Author and rhetoric professor Colleen Derkatch joins us to discuss why wellness sells (and her new book by that name), how wellness culture promises an alternative to the biomedical/pharmaceutical model but fails to deliver, why it’s important to acknowledge that certain aspects of wellness culture are helpful to people even as we critique its harms, and more.
Colleen Derkatch is Associate Professor of Rhetoric in the Department of English at Toronto Metropolitan University. She is the author of Bounding Biomedicine: Evidence and Rhetoric in the New Science of Alternative Medicine (University of Chicago Press) and Why Wellness Sells: Natural Health in a Pharmaceutical Culture (Johns Hopkins University Press). Her Twitter handle is @ColleenDerkatch.
Resources and References
Colleen’s new book, Why Wellness Sells: Natural Health in a Pharmaceutical Culture
Christy’s new book, The Wellness Trap: Break Free from Diet Culture, Disinformation, and Dubious Diagnoses and Find Your True Well-Being
Subscribe on Substack for transcripts, Q&As and bonus content
The Conspirituality podcast
Christy’s online course, Intuitive Eating Fundamentals
Transcript
Disclaimer: While every effort has been made to provide a faithful rendering of this episode, some transcription errors may have occurred. The original audio file is available above.
Christy Harrison: Welcome to Rethinking Wellness, a podcast exploring the diet-culture, disinformation, dubious diagnoses and disordered eating that are so pervasive in contemporary Wellness culture and how to avoid falling into these traps so that you can find your own true wellbeing. I'm your host Christy Harrison, and I'm a registered dietician certified Intuitive Eating counselor, journalist, and author of the books Anti-Diet, which was published in 2019 and The Wellness Trap, which came out on April 25th and is now available wherever books are sold. You can learn more and order it now at ChristyHarrison.com/TheWellnessTrap.
Hey there. Welcome back to Rethinking Wellness. I'm Christy and my guest today is author and rhetoric professor Colleen Derkatch, who joins me to discuss why Wellness sells and her new book by that name, how Wellness culture promises an alternative to the Biomedical and Pharmaceutical Model, but fails to deliver why it's important to acknowledge that certain aspects of Wellness culture are helpful to people even as we critique its harms and lots more. I really love this conversation and I can't wait to share it with you. Before I do a few quick announcements. If you're in the Los Angeles area, I'll be doing a rare live book event on July 16th and I'd love to see some listeners there. You can get all the details at ChristyHarrison.com/events. That's ChristyHarrison.com/events. This podcast is brought to you by my new book, The Wellness Trap: Break Free from Diet Culture, Disinformation, and Dubious Diagnoses, and Find Your True Wellbeing, which is now available wherever books are sold.
It explores the connections between diet and Wellness culture, how the Wellness space became overrun with scams, misinformation and conspiracy theories. Why many popular alternative medicine diagnoses are misleading and harmful, and what we can do instead, to create a society that promotes true wellbeing, just go to ChristyHarrison.com/TheWellnessTrap to learn more and buy the book. That's ChristyHarrison.com/TheWellnessTrap. This podcast now has a full-fledged newsletter where I answer questions about Wellness diets, how to spot Wellness scams and misinformation, how to know whether you've gotten a dubious diagnosis or anything else I cover on the podcast. Just subscribe at rethinkingwellness.substack.com to get new answers every other week and a chance to ask me your questions. And if you upgrade to a paid subscription, you'll also get tons of bonus Q & As, early access to podcast episodes, plus bonus episodes, occasional community threads and other members only content. Just go to rethinkingwellness.substack.com to learn more and sign up. And by the way, you can also sign up for the newsletter to get transcripts of the podcast delivered to your email every week. That's rethinkingwellness.substack.com.
Now, without any further ado, let's go to my conversation with Colleen Derkatch.
Christy Harrison: Colleen, welcome to the show. Thank you so much for being here.
Colleen Derkatch: Thank you for having me.
Christy Harrison: Yeah, it's really great to connect with you and I'm excited to talk because we have a lot of alignment I think in our books, our most recent books and things we cover, and you have a longstanding interest, I think, in this area of Wellness culture, and I'm just curious what your personal experience of Wellness culture has been and how you came to be interested in studying it.
Colleen Derkatch: I came through a variety of different ways. I think academically Wellness really emerges out of my last book, my first book, and in that book, I was really interested in how the idea of evidence gets mobilized in arguments about the safety and efficacy of alternative health practices such as acupuncture and chiropractic. And in that book, I really focused primarily on medical literature, and so how medical studies of practices like acupuncture are designed, how are they reported in journals, how do people respond to them, and then how do those studies get taken up in public culture? And through the course of that project, I really started to see, especially sort of the latter years I was working on it, the increasing rise of the term Wellness. I was just seeing it everywhere. And so that really led me to think about what is it that draws people to alternative health practices?
And increasingly I was seeing that Wellness was actually the answer. So I was interested in understanding more about how that works. Personally, I also came to the topic partly just out of my own personal experience. So I lived most of my early adult life in East Vancouver in the West coast and was kind of caught up in that West coast sort of natural health culture. And I had an early a teenage experience with chiropractic that prompted some really interesting questions for me about how we come to decide which health practices and practitioners to consult with and not to consult with. And so that also led me to thinking about how we think of some kinds of health practices as being for illness, but some of them seem to be more about Wellness. And so all of those things kind of coalesced into the formation of this book.
Christy Harrison: That's so interesting. You make the distinction in the book between what you call the logic of restoration and the logic of enhancement. I think that's a little bit what you're talking about in terms of Wellness and illness, but can you define and distinguish those terms a bit for us?
Colleen Derkatch: Sure. Yeah. So the logic of restoration is really in many ways it's the logic of medicine, it's the logic of pharmacy. It's about returning the body to a prior state of functioning. When I first started this project on Wellness, I actually wanted to make a kind of crankier and more clever sort of gotcha argument that Wellness was really a new form of illness. And I do think that that's true in the sense that it's premised on a logic of restoration, of restoring the body to this prior state of functioning. But I also saw another kind of counter thread, well, it was counter at some points and sometimes it was actually concurrent, which was the logic of enhancement. And the logic of his enhancement is really ostensibly, at least the logic of Wellness. It's about positivity and balance. It's about optimizing the body and the mind and the self rather than restoring the body. It's about making the body and really the mind itself better than it already is.
Christy Harrison: Well, and it's interesting because I mean in writing my book about Wellness too, I was trying to keep the idea of Wellness and illness separate I think is really hard to do because I think there's this notion of optimization and this idea that we should always be optimizing and always striving for better health and wellbeing, whatever capacity. And yet also I think so many people with any sort of preexisting illness or symptoms of an illness or something that's undiagnosed and that they're not sure about are attracted to Wellness culture for its promises of healing. And so it's really hard to separate out Wellness from illness actually. And I think they are very intertwined. And I think that it's really interesting the way that you point out that these distinctions of the logic of restoration and the logic of enhancement really break down in Wellness culture where the logic of enhancement tends to fold back into the logic of restoration. So can you explain a little bit how that works and how you see that play out?
Colleen Derkatch: So what I found when I examined examples of Wellness discourse from across a range of texts, I looked at advertisements, websites, newspaper articles, magazine articles, blogs, and I also interviewed 40 participants and looked at a few other data sets as well. And what I found consistently is that when people talk about Wellness sort of in a general sense, they really talk about it in very positively charged language. They talk about it in terms of sort of felicitous excess, really just happy abundance. And you see a lot of verbs like boosting. So in a very general sense, people think of Wellness as a positive thing that they do for themselves to sort of optimize and improve themselves. But when I asked focused questions in the research interviews, the language that participants used really shifted quite suddenly to a language of illness and symptom treatment and restoration.
And it was often quite fluid. So they would talk about taking a supplement because they wanted to promote immune health, but then they would most often reach for that supplement actually when they were feeling ill. And so there was just a lot of slippage between these two different approaches. Another thing that I saw frequently was when individuals talked about using a supplement to restore their sleep or their mood or maybe to restore their iron levels, when those symptoms improved, they actually talked about how they keep taking them just because their energy and their mood, their cognition could always be better. And so there was a real kind of fluid movement between those poles. And sometimes it even happened in the same sentence. I recall one participant who was talking about using a supplement to optimize her blood. I can't remember the details now, but it was about I think making more hemoglobin or something. And so she used the supplement, but then it really became clear that actually it was about treating low iron and it would often happen even in the same sentence. So I found that really interesting because what we think we're doing when we engage in Wellness behaviors isn't always actually what we're really looking for. And so I found that kind of cycling between the logics of enhancement and restoration really fluid and sometimes can be mapped onto each other quite directly.
Christy Harrison: It's so interesting that you articulate that, and I feel like that's something that I grappled with in trying to define and explain what Wellness is. I couldn't quite put my finger on it. And I think that you articulate that so beautifully that it is this slippage between the two logics. You also talk about how Wellness promises something outside of the pharmaceutical model and the sick care of the conventional healthcare system, but then in fact, Wellness actually conceives of our bodies and our health within a biomedical framework, just the same as those other systems. So I'm curious if you can unpack that a little bit for us and sort of how Wellness slots into this biomedical framework.
Colleen Derkatch: And that's one of the things that I found surprising really as I worked on this project was how deep the roots go within Wellness culture and natural health, how deep the roots go into the biomedical model and into the world of pharmaceutical marketing especially. And so Wellness culture as it currently manifests really approaches bodies as infinitely provable bodies become projects that we as good citizens and as good people need always to be working on. And this was really interesting to me because optimization seems kind of like the opposite of restoration, but in fact, failure to optimize or failure to self-improve, is itself, it's a form of failure. It's pathologized really within Wellness culture. So not only now do we have to get better when we're sick, but we have an obligation to ensure that we are as well as we can be or maximally well. And that pathologization really is characteristic of Biomedicine and particularly of pharmaceuticals. And so that was surprising to me because Wellness seems on the surface so opposite that.
Christy Harrison: Yeah, you've said that there's the idea of Wellness, it becomes incipient illness, that if you're well and you're pursuing Wellness, but you'll never totally achieve Wellness cause it's this thing that's always receding in the distance, it's never quite attainable. And so the lack of being optimally well, whatever that means is actually you're just at risk for illness. You're always teetering on the edge of illness.
Colleen Derkatch: Right. And that idea, because Wellness has no ceiling, and that's a core part of my argument is Wellness, there's you don't ever reach maximally well, there's always something else you can do. And in fact, this is where multidimensional models of health and Wellness can be challenging. They sound good. It sounds like an inherent good to think of health as more than just whether the body machine is running okay, because that's kind of a very traditional biomedical approach. And so widening the scope of how we think about health is positive in many respects, but one of the hazards is that it really expands the scope in which we can be ill. And so in that case, it's not just failure to optimize in one domain, but we can fail to optimize in multiple domains. So there we see that impulse of medicalization. When we saw, thinking back to sort of the emergence of medicalization as a concept with sociologist Peter Conrad in particular talking about how medicalization really is the process through which ordinary bodily states become reframed as medical problems, particularly when there's an intervention at the ready to treat it.
And so he tracked, this is going back to 94, I think was his first article on this, and then that concept has really taken root in social studies of health, but the idea where baldness can be reframed as a medical problem that has an existing treatment, erectile dysfunction, the same kind of thing. And what I found is that Wellness was actually really becoming medicalized in a significant way as well, except with the difference that now it's not just the body that can be pathologized, but it can also be I'm not engaging enough self-care psychologically, for example. So I think that's something to be really cautious about.
Christy Harrison: Yeah, it's almost like this new yard stick to measure ourselves against or this new stick to beat ourselves with really when we don't measure up, which is a flaw in the model. And I've tried to think about what is a model of wellbeing that is sort of more true to what we actually might want to encourage and strive for in thinking about centering mental wellbeing and social connection and economic stability and stuff like that. But even that can be twisted into this yardstick to measure yourself slash beat yourself with. So it's like can we ever really get away from, is the solution maybe not conceiving of a model of Wellness or illness at all, but just sort of doing less to measure the health or wellbeing of bodies and people in general? I don't know.
Colleen Derkatch: Yeah, I think that that's really interesting and you touch on some important things and there is exciting stuff happening out in different Wellness spaces that are challenging kind of dominant models because the dominant model that I critique is really about how if you really boil it down, it's just more stuff for us to buy and do typically by hiring somebody to be a guru or to coach us or I don't know. I think about this a lot. For example, naturopathy, and I have friends who are naturopaths and really good friends, but one of the key things about the model is a lot of people are drawn to something like natural medicine because of the word natural. And I know you've had Alan Leitz on the podcast before and he's done great work in understanding the kind of really spiritual and religious undertones of that idea of the natural.
But if you look at practices like naturopathy, the range of tests now that you can do there with regular surveillance of all kinds of different things like hormones that aren't even done in mainstream Biomedicine, but it's something else to pay for that requires another intervention, typically it requires supplements. And so it all kind of spins out in a way that I think that this is what happens to health and bodies under capitalism. And so there's really interesting work happening, grassroots stuff, especially where people are asking questions about, do we really need to meditate our way out of precarious employment? Is that even possible? There are increasingly compelling calls for systemic approaches to problems that have so far been treated really as individual problems and individual failures.
Christy Harrison: And that's one thing I see in Wellness culture a lot, is the total ignoring of social determinants of health and the fact that economic security and avoiding discrimination and having access to safe sources of water and clean air and access to good healthcare, those are the things that actually promote wellbeing at the societal level far more than individual behaviors ever could. And that's just totally missing, I think from the kind of typical Wellness culture model.
Colleen Derkatch: And I think, you know, can't monetize that. I think that that's a really big piece of it, the kinds of systemic solutions I think that we need. They're really expensive and they don't make anyone any money, and that's a real challenge. This is something that people have asked me about my book and said, okay, well what's the solution? And I mean, I don't have an easy solution because we're so embedded in this very particular framework of thinking about bodies and thinking about health and just for us living in contemporary 21st century capitalist society, it's sort of the nature of the beast really. What we can do though is ask questions and we can draw attention to things that need attention as a way to add pressure so that for example, individuals who face pressure from their workplaces to do lunchtime yoga can push back and say, what we need is more reasonable working hours and reasonable working conditions and those kinds of things. So I think there's potential for shifting the conversation and I think there's a wonderful course of books right now, including yours that really lending weight to that pressure.
Christy Harrison: Yeah, thank you. I'm glad to be a part of this moment. I think a lot of us were thinking about these things in tandem because I mean, for me, just seeing the pandemic and how striking the impact of social determinants of health were and are, especially as that emerged in the early days of the pandemic with who was being the most impacted and who was able to stay at home and not expose themselves to the virus and stuff, it was just so clear that social determinants of health played such a huge role in people's outcomes there. And then seeing the way that Wellness culture capitalized on that moment to sell immune boosting supplements and you know, had all these multi-level marketing people coming out and saying that their essential oil was going to cure covid or whatever, and just wild claims kind of abounding left and right and just the striking difference between Wellness cultures, like individualistic approaches and sort of capitalistic approaches to Covid prevention and cure versus what was actually happening at the systemic level and the level of social determinants of health, I think was really interesting
Colleen Derkatch: That there was this moment that I was so hopeful at the beginning of Covid, which is a weird sentence to say I'm aware, but it seemed for the first couple of months at least, I'm in Canada. And I think the Canadian response was a little bit different maybe, but it seemed that public health authorities, political leaders, and various other interested parties, the media all seemed to get on board with the idea of health on a collective level and on a population level rather than on an individual level. And it was so exciting for me as somebody who studies health communication and to look at how medical health officers would appear in the news and talk about stopping the spread in various ways and talking about things like herd immunity in ways that were really accessible and appreciable to sort of everyday people. And it was this really, really exciting moment because I'm a cynic at heart, but I just was optimistic that this might change the general conversation around health.
And then when all of the restrictions were in place, it was all kind of for the benefit of the good, but it was very easy to forget about the Amazon workers who were delivering all the packages to our houses and the delivery people, the people stocking warehouses, and it was kind of easy to forget about that, but it was a piece of a broader conversation, but then slowly as all the restrictions were peeled away and then masks became a personal choice and vaccination became a personal choice, that moment kind of vanished, but it was for a minute there I was pretty hopeful and excited.
Christy Harrison: I know I felt the same way too. I felt like it was finally social determinants of health were finally getting into the mainstream conversation and all the talk of stop the spread, flatten the curve, your mask protects me, my mask protects you, all of that stuff. It just felt like there was finally some emphasis on collective wellbeing. And then I mean in the US I think it was far less than in Canada, but still was happening to some extent. And then, I mean everywhere this is happening now, but I think it maybe started in right wing American spaces and probably in other countries as well. This idea that it was oppressive to make people wear masks or to have shutdowns and the right-wing seizure of these ideas and vilifying of public health figures and turning it into this, it kind of got folded into preexisting debates, I think, and preexisting culture war issues that were raging on already, but then you know, had this interesting nexus of conspiracist and anti-vax movement and right-wing ideology. I know you are on the spirituality podcast, and I think they do such a great job of unpacking that nexus. But yeah, it's just gone in such weird directions, and I couldn't have predicted that I think at the beginning of the pandemic or I guess I didn't want to predict that. I'm also a cynic at heart, but I think have a really optimistic side too, I guess, I don't know, maybe I'm equal measures cynical and optimistic. So I was hopeful and had those hopes dashed pretty quickly as well.
Colleen Derkatch: Yeah, it lasted a long time. So in Canada, and I think it's because our health system is so wildly different in many ways, we have publicly funded healthcare. It is universal, it's not perfect and it is uneven across the country. But I live in Ontario, I live in Toronto, Ontario, and we have a conservative government. And what was interesting is that Ontario actually had the longest lockdown across the country. We were always able to move around, so we weren't locked down in our homes, but schools were closed the longest. And I feel like without any evidence to back this up at this moment, I think the scene in Canada was quite inherently different because it wasn't so sharply politicized. We did have the kind of trucker convoy that you probably heard abouts. Yeah. And ended up in DC as well, I think. But that was quite fringy and mainstream conservative politicians were very quick to distance themselves.
It was a really interesting cultural moment because even though the pandemic kind of shifted from the kind of really acute emergency phase where it was about flattening the curve, et cetera, there was still a kind of broader sense of collectivity that lasted really quite a long time. I think, what are we, it's 2023 now, spring 2023, and I think hospitals in my province only just dropped their mask mandate in the last couple of weeks. So up until then you had to have a mask in a hospital. So really quite longer restrictions. So in some ways this question about Covid-19 and public health, the cultural differences between the US and Canada, if we zoom out, we can think about those distinctions even with Wellness itself, because my book looks at Wellness in both Canada and the US. So I have research data from Canada, particularly interviews, and I did an analysis of a data set of public comments on a petition against supplement regulation. But most of my public texts are from the US and so I do kind of track some of those distinctions a little bit. And so I think there are some kind of characteristic differences between approaches to public health or let's say the health of the public. So not public health as a discipline, but the idea of social determinants of health. There are some major distinctions between Canada and the US, but I think that Covid didn’t leave a huge imprint on how we talk about things like Wellness in terms of social determinants of health. But maybe there's just the tiniest, tiniest little impression.
Christy Harrison: Well, I think that transitions nicely into talking about language and Rhetoric of Wellness. You write that Wellness is a language which I really find interesting. I actually majored in Rhetoric as an undergrad, so I really appreciate the idea of exploring the Rhetoric of health and Wellness and the rhetorical power of the concept of Wellness. Can you explain a little bit what you mean when you say that Wellness is a language and why do you think it's important to examine Wellness in this way at the sort of rhetorical linguistic level as opposed to only critiquing the Wellness industry, which I know important critiques have done as well.
Colleen Derkatch: And they are important for sure. My point of intervention is language always because I'm a language scholar, and so I refer to Wellness as a language in the sense that it's a code for communication. Maybe it's not technically a language, maybe it's more of a dialect because it's not officially sanctioned and it's obviously not a complete language, but it does have characteristics of language that are important to recognize. It has a kind of internal grammar; it has an internal set of logics and symbolic patterns. I'm using the idea of language there really metaphorically, no linguist would ever agree with me that Wellness is a language. But what I mean by that is that language really provides the stuff we think with it happens really below the level of everyday consciousness. And that's I think the kind of important distinction with my book and other contemporaneous books about Wellness and the Wellness industry.
My book says something slightly different. And so it's a voice in a chorus where what I'm able to offer is that because Wellness works like a language, it really becomes a framework for thinking about and seeing the world that goes beyond marketing campaigns. It goes beyond influencers and producers because it becomes part of all of us in the ways that we think about our bodies and the ways that we think about what to do when we feel an ache or a pain or a cold coming on, how do we make decisions about our health and our bodies? And so using that metaphor of a language gets at that idea and it really moves the emphasis away from those who are consciously out to sell you and more looks at the diffuse patterns of speech and talk and writing and discourse that happened at all scales in contemporary life. Whether it's an ad for a supplement I see in the back of a magazine or the conversation I have with myself when I'm trying to convince myself to meditate or to work out, it really kind of affects all aspects of human life.
Christy Harrison: Yeah, I mean language really determines what we pay attention to. I've been thinking about that a lot lately because I have a one-year-old daughter who's learning how to talk and seeing her start to put words to things and point them out. She's so excited to point out things that she knows the words to, but then how already at such a young age that's limiting what she pays attention to in her surroundings. That probably happened for everyone at a young age that we learned to pay attention to certain things based on what we had concepts for and language for, and maybe we sort of filter out other things. And so I thought about that when reading your book in terms of the concept of Wellness, the tension between the logic of restoration and the logic of enhancement, it sort of collapses and people end up speaking about both things in the same sentence.
We're thinking about illness in Wellness terms and we're thinking about Wellness in illness terms, and these things get so collapsed that I think it becomes easy to sort of buy into some of what the industry is selling as supposed solutions for illness or supposed tools for optimization. Because I think whether we're feeling ill and dealing with a chronic condition or whether we're feeling well but think we should be feeling better or having some symptoms that we think are signs of incipient illness, we're at always feeling at risk of not being well. And so therefore we're always more susceptible to pitches that make us feel like something is going to save us from ourselves or save us from the illness that's just around the corner.
Colleen Derkatch: And that's something I thought about a lot. One I came across early in my research was an article, I think it's from way back, I think it's from like 94 or something, but it's two ethnographers, Nick Duran Thompson who did an ethnography. And the article is called For My Wellness Now My Illness. And they did an ethnographic study of people who use supplements, and they were really interested in the reasons people cited. And the title of the article actually comes from one research participant who said, oh, that supplement, I take that for my Wellness, not my illness. And so they really conceived of these as really separate things. What I'm really interested in, and I think part of the reason why I use this metaphor of Wellness being a language is because language is the stuff we think with as we sort of understand and interpret the world around us.
And what I wanted to highlight in the book is how Wellness works as a kind of universe of discourse that is very self-reinforcing. And you mentioned the idea of risk a minute ago, and I think risk was really important for me in thinking about how the language of Wellness works because scholars who have studied risk and even communication scholars who have studied risk like Lisa Keränen, have studied how the more at risk we feel, the more risk mitigating behaviors we engage in. And so for Keränen, and Keränen examines disaster preparedness, particularly she looks at rhetoric’s of bioterror in particular. She's a colleague in communication who's at University of Colorado, Denver. And it was her work really on this concept of autopoiesis that became the framework for the book. And autopoesis just means self-driving, and I argue that Wellness is a self-driving discourse and this concept I borrow from Keränen and who looks at how.
So in terms of risk preparedness when there are big terror preparedness exercises that happen in the US as they engage in these exercises to protect from risks of terror, the more at-risk people feel and then the more sort of preventative measures they engage in. And so these rhetoric of risk in terms of bioterror for Keränen and sort of spiral and grow. And I really saw something very similar happening in Wellness culture where the idea of risk in particular helps the language of Wellness spiral and grow kind of out of control in a way because we're always at risk of something in the world of Wellness, whether we're at risk of becoming ill or at risk of just failing to self-optimize to not live our best lives. And I started to wonder what would it be like if we just embraced sitting on the couch playing Mario Kart for an evening when we could be doing laundry or maximizing our social time with friends or other things? What does it mean to just waste time? And so that became kind of a big piece of what I was thinking about.
Christy Harrison: So fascinating. And I think all this speaks to the fact that Wellness culture has many problems and that feeling of constantly being at risk can make people feel worse in the long run. And Wellness, the emphasis on the individual responsibility I think has a flip side of individual blame and self-blame when things don't work out, when we get ill, when we fail to optimize and whatever. And so all of that to me speaks to the harms of Wellness culture. And you write in the book too, you say Wellness is among the most compelling and possibly most harmful concepts that govern contemporary western life. And yet you also say that your book isn't meant to be a polemical takedown of Wellness culture because Wellness culture provides some important benefits for people. And I think that's really important and that's something I also grappled with in writing this new book, which is probably a bit more polemical maybe than yours and some ways.
But I also have so much compassion for people who find themselves attracted to Wellness culture, find value in Wellness practices. And I was very much one of those people in the past as I am still to somewhat lesser degree today as someone with multiple chronic conditions that I'll probably always be managing. So I'm just curious to unpack a little bit that need for compassion and that need for understanding of the aspects of Wellness culture that people find helpful or the participants in your study found helpful and why it's important to acknowledge those even as we critique Wellness culture and even as we recognize its profound harms that it's causing.
Colleen Derkatch: This is a great question. I had to work really hard to not be polemical because I had to grapple with things that I found kind of hard to get on board with. Some things I actually found pretty easy to get on board with. Some things I find harder to get on board with in terms of different Wellness behaviors people engage in. So I dunno, I'm not very psyched about going to a vitamin IV clinic, for example, but I understand why people do it, and I think that that's really key because that gets lost. Cause I think there is really important information in letting your guard down and trying to work within the kind of internal logic that people employ when they make decisions about their health. If you enter the situation, sure that you know the right thing, then it makes it much harder to see the really valid reasons people make decisions that they make.
Even if it's a device. I really try hard not to make fun of things that people do for health, but I feel like a device, the Healy device is maybe one, it's okay to make fun of, but little gadgets you can buy online that ostensibly do something amazing for you, but probably do nothing at all. But people are looking for solutions to problems and they're not finding them elsewhere, and that just really gets lost. And so I think that there's definitely room for correcting scientific misinformation and disinformation. I think that there's value in that for sure. But if we want to kind of address the upstream causes of why people make the decisions they make about their health, why do people choose not to vaccinate themselves or their children, for example? Why do people eat certain kinds of diets or take certain kinds of supplements?
I think we need to make ourselves a bit vulnerable in our inquiry because what we find is that what's at the very center of someone's reasoning, it might all seem illogical on the surface, but if you get to the core, it's usually about some kind of unmet need. And so for a lot of people it's chronic conditions, degenerative conditions, conditions for which Biomedicine isn't able to offer a lot of support. Things like pain, low energy, brain fog. These are things that are extremely difficult to address. So for a lot of people, particularly my research participants, they weren't finding any help or relief anywhere else. But what was really key is that for the most part, the people I interviewed were pretty circumspect actually about the different supplements they take. They weren't sure if they worked or not, they knew that a lot of it was about marketing and sales pitches, but something I heard often was, but it's the only thing there is for me to do where I feel like I'm doing something for myself because I don't have any other options because it won't hurt.
And I think part of that actually circles back into mainstream pharmaceutical medicine. And the idea is for decades now that health is an individual responsibility, that we are each responsible for making choices about our health, and then we're primed by pharmaceutical marketing, advertising. Even the way that doctors in clinics prescribe and talk about medication is that the right step always to take is to take action, to seek a treatment in one way or another. And so in a lot of ways, people who are engaging in Wellness oriented behaviors, I'm looking particularly at supplements, they're kind of acting in accordance with those foundational logics of pharmaceutical Biomedicine, which is on that idea of, I can't remember who said this, but a pill for every ill, that idea that we can and should treat anything that can be treated. And so I think that that's really an important piece also.
Christy Harrison: Yeah, it's hugely important. It's so interesting to think about how conventional medicine is sometimes justifiably, but also, I think there's sort of an amplification of this that it's called out for just prescribing pills and not getting to the root cause. And I think that's Rhetoric, that shows up a lot in alternative healthcare spaces and just Wellness culture more generally. And ironically, I think a lot of those spaces prescribing pills too, it's just a different form. It's just supplements instead of pharmaceuticals with the added layer of potential harm that supplements are really largely unregulated, and you don't really know what's in them. Nobody's kind of looking out for you before they go to market in the US. And from what I understand from your book, in Canada as well, that there's not really pre-market regulation on supplements in the supplement industry in these countries. And so people are really taking a risk when they take supplements, but they're framed as being more natural, more gentle, a better alternative to pharmaceuticals, even though sometimes they literally contain pharmaceuticals that are just undeclared on the label.
But the Wellness rhetoric around them is that they're always good and they can't hurt. And I think a lot of people do. I've found in my research and working with clients and also my personal experience that it was the same thing. So many people who are skeptical, thoughtful, consider the evidence type of people when faced with health concerns that they don't have good answers for in the conventional healthcare system, will kind of shrug and go, well, what's the harm of taking this pill? What's the harm of changing my diet in this way? And what I've found is that there can be significant harm in doing those things, but I think it's understandable to think that especially given the failings of the conventional healthcare system.
Colleen Derkatch: And I mean I don't mean to be down on Biomedicine either because any given health practitioner or health practice or health specialty can only do so much. And a lot of the failings of Biomedicine are more political and economic failings than the disciplines themselves. If we look at how medicine is prioritized economically, how it's structured in terms of policy, how our doctor's appointments scheduled, how much time do patients get? And that also comes down into medical schools and medical education where we talk about how we want well-rounded individuals to be doctors. But then if you think about the kinds of hours that are required for doctors in their training, the kinds of things they're taught, all of these things are kind of a bit of a perfect storm that you can't, can't point to any one bad actor, but really this whole system is set up to create some pretty substantial cracks.
And for a lot of people, Wellness is appealing because it gives them a sense of agency. So you don't have to go to a doctor to get a prescription, you don't have to go to a pharmacy, you know you can go to Whole Foods with wood floors and organic produce displays. And it feels like something good you're doing for yourself. And that's something I saw again and again in my research across all of the different types of materials I examined, was that people found significant value in being able to do good things for themselves to make them feel good, because many people feel really disempowered within the medical system and unimportant, and they don't get to express the full range of their concerns. Each specialty has its own specialty body system or part. So there's not a lot of space to talk about that bigger picture.
And the reason why I look at supplements in particular is for exactly the reasons you cite, because supplements are for the most part, pills and bottles just like most pharmaceuticals are. And so they're so substantially and yet unlike pharmaceuticals, that it's a really interesting place to look for how Wellness culture operates because for a lot of people, they really think of supplements as just fundamentally distinct, even though as you mentioned, sometimes they actually even contain pharmaceuticals, they're not tested for safety and efficacy, and most people don't actually know that, at least in Canada, what I found consistently is that people think that supplements are regulated by Health Canada. There are regulations, but they all are aftermarket. So that's really key. And then if you track supplement companies’ ownership high enough, you often get to a pharmaceutical company anyway and supplements. It's not like someone has taken a plant and grounded up finally and put it straight in a capsule, right? They are synthesized in labs. There's just this really interesting tension. So that's why I focused on supplements in particular, but I think a lot of my findings can be extrapolated to other manifestations of Wellness culture.
Christy Harrison: One thing that I found really interesting was your discussion of the term toxins and why they've become such a focus of Wellness culture and why detoxes sell so well. And I think it's a really interesting and important counterpoint to some of the debunking that happens in mainstream publications that we talked about. And I've participated in that myself. I wrote a piece in 2016 for Refinery 29, why detoxes and cleanses always fail. And talking about how the liver works and the kidneys work and why these things are bogus. And like you said, I think that's important and has its place, and there are people maybe who are ready to hear that or find that helpful counterpoints themselves to kind of push back against the pressure to engage in these sorts of things. But I think there's this other piece that you explore in your book that I think is really important about why toxins have captured our imagination and why they've resonated with so many people, why detoxes have felt like the answer for so many people. So love for you to share a little bit about why you think that is.
Colleen Derkatch: Sure. Let me just preface this by saying that I don't think detoxes work. I don't know. So one of the funny things about my work, because I'm a humanities scholar, I'm a communications scholar, I have never driven deep into the literature to find out whether or not things actually work. I'm not actually interested in that myself. I think that's a different question for different people to answer. I'm really interested in what are people looking for and what are they getting and how are they making decisions? How do they weigh different kinds of evidence? And I think the idea of toxins is really key to understanding this because what we know about toxins in our environment, and by toxins here, I mean dangerous chemicals, I think we know everything is actually a chemical. And so we can talk about the rhetoric of chemicals in Wellness language because that term is often used in a very specific way.
But we know about environmental contamination, for example, from industry, from agriculture. We know that certain mattress coatings can end up in tissues in the human body, fire retardants, et cetera. We know that the boundaries of our bodies are permeable. And toxins capture sort of a very interesting piece of the larger puzzle because I talk about this in the book. Our bodies are opaque. We can't see inside them. We don't know what's going on in inside them. If you look at contemporary public discourse about health, most of us have sort of secret illnesses harbored within us at any given time, and we need to engage in really close surveillance to figure out what's going on inside of our bodies. And so we're already primed to think of our bodies as potentially ill, and now we also think of them as potentially contaminated. And if you think about decades of environmental deregulation and loosening restrictions on dangerous outputs in the air, in water, in soil, I think people are pretty rightly concerned about being surrounded every day by toxins.
There's no easy answer for that, right? We can't stop breathing. Covid was a really good moment on this because then we realized, oh yeah, when we're out in public together, we breathe all over each other. And so what's outside comes in our bodies. And so toxins, I think, really capture people's interest because you can control to some extent what you eat and how much your body moves, et cetera. But it's incredibly difficult to control what seeps in without us noticing whether it's chemicals in sunscreen or coatings on the foods that we eat or the mattresses we sleep on, or the air that we're walking through in the city, et cetera, et cetera. And so detox is one of the things that they do kind of rhetorically is help us feel like we're able to protect ourselves and to purify ourselves of these kinds of daily exposures.
And so I think that that's one reason why detoxes are so popular. And so the question of debunking detoxes, if someone's really into cleanses because they have these deep penetrating concerns telling them they have a liver and kidneys probably won't allay their concern because I think most people feel like what we're exposed to every day is maybe more than a body can bear. And so the body needs some extra help with that. And so I think that's one of the key appeals with detoxes. The thing about a detox rhetorically is they're very persuasive because you do have inputs and outputs when you do a cleanse. And I think this is largely because a lot of supplement supported cleanses contain laxatives, but there's poop at the end of this that you can see marked changes in. So that's a very physical indication that something important has happened in the body.
I didn't put this in the book. I did end up going on an unfortunate internet rabbit hole. I haven't looked in years, so I can't promise it's still there. But if you looked up like cleanse poop or keywords like that, people would actually take pictures of things that came out of their colons during cleanses, and what they would do is cite this as evidence that the cleanse is effective, and they would refer to it as “toxic sludge.” So it's all the toxins coming out of your body, but it also works quite metaphorically too, and I think this is something that Alan Levinovitz touches on. We can also think of cleanses as sort of rights of purification that help us kind of renew ourselves. And so there's kind of a whole metaphorical dimension of cleanses and toxins as well that I think it makes them really compelling and in a way that debunking probably can't access those sort of deep social and psychological and spiritual significations.
Christy Harrison: So well said. I really, really could talk to you forever. I really appreciate your work. I feel like this is so aligned with this podcast and with just my interests these past few years. I'm really grateful to you for coming on and sharing all of that with us. So can you tell us where people can find you and learn more about your work and get your book?
Colleen Derkatch: Sure. My book is available at all major booksellers that sell academic books. So not a lot of brick-and-mortar stores probably, but certainly available on the publisher's website, which is Johns Hopkins University Press, as well as Amazon and Barnes & Noble, et cetera. And I can be found on my website at
http://www.ColleenDerkatch.com
or on Twitter @ColleenDerkatch. Not sure how much longer I'll be on Twitter for, but it's a bit of a dumpster fire these days, but that's where I am for now.
Christy Harrison: Yeah, we'll put links to all that in the show notes too. I also recently got off Twitter, so I feel you on that.
Colleen Derkatch: I tried. I tried looking for you and I did not find you, and I thought, well, good for her.
Christy Harrison: Yeah, I was there for years, and I just said, nope, not anymore. I went on maternity leave and didn't use it for a year, and then I was like, well, what am I even doing here? Then it just kind of feels like a liability now with Elon Musk's takeover and all of that.
Colleen Derkatch: Yeah, I hear you. It's such a good academic tool, so I'm kind of hanging on right now, but I think I'll, I'll go that way too because it's not good for my Wellness to be on there.
Christy Harrison: Right, right. Yeah, that's a whole other piece of this conversation too, is the impact of social media on our collective wellbeing. I'm sure we could have a whole other conversation about that, so we'll have to have a part two at some point.
Colleen Derkatch: Alright, I'll look forward to that.
Christy Harrison: Yes, me too. Thank you so much.
Colleen Derkatch: Thank you.
Christy Harrison: So that's our show. Thanks so much to our guest for being here, and thanks to you for listening. If you enjoyed this conversation, I'd be so grateful if you take a moment to subscribe, rate and review the podcast wherever you're listening to this, and you can get new episodes delivered by email every other week by signing up at rethinkingwellness.substack.com, where you can also become a paid subscriber for early access to episodes and to help support the show. That's rethinkingwellness.substack.com. If you're looking for help healing your own relationship with food and breaking free from diet and Wellness culture, I'd love for you to check out my online course, Intuitive Eating Fundamentals. You can learn more and sign up at ChristyHarrison.com/course. That's ChristyHarrison.com/course. If you have any questions for me about Wellness and diet-culture, you can send them in at ChristyHarrison.com/questions for a chance to have them answered in my newsletter or possibly even on this podcast sometime in the future. Rethinking Wellness is executive produced and hosted by me, Christy Harrison. Mike Leland is our audio editor and sound engineer, and administrative support is provided by Julianne Wotasik and her team at A-Team Virtual. Our album Art was created by Tara Jacoby, and theme song was written and performed by Carolyn Pennypacker Riggs. Thanks again for listening.
