIV/AIDS cases continue to rise dramatically among marginalized and disenfranchised groups, analysis of health communication directed toward them becomes crucial to their survival. This book provides valuable insights and information for scholars, professionals, readers interested in the relationship among language, power and marginal identity, and for classes in gay and lesbian studies, health communication, or political communication.

Chapter 1

The Construction of the Homosexual as Subject According to Michel Foucault

Michel Foucault’s critical discussion of the history of sexuality and discourse has a direct bearing and focus on the way contemporary gay identity is constructed through institutional communication, in this case communication regarding health messages about AIDS and HIV. Foucault argues that communication about sexuality that presents itself as objective, educative, and/or informational–and therefore apolitical–often constitutes discourse that presents politically charged issues as value-free truths.

Foucault argues that institutional communication creates and reinforces power relationships that define cultural identity. He develops this point by examining nineteenth-century medical discourse, which labeled nonprocreative sexuality, especially homosexuality, as deviant. Foucault’s analysis offers a broad theoretical base for understanding sexuality and identity as a social construction, a move that remains crucial for understanding the politics of recent public health communication about sexuality.

FOUCA ULT’S PROJECT

In order to get a clearer sense of Foucault’s relevance for an analysis of AIDS messages and gay identity, the following discussion will lay out his general approaches of archaeology and genealogy as they appear in two of his central works. Fundamental to Foucault’s project, and the subsequent analysis of AIDS messages, is his complex understanding of a world and culture that come to exist largely through language and power.

In Archaeology of Knowledge (1969/1972), Foucault establishes his understanding of the epistemology and ontology of communication by examining the relationship of language to what is taken to be knowledge and truth. By analyzing historical discourse from the time of the Enlightenment (which coincided with the rise of certain institutions, such as asylums), Foucault discerns that language enables certain power relationships and thus speaks certain institutional realities into existence. (See also Foucault, 1961, 1973, 1966/1973, 1975/1979.) In other words, it is through discourse that institutional power comes to assert itself and, thereby, to constitute its existence. This construction of “reality,” the knowable, the truth, comes about through the existence of certain discursive practices, in a process through and by which subjects and objects become visible-knowable, which linguistically, through the use of lexical (metaphoric) and grammatical tropes (structural and thematic movements in language), produces possibilities for a culture. Not only does language constitute what can be known as reality for its users, but language constitutes what can be considered speaking subjects. Language for Foucault (and he draws heavily on Nietzsche’s sense of language here) speaks and creates the world and its inhabitants by empowering certain people, ideas, and relationships as such. The ultimate consequence of this linguistic activity is to define, or fix, what can be taken for knowledge.

To examine the way language works, Foucault focuses the History of Sexuality: An Introduction (1976/1990) on an analysis of the power relationships in discursive practices that constitute sexuality and construct the self after the eighteenth century, and his analysis offers a general, theoretical, foundational context for understanding the contemporary, culturally constructed identity of gay men in the wake of the AIDS crisis. Foucault remains important here despite/because of the fact that he never wrote about AIDS, though he died of the disease in 1984.

In “The Repressive Hypothesis” (1976/1990), Foucault examines the notion that contemporaries are living in a post-Victorian, repression-free episteme, or cultural moment. His conclusion is that the proliferation of talk about sexuality in the twentieth century, exemplified later in this discussion as educative talk about AIDS, discursively works to define the self, both gay and nongay, in a position that maintains certain power relationships.

Foucault (1976/1990) begins by claiming that, with the Victorians (and this is not necessarily a starting point as much as a genealogical association), sex is transformed into discourse with the increase in the practice and manifestation of confession:

Discourse, therefore, had to trace the meeting line of the body and the soul, following all its meanderings: beneath the surface of the sins, it would lay bare the unbroken nervure of the flesh. Under the authority of a language that had been carefully expurgated so that it was no longer directly named, sex was taken charge of, tracked down as it were, by a discourse that aimed to allow it no obscurity, no respite. (Foucault, 1976/1990, p. 20)

And the consequence?

An imperative was established: not only will you confess to acts contravening the law, but you will seek to transform your desire, your every desire, into discourse. Insofar as possible, nothing was meant to elude this dictum, even if the words it employed had to be carefully neutralized. The Christian pastoral prescribed as a fundamental duty the task of passing everything having to do with sex through the endless mill of speech. The forbidding of certain words, the decency of expressions, all the censoring of vocabulary might well have been only secondary devices compared to that great subjugation: ways of rendering it morally acceptable and technically useful. (Foucault, 1976/1990, p. 21)

Sexuality, and the self as constructed by sexuality, finally becomes something to be managed through discourse, and Foucault argues that it is a proliferation of talk about sexuality, not the repression of it, that allows for the association among control, pleasure/sexuality, and the construction of the self. So one of Foucault’s crucial tenets is this notion that increasing institutional discourse and communication about sex in the nineteenth century allows for a situation and experience in which people become identified as a coherent, knowing self through particular kinds of talk about sex.

According to Foucault, this has direct relevance for contemporary gay identity because, prior to the nineteenth century, same sex desire was seen as an activity, not necessarily as something that defined who one was. However, in the nineteenth century people became encouraged to talk about their sexual activities as though they revealed truths and knowledge about themselves. The person who experiences same sex desire, or who engages in same sex encounters, undergoes categorization, systematization by a discourse that increasingly constitutes a self as always and only homosexual: “the sodomite had been a temporary aberration; the homosexual was now a species … nothing that went into his total composition was unaffected by his sexuality. It was everywhere present in him; at the root of all his actions because it was their insidious and indefinitely active principle; written immodestly on his face and body because it was a secret that always gave itself away. It was consubstantial with him, less as a habitual sin than as a singular nature” (Foucault, 1976/1990, p. 43).

Foucault argues that the above situation is made possible and observable because of the increasing medicalization of talk about sexuality, a discursive situation that clearly recurs and continues in the 1980s with associations between sexuality and disease. The medical discourse, and other kinds of discursive controls,

function as mechanisms with a double impetus: pleasure and power. The pleasure that comes of exercising a power that questions, monitors, watches, spies, searches out, palpitates, brings to light; and on the other hand, the pleasure that kindles at having to evade this power, flee from it, fool it, or travesty it … these attractions, these evasions, these circular incitements have traced around bodies and sexes, not boundaries not to be crossed, but perpetual spirals of power and pleasure. (Foucault, 1976/1990, p. 45)

The construction of the homosexual in the nineteenth century then emerges not as the product of a linear power relationship between heterosexual oppressors and homosexual victims. Rather the homosexual actually enjoys the pleasure of identity through multiple experiences and moments of surveillance.

Ultimately, sexuality comes to be associated with the body and what one does with it in order to experience pleasure; as such, the body emerges as the central site for surveillance (Foucault, 1976/1990, p. 47). And the relevance here for the homosexual is that

the implantation [or encroachment of a type of power on bodies and their pleasures] of perversions [which homosexuality is named in one way or another] is an instrument-effect: it is through the isolation, intensification, and consolidation of peripheral sexualities [including homosexuality, such as occurred in the early, and even recent, days of AIDS when it was always and only linked with gay men] that the relations of power to sex and pleasure branched out and multiplied, measured the body, and penetrated modes of conduct. (Foucault, 1976/1990, p. 48)

The homosexual, as a speaking subject, ultimately emerges as a way for power to be extended to and implanted within the body. Contemporary sexual identity, then, can be seen as the institutional need for power to become inextricably tied up with and to the body. And in order for the body to be a part of institutional “spirals of power,” and thus enjoy pleasure, it must be made visible, representable, and subject to discourse.

Thus, the homosexual voice and body, and the proliferation of medical, psychological, and familial discourse that speaks the homosexual into existence, is not about silence, but rather about endless and relentless communication and representation. Here it is important to reemphasize that Foucault’s objective is to analyze a certain form of knowledge about sex in terms of power. He is not looking at the relationship of sex to power in terms of laws or prohibitions, but in terms of techniques, norms, and truth (Foucault, 1976/1990, p. 90). So it is not a question of what can/cannot be said, but which techniques of sexuality constitute power, and this is why his analysis is particularly useful for an analysis of gay men, representation, and AIDS; gay men have not simply been silenced, they have been talked to death.

In the History of Sexuality, Foucault charts historical changes in discourse about sexuality, ethics, and the self in order to understand the contemporary constructions of sexuality and the self that are, and have been, played out during the AIDS pandemic.

The above discussion reveals much about Foucault’s main concepts. Ultimately, it is through discursive practices that subjects, objects, institutions, and knowledge come to exist; language creates what can be considered as possible. By analyzing discursive formations and linguistic practices, power relationships can be identified that are maintained through such discourse. Discursive practices have the power not only to police desire, but to constitute what that desire can be in order to maintain existing power relations.

Foucault’s analysis foregrounds the cultural construction of gay identity, thus resisting and deconstructing normalizing theories of biology. This, in turn, allows for a political analysis of gay identity, or an analysis that examines the way spirals of power work to institutionally constitute what is possible, real. Furthermore, Foucault’s emphasis on the body as the most recent site of the infliction/implantation of institutional power is of great importance for the following discussion. With his focus on the body, and discourse that inscribes the body, he allows for the analysis of the way language works to represent, make visible, and police gay bodies, desires, and voices. In fact, representation and visibility are two of the ways in which the culture has been able to use language to associate AIDS with gays. And given the physical ravages AIDS has wreaked on gay communities, issues of representation and the body remain inescapable. Finally and most important, Foucault’s analysis of the complex ways institutional power works opens the most important space for gays. With his analysis of spirals of power that go beyond linear maneuvers, Foucault offers an explanation of identity that can be used by the marginal for their own survival. And this seems to be a strategy gays used in the 1980s to invent new possibilities for experiences and relationships that allowed them to emerge as a powerful political group in the 1990s.

NIETZSCHE AND THE ASSUMPTIONS AT WORK IN FOUCAULT’S PHILOSOPHICAL PROJECT

Foucault’s most solid foundation, according to any source on the subject, is Nietzsche. Foucault is indebted to Nietzsche for both the subject of his study and the approach he used to study that subject. Mahon (1992) explains that Foucault shared Nietzsche’s three main philosophical concerns: truth, power, and the subject. According to James Miller (1993), Foucault’s U.S. biographer, Foucault’s entire life, both personal and professional, was spent trying to fulfill his sense of a Nietzschean quest, to determine who he was and why he suffered because of who he was. And, while both Nietzsche and Foucault share what is conventionally understood as a nihilistic position with reference to “reality” and the subject, Foucault, according to Miller (1993), was completely caught up in new ways to invent the subject once the current culture was finally deconstructed, which his analysis calls for.

The notion of the opacity of language that Foucault relies on is also one that originates with Nietzsche. His understanding of language is clearly explicated by Tracy Strong (1984) in “Language and Nihilism.” According to Strong, Nietzsche sees language not as the container of some hidden meaning, but as always and only constituting and maintaining the possible, the knowable. Nietzsche (1886/1981) views language (as it has developed in and constituted Western civilization) as speaking, entrapping, and creating subjects because of its figurative capabilities. Language, through the use of metaphors and other tropes, is constantly able to speak the figurative as that which is scientific. Discourse that makes use of institutional metaphors and empowers institutional subjects, and defines all in terms of institutional control, is thus able to create what seems to be a scientific and, therefore, natural/uncontestable “reality,” a recurring theme in all of Foucault’s work.

For Nietzsche, according to Strong (1984), language ultimately creates this uncontestable reality through the fetishization of the subject. This is accomplished through certain epistemological assumptions in which Western language participates. First, language assumes the sovereignty of the subject as an active agent that exists outside of discourse. This sovereign subject is linguistically invested with free will and the autonomous power to act on his/her best behalf, which is usually the quest for absolute knowledge/truth. Second, language, as it has developed in the West, speaks in terms of cause/effect relationships, and these relationships have been invested, culturally/linguistically, with great import: they explain, predict, and control (the traditional social scientific credo) and thus constitute “true” knowledge. As a result of these two epistemological assumptions, language remains capable of treating the subject as a natural, real entity that has control over language and its own destiny. Strong (1984) claims that Nietzsche saw language as inescapable unless people understand that they are products of and trapped by language, which seems impossible, since to speak of such entrapment would be to remain within the power and control of language (an example of Nietzschean nihilism). Nietzsche’s analysis remains a striking example of the way language fetishizes the metaphoric, which becomes central to Foucault’s understanding of the way power and language work to construct knowledge and identity.

Deleuze (1986/1988) claims that the real strength of Foucault is that he resists being fixed and locked into one philosophical category, such as Marxism, structuralism, or post-structuralism. Deleuze asserts that what are interesting and recurrent about Foucault are the “foldings in thought”: the moments of subjectivization in Foucault in which subjectivity is simultaneously identified and deconstructed. Deleuze also responds to those critics of Foucault who claim that his analysis of power is too totalizing to offer any hope; Deleuze points out that Foucault’s solution avoids humanistic liberation, but also encourages an informed opposition to the ordinary.

Foucault is a nihilist in one sense–he views the power of discourse as inescapable. But he does not stop there. He also calls for new ways to invent the self, (as Miller [1993] points out) and while he avoided saying what this might look like while he was alive, at least in academic circles, he may have discovered possibilities, according to Miller (1993), in his experiences with the eroticization of the body through sadomasochism and the new relational positions this offered.

Hunt (1992) claims that Foucault’s focus on the body as the most recent site of the implantation of institutional power is his most important contribution to the study of the history of sexuality: “by focusing on bodies, Foucault offered perspectives that help disengage us from a dreary, repetitive, totalizing history of patriarchy and misogyny” (p. 82). This emphasis on the body, sexuality, and power would seem to make Foucault a logical theorist to use in order to understand contemporary messages about AIDS. However, Butler (1992) claims that Foucault’s emphasis on power as productive denies death in a postmodern, technological, post-plague world, and his analysis, therefore, cannot account for AIDS. But according to Miller (1993), one of Foucault’s central driving forces in his personal as well as professional life was to achieve an erotic union of life and death; to this end, he found creative pleasure in sadomasochistic experiences in San Francisco. Such an ability to create sexual experiences that resist and/or make ironic institutional life certainly seems to run counter to Butler’s understanding of Foucauldian analysis as humanistically life-affirming and death-denying. Foucault’s analysis of sadomasochism will be discussed in more depth later in relation to his reading of contemporary gay political movements.

To enact his focus on the body, self, power, knowledge, and discourse, and his rejection of the Enlightenment, Foucault used methodological/theoretical approaches of archaeology and genealogy, and at different times in his life and in different works these approaches received varying degrees of emphasis. Dreyfus and Rabinow (1982) offer the clearest description of these two terms:

It is necessary, Foucault seems to be arguing, to look at the specific discursive formation, its history, and its place in the larger context of power in order to be able to evaluate its claim to describe reality. Whether we are analyzing propositions in physics or phrenology, we substitute for their apparent internal intelligibility a different intelligibility, namely their place within the discursive formation. This is the task of archaeology. But since archaeology has bracketed truth and meaning it can tell us nothing more. Archaeology is always a technique that can free us from a residual belief in our direct access to objects; in each case the “tyranny of the referent” has to be overcome. When we add genealogy, however, a third level of intelligibility and differentiation is introduced. After archaeology does its job, the genealogist can ask about the historical and political roles that these sciences play. If it is established that a particular discursive formation has not succeeded in crossing the threshold of epistemologization, then archaeology has freed us to shift to the question of what role this pseudoscience, this doubtful science, plays in the larger context. (Dreyfus and Rabinow, 1982, p. 117)

To reduce the above, archaeology enables the analysis of how language works to constitute subject...