Illness as metaphor – an analysis | Personal thoughts

“Illness is the night side of life, a more onerous citizenship. Everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick. Although we all prefer to use the good passport, sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place.”

Sontag, S. (1978). Illness as metaphor

In her book, Illness as metaphor by Susan Sontag, Sontag compares between Tuberculosis and Cancer and how different people and societies perceive the two diseases.

While thinking about my topic, I was comparing the perceptions between mental and physical disease. I never really thought much about the perceptions between physical diseases and how within that category itself was a myriad of perceptions going between different illnesses. How an illness could be perceived as almost tragically beautiful while being a symbol of rot and decay.

But first, what is a metaphor?


1. a figure of speech in which a term or phrase is applied to something to which it is not literally applicable in order to suggest resemblance, as in “A mighty fortress is our God.”.

2. something used, or regarded as being used, to represent something else; emblem; symbol.


For both cancer and TB, they are illnesses that are still prevalent and dangerous today with how difficult it is to treat them especially in their terminal stages. I found it interesting how TB was perceived by societies back centuries ago was almost like how cancer is seen today. The prevalence of it, the inevitability of a slow death looming, and the lack of comfort knowing that there’s no absolute cure for it yet, are big things that societies have to deal with emotionally.

It made me wonder about the human obsession with metaphors: the romantisation and personification of illnesses. Is it the fear of the unknown? The need to control and understand something that is always way beyond us? To give disease another attribute, to compare it to something we already know, do we understand it better or do we further alienate it from what it really is?

Are the metaphors in some way a sort of comfort? It seems so when Sontag brought up examples the melancholy present in TB patients, was written and seen as a positive, beautiful trait. Were they written by patients of TB or the people around them, trying to find positivity in grief.

Are the metaphors part of superstition? Once again Sontag brought up how TB as a “wet-based” disease, could be cured by moving to dryer locations, (a typical scene in victorian-era novels).

Are the metaphors a critique on our society? How Cancer is seen as a product of our excess consumerist culture, through over-eating, over-exerting our bodies from work.

Sontag’s overall argument is this:

My point is that illness is not a metaphor, and that the most truthful way of regarding illness—and the health- iest way of being ill—is one most purified of, most resistant to, metaphoric thinking. “ – Susan Sontag

Many critics have called Sontag’s book as liberating and empowering, powerful for arguing against fear inducing metaphors that inhibits people to seek recovery.  By comparing TB and Cancer, two similarly perceived diseases, one of which is less of a threat today as the other, Sontag shows the absurdity of thoughts past and how thoughts of the present are and will be.

So what about mental health? I’ll be writing on that more on my analysis on A Philosopher’s Madness by Lishan Chan in my next post.


Total Biblography of books|articles|etc  read ( for my own reference):

Sontag, S. (1978). Illness as metaphor. New York: Farrar, Straus and Giroux.

Flessner, C. A., Woods, D. W., Franklin, M. E., Cashin, S. E., & Keuthen, N. J. (2007). The Milwaukee Inventory for Subtypes of Trichotillomania-Adult Version (MIST-A): Development of an Instrument for the Assessment of “Focused” and “Automatic” Hair Pulling. Journal of Psychopathology and Behavioral Assessment J Psychopathol Behav Assess, 30(1), 20-30. doi:10.1007/s10862-007-9073-x

What is Trichotillomania? – The TLC Foundation for BFRBs. Retrieved September 01, 2016, from

Trichotillomania. Retrieved September 01, 2016, from