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Health:
DOI: 10.1177/13634593030070028732003; 7; 161Health (London)
John Coveney and Robin BuntonPractice
In Pursuit of the Study of Pleasure: Implications for Health Research and
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In pursuit of the study of
pleasure:implications forhealth research andpractice
John Coveney & R obin B untonFli nders University,A ustralia & University of Teesside, UK
A B S T R A C T Many public health interventions attempt to promote health
and well-being while simultaneously engaging with or negating pleasure-
seeking activities. Yet the examination of pleasure is under-researched,
especially within health and health-related areas. We examine pleasure as
both an innate drive and a socially constructed phenomenon. U sing the
development o f religious ideas in western cultures, we ident ify fo ur forms of
pleasure: carnal pleasure, disciplined pleasure, ascetic pleasure and ecstatic
pleasure. These pleasures dramatically affect the construction of social and
cultural identities. Moreover, they influence approaches to our understand-
ings of health in general and interventions to public health in part icular. The
pursuit of the study of pleasure opens up a number of worthwhile areas for
cross-disciplinary discussion and study.
K E Y W O R D S body; health pr omotion; history; pleasure; public health;r eligion
A D D R E S S John C oveney, The D epartment of P ublic H ealth, Flinders
U niversity, B ox 2100, Adela ide, 5001, Austra lia . [Tel: + 61 (0)8 8204 5862; fax:
+ 61 (0)8 8204 5693; e-ma il: john.co veney@fl inders.edu.a u]
In his popular book The pursuit of pleasure , Lionel Tiger (1992) asks whywe are so apprehensive about pleasures, especia lly those of the body. What,
he asks, is the attraction of saying ‘no’ and the fear of ‘yes’ to pleasure?
While not endorsing Tiger’s evolutionary deterministic approach in
addressing this question, we would side with his curiosity. Working as
researchers involved in socia l aspects of public health, nutrition, and of drug
use, we are struck by the fact that pleasure is under-examined in public
health research and practice. G iven tha t pleasure is addressed in many
public health policy issues and programmes, this is a curious absence.
Though a great deal of public health research and practice deals tangen-tia lly with issues of pleasure, there have been few a ttempts to focus directly
on the topic. Pleasure appears almost to o f rivolous a t opic to discuss in the
161
health: A n I nterdiscipl inary Journal
for the Soci al Study of H ealt h,
I l l ness and M edici ne
Copyright © 2003 SAG E Publications(London, Thousand Oa ks and New D elhi)
[1363–4593 (200304) 7:2]Vol 7(2): 161–179; 031873
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face of the ea rnest struggle a gainst pandemics such as globa l human suffer-
ing, and yet many attempts to address these rely on implicit assumptions
about the nature of pleasure and human activity. A reluctance to address
pleasure may be a nother ma nifesta tion o f medical science’s preference for
studying the causes of illness rather than health. It may also reflect more
deep-seated diffi culties with mod ern western ideas about pleasure and w hatis considered ‘serious’ scientific pursuit. In this article we attempt to high-
light some areas for exploration and further research in the examination
of pleasure in relat ion to health in general and public health in part icular.
We identify a number of issues that might be a fruitful way of opening
discussions about pleasure and health. Some recent discussion has focused
on the related concerns of health, discipline and transgression (Williams,
1998). In a similar vein, we discuss questions about the potential of a focus
on pleasure. Our aim is to roam broadly over a large and, we propose,
largely uncharted terrain. In doing so we appreciate that we run the riskof an inevitable sketchiness in our approach. We think, however, this is a
risk worth taking, especially if it inspires others to contribute to the argu-
ments and discussions we raise.
Pleasure – contributions from the human sciences
When Plato denounced the study of human emotions as inferior to the
study o f rea son (G osling and Tay lor, 1982) he effectively extinguished a n
examina tion o f pleasure as a serious aca demic subject. Thus while classicalliterature is replete with references to the importance of ‘good ’ or of ‘happi-
ness’, there is little covera ge of pleasure, especia lly as a bodily experience.
Foucault (1990a) reminds us of this when he discusses Oribasius (500AD )
whose seven-volume work documenting mind a nd body maintenance in the
classical era contains only two paragraphs on matters sexual.
It is true that during the Enlightenment writers like Locke, Mill and
B entham a ddressed pleasure as a motive of human happiness and common
good. But the notion of pleasure in the hands of these philosophers is
heavily sanitized into various forms of virtue (Porter a nd Mulvey Roberts,
1996).
Yet physical pleasure is not completely absent from philosophical
considerations. Pleasure lurks in the background of western thought like a
ghostly shadow; neither fully present nor fully a bsent. Take Nietzsche’s The bir th of tragedy (Nietzsche, 1966 [1888]), for example, in which he drawson G reek mythology to explicate the tensions that exist in the human
experience. Here we have the god D ionysus, representing the intoxicat ing,
orgiastic and chaotic (but also fertile) elements of the human condition,
pitched against Apollo, who stands for light, beauty and harmony (Pffefer,
1972). The union between the two deities is Nietzsche’s way of summariz-ing the relationship between our pleasure-seeking and ascetic tendencies
(Ma y, 1999). B ut Nietzsche never quite manages to express it in these terms,
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preferring instead to consider the nihilistic consequences of the forces of
destruction and creativity for human cultures. Nietzsche’s position may of
course reflect the 19th-century morals that he no doubt tried to rebel
against. But this position in relation to pleasure follows through into the
philosophy of the 20th century. Work like tha t of B ata ille, for example,
purports to explicate the human spirit in terms of pleasure-seeking activi-ties, especia lly eroticism. E ven here, however, B ata ille excuses himself from
dealing directly with the resulting pleasures of erotic activities. His main
aim, he says, is to explore the relationship between eroticism, philosophy,
religion a nd dea th (B ata ille, 1987).
Recent attempts to subvert traditional western philosophical traditions,
especially by feminists writers (e.g. G rosz, 1994), have privileged an exa min-
ation of the body and experiences such as pleasure and other emotions.
This effort directly challenges the primacy given to the investigation of
thought and reason, the heartland of mainstream philosophy. So presum-ab ly in philosophy a t least, we ca n hope to see more work directly related
to pleasure.
In the social sciences, pleasure often makes an appearance in research
on food a nd ea ting, sexuality and pornogra phy (Murcott , 1983; D workin,
1990; Mintz, 1997; Warde a nd Martens, 1999). B ut a ga in, it is only fleeting.
In specific fields of psychology we do see pleasure, as hedonistic scales,
standing as a topic of in-depth examination. E ven here, though, the study
of pleasure has become peripheral because of the perceived problems of
objective quantification of emotional, and therefore unstable, measure-ments (Mellers, 1995).
In relation to health, theoretical and empirical studies of pleasure are
very limited. This is strange, given that pleasure might be considered a
motive for human action (or indeed inaction) and is integral to under-
standing how humans interact with each other and their environment in
wa ys that promote hea lth or create disease. Moreover, so ma ny injunctions
to healthy behaviours seem to be concerned with restricting or overcoming
our seemingly ‘natural’ inclination towards certa in pleasures. A ccording to
Freud (1957), neuroses develop when libidinal instinct, or the ‘pleasureprinciple’, is not resolved satisfactorily into the ‘reality principle’ through
sublimation as the ego matures. That is, where sexual energies are chan-
nelled into so-called ‘productive’ energies: religion, art, education, science
and the like. Marcuse (1970), who reads Freud as an apologist for the
repressive (and therefore unhealthy) capitalist organization of labour,
arrives at his own solution to the maturation of the ego – non-repressive
sublimation, or narcissism. However, Marcuse’s privileging of individual
libidinal pleasures comes in for trenchant criticism when it is seen to be
incompatible with mutuality and wider social goods (Alford, 1987).
Pleasure, it appears, creates problems.
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Differentiating pleasure
It is useful at this stage to examine the tensions between an essentialist
notion of pleasure which postulates a universal and non-discursive
ontology, and notions that pleasure is a product of culturally and histori-
cally specific discourses (Alasuutari, 1992). These tensions have been takenup in recent literature on the sociology of the emotions (James and G abe,
1996; B endelow and Williams, 1998; Williams, 2000). D eborah Lupton
provides a useful summary o f the a rea (L upton, 1998) pointing out tha t
fields such as psychology and neurophysiology have developed biological
foundations for emotions, including pleasure. Central neurological
pathways are credited with the passage of pleasure-receiving signals, and
specific parts of the brain have been identified as centres where pleasure
is registered (B oza rth, 1994). Viewed this way, pleasure is an inherent –
some may say primitive – human phenomenon. An a lternative approach is
to see emotions, and with them pleasure, as a socio-cultural construction.
Lupton separa tes this approach into two schools of thought. The less rela-
tivistic (‘weak’) thesis recognizes that the physical sensations created by
emotions may indeed be biologically inherited, but they are context-depen-
dent and therefore socially conditioned. The ‘strong’ construction support-
ers differ in tha t they view emotions as experiences tha t cannot be separa ted
from the words and concepts that are already in circulation to define and
describe them. Thus, even to describe something like pleasure (physical
and emotional) in the ways that we do is to draw upon specific discourses
of desire that are themselves culturally and historically situated.There is certa inly evidence to support cultura l differences in the experi-
ence of pleasure. Lu and Shih (1997), for example, have shown that the
concept and the experience of pleasure in Chinese culture differs from tha t
in the West. Rozin et al. (1999) demonstrated that pleasure of food and
enjoyment of eating differ widely across cultural groups. Similarly, the
expression a nd a ppreciat ion of food pleasure at mea ltimes has been shown
to va ry greatly betw een families in the U SA and families in Ita ly (Ochs et
al., 1996). And eroticism, as expressed in the tradition of the Huli culture
of the highlands of P apua New G uinea (C larke, 1997), would probably beunrecognizable in western cultures. So pleasure it seems is differentiated
across contemporary space.
It is also apparent that experience of pleasure has been altered across
time. The ways that we seek and express pleasure today is different from
earlier periods in western history. Foucault’s work on the history of sexu-
ality concerns the ways that the management and enjoyment of pleasure
differed from G reek antiq uity to early C hristianity (Foucault, 1993). E lias’
work shows how power and control over urges and desires, through the
gradual internalization of outer institutional constraints, transformedetiq uette, a ppetites and, importantly, pleasures through so-called ‘civilizing
processes’ in western history (E lias, 1982). O ther work has traced the
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meanings of the pleasures of eating in the West, examining the ways in
which gustatory enjoyment has been manifested and managed at different
historical moments (Coveney, 2000).
The differences in the understa nding of emotion a nd pleasure – as either
essential or socially constructed – arise as a result of differing epistemo-
logical positions and reflect the current debates around the ‘body’ in thehuman sciences. For our current purposes we are not endorsing one or the
other: all approaches are of interest as they apply to health.
We are also interested in the w ays that pleasures are d efined differently
in different contexts. O’Ma lley and Mugford (1991), for example, point out
that not all pleasure-seeking pursuits, e.g. the taking of drugs, are seen as
desirable or even pleasurable by all people in all cultures and all times.
Pleasures are highly contextual – socially, economically and materially.
Turner (1982) demonstra tes tha t the pleasures of the ta ble af ford ed to elite
classes in 18th-century England were a product of the widening choice ofava ilab le foods. The explosion o f tra de and commerce at tha t time brought
a variety of new culinary ingredients – foods, spices, liquors – to whet the
appetites of the wealthy. In contemporary western society, however, such
food choices are, w ith a few exceptions, ava ilab le to most people. Pleasure
now does not result merely from the enjoyment of gastronomic riches but
a lso, paradoxica lly, from a refusal of them (B ordo, 1993). The ascetic
appreciation that comes from attaining a slim, toned body and regulated
lifestyle – in the midst of plenty and pressures to consume – demonstrates
that pleasures are situated within specific social discourses and practices(Turner, 1995).
Forms of pleasure are not only socially situated; they also demonstrate
social locat ion. B ourdieu (1989) has pointed out how holiday leisure activi-
ties vary across classes, acting to distinguish one’s status by discernment
and taste. The ‘loftier’ pleasures of alpine walking, for example, are
preferred by middle class groups over a package fortnight’s holiday on
Spain’s C osta D el Sol.
Within western cultures, we know then that pleasure comes in various
forms and patterns. E ven the experiences of pleasure are q uantita tively andqualitatively different. The pleasures of shopping (Miller, 1997) for
example, differ vastly from the pleasures of smoking (Klein, 1993), the
pleasures of unclad bathing (Sul, 1999), the pleasures of sex (Lowe, 1997),
the pleasures of good fo od and good company (Warde and Martens, 2000).
Yet the pluralities and complexities of pleasure, as something experienced ,are hard ly ever considered. L upton comes close to differentiat ing pleasure
when she discusses the ways that ascetic approaches to eating carry their
own pleasures through a sense of self-control and self-discipline (Lupton,
1996), or when she describes the thrills or pleasures associated with risk
taking (Lupton, 1999). Clearly, pleasure comes in many guises.
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Pleasure and public health
B y privileging health a nd well-being, public health a ims to develop forms
of the goo d life for the populat ion as a whole. The broa d and positive defi-
nitions of hea lth used in more recent public health policy sta tements appear
to work with an implicit notion of an equitable distribution of life’spleasures, as well as production capacity (Aggleton, 1995). However,
pleasure and pleasure-seeking activities are often considered to be at the
root of irrational, o ften spontaneous actions which predisposes individuals
to unhealthy, so-called risk-taking behaviours. Sexual gratification and
pleasure-seeking activities in gay men, for example, have been linked with
unprotected and therefore unsafe sex (Schoennesson a nd D olezal, 1998).
Smoking, excessive drinking and eating unhealthy foods are all sources of
pleasure, which a re considered to damage hea lth. P leasure is considered a s
a prime force creating the ‘root of resistance’ whereby individuals flout thenorms which public health at tempts to impose. Lupton (1995) discusses the
wa ys that pleasure and d esire, as libidinal forces, may be regarded a s pre-
or non-discursive; they are innately undisciplined and undisciplinable.
Pleasure and pleasure seeking is thus conceived as the weak link in the
chain of command from authoritarian discourses of health governance to
docile compliance for body maintenance.
Efforts of reform in contemporary public health always run the risk of
standing a ccused of ‘nannyism’, through negating individuals’ pleasure and
spoiling spontaneity and fun. There is a growing body of literature – part,some say, a t rend to wa rds the ‘pleasure revenge’ (B ell and Valentine, 1997)
– which accuses the puritanical ‘healthist’ culture in the West of denying
pleasure and promoting guilt, and therefore stress, in individuals (Klein,
1993, 1996; Warburton, 1994; Warburton and Sherwood, 1996; Lindeman
and Stark, 1999; Rozin et al., 1999).
Pleasure can also be seen as an organizing principle in democratic
societies providing a critical vantage point on public health and health
promotion (Luik, 1996; Netter, 1996). Pleasure thus can act as a rallying
point or ‘clarion call’ to oppose the forces of unwanted ‘authoritarian’control of individual choice, and the unwelcome incursion of expert reason
into the life-world. Critics wish to defend the liberal subject’s right to
‘freedom’ and ‘autonomy’, thereby protecting the threatened liberal
subject’s right to self-determination a gainst the threat of experts who would
‘interfere’ in their autonomous (sometimes pleasure-seeking) decisions
(AR ISE , http://www.a rise.org/).
Although from a differing perspective, and with perhaps a differing
politics, this objection is ra ther similar to the critical att ention tha t has been
levelled at health promotion and public health which has highlighted the
surveillance potential of newer forms of health care (Armstrong, 1983;Nett leton a nd B unton, 1995; Petersen and L upton, 1997; Crawford , 2000a).
New sets of rights and responsibilities of citizens, state instrumentalities
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and health-care professionals are being constructed as western health-care
systems privilege public health and self-care. Newer more self-reliant,
‘empow ered’ citizens are being estab lished who take on more responsibility
for their own health risks. Indeed, risk management is changing in ways
that increasingly involve the personalized policing of pleasure and risk.
Pleasure conceived as the other side of risk cannot escape increasedattention from scientific expertise and new forms of health governance.
Personal pleasure and self-satisfaction, it can be argued, are now derived
from a range of practices appropriate to self-transformation through self-
policing.
The self-policing, or self-management, of health involves the fashioning
and rat ioning of pleasure in ways that are highly socially situated. L ike risk
taking, and often experienced as risk’s other side, pleasure is socially
distributed. R isks exposure and risk-ta king beha viours have a recogniza ble
social gradient, with lower socio-economic groups being exposed to andta king the brunt of available risk (B eck, 1992; Furlong a nd C artmel, 1997).
Castel (1991) has pointed to the redistribution of risk management in late
modern societies and argues that, increasingly, those considered economi-
cally active are allowed the freedoms to self-manage risks, while those
socially excluded a nd/or w ithout the economic power to do so, have their
risks, often austerely, managed for them by state agencies. Similarly,
pleasures are mana ged differentially by social ca tegory, often w ith scarcely
concealed hypocrisy. The pleasures of opium, laudanum and hashish were
much appreciated by a number of romant ic artists and writers in late 19th-century Europe, including for example, D e Q uincey, C oleridge and Poe
(Plant, 1999). Later, when these drugs began to be used by the newly
urbanized working classes, calls for disciplining the habits and prohibition
ensued, often with the stated purpose of protecting public health and
welfare, resulting in unprecedented restrictive legislation in the early 20th
century.
The origins of many modern public health initiatives have roots in evan-
gelical, often highly disciplined and religious movements in the 18th and
19th centuries designed to reform unwholesome habits, disruptive behav-iours and, in the process, transform pleasures. Within this discourse,
pleasure was regarded as emotional (therefore irrational) and in direct
opposition to reason a nd ra tionality. B y reifying the ‘joys’ of asceticism,
ab stinence and sobriety o ver decadence, depravity a nd debauchery, public
health sought to replace one form of pleasure (hedonistic, carnal, libidinal)
with others (aesthet ic, ascetic, civilized). We can therefo re see public health
as a series of a ttempts to t ransform pleasure by constructing new ‘modern’
secular moral and ra tiona l positions. P ublic hea lth discourses intersect with
pervasive religious beliefs, which still have a n inhibiting effect on risk taking
(Abb ott -Chapma n a nd D enholm, 2001). O f course, public health did notinvent these transformations but was a part of an emerging western
episteme influenced by the economico-political regulation of populations
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which changed the understanding of the body and the soul in the modern
period (Foucault, 1980).
A history of pleasure
In seeking to map the transformations in pleasure and pleasure-seekingexperiences, we w ill now look a t the emergence and circulation o f d ifferent
forms of pleasure in western culture. In doing this, we are not suggesting
that one form of pleasure existed without others. It is to suggest instead
that different systems of thought, different forms of expressivity and,
importantly, different religious influences at different historical periods
prioritized one form of pleasure over others. In contempora ry public health
discourse, as we sha ll see, these different fo rms of pleasure present multiple
opportunities for engagement a nd regulation.
The point of departure for our analysis is the research undertaken byMellor a nd Shilling (1997) on the w ays tha t religious influences in the West
have shaped or reformed the body. This work, rightly, reminds us that the
holy trinity of sensuality, embodiment and the sacred have vastly shaped
the relationship between religion and sociality.
Carnal pl easure
We begin with fl eshy desire. To t a lk of carna l pleasures is to ta lk about
bodily basics: warm flesh, moist orifices and libidinal urges. Carnal
pleasures emerge from the ra w, physical body. For the a ncient G reeks, the‘natural’ appetite, or energia , formed one of the most important drives forcarnal pleasure. Carnal pleasures are sensuous, and come from the senses.
They a re therefore o ften unant icipated, a rising out of nowhere but calling
for at tention a nd gra tification. To be sure, carna l feelings and instincts can
be evoked: the smell of good food, the ero tic image, the stroking of sensi-
tive body parts. All these produce sensations tha t conjure fleshy desire from
which carna l pleasures emerge. B ut it is the unexpected a rousal that make
carna l aw akenings so startling and therefore problemat ic. The early C hris-
tian J ohn C assian (360–435AD ) believed tha t it w as the innateness of the
natural appetite that made it so hard to tame a nd cure. For C assian, food
and sex were inextricably linked and an overindulgence in eating and
drinking lead to the urge to fornicate (Foucault, 1990b).
Carna l, physical pleasures connect the body to the w orld. They literally
‘open up’ the body to the influence of other people and the w ider environ-
ment. The notion of a body open to senses indicates a sharing of values,
rituals and community. Thus Falk’s discussion of an ‘eating community’ in
relation to an inclusive society indicates not merely a sharing of food but
the construction a collective boundary (Falk, 1994). It wa s within the medi-
aeval period of Europe, where communities were open to all manner ofenvironmenta l (plague, pestilence, famine) and huma n (war) cata strophes,
that Catholicism found its niche (Mellor and Schilling, 1997). Carnal
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pleasures formed the basis of many prohibitions. Rituals of the flesh and
physicality, invoking and inflaming the senses, were important practices in
Catholic worship and penitence. Self-flagellation, penetration of bodies
with pins and irritating the body with harsh clothing were all rituals
designed to curb carnal pleasure by disciplining the physical self. The
importa nt point here is that bod ily senses and the physical bo dy itself w ereboth instruments and targets of Catholic practices. Even the Eucharist –
literally the embodiment of Christ through ritualistically eating of bread
and drinking of w ine – echoes this physica lity. The synergism between open,
often volatile, bodies, sensuousness and superstition provided a fertile
environment for the growth of Catholicism in the mediaeval period of
E urope. D espite its apparent strict doctrine and dogma, the C hurch at t hat
time absorbed pre-existing pagan rituals and practices, which allowed it to
penetrate and make its mark on social values. The carnival is a good
example of this. Culminating in the mardi gras , the carnival involvedritualistic, often grotesque practices, including overindulgence in food and
sex to the point of orgy. In one part of France, the patron saint of Shrove
Tuesday was Sa int D egobillard, otherwise known a s St Vomit (Mellor a nd
Schilling, 1997). B ut the carnival was succeeded by L ent, one of the most
importa nt a nd most pious occasions in the C hristian ca lenda r. Lent reminds
C hristians of the need to deprive the physical bod y – and w ith that the soul
– of food and pleasure as an enactment of Christ’s suffering. The breaking
of Lent coincides with the feast of Easter, and the celebrations of fertility
and rebirth. Fertility festivals were o f course in place long before the a rrivalof Christianity, and aga in we see a superimposing of religious doctrine on
pagan activities, demonstra ting the tolerance to carna lity that existed in the
early Christian Catholic church.
Today, the instinctua l urges tha t a rise from bodily pleasures are, as we
saw earlier, believed to lead to ma ny risky and health-damaging behaviours
(unsafe sex, over-eating and drug ta king). This volatile body, which refuses
to be disciplined, is highly disordered, dangerous and polluting. Like many
forms of pollution it represents ‘ma tter out of place’ (D ouglas, 1966). Such
pollution presents a threat to the public’s health and requires sanitarymeasures (Armstrong, 1983; Crawford, 2000b).
D i sci pl i ned pleasure
Throughout the late mediaeval period, the power of the Catholic church
wa s gradually challenged from within its own ra nks and from outside. The
emergence of movements we now regard as Protestant brought an under-standing of pleasure that had not been fully celebrated outside all but the
most cloistered communities. Much of the early movements of Protes-
ta ntism claimed they w ere the vera reli gion , the t rue religion. The proof o f
this wa s in the strict interpretation of the word of G od. A ccusingCatholicism of practising superstition and worshipping idols, especially
through Mariology (the praising of the virgin Mary), Protestants stripped
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bare the rituals, the revelations and the rites that formed the core of
C atholicism. G od was now a vailable to all, not through the ciphers of the
Church – the priests and the popes – but directly through the reading of
His words. The text became the symbol of G od a nd reading or listening tothe Scriptures with a calm at titude turned into one’s self, replaced the open,
public and communal ritual that characterized the Catholic mass. As thedisplay of emotions and physicality became subordinated to more cogni-
tive practices for worship, narra tives of the self a nd the reifi cation o f ‘inner-
liness’ flourished a nd beca me sacred. These practices were not new. Indeed,
Foucault points out tha t early Christian writing encouraged the practice of
constantly turning over one’s thoughts and feelings to seek out evil, much
as the miller turns over his wheat grains to pick out those which are bad
(Foucault, 1988). The Reformation took these early writings seriously and
turned them into religious practices. Pleasure now does not merely involve
the immediate gratification of carnal urges. Pleasure now assumes a moresublime quality. Indeed, the stepping back and deferring from immediate
instinctual grat ificat ion in order fully to a ppreciat e the wo rld and its offer-
ings gives rise to a range of aesthetic, so-called ‘cultivated and civilised’
practices (Elias, 1982). Kant’s ‘Critique of judgement’ stands as the sine qua non of the discourses on reflective beauty (Falk, 1994). The supplant-ing of words for deeds provides a number of opportunities for disciplined
or deferred pleasure. The categorizat ion of w hat and how things can please
– through the creation of archives, manua ls and cata logues – allowed for a
vicarious experience of pleasurable acts. The experience of the actualpleasure itself was no longer a requirement now that the very form and
nature of pleasure was captured in words.
O ther written forms a llowed for the production o f disciplined pleasure.
For example, cooking sta ndards could now be judged by the written word,
as recipe books and cooking manuals become the standards for quality.
Prior to this, recipes were passed by word of mouth leaving many oppor-
tunities for misinterpretat ion, poor tra nslat ion and poor results. Stat ic anddisciplined in words, the recipe stands for all time. And the practice of
cooking,by the book
, takes on a status all of its own. The fact that only the
most privileged in society could actually read and write served further to
elevate the written word as a form of cultivated expression.
D isciplined pleasure is pleasure tha t ha s been rat iona lized. Within the
ra tiona l knowledge of 19th-century food science and nutrition, for example,
pleasure was subordina ted below ra tions, reason a nd science. Too much
flavour from food was considered to overtax the digestive system and
damage health. What was needed was just enough flavour to accomplish
nature’s economy (Richards and Elliott, 1910).
D iscipline in drink wa s also pa rt o f this pleasure. Victorian and E d-
wardian concerns about the drinking of the newly urbanized workingclasses illustra tes the coincidence of interests between the public health a nd
the Church (H arrison, 1971; A lasuutari, 1992) The ‘ tempera nce’ mo vement
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of the turn of the 20th century was an ambitious socio-political programme
or ‘mo ral crusade’ (G usfield, 1963). Measures to contro l and discipline
alcohol a nd drug consumption stem from this period, w hen the concept of
‘addiction’ re-emerged and eclipsed other ways of problematizing intoxi-
cation, such as that encapsulated in the concept of ‘habituation’ (Levine,
1978). A drinking hab it tha t w as a menable to human intention a nd choice,wa s transformed in addiction discourse into a ‘disease of the w ill’ that wa s
in need of ‘correction’ by medical a uthorities. Addiction discourse afforded
little, if any, space for the pleasures of intoxication. Rather, there was a
‘systematic silencing’ by discourses that pathologize the practice of alcohol
and drug use (O’Malley and Mugford, 1991).
Rationalized and disciplined pleasure stands against vulgar and
emotiona l displays of enjoyment. The fi rst being reasoned, rea sonable and
safe, the second being unpredictab le, perverse and risky. D isciplined
pleasure is arguably at the foundation of many public health initiatives.Moderation, restraint and tempered practices are integrated into the very
fabric of public health discourse. Immediate gratifi cation is relinquished for
the pleasure and sat isfaction of rat ionalizat ion and rea son. This subtext is
inherent in attempts to improve public health: from smoking cessation,
improvements in diet, to mo dera tion in drinking. ‘You know it makes sense’
has been a well-used motto in public health to call up in consumers the
reasoned and rational understanding of what is best for them, and for the
community. B ut as we shall see shortly, the a bility to ta ke this ‘sense’ to an
extreme is ever-present in public health.
A sceti c pl easures
In contrast to the immediacy of carnal pleasure and the rationality and
intellectualizing of disciplined pleasure, ascetic pleasure requires the
practice of askesis or self-training. Foucault reminds us that for the ancientG reeks, the careful mana ging of pleasure actually enhanced one’s experi-ence of pleasure (McHo ul and G race, 1995). Virtue wa s regarded a s the
ha llmark of one’s excellence as a G reek citizen (Kippo, 1975) especially
through the moderation of pleasure. As early Christians incorporated
elements of classical G reek thought into their doctrine, however, virtue
became synonymous with a scetics – the denial o f a ll pleasure (B rown,
1988). The R ules of St B enedict, written around 500AD stipulate the import-
ance of ‘loving to fast’ and ‘not being too fond of pleasure’ (St Benedict,
1966). Pleasure from a scetics and a bstinence reached its apogee in the prac-tices of a number of monks and early C hristians. Ca therine of Sienna, C laire
of Assisi and A ngela of Foligno, for example, all reached heights of ecstasy
through severe fa sting and other a scetic ritua ls (B ynum-Walker, 1987). The
ascetic approach to pleasure was not confined to the Middle Ages.
Throughout the growth of Protestantism, ascetic practices of many kindswere encouraged often with the aim of purifying the body. The arousal of
pleasure qua passion, wa s considered to contaminate the soul and was thus
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a source of sin. All manner o f foods which might be considered a s arousing
passions in the body – ‘earthy’ foods producing flatulence, or highly
seasoned foods – were considered polluting and were therefore eschewed
(Tryon, 1695).
The basis of ascetic pleasure arises from the acknowledgement of total
control of the body’s natural urges. This is not so much a civilizing of thebody, as we saw with disciplined pleasure, but more a total conquering anddomination of the body. As Lupton explains (Lupton, 1996), modern-dayexamples of ascetic pleasure can be found in the testimonies of people who
have self-starved with conditions like anorexia nervosa. Interestingly, while
extreme forms of ascetic pleasure can be seductive, creating feelings of tota l
control and safety, in public health terms there are of course great risks to
personal health and well-being. In trying to supplant carnal pleasures with
disciplined pleasures, public health always runs the risk of paralleling
religious zeal which reifies ascetic pleasures. Obsessions with one’s food,drink and bodily function can easily arise from pursuing so-called healthy
lifestyles (Turner, 1995). Thus, the punishment of the physical body, in the
name of health, is always a possibility. Ascetic pleasure is almost always a
solitary pursuit and stands in stark contrast to forms of pleasure arising
from collective ecsta tic experiences. These a re d iscussed below.
Ecstati c pl easures
Pleasure as a ritualistic, spiritually bonding experience, often with the
assista nce of mind/mood-altering substa nces and rhythmic dance, has atradition in many cultures. The suspicions with which such traditions have
been viewed are well evident in the Christian missionary attempts to
dampen and extinguish so-called ‘dangerous’ tribal practices in distant and
exotic locations. However, we can examine this phenomenon closer to
home in public health at tempts to dea l with the variety of pleasures emana t-
ing from youth ‘club-culture’.
The unruliness of bodies under the influence of psycho-act ive substa nces
has long since concerned public health specialists (G usfield, 1963; B erridge,
1989), but rema ins an a biding focus (Valverde, 1999; B unto n, 2001). More
recent literature, however, has begun to examine issues related to the
aesthetic body. There has been some discussion o f a so-called ‘post-modern’
pattern of drug use and drug use identity that involves a normalization of
illicit drug use (Parker and Measham, 1994; Shiner and Newburn, 1997,
1999; South, 1999).
The upturn in the use of illicit drugs among the young in the 1990s and
development of ‘pick and mix’ use patterns of drug use would appear to
mimic more general shifts in the consumption of goods and services under
the influence of consumer society. ‘Intoxicating commodities’ (O’Malley
and Mugford, 1991) can be placed within a response to the increasedrationalization and regulation of the life-world. Indeed, popular music,
dance drugs and club-culture – ‘rave’ or ‘Ecstasy culture’ – as a mass
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cultural phenomenon in the 1980s and 1990s (Thornton, 1995; Shapiro,
1999) is arguably an example of a social form responding to the over-
rat ionalization and bureaucratiza tion of everyda y life. Interestingly, groups
formed in such mass consumption appear to be self-consciously creating
their own philosophy. Offering libera tion, pleasure and communa lity – even
of fering alterna tive spiritual realms – these forms of social life and embodi-ment are the result of what Miles (1992) has called ‘carnal knowing’. This
use of drugs appears, almost nostalgically, to seek a period when society
produced an altogether more intense, sensual existence; before the civiliz-
ing processes, tha t E lias documents so well, transformed E uropean society.
Public health seems to have overlooked the obvious point tha t people take
drugs for the experience of pleasure, how ever socially defi ned. D rug use
has many affinities (as well as ‘risk factors’) with sexual pleasure (Eisler,
1995; H art and C arter, 2000).
An example of philosophies tha t celebrate pleasure can be found a mongsome groups of participants in the Sydney G ay Lesbian Ma rdi G ras
Festival. In the early 1990s a wave of resistance reacted against attempts
by Festival organizers to make ‘Australia’s premier summer community
festival’ d rug free (Southga te a nd H opwood, 1999). Indeed drug use during
the Festival wa s seen by many to be integral to the celebrat ions of gay pride,
and an ant i-drug sta nce by organisers was considered to be a sellout on the
philosophy o f the event . This resistance to a uthority is an excellent demon-
stration of the ways in which pleasure seeking itself can be reasoned and
rat ionalized w ithin a nd by counter d iscourses.The directly spiritual experience of use of the drug Ecstasy is interest-
ing, given the claims made by Maffessoli (1996) and Mellor and Shilling
(1997) concerning the ‘re-consecration’ of existence through sensual soli-
darities. Modern tribalistic and ritualistic experiences offer relief from the
alienation of banal association. They present a return to the sacred in
everyday existence by a combination o f a range o f technologies including:
lighting, sound, space, drug use and crowds.
The ecstatic pleasures derived from collective spirituality are of course
evident in many religious movements. In Christianity, communion is acollective practice that not only connects individua l worshippers with Christ
but also with one another. In more fundamentalist Christian sects the
combination o f gospel music, song and prayer can give rise to sponta neous
ecstat ic and rapturous responses from congregations. Speaking ‘in tongues’
has a similar ef fect. The connectedness tha t derives from collective ecsta tic
experiences, whether they be w ithin the secular youth culture, the G ay
community or religious church gatherings, bonds individuals both spiritu-
ally a nd pleasurably.
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Conclusions
O ur aim in this article has been to begin to reflect upon pleasure in relat ion
to public health and health more generally. Pleasure is so integral to the
challenges of public health, it is surprising tha t there is not more empirica l
or theoretical literature on the topic. In its attempt to transform pleasures,public health always runs the risk of introducing new and unanticipated
elements that ma y run counter to the goals of health enhancement. In part,
this is because it has not been able to theorize the place of pleasure in
hea lth a nd w ell-being. The rise in ascetic practices, for example, especially
related to strict dieting and associated distortions of body image, is arguably
linked to a focus on the need to restra in eating for the sake o f health. Simi-
larly, embodied pleasures can develop in relation to public health behav-
ioural interdictions. U nhealthy, ‘da ngerous’ practices or consumption can
exploit these interdictions to enhance the aesthetic pleasures – carnal,
ecstatic or other.
By examining the ways that pleasures are represented and experienced
we can also examine some of the ways that power and social relations are
reproduced – the uses of pleasure as Foucault reminded us. The coercive
and governing power of risk discourse and risk management in the name
of health has been analysed and critiqued by those concerned with a
number of perspectives and political positions. The problematization of
pleasure itself and its relationship to health and public health in particular
is also in need o f closer examinat ion. While the discourses and experience
of pleasure are normally associated with freedom from interdiction, theyare replete with social regulation or control. Maffessoli observes that
certain consumption phenomena, such as ‘Club Med’, may be extensions
of q uite regulat ed consumption socia lities (Ma ffessoli, 1996). The consump-
tion of ‘risk products’ can in fact merely reproduce other forms of social
identity along traditional class and gender lines, like other forms of
consumption (B ourdieu, 1985; Sulkunen, 1992; B unton and B urrows, 1995).
Similarly, sexual health education that sought to ‘eroticize’ sexual activity
was not free from social or ideological influence (Wilton, 1996).
We would argue that the religious elements that influence the dimen-sions of cultures cannot be underestimated when considering the shaping
of attitudes to, and practices of, pleasure. The work of Mellor and Shilling
among others, is evidence of this. Our understanding of pleasure is
deepened and broadened through historical analysis of the influence of
religion on conceptions of the body and the soul.
In this article we have attempted to sketch some possible approaches
tha t such an ana lysis might ta ke, rather tha n systemat ically review the range
of work currently being undertaken across a variety of disciplines. In
addressing pleasure more centrally in public and health research, andattempting to open the topic for further discussion, we are aware of the
potential brea dth of such a focus. I t w ould certainly cross many disciplines
health: 7(2)
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and doma ins of study, like many o ther aspects of the study of the body. In
this brief sketch of some possible directions we have ignored important
contributions to the area which would repay closer examination, for
example: psychoanalytic aspects of pleasure, self and subjectivity; anti-
pleasure as a momentum of hea lth promotion and public health; the work
of D eluze and G utta ri on desire and the implications for public health; theunderstanding of late-modern patterns of drug use; sex, pleasure and
subjectivity; food, pleasure and the problems posed for health promotion
intervention; public health risks and the pleasures of tra nsgression; a nd the
public health imperative of a disembodied experience of pleasure.
In pursuing the study of pleasure in relation to health, even document-
ing the absence of a pleasure focus may be of immediate interest. If w e are
to avoid opposing pleasure and reason, what complementary experiences
to pleasure would we suggest? Theorizing pleasure has a potentially rich
source of da ta in the field of health, and one which should be seriously (andpleasurably) considered.
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Author biographi es
J O H N C OV ENE Y is Senior L ecturer in the D epartment of P ublic H ealth at FlindersU niversity, Adela ide, Austra lia. He worked in clinical dietetics and public health
nutrition before entering academia. His teaching and research interests are in food
policy and hea lth promotion. H is most recent book, Food, morals and meaning: The pleasure and anxi ety of eating , was published by Routledge in 2000.
R OBI N BU N TON is P rofessor of Sociology in the School of Social Sciences, U niversity
of Teesside, Middlesbrough, U K. H e tea ches and researches in sociology w ith
part icular interests in health promo tion, drug misuse and the bo dy. H e has published
widely in the field of health and is Editor of the journal, Cri tical Public H ealth
(Taylor & Francis).
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