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i
Geographies of Health
Series Editors
Allison Williams, Associate Professor, School of Geography and Earth Sciences,
McMaster University, Canada
Susan Elliott, Professor, Department of Geography and Environmental
Management and School of Public Health and Health Systems, University of
Waterloo, Canada
Published:
Non-Representational
Theory & Health
The Health in Life in
Space-Time Revealing
Gavin J. Andrews
iv
This book is dedicated to San and Justin who have provided all
the love and energy to my life in Canada. I often cringe when
I read dedications to family because they so often include the
author’s apologies for being physically and mentally absent from
family life during the production of their product. My typical
thought when I read these being, ‘well I’m sure they would rather
have had you around than endure this involuntary sacrifice and
read your dedication’. Hence, I hope to have produced this book
without San and Justin noticing too much, time-wise as least
(however I do apologize for boring you both with occasional
monologues on onflow, affect, space and time etc.).
vi
vi
Contents
References 158
Index 186
vi
Figures
3.1 Vitality 49
3.2 Virtuality and multiplicity 53
4.1 Affective 63
5.1 Practice and performance 77
5.2 Foregrounds and backgrounds 80
5.3 Senses and sensations 84
5.4 Ordinary and everyday 94
7.1 Speed 113
7.2 Imminence 126
7.3 Encounter 129
7.4 Stillness 136
Tables
1.1 Empirical areas of health geography informed by, or aligned
with, or explicitly NRT 15
1.2 Theoretical debates on health geography and NRT 17
ix
A professional moment…
‘Energy! Energy! Energy!’ is the mantra of a recent paper by Chris Philo and
colleagues (Philo et al., 2015). On one level they were calling for ‘new energy
geographies’; for academic attention to different/non-conventional forms of
energy, and to thinking about energy in new ways (something that, as we shall
see, this book aims to do). On another level, however, with both the lively
delivery of the paper itself and in a few of its final words, the authors also
dangled the idea of energetic conversation, something more-than-subject
matter; that academics and academic objects also create energy. This idea is
certainly interesting and deserving of some attention but, in the current con-
text, it evokes two immediate questions. What gave me the energy to write this
book dedicated to non-representational theory (NRT) and health? What gives
this book, as an object, some energy and energy creating potential?
In terms of the former question, on reflection, I think that there are really
a number of motivating factors, or energizing boosts, behind this book. The
first is my own experience of health, and how I have come to appreciate par-
ticular ways in which it surfaces. I am not an overly spiritual person and nor,
although I study holistic medicine from time to time, am I personally invested
in alternative explanations for health and wellbeing. That said, I have become
increasingly aware that in a world where physical threats loom, economic inse-
curity and social inequalities persist, work life is long, stressful and uncertain,
connections and commitments seem endless, and illness and old age seem
imminent –the basics and the moment matter. What as humans we are doing,
what we sense, what is taking place around us, and whether or not they give
us joy, matters. Indeed, compared to other facets of life, the immediacy of
the human experience seems somewhat malleable, positivity here somewhat
attainable; a place of hope. Such joy is, of course, not always organic and
free-flowing (such as encountering a lovely view whilst out on a walk), and
can be encouraged by design; textures and atmospheres engineered by public
and private interests to entice and engage us (Thrift, 2008). One only has to,
for example, enter a busy restaurant, sports arena, shopping mall, spa or even
x
Acknowledgements
1
New intellectual energies
The emergence and basis of
non-representational theory
We all know the feeling, often vague and in the background yet very famil-
iar. The feeling of not only being present in the moment and participating in
the moment, but experiencing life’s basic movement and energy. The passion
pushing it and us forwards; the surge and the ride. It can be a subtle undercur-
rent, adding momentum to what we are doing, or a powerful force that sweeps
us up and moves us along. It arises through the actions and motions of people
and things, but it seems to have a life of its own; something more than the sum
of its parts. It is basic, physical and not often consciously reflected on, yet it
has a bearing on our immediate sense of wellbeing because being in sync with
it, and working in the same direction as it, can be an energising and joyful
experience. On the other hand being out of sync with it or moving against it
can be difficult, draining and frustrating. It’s an experience that happens to
greater or lesser extents in all areas of, and places in, our lives; in our homes,
workplaces, where we are entertained and spend our leisure time, where we
shop and where we are educated and are cared for. It is an important but aca-
demically neglected part of the world engaged by non-representational theory.
A group of nurses are at their work station for the last hour of their shift; a
geometrically shaped beige island home to computer screens, plastic furniture
and wires bathed in artificial light, all but the smallest of corners observable
through its see-through acrylic barrier. Despite the nurses’ tiredness, many
things happen that make it a busy time for them, shortening the hour. Some
of these things involve a great deal of their conscious thought and action,
particularly regarding the latest institutional infection control strategy which
seems to be the order of the day (e.g. attention to the leaflets given to them,
patients’ families and doctors appearing and asking questions, their shared notes
on the day’s practices). Some of these things do not require much conscious
thought or action on their part (e.g. various internet information that flashes
unread on their computer screen, the sun’s warmth filtered through a window
hitting their faces, bodies moving past in various directions, and background
chitter chatter). Meanwhile some of what happens they do not think about
at all (e.g. their breathing, repetitive typing, subtle movements of their legs
and arms to undertake simple tasks or for comfort). Regardless of their
levels of attention, all of what happens in that hour rolling out constitutes
their working lives. All of it has some energy and movement to it, and all of
it contributes in some way to the whole. It reflects and affects their mood,
2
Non-representational theory arises from the simple (one might say almost
commonplace) observation that we cannot extract a representation of the
world from the world because we are slap bang in the middle of it.
(1999:296)
Thrift’s argument is that traditional social science approaches are not best
placed to engage this faster moving sensory world which is more loosely
and differently stuck together, and that we need a new lens, something more
7
The focus falls on how life takes shape and gains expression in shared
experiences, everyday routines, fleeting encounters, embodied move-
ments, precognitive triggers, practical skills, affective intensities, endur-
ing urges, unexceptional interactions and sensuous dispositions…which
escape from the established academic habit of striving to uncover mean-
ings and values that apparently await our discovery, interpretation, judg-
ment and ultimate representation.
(Lorimer, 2005:84)
Two draws of NRT are clear, the first being about the fundamental nature of
what NRT is as an approach that makes it both academically necessary and
attractive. Indeed, in addition to its critique of traditional forms and para-
digms of geographical scholarship, NRT has arisen through its own set of
fundamental realizations on what it is to be human. Commenting on these,
McCormack (2008) notes that central to NRT are a number of claims: that
humans do not always consciously reflect upon external representations when
they make sense of the world, that thinking does not necessarily involve the
internal manipulation of picturesque images/representations, and that intel-
ligence is a relational process involving a number of actors (human bodies
and non-human objects) as active participants. Thus, as Thrift (2008:7) sug-
gests, ‘non-representational theory is resolutely anti-biographical and pre-
individual. It trades in modes of perception which are not subject-based’.
Evidently then there is an attractive belief basis to NRT, but also add-
ing to its popularity is a high degree of theoretical compatibility between
it and other traditions currently on the rise in human geography –together
they perhaps constituting a broader ontological turn. As Anderson and
Harrison (2010) note, these include a general movement of post-structural-
ist thought towards more ‘lively’ theory (such as Deleuzian); the emergence
of hybrid geographies that explore nature/culture and human/non-human
relations; public geography and its concern for action, intervention and
8
As indicated earlier and in the above quotation, the word ‘theory’ in NRT is
not meant to be read as singular (Lorimer, 2008; Simpson, 2010). NRT does
not signify a single theory, or a clearly mapped amalgamation of theories.
Rather it describes a number of ‘contact zones’ with a range of established
theoretical traditions and positions. In engaging with these zones NRT is
unashamedly selective, adopting a magpie approach of teasing out particu-
lar ideas that serve its purposes the best (Simpson, 2010). The fact that, as
we shall see, some of these zones appear to be non-complementary reflects
the varied positions taken within NRT and its tangled intellectual genealogy.
Moreover, it also reflects the fact that NRT is a quickly evolving intellectual
project with many thought leaders each adding to a theoretical ‘cooking pot’
(who may or may not always agree with one another). It is not the place of
this book to completely disentangle these threads and their complexities –
which has been more than adequately done elsewhere (Thrift, 1999, 2008;
Cadman, 2009; Anderson and Harrison, 2010) –but some examples are given
in the following paragraphs.
As Vannini (2009) suggests, NRT endeavours to draw together ideas from
a variety of social science sub-disciplines and fields (such as material culture
studies, performance studies, ecological anthropology, sensory sociology
and political science’s radical democracy), and at least connect with science
disciplines typically quite remote from geographical thinking (such as neu-
rosciences and molecular physics). Hence, although it is a new geographical
tradition practiced predominantly by geographers, it is clearly quite trans-dis-
ciplinary in terms of its constitution and ideas.
Although NRT reacts strongly to a number of traditional theoretical
orientations and ways of viewing the world (as described in a previous sec-
tion) scholars do look back and acknowledge a debt to certain arguments in
them that they regard as foundational. So for example, although much of
humanism’s emphasis on the richness and primacy of human narrative does
not sit well with the NRT’s relational materialism –even to the extent, as
Duff (2014a) suggests, that some scholars of NRT think of humanism as
promoting ‘cultural fiction’ –valuable points of its departure for NRT are
noted. As Lorimer (2005) observes, Tuan (2004) stresses how belonging is
formulated by direct physical experience and immediacy in place (i.e. through
how place is repeatedly heard, smelled and touched as an intimate world),
and how belonging is re-evoked by recollections of this immediacy. Similarly,
although social constructionism is heavily critiqued by NRT in the ways
described earlier, scholars acknowledge how both traditions share the same
recognition that orders and symbolic orders in life are arbitrary and invented
(rather than ‘natural’), and can be contested. Moreover, they acknowledge
that, although they have very different contact points, both NRT and social
10
Yet it is not in secular music only that the Scots excel. They have
also a rich treasury of devotion and praise, though for centuries the