COMMUNICATION 2021 | Chapter Showcase

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FROM THE EDITOR

Over this past year, we have had to adapt how we communicate with our colleagues, friends, family, and community. As the way we communicate continues to evolve and present new challenges, our goal at Lexington Books is to publish timely and diverse research that interrogates and investigates questions surrounding communication’s role and impact in our interpersonal relationships, politics, organizations, communities, and workplaces. The chapters I selected for this showcase explore intersectionalities in the fields of Chicana feminism; analyze ways in which Indigenous Knowledge is effectively incorporated into an Indigenous postsecondary setting; examine the challenges of voicing a womanist ethic of liberation and social justice; address how culture and integrated marketing can be situated within risk and crisis communication; and highlight how the ecological model of wholeness is applied to chronic condition self-management. I invite you to publish your next book with Lexington Books. In 2021, I plan to expand our list with more titles on family communication, risk communication, journalism, and health communication and welcome proposal submissions outside of those areas as well. We publish monographs, edited collections, and revised dissertations by both emerging and established scholars, including interdisciplinary and multidisciplinary works. While we publish many standalone titles, we also publish books in series that bring together incisive scholarship around a key subject, such as Lexington Studies in Political Communication; Lexington Studies in Health Communication; Lexington Studies in Contemporary Rhetoric; and Environmental Communication and Nature. Click here to see a full list of our series. Lexington Books offers an expedited decision-making process, peer review, and a rapid production process to ensure that your research is published quickly. We publish high-quality books with full-color covers, and we market our new titles aggressively around the world. Our titles are regularly reviewed in scholarly journals and have received significant awards and honors for academic scholarship. To submit a proposal for a book project, please review our submission guidelines and email a full prospectus to me at [email protected]. Or, if you prefer to discuss your project with me first, please email me to set up a time for a phone call. I look forward to hearing from you about your research.

Sincerely,

NICOLETTE AMSTUTZ Director of Editorial, Senior Acquisitions Editor, Communication LEXINGTON BOOKS

contents

4 - 25 Michelle A. Holling, “Intersectionalities in the Fields of Chicana Feminism: Pursuing Decolonization through Xicanisma’s ‘Resurrection of the Dreamers,’” in De-Whitening Intersectionality: Race, Intercultural Communication, and Politics, ed. Shinsuke Eguchi, Bernadette Marie Calafell, and Shadee Abdi

26 - 43 Keith Williams and Suzanne Brant, “Plant Persons, More-than- Human Power, and Institutional Practices in Indigenous Higher Education,” in Communicating in the Anthropocene: Intimate Relations, eds. C. Vail Fletcher and Alexa M. Dare

44 - 59 Annette D. Madlock, “Voicing a Womanist Ethic of Liberation and Social Justice among the Religious Right,” in Womanist Ethical Rhetoric: A Call for Liberation and Social Justice in Turbulent Times, eds. Annette D. Madlock and Cerise L. Glenn

60 - 78 Robert S. Littlefield, Deanna D. Sellnow, and Timothy L. Sellnow, “Situating Culture and Integrated Marketing in Risk and Crisis Communication” in Integrated Marketing Communications in Risk and Crisis Contexts: A Culture-Centered Approach

79 - 109 Vinita Agarwal, “The Wholeness Project” in Medical Humanism, Chronic Illness, and the Body in Pain

The pagination of the original chapters has been preserved to enable accurate citations of these chapters. These chapters are provided for personal use only and may not be reproduced in any form or by any electronic or mechanical means without permission of the publisher. All rights reserved. Michelle A. Holling, “Intersectionalities in the Fields of Chicana Feminism: Pursuing Decolonization through Xicanisma’s ‘Resurrection of the Dreamers,’” in De-Whitening Intersectionality: Race, Intercultural Communication, and Politics, ed. Shinsuke Eguchi, Bernadette Marie Calafell, and Shadee Abdi (Lanham, MD: Lexington Books, 2020), 3–24. All Rights Reserved.

Chapter 1

Intersectionalities in the Fields of Chicana Feminism Pursuing Decolonization through Xicanisma’s “Resurrection of the Dreamers” Michelle A. Holling

Over twenty years ago, I began studying Chicana feminism—“a national- ist and feminist struggle against racism and sexism, designed to improve the position of Chicanas in American society” (García, 1989, pp. 220–21). Chicana feminism was and remains a means to know them/us/me and, as important, to (w)rite them/us/me into a disciplinary field in which they/we/ me had been invisible. That is, throughout most of my graduate education, there was no published literature in communication about Chicanas and, there were less than a handful of articles that examined the rhetoric of Chicanos. Such an absence made me question if they/we/me had a place in the field of communication and if Chicana feminist theory, when integrated, would be perceived as instructive to understandings about the field and its subfields. Scholarship over the years has since made significant inroads not only to fill the gaping hole in knowledge but also to demonstrate Chicana feminism as a heuristic for the study of communication.1 Within Chicana feminism lies the affirmation of racial, ethnic, gendered, and classed identities and voces2 [voices] that speak of cultural struggles and resistance. In addition to the widely known and cited Chicana feminist voces of Gloria Anzaldúa and Cherríe Moraga are many other less-known Chicana feminists who began putting pen to paper to articulate a set of experiences that pointed to triple oppression3 or, the triumvirate of race, class, and gender oppression. Although rarely heard nowadays, triple oppression was the ter- minology adopted by Chicana feminists preceding what many now recognize

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as “intersectionality” (Crenshaw, 1993) or the matrix of domination (Hill Collins, 1991). By turning to Chicana feminists, the point is not a matter of whose claims to intersectionality are the basis for intersectionality, but rather how particular racial-ethnic, gendered, classed, and sexed identities structure and offer unique understandings about intersectional matrices, power, resistance, and levels of oppression. Moreover, in thinking about how to enlarge current understandings of Chicana feminism and its emphasis on intersectionality, I turn to the voz [voice] of Ana Castillo in particular, her monograph Massacre of the Dreamers (1994).4 She is considered “one of the most outspoken voices for the ‘colonized woman’” and her book is “a work that explains more clearly than any other the historical, philosophical, and political underpinnings of contemporary Chicana writing” (Milligan, 1999, pp. 19–20). In Massacre, Castillo theorizes Xicanisma and its possibilities for reinvigorating Chicana feminism which “has fallen prey to theoretical abstractions” (1994, p. 11). Although she at times explains Xicanisma as conceptually referring to Chicana feminism, Castillo harkens to indigenisma, feminine principle, and activista and feminista impulses to advance an alternate view. Her use of “X” is a gesture to the racial-indigenous roots that metaphorically and literally ground Xica- nas subsequently predating nascent appearances of “x.” Xicanisma contains within it an expanded perspective on intersectionality as both repressive and restorative that is racially ethnically situated, cognizant of forces of oppression, guided by conscientización, and a (re)turn to ethnic-cultural practices that seek to decolonize Xicanas. Xicanisma, therefore, contributes to this volume’s goal of de-whitening intersectionality given the primacy placed on culturally grounded ideas and emphasis on difference that is firmly steeped in a “MexicAmerIndian”5 identity. Castillo’s ideas offer points of connection for (critical) (inter-)cultural scholars interested in decolonization, cultural practices, and, of course, intersectionality. Before turning to her work, I first revisit pivotal Chicana feminist writings from the Chicano movement period to familiarize readers with how Chicanas were thinking and writing about triple oppression. I then move inward by synthe- sizing a sampling of scholarship in communication that made inroads to establish Chicana feminist frameworks, ones that implicated intersectionality. From Chi- cana feminism, I turn to Castillo’s notion of Xicanisma and advance intersectionality, as both repressive and restorative, concluding with final thoughts.

CHICANA FEMINISM IN THE FIELD(S)

As a trope, “field(s)” acknowledges various material sites in which Xicanas have labored. For example, there are historical battlefields in which Malinche,

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soldaderas, and adelitas found themselves laboring to survive; agricultural fields in which Dolores Huerta and many unnamed Chicana (and Filipina) migrant workers challenged exploitative conditions and resisted treatment experienced from agribusiness; and fields of struggle, cultural and ideological, occurring within the Chicano and women’s movements. Extended discussions of each type of field that burgeons Chicana feminism is beyond the scope of this chapter. I do, however, provide an overview of Chicana feminism from the fields, historically and contemporarily, that (re)inscribes a set of experiences, knowledge, and theories foretelling triple oppression.

Early Feministas Culture-based infusions of Chicana feminism date to Chicana writings in which scholars, poets, and writers drew from a colonized history and archetypes arising in and from it to begin theorizing the specificities of Chicana feminism. La Virgen de Guadalupe, la Malinche, la adelita, and la soldadera are key archetypes6 who were “products of their environment and producers of history”7 (Williams, 1998, p. 218). The first two are products from a history of conquest(s) and subsequent colonization that sought to deny the indigenous origins of both Tonantzin8 better known as la Virgen and Malinalli or Malintzin better known as la Malinche, supposed traitor to her race due to her alliance with Hernán Cortés. Not until Chicana feminists’ writings are different interpretations of those two archetypes rendered, but in particular of Malinche as a producer of history and feminist prototype for Chicanas.9 In terms of la adelita and soldaderas, as participants in the Mexican Revolution, they retain symmetry to la Virgen and Malinche. Adelitas, as with la Virgen, historically are adored and venerated, whereas soldaderas and Malinche are positioned in and at the service of others,10 despite their acumen and strategic maneuverings in actual war times. Turning to the archetypes not only affirms a cultural legacy left for contemporary Chicanas, but they also intimate a distinct understanding of intersectionality as pointing to conditions of conquest, colonization, and religiosity. Such a view directs attention to the interaction of conditions that produce cultural domination on the basis of race, class, and gender; indicate oppressor/oppressed relationship that brings about subordination; and orient scholars to discern intersectionality as temporally inflected by conditions that then bear upon identities and subjectivities. The mix of conquest, colonialism, and religion had lasting impacts on Chicanas’ insurgency of the 1960s who turned to soldaderas and Malinche for inspiration and who contended with the strictures of la Virgen, all of which brought about particular tensions. One such tension is that of the buena mujer [good woman] and mala mujer [bad woman], an additional way that Chicanas’ identities are scripted

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dichotomously along sexual[ized], gendered, racialized, and classed ways (Castillo, 1994; Holling, 1994, 2000; NietoGomez, 1997). As a derivative from the intersection of conquest, colonization, and religiosity, the dichotomy of buena-mala mujer later played out along the lines of Chicana loyalists and Chicana feminists that parallels the cultural values attached to La Virgen and the ascribed traitorous behavior of La Malinche, respectively. In brief, “loyalists viewed Chicanas who called themselves feminists as allies of a middle-class women’s movement who advocated individualistic upward mobility rather than struggle against race/class domination. Feminists . . . argued that the struggle against male domination was central to the overall Chicana/o movement for liberation” (Segura & Pesquera, 1988/1990, p. 74). The split was an ideological and hence a cultural one in that loyalists were traditionalists, emphasized Chicana/o familial values and gendered roles, and “believed that racism not sexism was the greater battle” (Castillo, 1994, p. 34). Chicana feminists, on the other hand, identified racism, sexism, and classism as triple oppressive factors that impeded their social and familial mobility. Perceived as mujeres malas, Chicana feminists’ tenuous alliance with each of the Chicano and women’s movements would both fall short in addressing the layered forms of oppression experienced by Chicanas (Hol- ling, 1994); thus, their formation of distinct organizations11 and their own feminist movement. Chicana feminists’ writings during movement periods indicate a growing awareness of what was then termed “triple oppression”; the three levels of oppression based on race, class, and gender that produce social inequalities. Reflecting on her own participation in the Chicano movement, Ana Castillo (1994) identified racism, sexism, and sexist-racism “as ways that oppressed socially and economically” (p. 33). Triple oppression may attribute to economic-structural dimensions and/or be “reproduced ideologically and socio- culturally” (Segura, 1990, p. 58). Important to note is that triple oppression presumes interplay, rather than an additive approach to understanding social inequities. Segura (1990), for example, emphasizes the interactive consequences experienced by Chicanas who are subordinated socially and economically on the basis of race, class, and gender relative to men of color and white counterparts, within and outside of the home. A survey of Chicana feminist writings is apt to find both perspectives of triple oppression (i.e., economic- structural and ideological-cultural). Ideologically, Chicana feminists bore responsibility for challenging hierarchical views of triple oppression in which racism was perceived of utmost importance (a viewpoint among Chicanos) or, challenging the view that sexism compromised cultural notions of familia [family] or Chicanas’ femininity in identifying as feminists (Longeaux y Vázquez, 1973). A prime example of a Chicana feminist’s effort to unseat a hierarchy of triple oppression is Cherríe Moraga’s (1981) autobiographical

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poem “La Güera.” In comparing her lesbianism to her mother’s brownness, she realizes both are poverties and “the danger lies in ranking the oppressions. The danger lies in failing to acknowledge the specificity of the oppression” (p. 29). Her cautionary words are significant in that she warned against viewing oppressions as a competition and, in doing so, encouraged feminists, Chicanas or otherwise, to identify points of commonalities amid distinctions that differently anchor oppression as a means toward solidarity. Moreover, Moraga, among others, expands triple oppression to account for sexuality as another axis of which Chicana lesbians contended. Cataloguing Chicana feminists’ herstorical12 legacies and more broadly Chicana feminists’ writings is Alma García’s (1997) Chicana Feminist Thought: The Basic Historical Writings, culled from prose, poetry, conferences, and newspapers. It remains a premier, if not primer, on the ways that Chicanas experienced racist-sexist and/or racist-sexist-classist oppression that was a basis for their activism, resistance, and theorizing. The purposes of Chicana feminists’ writings are complex given desires to challenge restrictive cultural ideologies, to create a sense of place given bicultural identifications, to craft identities and subjectivities uniquely their own as revealed in scholarly writings, and to alter imbalances of power (Castillo, 1994; Dicochea, 2004; Flores, 1996; Holling, 1994, 2000). Ana Castillo characterizes Chicana feminists’ writings as “un tapiz,” a “tapestry of conscientización” (1994, p. 171). She names writings by herself, Gloria Anzaldúa, and Cherrie Moraga who revision culture through inventional resources of metaphors, subversion, and word play. The invention inherent in Chicana feminists’ writings becomes apparent when considering, for example, Pat Mora’s (1990) poem “Legal Alien” or Ana Castillo’s (1994) motif of “countryless woman” that speak to resulting feelings from triple oppression. Implied in each motif are layers of displacement. One layer is from justice-oriented movements in which Chicanas’ concerns with triple oppression were not wholly embraced thus necessitating them to break away and foment change on their own behalf. There is also displacement from nation-states, United States and Mexico, in which Ch/ Xicanas although legally possessing U.S. citizenship, remain perceptually as “alien” or “countryless” consequently exist outside of representational boundaries, left to navigate bicultural identifications. Mora explains, “Ameri- can but hyphenated,/viewed by Anglos as perhaps exotic,/perhaps inferior, definitely different,/viewed by Mexicans as alien,/their eyes say,‘ You may speak/Spanish but you’re not like me’ ” (p. 376). Ascribed a “foreign-like identity” (Castillo, 1994, p. 39) are resulting traumas of assimilation and internalized racism produced from colonial relations in a U.S. context and lack of acceptance in a Mexican context that produce a countryless woman. Ultimately, Chicanas are tokenized: “A handy token/sliding back and forth/

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between the fringes of both worlds/by smiling/by masking the discomfort/of being pre-judged/bi-laterally” (Mora, 1990, p. 376).

Intersectional Chicana Feminist Perspectives The marginality Chicanas experienced in U.S. society regrettably extends into the field of communication wherein the appearance of scholarship that centralizes them was slow to manifest even as scholarship about Chicanos was published (Holling, 2008). I turn to select seminal works and scholars for two reasons.13 Early scholarship indicates a disciplinary micro-herstory of Chicana feminist ideas by communication scholars that reflects their work as “archeologists,” a role Castillo (1994) encourages. In such a capacity, scholars excavate Chicana writings, along with their own experiences, to develop theoretical frameworks by which to study voces [voices] of difference. As I argued elsewhere, “the use of difference to herald identities historically stereotyped, scorned, and/or negated is significant in light of public discourses that exert control (or attempt to) over how” Chicanas are understood by publics at large (Holling, 2008, p. 304). Second, the selected essays are ones that to date have received varying degrees of attention. The collective “we” have failed to apprehend key moments in which scholars theorize what I term an intersectional Chicana feminist perspective on theoretical and methodological levels for the field of communication. Therefore, digging up seminal essays is to know (and, possibly adopt) scholars’ early accountings of intersectionality that surfaced most in (inter)culture, rhetoric, performance studies, and Latin@ communication during a “decade of repoliticalization” (Holling, 2008).14 The contours of an intersectional Chicana feminist perspective begin with a critical orientation that concerns itself theoretically with voz [voice], through which power struggles and resistance surface, and with materiality. The principle of voz highlights embodiment and contributes to decolonizing efforts. She who speaks reclaims her (cultural) truths, speaks through different linguistic tongues (e.g., English, Spanish, Spanglish, Nahuatl, etc.), expresses experiences of triple oppression, instructs how a marginalized population has proceeded in their pursuit for justice, and disrupts colonialist efforts to silence and erase Chicanas. This is much like the reclamation of Malinalli who possessed “the gift of the voice” (De La Garza, 2004, p. 108); this is much like the efforts of Chicana scholars to have their writings and acts of speaking reflect their“ effort to live and become that which has been silenced in [her] life” (Martinez, 2000, p. 130); and, this is much like some who have contributed to the development of Latina/o performance as a way of expanding disciplinary voices heard (Calafell, 2003). In each/all instances,

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countering silences obviously relies upon voz (and/or vocalities) and sources of knowledge. Chicanas’ bodies15 and experiences are the sources from which they produce insights and acknowledge their material realities that belie intersectionality. Martinez (2000) asserts, Chicana experiences “become the site of interrogation whereby we may come to better understand how a racis t-sex ist-c lassi st-ho mopho bic-a ssimi latio nist culture works so as to more effectively counteract it” (p. 106). Evident is that intersectionality anchors Chicana feminist theorizing, whether multilayered or the triumvirate of race, class, and gender. Depending on which scholarly work is consulted, other manifestations of intersectionality come to the fore.16 Flores (2000), for example, extends identity categories to mean the “interconnectedness of gender, race, class, and heterosexuality” (p. 693). Differently is De La Garza (2004) who, in thinking through labels attributed to women of Mexican descent, notes “four primary dimensions . . . religion, sexual mores, social class, and race” (p. 13) that due to their ideological force intersectionally constrain Mexican-Chicana women (p. 32). Methodologically, Chicana scholars draw on personal narratives, auto-ethnography and biography, and personal experience as a basis for knowledge production as well as a means to analyze culture (Calafell, 2003, 2005; De La Garza, 2004; Flores, 2000; Martinez, 2000).17 In so doing, the body is a means through which loss, memory, and “queer temporality,”18 among other possibilities, come to the fore (Calafell, 2003). As “sources of political power” (De La Garza, 2004, p. 123), Chicana feminists act as “cultural scribes” (Flores, 2000, p. 692) writing to tell of their own experience and cultural history in order to “challenge the neo-colonial practices which shape the lives of Chicana/os” (Flores, 2000, p. 693). Endeavoring as they do, an array of Chicana feminist scholar[s] in diverse disciplinary fields bring forth and highlight Chicanas’ voces [voices] yet, re/membering they are “one voice among many” (Flores, 2000, p. 695). Chicanas’ knowledge and experiences, existing in archives or catalogued in anthologies and literature, are a basis for theorizing Chicana-centered frameworks. Ones developed include Chicana critical rhetoric (Dicochea, 2004) or subject/ivity, identity, and agency (Holling, 2000) that provide a means by which to analyze Chicanas’ writings, news-like publications, and fictional literature, respectively.19 Dicochea and Holling each merge Chicana feminist studies with critical veins of rhetoric in order to herald Chicanas’ “unique body of knowledge” (Dicochea, 2004, p. 78) as influenced by their material realities that range from economic or educational inequalities to culturally constraining ideologies. Their scholarship also indicates the ways in which Chicana feminist writings convey resistive and transformative possibilities for living.20

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Complicating the principle of voz (and, intersectionality) is Garza (2011) who offers a way to include and move beyond the potentialities (and limitations) of a singular voz [voice] by turning to vocalities21 related to the Mexica legend of Coyolxauhqui. Garza explains that vocality not only gives “voices its rhetorical emphasis” (p. 37), it also “attempts to account for the ways in which subjects of discourse become creators, innovators, or producers of discourse, in order to forge new articulations that aim to expand agency and empowerment through calls for consciousness” (p. 41). Although the term “intersectionality” does not appear in Garza’s theorization of vocality, there is a sense that uni-, multi-, and hypervocality form a type of intersectionality that highlights power (i.e., struggles over which layering of vocality acquires prominence). Layerings of vocality may be compounded based on textual, narrative, or experiential voicings from Chicanas that overlap thereby revealing the urgency behind voice(s) and indicating possible conflicts or tensions inherent in or following from the interaction of vocalities. From this concise survey of scholarship that advances an intersectional Chicana feminist perspective, some observations. Intersectionality appears in triumvirate form and extends to account for sexuality that harken to early feministas. Martinez (2000) and Calafell (2003), for example, weave sexuality and queerness, respectively into their monographs that deepens their reflections on processes of assimilation, for instance. What becomes evident among the works discussed under this section is the incremental movement to expand intersectionality as race, class, and gender. The modicum of attention on sexuality and queerness might also be contextualized and hence understood as a reflection of the literature selected and/or as the state and development of scholarship within the field in particular moments. In addition, vocalities (Garza, 2011) or ideological layerings (e.g., De La Garza, 2004; Holling, 2000) indicate robust intersections that are culturally situated and beckon attention to the ways that race, class, and gender play out in these formations of intersectionality. Next, intersectionality in Chicana feminists’ lives reflects and urges deep-seated grappling with the ways that identity categories and ideologies overlap to position them against that which they resist. This point is crucial; intersectionality exceeds mere (ac)counting of identities. To engage intersectionality as simply a matter of overlapping identities is not only reductive, it abandons a focus on power that animates the lives of individuals. Instead, intersectionality is a modus operandi that has, and continues, to play a role in Chicana feminists’ activism, organizing, and efforts to create social change. A contemporary example is the Esperanza Center that views optimism, holistic approach, intersectionality, relationality, and historicity as key components to its methodology to social justice (deTurk, 2015). Further complicating intersectionality is the work of Castillo, who identifies other facets that affect Chi- canas’ identities and provides entry points to reinvigorate Chicana feminism.

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“WE ARE A GOD-DAMN WALKING MIRACLE”

The epigraph, voiced by Inez Talamantez (qtd. in Castillo, 1994, p. 221), opening this section pays homage to the resilience of Xicanas, who persist and survive (while aiming to thrive) amid oppressive forces that seek to squelch her/our spirit. Two aims compose this final section—one is to advance what I label repressive intersectionalities that enliven the meaning- fulness of Talamantez’s words thus providing a backdrop to apprehending the necessity of Ana Castillo’s conception of Xicanisma. The second aim is to elaborate on the contours of Xicanisma and its ideas for what I term restorative intersectionalities that hold relevance for the everyday and, as important, suggest a pathway toward decolonization. Scholars in communication view decolonization as important move to pursue and reveal in Chican@-Latin@ communication (Flores, 2000; Holling & Calafell, 2011; Martinez, 2004). Thus, Castillo’s work revalues cultural facets that seek to restore Xicanas’ spirituality, reclaim sexuality, and redress the harms committed in, by, and through culture at large.

Repressive Intersectionalities Massacre of the Dreamers provocatively compels reflection about the agent(s) and victims of violence. To massacre indicates full-on assaults against individuals, populations, or groups in order to usurp their power, agency, and way of being. Following from a massacre are the relations of col- onizer/colonized in the case of Xicanas and its significant impacts on knowledge received and learned. As a consequence, perpetuated is “systematic and determined ignorance” among Xicanas, who have been denied access to their historical-cultural knowledges and “white dominant society,” who have suppressed the histories and literature of marginalized peoples (Castillo, 1994, p. 5). The repressive forces affecting Xicanas, historically and contemporarily, are macro level and point to an understanding of intersectionality shaped by colonial legacies. Forces that repress Xicanas are distinct yet, also intersect to include nationalism, machismo, capitalism, and Catholicism that inhibit conscientización. While page limits prevent me from going into immense detail on each factor, I offer some elaboration. A problematic of nationalism—whether from a movement period as in the Chicano movement or nation-state—is its premise of ethnic and racial identification to the subordination of other identity categories that resulted in the marginalization of Xicanas. More broadly, nationalism is exclusionary and “always find[s] justification for manipulation of power” (Castillo, 1994, p. 226). The nationalism of the Chicano-era movement, and by extension the nation-state, results in a “countryless woman”

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(Castillo, p. 21). She is accorded no space within la causa as a feminista and representationally absent in the United States; her visibility becomes possible if she opts to subscribe to “Hispanic,” a flattener of difference that names Spain as the “paternal cultural progenitor” (Castillo, p. 28). Displacement then produces alienation, demoralization, dominant/subordinate relations, racial rejection and/or invisibility, consequences that necessitate a pathway to conscientización. A by-product of the aforementioned forces is perceptions of Xicanas’ role as producers-reproducers that create a contemporary manifestation of being colonized. That is, economic (among other) systems co-opt and control Xica- nas’, extending to marginalized womens’, labor and bodies.22 The role of producer-reproducer certainly has a political economy bent considering the relationality of “the domineering husband, the sexist activist, and el patrón” (Castillo, 1994, p. 58) to Catholicism as it hails from Christianity, nationalism, and capitalism respectively, that perpetuate women as “productive/ reproductive entit[ies] within U.S. Mexican society” (p. 36). Capitalism may be broadened to include global economic forces in light of neoliberal policies (e.g., NAFTA) wherein corporations have readily available and exploitable labor forces that perpetuate economic inequities based on race and gender. A concern of Castillo is the absence of conscientización—for some but not all women—that “makes the maquiladora an ideal worker for the semi-legal, exploitative operations of multi-national factory production” (p. 38). In the case of factory workers,23 if conscientización is not developed, discerning discrimination remains possible; the challenge is coping or resisting it. In the absence of conscientización, it may be fostered through labor activism (p. 47), as an act that challenges “white supremacist patriarchy” (p. 58), and building solidarity with marginalized women globally (p. 61). With the intensification of capitalism so too has women’s oppression as they have been viewed as “property” (Castillo, 1994, p. 64), a notion that surfaces with the appearance of machismo attributable to “tribal societies” (p. 70) in particular. The intersection of machismo, a means through which patriarchy manifests, with Catholic doctrine enforces the “reproducer” role of Xicanas that leads to a repression of their spirituality and sexuality. Such repressions, particularly the (con)scripting of heterosexual desire serve men, are premised on domination and power, and objectify women (Castillo, p. 127). For Xicanas to reclaim both spirituality and sexuality would challenge systems that have long benefited. “There is no utopia” for Xicanas, not to mention “brown women,” when one resides in a world that colonizes Xicanas spiritually, mentally, physically, and sexually (Castillo, 1994, p. 145). The process of colonization brought with it transformative forces, such as those elaborated upon, that deleteriously affect Xicanas. Colonization vis-à-vis internalized racism has also enforced

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a presumption that Xicanas possess no right to their perspectives (Castillo, p. 175). As a consequence, they seek to overcome cultural “self-contempt” and writing inferiority (p. 168), lest they adopt “white writing”24 (p. 167). Intimated here, but also throughout Massacre of the Dreamers are levels of oppression based on race, ethnicity, class, gender, language, and skin color that “all determine identity and predict one’s fate in the United States” (Castillo, p. 29). Where various forces literally and metaphorically massacre Xicanas, or seek to, in light of a history of subjugation, racism, ethnocen- trism, and imperialism, Castillo is hopeful about possibilities. The title of her final chapter—“Resurrection of the Dreamers”—completes her vision. It is not of a religious orientation; rather, a recovery of knowledge and practices, suppressed due to forces previously reviewed, that she discusses across different chapters as ways to promote Xicanas’ conscientización that aims for human liberation.

Restorative Intersectionalities Castillo’s hopefulness for a future other than what it is garners strength from the fact that Xicanistas have a history of activating themselves and those around them. She identifies “the activista” of the 1960–1970s era and the generation that came of age during the Reagan–Bush era because their “flesh, mind and soul serve[d] as the lightning rod for the confluence of her consciousness” (1994, p. 93). Activism is a path toward conscientización and, so too is higher education (although it sometimes requires Xicanas viewing themselves as “educatable,”25 a hurdle to overcome given socializing messages that convey otherwise, p. 50). Regardless of the path taken toward conscientización, it and related practices is of necessity for Xicanas to recover their creative powers that aid in attaining larger aims to sustain themselves and those around them. From the perspective of Xicanisma, an understanding of intersectionality as restorative is suggested; the intersectional axis being spirituality, sexuality, and identities (e.g., race, class, gender). The first two replenish Xicanas’ identities that put her on a path of conscientización and embolden her. To begin, self-defining as a Xicanista“ is a rejection of colonization” (Castillo, 1994, p. 12) in that her point of origin so to speak anchors in its meaning. Contrary to what Xicanas experienced in previous social justice movements, Castillo advocates that Xicanisma resist hierarchical ideologies, not be elitist nor woman-identified nor quick to attack or retaliate against those who contend with their own spiritual distancing (p. 224). The presence of any undercut a resurrection of the dreamers. Instead, Xicanisma is a way to reclaim the erasure of mestizas and Chicanas as well as counter perceptions of them/us as recently immigrated absent a colonial history (p. 23). Fending

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off erasures harkens possibly to a primordial period when considering the following: “The basic premise of Xicanisma is to reconsider behavior long seen as inherent in the MexicAmerIndian woman’s character, such as, patience, perseverance, industriousness . . . we do not reject these virtues. . . . [they] may be considered strengths” (p. 40). Castillo’s assertion functions not as an “essentialist rhetoric of exclusion” (Carson, 2004, p. 123) instead, as a means to ground Xicanas in their racial-ethnic (and gendered) heritage. In so doing, they/we embark on a reclamation of culturally based practices and ways of being that enable Xicanas to carry on their work not only as “obreras cultura- les” [cultural workers] (Castillo, p. 94) but also as “cultural guerrillas” (Cas- tillo, p. 220) who work adamantly to subvert that which undermines their/our sense of being. The collectivist orientation and multilevel responsibility to the self, others, allies, and the environment that informs Xicanisma derives from “an ever-present consciousness of our interdependency” rooted in Xican@ culture and history (Castillo, p. 226) that enables Xicanas, and extending to men and non-Mexicans, to understand themselves. Toward that end, Castillo holds out a vision where Xicanas, and brown women generally, would no longer experience exploitation, predatory behavior, self- and other hatred, or objectification. Ultimately,“ our vision as Xicanistas expects peace. . . . not the opposite of war, [rather] the achievement of balance” (Castillo, p. 225). Viewing intersectionality as restorative (or as repressive) is a perspectival shift that recognizes when identities are influenced by cultural strategies that enrich the individual, she derives strength that assists her in combating inequalities. The cultural strategies Castillo names are a form of “self-care.” My reticence with such phrasing has most to do with its depoliticized middle- class overtones in which those with means, who feel beleaguered by a state of affairs in daily life that overwhelm, literally turn further inward to tend to the individual consequently away from structural matters that necessitate attention.26 Nonetheless, Xicanas’ self-care entails culturally based strategies such as dreams, visions, brujeria, and curanderisma, or language alchemy to reclaim an embodied connection to that which has been suppressed. Self-care for Xicanas begins with reclaiming their indigenisma and “reinsert[ing] the forsaken feminine into consciousness” (Castillo, 1994, p. 12). These inter- related practices help to counteract the spiritual imbalance created from centuries old dualisms that hail from religious doctrine and nationalism. Indigenismo, for example, has long been repressed due to Christianity and Chicanas’ conditioning to forget about their indigenous roots (Castillo, p. 87). However, by learning and embracing indigenismo, Xicanas learn about themselves and accept “oneself as an individual and of her/his people” (Cas- tillo, p. 6). Indigenismo invokes the feminine based on who it implicates, namely, Coatlicue, “the serpent skirt and mother of many deities”27 (Garza, 2011, p. 39). Mexican society transforms Coatlicue into Tonantzin, who due

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to Spanish colonization is transformed into La Virgen de Guadalupe, later appropriated during the Chicano movement to advance nationalistic aims. Through such transformations, the feminine is imbued with the negative and dichotomizes Xicanas’ roles as either the “buena mujer” or the “mala mujer” contra to the power that inhered in Mexica female deities. As Garza (2011) writes, “Mexica female cultural mythic, religious, and historical figures have become symbolic of the struggle for Indigenous [sic] female empowerment, and the right to self-determination” (p. 39). Thus, Castillo asserts the feminine “is best recognized in our devotion to Tonantzin/La Virgen de Guada- lupe”28 (p. 88). The feminine principle “is concerned with preservation, protection—especially of the young and less fortunate—and affiliations of communities for the common good” (Castillo, 1994, p. 87). It also exists within males and females, and “may be generally termed as the absence of machismo—all the qualities that have been negated, denied, denigrated, and made to be essentially valueless by our society” (Castillo, p. 82). By embracing indigenismo and the feminine, Xicanas begin to heal their traumatized, spiritual, and sexual selves; in so doing, she communicates her rejection of institutionalized religion, which has encouraged women’s submissive and secondary status and repressed women’s sexuality yet, men’s expression of it (p. 107) subsequently, beginning her decolonization. Proclaiming spirituality rather than religiosity becomes “an act of insurrection to the system” (Castillo, p. 147) as Xicanas’ agency manifests through their ability to define what is“ needed to give [them] courage” (Castillo, p. 145). Xicanas may draw on homeopathic or non-Western methodologies such as curanderas or brujas, sweat lodges, along with rituals such as creating altars, lighting candles, burning copal, or baños (bath infused with herbs and spirits to “remedy physical or emotional ills,” p. 160), or resurrecting Mexica goddesses to aid spiritual healing and cleansing. For example, curanderas are “a specialized healer” of the body who diagnosis ailments, whereas brujas are “a spiritual healer or psychic” (Castillo, p. 156), each of whom are differently skilled based on specialties related to healing.29 Evident is that spirituality is an individualistic endeavor given the array of methodologies or cultural practices and rituals available to Xicanas. The spirituality that Castillo advocates is woman-centered and values Xicana’s creatix ability (e.g., not being shameful of menses instead accepting it as a symbol of fertility and divine power, p. 123). By reconnecting to spirituality, which anchors Xicanas in the body, they simultaneously begin to challenge their expected role as reproducers. Their sexuality historically and contemporarily through religion, and Catholicism in particular, “has enforced female sexual repression” (Castillo, p. 128) outside of the confines of reproduction. Xicanisma encourages recognition of the functions of heterosexual desire that are at the expense of Xicanas embracing their sexuality and desires. Phrased

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otherwise, heterosexual desire is designed to serve men, offers no role models of sexual relationships other than that of domination and power, and objecti- fies women (p. 127). Instead, Castillo encourages Xicanas“ to explore our erotic selves while attempting to remain true to the Mexican/Chicana/Latina/ India/mestiza aspects of our sociopolitical identity” (p. 141). Ultimately, whatever forms Xicanas adopt to practice spirituality and pathways taken to reconnect to her sexuality should maintain the goal of restoring the feminine and address their contemporary needs.

CONCLUDING REMARKS

The aim of this chapter has been to present manifestations of intersectionality from Chicana and Xicana feminist perspectives that remind readers of the triple oppressive force of racism, sexism, and classism that initially shaped Ch/Xicanas’ view of intersectionality. In so doing, this chapter contributes to a goal of this collection—“de-whitening intersectionality” (Eguchi, Calafell, & Abdi). Its timeliness contributes to and advances “race(ing) intercultural communication” (Moon & Holling, 2016, p. 3). Either/both moves, as with this chapter, convey concern, if not take umbrage with, uses of intersectionality that strip it of its politicized orientation, reduce it to identity politics, and/or adopt it for decorative branding purposes in organizational settings (Blige, 2013; Crenshaw, 2015). Whether in the classroom, at conferences, or in organizational settings, when scholars apply intersectionality as though it is merely a mechanism for articulating identities that intersect does the theory and its origins a disservice. Recall Crenshaw’s (2015) originating idea, “intersectionality is an analytic sensibility, a way of thinking about identity and its relationship to power” (para. 6, emphasis added). Apprehending power becomes apparent through manifestations of intersectionality politically, structurally, or representationally that produce subordination among women of color given their identities (Crenshaw, 1993). A question that comes to mind is in what ways might those very identities that intersect be not only a basis for subordination or repression, as discussed, but also restorative? Carrying out Crenshaw’s view of intersectionality “requires paying proper attention to historical contingencies, to specific contexts, and the purposes of specific arguments” (Blige, 2013, p. 420). With “historical contingencies” and “specific contexts” in mind, I turned my attention to Chicana and Xicana feminism across different periods. Chi- cana feminism during movement period names triple oppression that they experienced in structural-economic ways and in sociocultural, ideological terms. A result were tensions (e.g., buena/mala mujer) Chicanas navigated and exposed in their writings that subsequently revealed Chicanas’ writing

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as multifunctional and inventional. This first field of knowledge indicates intersectionality as affected by conditions of conquest, colonization, and religiosity that produce cultural domination based on race, class, and gender. Next, analyzing Chicanas’ writings and/or cultural archetypes are Chicana feminist scholars in communication whose work indicates intersectional Chicana feminist perspectives. Apparent from the literature are formations of intersectionality as interconnected identities (i.e., gender, race, class, and [hetero]sexuality), ideological layerings (e.g., religion, sexual mores, social class, and race), and vocalities (i.e., uni, multi, and hyper), each of which foreground matters of voz [voice] and power. The varieties of intersectionality implicate identity matters and power thus engaging in a “politic of disruption” (Moon & Holling, 2016). The final perspective on intersectionality is from Xicanisma. A Xicana feminist view of intersectionality, as conceived from Ana Cas- tillo’s monograph Massacre of the Dreamers (1994), assumes an accounting of macro forces as sites in and from which triple oppression surfaces and identifying micro approaches for counteracting the effects from structures. Carrying out that view of intersectionality also works in the service of “a politic of disruption” (Moon & Holling, 2016, p. 3) precisely due to its disrupting the (mis)taken-for-granted use of intersectionality as micro oriented. Instead, attention to the macro-micro tension (Holling & Moon, 2016, p. 185) implicated in intersectionality provokes questions about the conditions that enable racist-sexism to persist or about the power dynamics that enable or constrain individual actions in the face of structural inequities; both of which, for example, help advance the call for race(ing) intercultural communication (Moon & Holling, 2016, p. 3). Alternatively, a decolonial frame, in the sense of disrupting various dominant and Chicano histories (consult Pérez, 1999), informs a Xicana feminist view of intersectionality. One way is Xicanisma’s recovery of cultural knowledge and practices that herald from their racial- ethnic-gendered history. Another way is Xicanisma’s acknowledgement of Xicanas’ stance as “countryless woman” (Castillo, 1994) that indicates disaffinity with the notion of nation (and culture as nation, see Halualani, Mendoza, & Drzewiecka, 2009) that is not only static but exclusive of intersectional identities that inhibit “cultural guerrillas” (Castillo). Finally, I further discerned intersectionality as repressive and as restorative which contribute to intercultural communication and race. Despite being presented as dualities, likely an unintended consequence of Western thinking, intersectionality as both repressive and restorative is a perspectival shift to accepting them as dialectical, a stance in better alignment with critical intercultural communication (Martin & Nakayama, 1999) and with Castillo’s conception of Xicanisma, which is “based on wholeness not dualism” (p. 226). For instance, where nationalism, machismo, capitalism, and Catholicism were

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identified as distinct forces that repress Xicanas and inhibit conscientización, Castillo’s vision of Xicanisma, along with its embrace of indigenismo, the feminine, and cultural practices and rituals, are restorative thereby providing a pathway to conscientización, an awakening central to decolonizing oneself. More specifically, repressive intersectionalities operate on a macro level wherein structural forces and ideologies repress on the basis of, for example, race, ethnicity, class, gender, language, and skin color, attributable to colonial legacies. Xicanas consequently experience displacement from themselves, communities, and society given dichotomized roles as producer/reproducer. Restorative intersectionalities are enacted on a micro level; they are individual in the sense of the diverse racial-ethnic cultural practices and rituals that may be selected to promote self-care. It is needed given the lingering impact of a colonial history on Xicanas’ spiritual and sexual selves that affect their racial, gendered, classed, and sexed identities. The idea is that through Xicanas’ ability to restore themselves bears implications for communities based on the interdependent and collectivist orientation of Xicanisma and those who avow the identity of Xicana. Intersectionalities in the way proposed (i.e., repressive and restorative) encourages scholars to discern possibilities of decolonization as arising from that which individuals are encouraged to disassociate (e.g., indigenismo). In so doing, new insights and knowledge may arise about the “cultural-individual dialectic” (Martin & Nakayama, 1999) that bear upon the production of knowledge and cultural transformation.

NOTES

1. Consult my retrospective essay (2008) in which I chronicle the development of Chicana/o-Latina/o communication. 2. Elsewhere, I and coauthor Bernadette Calafell asserted that voces [voices] is a trope operating within Latin@ communication that highlights marginalized speaking subjects who self-assert using cultural forms of expression, who operate from a personal-performative stance that is contextually bound and responsive to “ideological barriers,” and who write “within and against marginalized and dominant discourses” (Calafell & Holling, 2011, p. xix). 3. Predating “triple oppression” is Frances Beal, who coined “double jeopardy.” It is a means to elucidate the intersection of being “black and female” (1970, p. 382). 4. University of New Mexico Press, which published the 1994 edition from which I work, rereleased a twentieth edition of Massacre of the Dreamers. 5. Castillo (1994) uses the label to represent the racial and ethnic composition of women of Mexican descent and “to assert both our indigenous blood and the source, at least in part, of our spirituality” (p. 10). 6. In addition to those named, Chicana feminist scholars in communication theorize by returning to Mexica deities such as Coatlicue or Coyolxauhqui (Garza, 2011).

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7. Writing on the subject of Chicano [sic] cinema, Williams theorizes “type,” a resistive possibility to the promulgation of stereotypes in media during the 1960–1970s. She writes that type “represent[s] both the historical and material situation of that minority and its very real differences from the dominant society” (pp. 216–217) subsequently, characters as type would be represented as “products of their environment,” positioned between cultures, and “produced by and producers of history” (p. 218). 8. For a more complicated rendering of Tonantzin consult De La Garza (2004). 9. Consult, for example, Calafell (2005), Candelaria (1980), or Del Castillo (1997) who argue Malinche as a transgressor of limited gendered roles ascribed in narratives about her. 10. During Spanish conquest, soldaderas were servants who took soldiers’ pay in exchange for food and supplies (Salas, 1990) whereas during the Mexican Revolu- tion, both soldaderas and adelitas were military soldiers and strategists (Cantú, 1990). Adelitas were later immortalized in corridos [akin to ballads], a site of their cultural reformation narratively. 11. One example is the establishment of Comisión Femenil Mexicana in 1970, a national Chicana organization that developed in part as a response to the marginalization of Chicanas’ contributions in social movements of the time (Comisión Femenil Mexicana, 1973). 12. The term “herstorical” (and herstory) privileges and records women’s experiences from a feminist perspective. Such an act resists the notion of hetero-patriarchal, masculinist rendering of history in which men are perceived as active agents in the production of “History.” Following Lerner, “History” with a capital “H” references the “recorded and interpreted past” (1986, p. 4) that has excluded women’s contributions consequently, not viewing them/us as central to “History-making” (p. 5). 13. Those in mind include Dolores Tanno, Sarah Amira De La Garza, Lisa A. Flores, Jacqueline Martinez, Bernadette Calafell, Perlita Dicochea, and myself. Coincidentally, with the exception of Dolores Tanno, all named authors, shared time and space(s) while at Arizona State University perhaps indicative of sensibilities and sensory affinities to do work as Chicana feminists in the southwest. 14. I acknowledge, yet treat secondarily, publications by Flores (1996), Palcze- wski (1996), Sowards (2010, 2012), or Enoch (2004, 2005), for example. These are important works to be clear for each advances understandings about Chicana feminist writings from distinct historical junctures and diverse fields. Yet, some of the essays also evince an Anzalduaean shift in the study of Chicana feminism and read most as Chicana feminist oriented criticisms. 15. I have in mind Moraga and Anzaldúa’s (1983) “theory in the flesh” in which flesh and blood concretize what Chicanas specifically, but all women of color generally, experience that serves as a basis for theorizing. 16. For example, Darrel Enck-Wanzer’s (2006) work on the Puerto Rican Young Lords informed his postulating intersectional rhetoric as or, the various formulations of intersectionality contained in Chávez and Griffin’s (2012) edited collection. 17. With the exception of Flores, the other scholars noted interrogate Mexican (American) and Chican@ culture using distinct approaches to interrogate their

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experiences as Chicanas. For example, De La Garza’s monograph reflects a spiritual journey as a means of finding and examining herself and her culture that she supple- ments with her four seasons approach and art as mediation that provide a methodology for embarking on auto-ethnographic work. 18. My read of Calafell’s advancement of “queer temporality” is that it is produced from reminiscing or nostalgia which privileges memory and it is a way to disidentify. Queer temporality is employed by individuals who have been ignored or misrepresented within dominant discourse subsequently challenging those discourses, creating community, and offering counter-narratives. 19. More recently, scholars have analyzed letters authored by Chicanas such as Gloria Anzaldúa and Dolores Huerta revealing their unique rhetorical functions inflected by intersections of race, class, gender, and/or nationality as well as by cultural ideologies and archetypes, consult Palczewski (1996) and Sowards (2010; 2012). 20. Evidence of Chicana feminist writings as transformative also appear in Chi- cana/Latina Education in Everyday Life edited by Delgado Bernal, Elenes, Godinez, and Villenas (2006). 21. Garza (2011) names three vocalities—univocal, “it emphasizes one particular line of argument or perspective” or when a singular medium is used; multivocality, an individual or group assertion of voice through multi-mediums; and hypervocality, “an excessive, ubiquitous, over-saturation of voice” (p. 42). 22. As examples, Castillo names corporations’ encouragement of Filipina workers to sterilize (p. 61), depleted wage earnings among women of color in the United States (p. 36), and an underpaid labor force in Mexico due to maquilas, products of which Mexicanas produce and whose labor is exported across the border due to policies such as NAFTA. 23. Castillo’s central focus throughout Massacre of the Dreamers is Xicanas yet, broadens when she speaks of maquilas [factories]. Due to its exploitative nature, along with her commitment to exploring racial-ethnic identities particularly where colonization has played a role in identity formation, she recognizes the implicature of all brown women working in factories in Juárez, Southeast Asia, or metropolitan cities such as Los Angeles or New York (Milligan, 1999, p. 23). 24. Generally, “white writing” is standard English; however, Castillo, drawing from Ivan Argűelles, explains it as periodically politically correct, safe, sanitized, and absent passion (1994, p. 168). 25. Seeing oneself as “educatable” is an issue that has confronted not only Mexican (Americans) but all “impoverished” women of color (pp. 50, 52). Dominant groups’ perceptions of Mexican Americans as “educatable” is complicated by historical instances of educational injustices such as with the Mendez v. Westminister and Lemon Grove cases. 26. For more on the politicization shift of self-care readers may consult Harris (2017). 27. Coatlicue “the earth goddess, goddess of fertility. She also represents death” (Castillo, 1994, p. 106). As the “serpent skirt” (Garza, 2011), her powers included controlling knowledge, immortality, and fertility (Castillo, p. 106).

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28. Castillo acknowledges that Xicanas may continue their practice of Catholicism and religious rituals due to the influence on identity yet, may reorder the value of La Virgen to be above God. 29. Curanderas may specialize in any or all of the following as sobaderas (i.e., gives massages), yerberas (i.e., expert in use of herbs), or parteras (i.e., midwives). A contemporary manifestation is the ChicanoBrujo who “reflects a therapeutic subjec- tivity that engages in a decolonial practice of healing an identity that struggles against the legacy of colonialism and its impact(s)” (Holling & Calafell, 2007, p. 65).

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Holling, M. A. (2000). Extending critical rhetoric and feminist theory: Rhetorical constructions of Chicana subject/ivity, identity and agency. Unpublished disserta- tion, Arizona State University. Holling, M. A. (2008). Retrospective on Latin@ rhetorical-performance scholarship: From “Chicano communication” to “Latina/o communication?” The Communica- tion Review, 11, 293–322. DOI: 10.1080/10714420802511218. Holling, M. A. & Calafell, B. M. (2007). Identities on stage and staging identities: ChicanoBrujo performances as emancipatory practices. Text and Performance Quarterly, 27(1), 58–83. Holling, M. A. & Calafell, B. M. (2011). Tracing the emergence of Latin@ vernacu- lars in studies of Latin@ communication. In M. A. Holling & B. M. Calafell (Eds.), Latina/o discourse in vernacular spaces: Somos de una voz? (pp. 17–29). Lanham, MD: Lexington Books. Holling, M. A. & Moon, D. G. (2016). Conclusion—Continuing a politic of disruption: Race(ing) intercultural communication. In D. G. Moon and M. A. Holling (Eds.), Race(ing) intercultural communication: Racial logics in a colorblind era (pp. 184–86). New York: Routledge. Lerner, G. (1986). The creation of patriarchy. New York: Oxford University Press. Longeaux y Vázquez, E. (1973). Soy Chicana primero. In A. García (Ed.), Chicana feminist thought: The basic historical writings (pp. 197–99). New York: Routledge. Martin, J. N. & Nakayama, T. K. (1999).Thinking dialectically about culture and communication. Communication Theory, 91, 1–25. Martinez, J. (2004). Forward. In S. A. De La Garza (Ed.), María speaks: Journeys into the mysteries of the mother in my life as a Chicana (pp. xi–xii). New York, NY: Peter Lang. Martinez, J. M. (2000). Phenomenology of Chicana experience and identity: Com- munication and transformation in praxis. Lanham, MD: Rowman and Littlefield. Milligan, B. (1999). An interview with Ana Castillo. South Central Review, 16(1), 19–29. Moon, D. G., & Holling, M. A. (2016). Introduction – A politic of disruption: Race(ing) intercultural communication. In D. G. Moon & M. A. Holling (Eds.), Race(ing) intercultural communication: Racial logics in a colorblind era (pp. 1–8). New York: Routledge. Moraga, C. (1981). La güera. In C. Moraga, & G. Anzaldúa (Eds.), This bridge called my back: Writings by radical women of color (pp. 27–34). New York: Kitchen Table Women of Color Press. Moraga, C. & Anzaldúa, G. (1981). Theory in the flesh. In C. Moraga & G. Anzaldúa (Eds.), This bridge called my back: Writings by radical women of color (p. 23). New York: Kitchen Table Women of Color Press. NietoGomez, A. (1997). La Chicana—Legacy of suffering and self-denial. In A. García (Ed.), Chicana feminist thought: The basic historical writings (pp. 48–50). New York: Routledge. Palczewski, C. H. (1996). Bodies, borders, and letters: Gloria Anzaldúa’s “Speak- ing in tongues: A letter to 3rd world women writers”. Southern Communication Journal, 62, 1–16.

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Pérez, E. (1999). The decolonial imaginary: Writing Chicanas into history. Bloom- ington, IN: Indiana University Press. Salas, E. (1990). Soldaderas in the Mexican military. Austin, TX: University Texas Press. Segura, D. A. (1990). Chicanas and triple oppression in the labor force. In T. Cór- dova, N. Cantú, G. Cardenas, J. García, & C. M. Sierra (Eds.), Chicana voices: Intersections of class, race, and gender (pp. 47–65). Colorado Springs, CO: National Association for Chicano Studies. Sowards, S. K. (2010). Rhetorical agency as haciendo caras and differential consciousness through lens of gender, race, ethnicity, and class: An examination of Dolores Huerta’s rhetoric. Communication Theory, 20, 223–47. DOI: 10.1111/j.1468-2885.2010.01361.x. Sowards, S. K. (2012). Rhetorical functions of letter writing: Dialogic collaboration, affirmation, and catharsis in Dolores Huerta’s letters. Communication Quarterly, 60(2), 295–315. DOI: 10.1080/01463373.2012.669341. Williams, L. (1998). Type and stereotype: Chicano images in film. In C. E. Rodríguez (Ed.), Latin looks: Images of Latinas and Latinos in the U.S. media (pp. 214–20). Boulder, CO: Westview Press.

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Eguchi et al. _9781498588225.indb 24 03-07-2020 19:28:05 Keith Williams and Suzanne Brant, “Plant Persons, More-than-Human Power, and Institutional Practices in Indigenous Higher Education,” in Communicating in the Anthropocene: Intimate Relations, eds. C. Vail Fletcher and Alexa M. Dare (Lanham, MD: Lexington Books, 2021), 197–214. All Rights Reserved.

Chapter 15

Plant Persons, More-than-Human Power, and Institutional Practices in Indigenous Higher Education Keith Williams and Suzanne Brant

“The Anthropocene” describes the current era of the Earth’s geologic history and is characterized by unprecedented human-mediated climate change, changes to landscape structure and the water cycle, and biodiversity loss (Steffen et al. 2011, 842–43). Higher education as an institution of cultural and social reproduction (Bourdieu 1973) is deeply implicated in the Anthropocene “by teaching how to most effectively marginalize and plunder Earth and human communities” (Vargas Roncancio et al. 2019, 1). Despite the existential threat posed by the changes characteristic of the Anthropocene, there are also positive social developments at this time. For example, Indigenous Peoples of Turtle Island1 are experiencing unprecedented levels of inclusion and success in mainstream postsecondary education (Mendelson 2006, 24). The decades-long struggle for educational equality—marked by various watershed moments such as the Indian Control of Indian Education policy paper (National Indian Brotherhood 1972), the dissolution of residential schools and the findings of Truth and Reconciliation Commission of Canada (TRC 2015), and the United Nations Declaration of the Rights of Indigenous Peoples (United Nations 2007)—looks like it is finally paying off. Although Indigenous Peoples are still underrepresented in higher education, more Indigenous learners are enrolled in, and graduating from, college and university programs, and Indigenous graduate employment rates are higher than ever (Hu, Daley, and Warman 2019, 63–64; Mendelson 2006, 24). Many Canadian colleges and universities are attempting to Indigenize higher education, which essentially involves expanding the academy’s conception of knowledge—including knowledge transmission and knowledge creation—to include Indigenous perspectives for transformative outcomes (Kuokkanen 2008, 2). Indigenous Peoples now have the autonomy to govern our own postsecondary institutions, for example through the First Nations University

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of Canada in Saskatchewan, the Indigenous Institutes in Ontario, the Tribal College system in the United States, and Intercultural University system in México and the rest of Latin America (Williams and Brant 2019, 140). The equity advances in postsecondary education suggest that society should continue following the current charted course if we want to eliminate, or continue to reduce, injustice and inequality in higher education. However, Gaudry and Lorenz (2018, para. 7–10) suggest that most universities’ attempts at “Indigenization” rely on empty rhetoric and, for the most part, involve simply hiring more Indigenous scholars and other staff without sufficient support and with the expectation that those hires will adapt to a Western cultural institution, not that the university will change its structures and processes to reflect Indigenous cultural values and practices. Ultimately many Indigenization efforts serve to reproduce the very structures that have historically served to erase and marginalize Indigenous Peoples (Gaudry and Lorenz 2018, para. 13). Indigenous Institutes are well positioned to offer an approach to higher education rooted in Indigenous Knowledge (IK). However, from the authors’ experience, Indigenous Institutes have faced chronic underfunding, lack of formal accreditation requiring program brokerage from mainstream colleges and universities, and paternalistic government intervention which have all limited the extent to which Indigenous higher education institutions in Canada have been able adequately to meet local needs (Crum, 2015; Stonechild, 2006) including the incorporation of traditional teachings and practices at all institutional levels. This chapter proposes that a business-as-usual approach to Indigenous higher education, whether in mainstream or Indigenous contexts, serves to reproduce human exceptionalism and the human-nature dualism that is, arguably, foundational to the Anthropocene, the neoliberal project, and the inequity and oppression that Indigenous Peoples of the Americas have faced since colonization. We offer examples of ways in which IK is effectively incorporated into an Indigenous postsecondary setting at FNTI, specifically dealing with the recognition of plant personhood and enactments of more-than-human relationality, despite the challenges identified in the previous paragraph.

NEOLIBERALISM AND INDIGENOUS HIGHER EDUCATION

The modern university system—relatively unchanged in underlying structure and social intent for almost one thousand years—originated in Europe’s high medieval period in response to a growing need for trained church administrators, priests, and missionaries as well as civil administrators (Axtell 2016, 1–2).

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Higher education, despite remaining faithful to its medieval ecclesiastical origins for centuries, is facing significant contemporary challenges from neoliberal ideology. Neoliberalism is a distinctly economic mode of governance now insinuated in domains—including, but not limited to, postsecondary education—that had previously been framed and governed by democratic ideals (Brown 2015). As Wendy Brown (2015) points out, “Democratic state commitments to equality, liberty, inclusion, and constitutionalism are now subordinate to the project of economic growth, competitive positioning, and capital enhancement” (26). Foucault (2008) in Gildersleeve (2017, 286) describes four ways in which neoliberalism influences society: hyper- individualism, hyper-surveillance, economic determinations of productivity, and competitive entrepreneurialism. Zygmunt Bauman’s articulation of liquid modernity offers a nuanced theoretical lens through which to view the neoliberal era. Bauman’s liquid modernity (2000) can be characterized by a climate of uncertainty in which citizens and other public and private-sector actors are constantly required to demonstrate their value and territory is rejected, “with its cumbersome corollaries of order-building, order-maintenance and the responsibility for the consequences of it all as well as of the necessity to bear their costs” (11). The aterritoriality associated with neoliberalism and Bauman’s liquid modernity is antithetical to Indigenous ontologies that, according to Osage scholar Robert Warrior (1999, 52), are based on topos or territory rather than logos or the word or discursive reason which forms the basis of dominant European ontologies. MacDonald (2011, 260–70) and Altamirano-Jiménez (2013, 53–54) suggest that the discursive overlap between Indigenous self-determination and the emphasis on individual autonomy via marketization in neoliberal thought limits our ability to effectively critique forms of Indigenous self-determination such as various manifestations of state-sponsored self-governance and also neoliberalism more broadly. Following Warrior’s (1999, 52) insight regarding topos versus logos, we suggest that institutional practices rooted in territory—either directly or indirectly—offer a productive response to neoliberalism. The following sections describe the recognition and enactment of our relational responsibilities to the more-than-human (Whatmore 2006, 601–2), in the form of plant persons, as a place-based form of resistance to neoliberal governmentality in an Indigenous higher education context and as a productive response to the challenges associated with the Anthropocene.

PERSONALITY, PLACE, AND MORE-THAN-HUMAN POWER

As mentioned in the previous section, topos or territory is fundamental to Indigenous conceptions of reality (Warrior 1999, 52). The centrality of

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territory is further articulated by Bob Antone (2013, 168) and Vine Deloria and Daniel Wildcat (2001), who assert that everything in the universe is alive and is related through connection to place. Deloria and Wildcat (2001) summarize this understanding with the formula “power and place produce personality” (23). Following Antone (2013, 168) and Deloria and Wildcat’s (2001, 23) position, we suggest that the aterritoriality associated with neoliberalism and liquid modernity deprive us of the full expression of our personhood and the personhood of the more-than-human with whom we are entangled. Indigenous Peoples have developed many ways to connect with what lin- guist Andrew Cowell (2018) calls more-than-human power (MTH power). Cowell’s work among the Northern Arapaho led to the understanding that

a person is sacred and powerful because that person literally has within them— or has access to—power derived either from the natural world or from ances- tors—both of whom mediate the general MTH power of the creator, which is immanent in the world. (9)

MTH power, in the Haudenosaunee world, is exemplified by the principle of kasasten’sera which is variously translated as strength or power (Akwesasne Notes 2005, 34–35). Oneida elder Bob Antone describes kasasten’sera as the power of the collective, and the strength that comes from thought and action unified with all of creation and the cycles of life (Antone 2013, 21–22). In this chapter, we choose to translate kasasten’sera in English as “continuance.” Kasasten’sera, or continuance, is the vital life-force of the human and more-than-human individual, human collectivities, and ecological communities and is a form of power derived from the unity of all matter that supports the continued existence of all creation. Kasasten’sera, and MTH power more broadly, differ significantly from dominant conceptions of power in Western philosophy which tend to emphasize domination (Foucault 1978; Baumann 2000) as “power over” or the inherent capacity of human agency (Arendt, 1958; Parsons 1963) as “power to.” Important feminist contributions to our theoretical understanding of power include Amy Allen’s notion of “power with” as the collective ability “to act together for the attainment of a common or shared end or series of ends” (1998, 35). Another traditional Haudenosaunee principle is ka’nikonhri:io, or the “good mind,” which occurs when the people put “their minds and emotions in harmony with the flow of the universe” (Mohawk 2010, 33). Achieving ka’nikonhri:io and drawing on the relationality inherent in kasasten’sera are necessary for becoming Onkwehonwe which means original, unassimilated people whose minds are inseparable from territory (Sheridan and Longboat 2006, 366). Engaging in the seasonal cycle of ceremonies and other traditional

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activities such as hunting, medicine plant gathering, and gardening with the Three Sisters (corn, beans, and squash) serves as a conduit to MTH power indexed to place, referenced in both the creation teachings and the lives of contemporary Haudenosaunee people. Of the Three Sisters, Haudenosaunee white corn plays a particularly significant role in the spiritual lives of the Haudenosaunee Peoples. MTH power, including kasasten’sera, differs from the aforementioned Western power concepts, in that it is bound to territory and sustained through ceremonial and other traditional activities that emphasize our relationships with each other and the rest of creation (Cajete 2000, 77–83; Cowell 2018, 82). According to Nancy Turner (2014, 257–66), multiple traditional stories from Indigenous Peoples of the Pacific Northwest cast plants as central actors. For example, Skunk Cabbage (Lysichiton americanus Hultén and H. St. John) is personified as Skunk Cabbage Man who appears as a pot- bellied person in both Haida and Kathlamet stories as a provider of salmon and other foods. In one Nuxalk story, blueberries (Vaccinium spp.) are depicted as little boys who instruct a woman on appropriate berry-picking etiquette. Sword fern (Polystichum munitum (Kaulf.) C. Presl) is portrayed in a Kwakwaka’wakw story as a hairy faced person with dentalia earrings and cheeks colored with red ochre and with the ability to control weather (Turner and Bell 1973, 265). Devil’s-club (Oplopanax horridus (Sm.) Miq.) is depicted by the Ts’msyen as a beautiful young woman who teaches an unlucky hunter how to improve his success by using devil’s-club for purifica- tion purposes (Cove and MacDonald, 1987, 82–83). These stories typically serve as morally instructive, but they also function to maintain and transfer Traditional Ecological Knowledge (TEK) (Turner 2014, 231–34). Plants also figure as persons among some Indigenous Peoples and Mestizos of the Amazon River Basin. Luis Eduardo Luna (1984) relates several stories about “plant teachers” from Iquitos, Peru including those plants used to make the ayahuasca beverage (Banisteriopsis caapi (Griseb.) C.V. Morton and Psychotria viridis Ruiz and Pav.), tobacco (Nicotiana spp.), several members of the Solanaceae and Apocynaceae, and many more. According to Luna’s respondents, these plants teach the shaman or traditional healer how to diagnose and cure disease, how to use other medicinal plants, and how to perform specific shamanic activities. The relational ontology implicit in these stories and traditional views of plant agency offer a radically different view of who counts as “persons” and reflects a sophisticated understanding of the profound interdependence between the elements of our natural environment, at odds with the hyper-individualism (Gildersleeve 2017) of neoliberalism and human exceptionalism characteristic of the Anthropocene (Vargas Roncancio et al. 2019). Interestingly, over the past several years, plants have been increasingly recognized as sentient and agentic by a minority of Western

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scholars. For example, philosopher Michael Marder offers a reconceptualiza- tion of plant agency in Plant-thinking: A philosophy of vegetal life (2013) and Monica Gagliano and colleagues demonstrated, through a few simple experi- ments, that plant awareness is significantly more nuanced and complex than previously thought (Gagliano 2018, 57–66; 79–83). The Three Sisters (corn, beans, and squash), or áhsen nikontate’kén:’a in Mohawk, are central to Haudenosaunee cosmology, specifically the creation teachings. In one version of the creation teachings related by the late Seneca Chief Corbett Sundown, the earth was formed when the animals—who saw Sky Woman falling through a hole in the sky—brought soil from the bottom of the ocean and put it on turtle’s back to create a soft place for Sky Woman to land. Sky Woman had gotten pregnant in the Sky World before falling to the earth, and she gave birth to a daughter. In time the daughter also became pregnant, by the west wind, and she gave birth to twins—Sapling and Flint. She died giving birth to Flint (the second twin) and the áhsen nikontate’kén:’a, along with tobacco and wild potatoes, sprung from her buried body. O’nenste (corn) grew from her breasts, o’saheta (beans) grew from her fingers, and onon’onhsera (squash) grew from her navel (Cornelius 1999, 94). Sapling shared the Original Instructions with humanity, which included the Thanksgiving Address. The seasonal cycle of ceremonies was introduced later to remind humans about how to give thanks and to live in harmony with the natural world. The seasonal cycle of ceremonies is, as the name suggests, predicated on the natural cycles of creation. The Three Sisters play important roles in a number of the ceremonies, such as the Green Bean ceremony held in July when the green beans are ripe and the Green Corn ceremony which is held in August or September when the corn is in the milk stage (Cornelius 1999, 91–93). The Three Sisters also feature prominently in the Ohenten Kariwatekwen, or Thanksgiving Address, which is spoken at the beginning of important meetings to acknowledge nature and to align hearts and minds with all creation (Freeman 2015, 145–46). The Thanksgiving Address includes stanzas that pay homage to various elements of the natural and cosmological worlds of the Haudenosaunee, including (but not limited to): the people, the plants, the waters, the Three Sisters, the four winds, the earth, the four beings, and the creator. Each stanza typically praises the aforementioned element in relation to the Haudenosaunee people and ends with the refrain: “and now our minds are one.” For example, the waters are praised in this version of the Thanksgiving Address delivered by Chief Jake Swamp to the Fourth Russell Tribunal, Rotterdam, The Netherlands, November 1980 (Mohawk Council of Akwesasne 2015):

We have been given three main foods from the plant world-they are the corn, beans, and squash—the Three Sisters. For this we give thanks and greetings in

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the hope that they too will continue to replenish Mother Earth with the necessi- ties of the life cycle. Now our minds are one. (1)

In addition to these formal teachings, Carol Cornelius (1999, 97–101) intro- duces several stories in which the Three Sisters are cast as persons. In one story, Bean Woman and Squash Maiden vie for Corn Man’s attentions with Bean Woman ultimately prevailing, explaining the intimate entanglement between climbing bean tendrils and corn stalks. In another story called “The Bean Woman,” Bean Woman rejects a host of suitors (e.g., wolf, bear, and deer) before finally accepting Corn Man as her husband. In“ The Weeping of the Corn, and Bean, and Squash People,” people in an unnamed village experience crop failure for an unknown reason. One day an older woman heard weeping in the cornfield and found the Corn Spirit crying. When asked, the Corn Spirit explained that she felt neglected because the people did not plant the Three Sisters in a mound and failed to weed adequately. Squash Spirit and Bean Spirit were also there, weeping, and relayed similar grievances. The people then started to care for the Three Sisters properly. The second part of the story describes the wild animals that eat the Three Sisters (e.g., racoons and rabbits). Each of these stories cast the Three Sisters as persons with agency in direct relation to humans and in two of the cases, other animals. The Handsome Lake Code, or Kariwiyo in Mohawk (which translates as “Good Word” in English), was shared with the Haudenosaunee Confederacy by the Seneca prophet Handsome Lake in 1799. Handsome Lake’s message came at a time when the Haudenosaunee had endured decades of genocidal and then assimilative assault by American settlers (Akwesasne Notes 2005, 28–29; Holly 1990, 83–84). The Kariwiyo called upon the Haudenosaunee Peoples to revitalize traditional ways and to reject damaging aspects of Western culture such as drinking alcohol, gambling, and fiddle music (Antone 2013, 39; Johansen and Mann 2000, 286). The Kariwiyo was based on a series of visions received by Handsome Lake. In his last vision, a female corn spirit appears while Handsome Lake is walking in a cornfield (Lewandowski 1987, 80). Among other traditional practices, the Kariwiyo makes specific mention of revitalizing Three Sisters gardening and the seasonal cycle of ceremonies that spiritually contextualizes the cultivation and consumption of corn, beans, and squash (Antone 2013, 20). Recognizing and enacting our reciprocal responsibilities to the more-than-human through practices based on traditional teachings—which are rooted in relationality and territory—offer member of the FNTI community a safe-haven from the aterritoriality and lonely individualism associated with neoliberal governmentality. The following section describes the Indigenous postsecondary landscape in Canada and outlines some of the approaches we take, at First

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Nations Technical Institute, to recognize and celebrate nonhuman personhood—specifically the Three Sisters.

PLANT PERSONHOOD AND INDIGENOUS HIGHER EDUCATION IN CANADA

In Canada, the governance of higher education is decentralized to the prov- inces which has led to a complex diversity of institutional arrangements and governance mechanisms (Jones 2014, 1). For instance, the Province of Ontario recently passed the Indigenous Institutes Act (the Act) which, among other things, recognizes the autonomy of the nine Indigenous governed and operated postsecondary institutes in Ontario that serve the education and training needs of the communities in which they are based (Indigenous Institutes Act 2017; Province of Ontario 2017). The Act, as a policy instru- ment, supports Indigenous self-determination in the sphere of higher education (Williams, Umangay, and Brant 2020, 9). First Nations Technical Institute (FNTI)—founded in 1985 and based on Tyendinaga Mohawk Territory in southern Ontario—is an Indigenous-run postsecondary institution that offers both college- and university-level programming. FNTI serves 102 out of 129 Ontario First Nations communities through both on-site (at FNTI) and in-community training and has supported learners from 172 of 667 Indigenous communities across Canada (FNTI 2019a). FNTI’s graduation rate for college-level programming (certificates and diplomas) was 94 percent during the 2018–2019 academic year. In the same time period, our university-level offerings (degrees) had a 95 percent completion rate (FNTI Marketing Department 2020). One factor potentially contributing to our success is the profoundly Indigenous ontological approach taken to all our relations, specifically recognition of the animacy of all creation including the personhood of plants. The following paragraphs outline different ways in which the personhood of plants, specifically the Three Sisters, is incorporated into our institutional practices including how we run meetings and events, artwork displayed on campus or on the FNTI website, community gardening on campus, and our curriculum. As discussed earlier in this chapter, the Thanksgiving Address was part of Sapling’s Original Instructions and is typically recited at the beginning and ending of ceremonies, important meetings, or events. From the authors’ experience, delivery of the Thanksgiving Address brings peoples’ minds together and focuses a group—at the commencement of a meeting or other important event—on relationships central to Haudenosaunee existence. When used as a closing, the Thanksgiving Address releases the minds from the ceremony, meeting, or other event. Also, while the form of the Thanksgiving Address

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remains static, the specific content varies depending on the speaker and the context. With the final words of each stanza,“ now our minds are one,” the Thanksgiving Address inscribes a broad circle of personhood to encom- pass not just humans but also the Three Sisters, the waters, the medicine plants, and more. In addition to acknowledging personhood sensu lato, the Thanksgiving Address also contextualizes (as minor) divisive issues—that might otherwise prevent amicable consensus—so that the meeting or event can focus on important issues dealing with the fundamentals of life (e.g., clean water, healthy food). Recital of the Thanksgiving Address could be viewed as a kind of illocutionary discursive speech act (Butler 1993, 170–1) in which the speech is the act itself, the act of “bringing together minds.” This performative and citational act (Hey 2006, 446–8) serves to mediate the ongoing process of recognition between people and between people and important nonhuman persons and other elements of creation. In Undoing Gender (2004), Judith Butler invokes “German Idealism and earlier medieval ecstatic traditions” (151) to express that relationality “simply avows that that ‘we’ who are relational do not stand apart from those relations and cannot think of ourselves outside of the decentering effects that that relationality entails” (151). We suggest that in the case of the Thanksgiving Address, Butler’s de-centering is actually a radical re-centering, through which humans are re-situated (each time they participate) in a web of relations with the natural and spiritual world through a process of subjectification that helps us to “learn to identify with places in discourse” (Hey 2006, 446). The vitality of this citational act also creates a horizon of open futures via the variability of iterations made possible each time the Thanksgiving Address is delivered (Ruitenberg 2007, 263–64). Regular recital of the Thanksgiving Address helps us to remember, and in some cases reconceptualize, the personhood of what would be considered nonhuman or inanimate—such as the Three Sisters—by the human exceptionalism common to Western philosophical approaches and implicitly enacted in Western cultural institutions, including colleges and universities. The Three Sisters also figure prominently in various visual elements at FNTI including a Three Sisters drawing by one of this chapter’s coauthors (SB) that was made into a postcard with the illustration, on one side, and a summary of the Haudenosaunee creation teachings with a corn, beans, and squash soup recipe, on the reverse. The image (shown in figure 15.1), atableau vivant that is both symbolic and literal, depicts the daughter of Sky Woman entangled with the Three Sisters all oriented toward the life-enhancing eldest brother, the sun. Or perhaps they are engaged in mutual contemplation of the fissure in the Sky World through which Sky Woman fell, inaugurating life “as we know it,” on Earth? Even without knowing the creation teachings, the

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Figure 15.1 Three Sisters. Credit: Suzanne Brant.

viewer understands the profound relationality between, and animacy inherent in, the elements of this composition. The sun’s rays, animatedly undulating toward the daughter of Sky Woman and the Three Sisters, are echoed by (and also echo) the corn silks and tassels, squash anthers and vine, bean tendrils, and the daughter of Sky Woman’s wrist fringes, as well as the other vibrating lines that compose the various elements of this drawing. This drawing has proven so compelling to members of the FNTI community and visitors that it was uploaded on the website2 to share with online visitors. Photos of corn, beans, and squash pictured together or separately are found on FNTI promotional materials and throughout the campus including posters depicting traditional Haudenosaunee varieties of corn and beans created by seed keeper Stephen McComber from Kahnawake. Ceremonial objects such as corn-husk dolls, along with the aforementioned artwork, that are found on campus provide students, staff, and visitors with familiar iconography as a reminder of the creation teachings and our responsibilities toward the Three Sisters, or those who sustain us. Affective nondiscursive representationalism manifested by visual portrayal of the Three Sisters at FNTI offers viewers the opportunity to experience the layered, complex, mysterious, and unfolding relational gestalt (Zwicky 2011) inherent in a Haudenosaunee understanding of the cosmological significance of the Three Sisters. And, as Sara Ahmed (2010) points out, affect is “sticky” in that it “preserves the connection between ideas, values, and objects” (29) and is also “contagious” between

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proximate bodies (Gibbs 2001, para 12–13). The contagious stickiness of affect, although unpleasant sounding, serves to reinforce norms that recognize the Three Sisters as vital and necessary persons. The act of receiving this image—in addition to affirming the importance of traditional teachings and practices associated with the Three Sisters—also creates relational bodies (human and more-than-human), informed by Three Sisters MTH power, for the dynamic and embodied interpretation of quotidian experiences at FNTI. The sticky affectivity generated by regular interactions with Three Sisters imagery, for example the image depicted in figure 15.1 actively erodes the hyper-individualism and competitive entrepreneurialism characteristic of neoliberalism by emphasizing collectivity, non-economized values, and place-based understandings. Also, the ambiguity associated with interpretation of artwork creates lacunae for highly contingent reflexivity which resists the homogenizing effects of neoliberalism’s hyper-surveillance and economization of all life’s domains. FNTI’s community garden, which is primarily used by staff members, has included a Three Sisters garden bed which generates produce for the FNTI community to take home and for group meals on-campus. The community garden also facilitates traditional knowledge transfer. Like the presence of Three Sister’s inspired artwork on campus, gardening with—and preparing meals from—traditional crop varieties offers staff and other members of the FNTI community an opportunity for nondiscursive meaning-making via what could be viewed as an example of Carolan’s (2008) concept of “more- than-representational knowledge” which is based on “sensuous, corporal, and lived experience(s)” (412). Our obligations to the Three Sisters are fulfilled by sowing, tending, harvesting them, and saving their seeds. The reciprocally relational circle is completed when we derive sustenance by consuming them. Not only does this relational reciprocity meet culturally identified axiological standards but also offers an embodied epistemology that “give(s) rise to dis- covery in one’s body of relevant” knowledge (Diamond 2006, 59) and affords a specific configuration of sensory experiences that define embodied spaces (per Gibson 2014, 4). Like the aforementioned traditional design elements present on-campus, Three Sisters gardening in the workplace is essentially a spatializing activity that positions the work landscape as one of resistance to neoliberal norms, in which sacred responsibilities associated with ensuring life’s continuance are enacted despite not aligning with economic determinations of productivity or the competitive entrepreneurialism associated with neoliberal rationality (Gildersleeve 2017). Although curriculum and instruction are not the focus of this chapter, it would be remiss not to mention the extent to which the Three Sisters are incorporated into the curricula of the various programs at FNTI. FNTI cur- rently offers a range of college- and university-level programming. Many of

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these programs, such as the Social Service diploma and the Mental Health and Addition Worker diploma, include curriculum related to the Three Sisters. Until 2017, with the introduction of the Indigenous Institutes Act, FNTI degree level offerings were all brokered through accredited Ontario universities. Under the purview of the Indigenous Institutes Act, FNTI now has degree granting status. The bachelor-level degree programs starting in 2020 include Indigenous Social Work, Indigenous Sustainable Food Systems, and Indigenous Midwifery. Each of these programs has a suite of common courses taken during the first three-and-a-half semesters of study, prior to subject matter specialization. The common courses all focus on foundational aspects of Indigenous culture and are designed to help restore the cultural identities of our learners, all of whom has been negatively impacted by colonialism (Williams and Brant 2019). Multiple common courses include teachings related to Three Sisters, such as Worldview and Cultural Fluency, Founding Values, Indigenous Well Being and Health Teachings, Indigenous Agricultural Heritage, Plants that Heal: An Indigenous Perspective, Recovering Health Sovereignty, Relationship to the Environment, and Indigenous Ecological Knowledge. The Indigenous Sustainable Food Systems degree program also includes courses in years three and four that deal specifically with aspects of the Three Sisters polyculture. Inclusion of discussion-based and experiential aspects of Three Sisters teachings in various FNTI programs recognizes the Three Sisters as our sustainers and as persons in Haudenosaunee cosmology aligning with and reinforcing the aforementioned aspects of Three Sisters teachings that are incorporated into our pedagogic model. The inscription of more-than-human relationality as an onto-epistemological (Barad 2007) foundation in Indigenous higher education—through various institutional practices involving plant persons which draw on MTH power as kasasten’sera—undermines the totalizing economization and hyper- individualism associated with neoliberalism (Brown 2015; Gildersleeve 2017) and in the process offers a counternarrative to that informed by Western philosophy, which arguably unpins the Anthropocene (Vargas Roncancio et al. 2019).

FURTHER WORK

Our approach, presented here, recognizes and enacts a more inclusive relationality based on situated practices that provide access to MTH power. This is an example of an institutional-level intervention that counters neoliberal trends in the public sector which could potentially address the existential issues associated with the Anthropocene. Further research would both

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support the refinement of our more-than-human approach to higher education and extend this model to other contexts. At FNTI, we plan to document the ways in which a more inclusive relationality— exemplified by our reciprocal relationship with the Three Sisters—extends to the unnamed plant persons and other elements of the more-than-human at FNTI. Also, we would like to identify other more-than- human persons, in addition to the Three Sisters, that could strengthen our decolonized approach to higher education. Garibaldi and Turner’s (2004) Cultural Keystone Species concept could help to orient this identification process. Cultural Keystone Species are “the culturally salient species that shape in a major way the cultural identity of a people, as reflected in the fundamental roles these species have in diet, materials, medicine, and/or spiritual practices” (Garibaldi and Turner 2004, sect. Cultural Keystone Species, para. 1). Finally, we hope to understand, more deeply, the ways in which members of the FNTI community construct meaning through enactment of our mutual obligations to nonhuman persons. External to FNTI, we suggest exploring the possibility of incorporating culturally relevant more-than-human persons in higher education practices in non-Haudenosaunee Indigenous contexts. For example, how can the personhood of culturally salient plants be meaningfully included in various Indigenous higher education governance models? Do Skunk Cabbage Man or the Blueberry Boys (Turner 2014, 231–34), mentioned earlier, deserve a seat at the governance table in Indigenous-run education institutions in the Pacific Northwest? Do plant teachers, such as the Ayahuasca vine (Luna 1984, 136), have something to contribute to the governance of Amazonian Indigenous Intercultural Universities? How can recognition of plant persons and the enactment of human–plant reciprocal responsibilities contribute to accessing MTH power and decentering the human in non-Haudenosaunee Indigenous cultural contexts? Examining whether IK regarding plant persons can be equitably incorporated into Western higher education contexts is also of critical importance. If so, what is the role of IK keepers and community leaders in this process? If it is impossible to equitably introduce IK regarding plant persons in Western higher education contexts, how can these public sector institutions recognize plant persons and enact relational responsibilities to the more-than-human? Should higher education institutions look to long-forgotten Western traditions that recognize the vibrant animacy of the botanical world or should these institutions create new ways of acknowledging plant persons and enacting our relational responsibilities to the more-than-human? Engaging with the work of Indigenous thinkers (e.g., Antone 2013; Deloria and Wildcat 2001; Sheridan and Longboat 2006) and Western scholars such as Susan Ruddick (2017) and Michael Marder (2013)—who productively question human

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exceptionalism and offer novel ways of conceiving of nonhuman agency— could help the mainstream to enact a more reciprocally relational approach to Western social and cultural institutions.

CONCLUSION

Earlier in this chapter, we introduced Deloria and Wildcat’s (2001) formula: “power and place produce personality” (23) and suggested that the aterritoriality of neoliberalism and human exceptionalism associated with the Anthropocene both limit the full expression of our entangled humanity. In this work, we describe a living practice—formally encoded in the institutional practices of an Indigenous-run higher education institution (FNTI)— that re/inscribes human life within the more-than-human world exemplified by the situated practices (Haraway 1988, 590) associated with fulfilling our mutual obligations to the Three Sisters. This radical paradigm shift is a form of resistance to the dominant neoliberal hegemony in higher education and is accomplished by regularly drawing on kasasten’sera, or the power of life’s continuance associated with the Three Sisters, our sustainers, through embodied understandings and affective engagement with the Three Sisters, and through performative and citational re/articulations of the dynamic relationality that characterizes our reciprocal relationships with the more-than-human.

NOTES

1. “Turtle Island” refers to North America. This term was popularized, in English, by poet Gary Snyder in his 1974 collection Turtle Island. The name is based on the significance of turtles in the creation teachings of various Indigenous nations (including Haudenosaunee). 2. The Three Sisters image and information can be found on the FNTI website: https://fnti .net /mohawk -three -sisters.

BIBLIOGRAPHY

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Altamirano-Jiménez, Isabel. 2013. Indigenous Encounters with Neoliberalism: Place, Women,and the Environment in Canada and Mexico. Vancouver: UBC Press .http s:/ /d oi :10 .1017 /S000 84239 14000 717. Antone, Robert. 2013. “Yukwalihowanahtu Yukwanosaunee Tsiniyukwaliho: t^ As People of theLonghouse, We honor our way of life Tekal^ hsal^ Tsiniyukwaliho: t^ Praise our way oflife.” PhD diss. State University of New York at Buffalo. Arendt, Hannah. 1958. The Human Condition. Chicago: The University of Chicago Press. Axtell, James. 2016. Wisdom’s Workshop: The Rise of the Modern University. Vol. 89. Princeton: Princeton University Press. https://doi.org /10 .2307 /j .ctv7h0s90. Barad, Karen. 2007. Meeting the Universe Halfway: Quantum Physics and the Entanglement of Matter and Meaning. Durham: Duke University Press .http s://d oi .or g /10. 1215/ 97808 22388 128. Bauman, Zygmunt. 2000. Liquid modernity. Oxford: Blackwell Publishing. Brown, Wendy. 2015. Undoing the Demos: Neoliberalism’s Stealth Revolution. Cambridge: MITPress. Bourdieu, Pierre. 1973. “Cultural Reproduction and Social Reproduction.” In Knowledge, Education, and Cultural Change, edited by Richard Brown, 71–112. London: Tavistock. Butler, Judith. 1993. Bodies That Matter: On the Discursive Limits of “Sex.” New York and London: Routledge. Butler, Judith. 2004. Undoing gender. London, UK: Psychology Press . http s://d oi .or g /10. 4324/ 97802 03499 627. Cajete, Gregory. 2000. Native Science: Natural Laws of Interdependence. Santa Fe, NM: Clear Light Publishers. Carolan, Michael S. 2008. “More‐than‐representational Knowledge/s of the Countryside: How We Think as Bodies.” Sociologia Ruralis 48, no. 4: 408–22. https :/ /do i .org /10 .1 111 /j .1467 -9523 .200 8 .0045 8.x. Cove, John J., and George F. MacDonald. 1987. Tsimshian Narratives. Gatineau: Canadian Museum of Civilization. Cornelius, Carol. 1999. Iroquois Corn in a Culture-based Curriculum: A Framework for Respectfully Teaching About Cultures. Albany: State University of New York Press. Cowell, Andrew. 2018. Naming the World: Language and Power Among the Northern Arapaho. Tucson: University of Arizona Press. https://doi.org /10 .2307 /j .ctv550ctc. Crum, Steven J. 2015. “A History of the First Nations College Movement of Canada, 1969–2000.” Tribal College Journal of American Indian Higher Education 26, no. 3: 38–41. Deloria, Vine, and Daniel Wildcat. 2001. Power and Place: Indian Education in America. Golden: Fulcrum Publishing. Diamond, Timothy. 2006. “Where Did You Get the Fur Coat, Fern? Participant Observation in Institutional Ethnography.” In Institutional Ethnography as Practice, edited by Dorothy Smith, 45–63. Lanham: Rowman and Littlefield. FNTI. 2019a. Annual Report 2018-2019. Tyendinaga Mohawk Territory: FNTI. https :/ /fn ti .ne t /pho tos /c ustom /FNTI %20An nual% 20Rep ort %2 020 18 _19 _W eb .pd f.

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FNTI. 2019b. First Harvest at FNTI Community Garden. Tyendinaga Mohawk Territory: FNTI. https :/ /fn ti .ne t /New s /new s .inc .php? ID =53 andco mmand =mini ViewA rticl eandl ang =E nads= 0. FNTI Marketing Department. 2020. Enrolment and Graduation Statistics. Tyendinaga Mohawk Territory: FNTI. Foucault, Michel. 2008. The Birth of Biopolitics: Lectures at the Collège de France, 1978-1979. New York: Palgrave Macmillan. Foucault, M. 1978. History of Sexuality: Vol. 1. An Introduction. New York: Pantheon Books. Freeman, Bonnie M. 2015. “The Spirit of Haudenosaunee Youth: The Transformation of Identity and Well-being Through Culture-based Activism.” PhD diss. Wilfred Laurier University. Gagliano, Monica. 2018. Thus Spoke the Plant: A Remarkable Journey of Ground- breaking Scientific Discoveries and Personal Encounters with Plants. Berkeley: North Atlantic Books. Garibaldi, Ann, and Nancy Turner. 2004. “Cultural Keystone Species: Implications for Ecological Conservation and Restoration.” Ecology and society 9, no. 3. https:// doi .org/ 10.5751/ES-00669-090301. Gaudry, Adam, and Danielle Lorenz. 2018. “Indigenization as Inclusion, Reconciliation, and Decolonization: Navigating the Different Visions for Indigenizing the Canadian Academy.” AlterNative: An International Journal of Indigenous Peoples 14, no. 3: 218–227. https://doi.org /10 .1177 /1177180118785382. Gibbs, Anna. 2001. “Contagious Feelings: Pauline Hanson and the Epidemiology of Affect.” Australian Humanities Review 24, Dec. http:/ /aus trali anhum aniti esrev iew .o rg /20 01 /12 /01 /c ontag ious- feeli ngs -p aulin e -han son -a nd -th e -epi demio logy- of -af fect/. Gibson, James J. 2014. The Ecological Approach to Visual Perception. London, UK: Psychology Press. https://doi.org /10 .4324 /9781315740218. Gildersleeve, Ryan Evely. 2017. “The neoliberal academy of the anthropocene and the retaliation of the lazy academic.” Cultural Studies ↔ Critical Methodologies 17, no. 3: 286–293. https://doi.org /10 .1177 /1532708616669522. Haraway, Donna. 1988. “Situated Knowledges: The Science Question in Feminism and the Privilege of Partial Perspective.” Feminist Studies 14, no. 3: 575–599. https://doi .org /10 .2307 /3178066. Hey, Valerie. 2006. “The politics of Performative Resignification: Translating Judith Butler’s Theoretical Discourse and its Potential for a Sociology of Education.” British Journal of Sociology of Education 27, no. 4: 439–457. https:/ /do i .org /10 .1 080 /0 14256 906 00 80295 6. Holly, Marilyn. 1990. “Handsome Lake’s Teachings: The Shift From Female to Male Agriculture in Iroquois Culture. An Essay in Ethnophilosophy.” Agriculture and Human Values 7, no. 3–4: 80–94. https://doi.org /10 .1007 /BF01557313. Hu, Min, Angela Daley, and Casey Warman. 2019. “Literacy, Numeracy, Technology Skill, and Labour Market Outcomes Among Indigenous Peoples in Canada.” Canadian Public Policy 45, no. 1: 48–73. https://doi.org/ 10.3138/cpp.2017-068.

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Indigenous Institutes Act, S.O. 2017, c. 34, Sched. 20. 2017. https:/ /ww w .ont ario. ca /la ws /st atut e /17i3 4a. Johansen, Bruce, and Barbara Mann. 2000. Encyclopedia of the Haudenosaunee (Iroquois confederacy). Westport: Greenwood Publishing Group. Jones, Glen A. 2014. “An Introduction to Higher Education in Canada.” In Higher Education Across Nations, edited by Kishore Mahendra Joshi and Saeed Paivandi, 1–38. Delhi: B. R. Publishing. Kuokkanen, Rauna. 2011. Reshaping the University: Responsibility, Indigenous Epistemes, and the Logic of the Gift. Vancouver: UBC Press. Lewandowski, Stephen. 1987. “Diohe’ko, the Three Sisters in Seneca life: Implications for a Native Agriculture in the Finger Lakes Region of New York State.” Agriculture and Human Values 4, no. 2–3: 76–93. https://doi .org /10 .1007 /BF01530644. Luna, Luis Eduardo. 1984. “The Concept of Plants as Teachers Among Four Mestizo Shamans of Iquitos, Northeastern Peru.” Journal of Ethnopharmacology 11, no. 2: 135–156. doi: https:/ /do i .org /10 .1 016 /0 378 -8 741(8 4)900 36-9. MacDonald, Fiona. 2011. “Indigenous Peoples and Neoliberal ‘Privatization’ in Canada: Opportunities, Cautions and Constraints.” Canadian Journal of Political Science/Revue Canadienne de Science Politique 44, no. 2: 257–273. https:/ /do i .org /10 .1 017 /S 00084 239 11 00014 X. Marder, Michael. 2013. Plant-thinking: A Philosophy of Vegetal Life. New York: Columbia University Press. https:/ /do i .org /10 .1 017 /S 00122 173 13 00102 9. Mendelson, Michael. 2006. Aboriginal Peoples and Postsecondary Education in Canada. Ottawa: Caledon Institute of Social Policy. https :/ /ma ytree .com/ wp -co ntent /uplo ads /5 95ENG 1 .pdf. Mohawk Council of Akwesasne. 2015. Akwesasne: A Cultural Portrait. Akwesasne: Mohawk Council of Akwesasne Communications Unit. https :/ /ww w .cer p .gou v .qc. ca /fi leadm in /Fi chier s _cli ents/ Docum ents_ depos es _a_ la _ Co mmiss ion /P -207. pdf. Mohawk, John and Jose Barreiro. 2010. Thinking in Indian: A John Mohawk Reader. Golden: Fulcrum. National Indian Brotherhood. 1972. Indian Control of Indian Education: Policy Paper Presented to the Minister of Indian Affairs and Northern Development. Ottawa: Assembly of First Nations. https :/ /on eca .c om /In dianC ontro lofIn dianE duc at ion .p df. Neruda, Pablo. 1984. Still Another Day. Port Townsend: Copper Canyon Press. Parsons, Talcott. 1963. “On the Concept of Political Power.” Proceedings of the American Philosophical Society 107, no. 3: 232–262. Province of Ontario. 2017. “Indigenous Students—Find Out About Indigenous Institutes, Colleges and Universities, and Money to Study in Ontario.” Accessed June 13, 2020. https:/ /ww w .ont ario. ca /pa ge /in digen ous -s tuden ts. Ruddick, Susan M. 2017. “Rethinking the Subject, Reimagining Worlds.” Dialogues in Human Geography 7, no. 2: 119–139. https://doi.org /10 .1177 /2043820617717847. Ruitenberg, Claudia W. 2007. “Discourse, Theatrical Performance, Agency: The Analytic Force of ‘Performativity’ in Education.” Philosophy of Education

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Archive: 260–268. https :/ /ed ucati onjou rnal. web .i llino is .ed u /arc hive/ index .php/ pes /a rticl e /vie w /147 1.pdf. Sheridan, Joe, and Dan Longboat. 2006. “The Haudenosaunee Imagination and the Ecology of the Sacred.” Space and Culture 9, no. 4: 365–381. https://doi .org /10 .1177 /1206331206292503. Steffen, Will, Jacques Grinevald, Paul Crutzen, and John McNeill. 2011. “The Anthropocene: Conceptual and Historical Perspectives.” Philosophical Transactions of the Royal Society A: Mathematical, Physical and Engineering Sciences 369, no. 1938: 842–867. https://doi.org /10 .1098 /rsta .2010 .0327. Stonechild, Blair. 2006. The New Buffalo: The Struggle for Aboriginal Post- secondary Education in Canada. Winnipeg: University of Manitoba Press. Truth and Reconciliation Commission of Canada. 2015. Canada’s Residential Schools: The Final Report of the Truth and Reconciliation Commission of Canada. Vol. 1. Montreal and Kingston: McGill-Queen’s Press. Turner, Nancy. 2014. Ancient Pathways, Ancestral Knowledge: Ethnobotany and Ecological Wisdom of Indigenous Peoples of Northwestern North America. Vol. 74. Montreal and Kingston: McGill Queen’s Press. https://doi .org /10 .1111 /1467 -9655 .13006. Turner, Nancy, and Marcus Bell. 1973. “The Ethnobotany of the Southern Kwakiutl Indians of British Columbia.” Economic Botany 27, no. 3: 257–310. https:/ /li nk .sp ringe r .com /arti cle /1 0 .100 7 /BF0 29075 32. United Nations. 2007. “United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP).” https:/ /ww w .un. org /d evelo pment /desa /indi genou s peop les /w p content/up loads /site s/19/ 2018/ 11/UN DRIP_ E _web .pdf. Vargas Roncancio, Ivan, Leah Temper, Joshua Sterlin, Nina L. Smolyar, Shaun Sellers, Maya Moore, Rigo Melgar-Melgar, Jolyon Larson, Catherine Horner, Jon D. Erickson et al. 2019. “From the Anthropocene to Mutual Thriving: An Agenda for Higher Education in the Ecozoic.” Sustainability 11, no. 12: 1–19. https://doi .org /10 .3390 /su11123312. Warrior, Robert. 1999. “The Native American Scholar: Toward a New Intellectual Agenda.” Wicazo Sa Review 14, no. 2: 46–54. https://doi.org /10 .2307 /1409550. Whatmore, Sarah. 2006. “Materialist Returns: Practising Cultural Geography in and for a More Than Human World.” Cultural Geographies 13, no. 4: 600–609. https :/ /do i .org /10 .1 191 /1 47447 4006c gj377 oa. Williams, Keith, and Suzanne Brant. 2019. “Good Words, Good Food, Good Mind: Restoring Indigenous identities and Ecologies Through Transformative Learning.” Journal of Agriculture, Food Systems, and Community Development 9 (B), 131– 144. https:/ /do i .org /10 .5 304 /j afscd .2019 .09B. 010. Williams, Keith J., Umar Umangay, and Suzanne Brant. 2020. “Advancing Indigenous Research Sovereignty: Public Administration Trends and the Opportunity for Meaningful Conversations in Canadian Research Governance.” The International Indigenous Policy Journal 11, no. 1. https:/ /do i .org /10 .1 8584/ iipj. 2020. 1 1 .1. 10237. Zwicky, Jan. 2011. Lyric Philosophy. Kentville: Gaspereau Press.

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Fletcher and Dare_9781793629289.indb 214 24-12-2020 17:41:17 Annette D. Madlock, “Voicing a Womanist Ethic of Liberation and Social Justice among the Religious Right,” in Womanist Ethical Rhetoric: A Call for Liberation and Social Justice in Turbulent Times, eds. Annette D. Madlock and Cerise L. Glenn (Lanham, MD: Lexington Books, 2021) 1–16. All Rights Reserved.

Chapter 1

Voicing a Womanist Ethic of Liberation and Social Justice among the Religious Right Annette D. Madlock

The death of George Floyd and the COVID-19 pandemic have brought the social inequalities that ravage the Black community and other communities of color in the United States to national and global attention. Communities of women and men, young and old, have taken to the streets in protest. In the words of our foremother, Josepine St. Pierre Ruffin (The Women’s Era):

for the sake of our own dignity, the dignity of our race, and the future good name of our children, it is “mete, right, and our bounded duty” to stand forth and declare ourselves and our principles, to teach an ignorant and suspicious world that our aims and interests are identical with those of all good aspiring women. Too long have we been silent under unjust and unholy charge; we cannot expect to have them removed until we disprove them through ourselves.1

These are words that represent the sentiments of many and why one must have a voice in these turbulent times. In the current political climate, sharply divided along the lines of race, religion, and socioeconomics, there is the danger of a single story2 regarding conservative Evangelical Christians most often equated as the religious right. This is a single story perpetuated by the media (liberal, progressive, conservative)3 that shapes and frames a picture of Evangelical Christians4 equated to Make America Great Again (MAGA) Trump supporters. This rhetorical frame is an agenda set by the media that neglects the stories of those Evangelicals who might hold more progressive, moderate, or liberal views. There is no denying the existence of a select group of individuals within this conservative Evangelical Christian demographic that long for the days of the not-so-distant past (where slave codes and black codes prevailed).

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Historically this is a past filled with bigotry and hatred toward Black people and other people of color in the United States. At the same time, there are the conservative right-winged media outlets that report alternative facts, declare opposing factual news stories as fake, and state that systemic racism is a myth that does not exist in this country. This tactic, to some, is suggestive evidence that civil rights, issues of social justice and equality, and #Black Lives Matter are not on the list of conservative white Evangelical Christian priorities. Priorities that center on advocating pro-life, dismantling affordable health care, opposing the human rights of poor people, immigrants, and the LGBTQIAP (Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, Asexual, and Pansexual) community, to name just a few of their political priorities. However, there is a strategy for this agenda that some call the “Conservative Playbook.”5 For all sides involved, liberal and conservative alike, there is a set agenda put forth by each to tell a single story; however, one needs to remember that there is always more to the story. The danger of these stories is that it places Black people as invisible, a muted group, voiceless, or with select voices at best (those voices that represent or support a particular agenda). This chapter looks at the challenges of voicing a womanist ethic of liberation and social justice within these single stories (conservative, liberal, moderate, or progressive). A womanist ethic that demands that we manage and control the narrative of our community that speaks truth to political power.

THE WOMANIST ETHIC OF LIBERATION

“Womanism” is a term that has an often-quoted etymology, which will be sum- marized here. Walker first used womanism in her 1979 short story“ Coming Apart,” published in Laura Lederer’s anthology Take Back the Night.6 In 1983, Alice Walker shared with the world a four-part definition in her textIn Search of Our Mother’s Gardens. In summary, the first part of the descrip- tion emphasizes the importance of women handing down their wisdom from one generation of women to the next. Second, it highlights the importance of communal thought and action. Third, the definition critiques the Eurocentric standard of beauty imposed upon Black women. Fourth, womanism itself is used as a counter to the limitations of White feminist thought and activism as it is ineffective in dealing with issues of race and class. When discussing the etymology of the term “womanism” and the womanist idea, one must also remember to include the work of Chikwenye Okonojo Ogunyemi (African Womanism) and Clenora Hudson-Weems (Africana Womanism).7 Walker, Ogunyemi, and Hudson-Weems each worked to “form the collective basis for an interpolated field of theory and praxis used by a host of people to follow.”8

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The womanist tradition captured my attention because of my vocation as a higher education professional. Womanism has an emphasis on communal thought and antioppression (anti all of the “isms” that bind and foster inequality) activism. Phillips provides explanations for womanism in this way:

Womanism is a social change perspective rooted in Black Women’s and other women of color’s everyday experiences and everyday methods of problem solv- ing in everyday spaces, extended to the problem of ending all forms of oppression for all people, restoring the balance between people and the environment/ nature, and reconciling human life with the spiritual dimension.9

I answered a call to missions and accepted an assignment in an educational environment that is theopolitical and hostile to those with opposing (religious and political) views, an organization with a contrived presence on conservative media outlets. As I discussed in an issue of Listening/Journal of Communication, Ethics, Religion, and Culture,10 listening for God’s call includes work outside of the church in one’s chosen profession. There is a concept called the Theology of Work,11 which helped to clarify my decision to listen to God’s voice and take a new journey.12 Janet Woodlock (2018),13 in her article “Vocational Discernment and Female Experience of Pastoral Ministry Call,” states, “Individual discernment of God-given vocations occurs in a social context.” The context for this call is a White Christian Evangelical institution of higher education with a fundamentalist segrega- tionist history. A treacherous journey for a Black woman with womanist liberationist tendencies (antioppressionist). Womanist and Black feminist theories are culturally based perspectives that take into consideration the contextual and interactive effects of history, culture, race, class, gender, and other forms of oppression and fragmentation.14 These frameworks provide a contextualized understanding of African American women’s life spanning experiences and perspectives. Perspectives that culminate in emancipation and freedom for women. They are collectively a continuation of intellectual and activist traditions that continue to develop over time and push for equality and liberation. Womanism specifically leaves space for solutions that work for the good of the whole community rather than merely the interest of women. A womanist ethic centers on the ethical and moral choices that Black women make as foundational discourse.15 Katie G. Cannon discusses how Black women are often compelled to act or to refrain from action under the powers and principalities of the external world; Black womanists search the scriptures to learn how to dispel the threats and fight for the oppressed. The Black womanist identifies with those biblical characters who hold on to life in the face of formidable oppression. The Black womanist tradition motivates one to chip away at oppressive

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structures. It identifies those texts that help Black womanists to celebrate and rename the numerous incidents of unpredictability in empowering ways.16 The Black womanist tradition is used as a frame, as this chapter explores how one might communicate a womanist ethic of liberation and social justice among the religious right in a divisive political climate—in essence, countering the single story in a contested space to assist in controlling the narrative about Black people and other oppressed groups.

MEDIA NARRATIVES

The black press was and continues to be extremely important to the community where I grew up.

For a time, the narrative of the black press and Black America were intertwined because there were no other outlets covering the African-American experience—only the black press carried the news, expressed the pain and outrage and joy and triumph of the black community.17

As I reflect, individuals and families took the time to read the various local newspapers (Milwaukee Courier,18 Milwaukee Community Journal,19 Milwaukee Journal), watch the local news, and listen to the news on local black radio. Staying current with the community and national news was just what people did. Even with the shrinking pages or the disappearance of printed papers, many continue to get their information this way. For instance, my mom continues to get some of her news from the local print media. For her national news, Lester Holt is the gospel; she has her DVR set for him, and members of her peer group still discuss how Shirley Chisolm should have been president (when your mom puts her friends on speakerphone to talk politics). But the internet and social media have changed the way traditional media outlets deliver information and how news is consumed; even my mom uses her smartphone to stay current with news and events. It is essential to take note of this everyday experience with the media for this generation20 and others. One Pew Research article identifies seven areas regarding Black Americans perceptions of the media,

1. A third of Black adults trust information from local news organizations. 2. Black adults are more likely to feel connected to their main source of news. 3. Black adults are more likely to say news organizations keep an eye on political leaders, deal fairly with all sides.

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4. Black Americans are less concerned about made-up/fake news than other national issues. (They are more concerned about social issues such as drug addiction, racism, violent crime, the gap between rich and poor, affordable health care, U.S. political system, and climate change.) 5. Majority of Black Americans prefer to get news from television. 6. Black newspapers are small, community-oriented publications. 7. Black Americans are underrepresented as newsroom employees in the United States.

Consider the results of the Pew Research poll for item number four listed above. It is of note that Black Americans are possibly less concerned about made-up/fake news. The explanation for this can be explored further by looking into the historical record of the relationship between the Black community and mainstream media. Historically, many (from explorers to journalists) have created narratives that have misrepresented Black people, their society, and their culture, which could explain why Black Americans do not prioritize what is deemed made-up/fake news. This information is readily spotted for what it is—half-truth and manipulated information. Another Pew Research poll indicates that many Black American adults felt the news media misunderstands them and for different reasons than their white and Hispanic counterparts. “Black American adults are far more likely than the other two groups to feel that the misunderstandings are based on their race or some other demographic trait.”21 But what narrative are some majority news organizations (non-black-oriented news media organizations) spinning? If it does not fit the narrative of unwed mothers on welfare, gun violence, gang violence, or looting protestors, any other story of Black America is not valid.

THE CONSERVATIVE NEWS PLAYBOOK

Since the 2016 election, much has been said and written about the bewilder- ing affection between Evangelical Christians and Donald J. Trump. Terry Heaton, the former executive producer of The 700 Club, states that “10 years before Fox News came on the scene we, the Christian Broadcast Network (CBN), wrote the playbook for conservative news.”22 Heaton continues, “we called it T.V. News with a different spirit, and all it was, was an attempt to insert conservative propaganda into the news. In the end, right-wing news is only propaganda; it is not news. There is no attempt to be unbiased. It has gone so far now that the public does not know it.”23 It is within this media plan that the negative narrative that frames the lives of Black people, the poor, and the oppressed is normalized.

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EVANGELICALS DEFINED

So, who exactly are these Evangelicals? A 2014 Pew Research Center study on religion and public life interviewed 35,000 American adults in all fifty states by phone to determine the demographic characteristics, religious beliefs and practices, and social and political views for specific religious traditions.24 The results found that 70.6% of American adults identified as Christian with the following breakdown:

• Evangelical Protestant 25.4% • Mainline Protestant 14.7% • Historically Black Protestant 6.5% • Catholic 20.8% • Mormon 1.6% • Orthodox Christian 0.5% • Jehovah’s Witness 0.8% • Other Christian 0.4%

In its most concise definition, the term “evangelical” comes from the Greek word evangel, which refers to the good news that Jesus Christ came to save humanity. The Evangelical Christian movement historically has been defined by its members’ specific doctrinal standards and practices. Yet in recent years, many Americans have come to understand Evangelicals more by their political, rather than religious, identity.25 On the surface, this is no different from that of other mainline Protestant beliefs. But the devil is in the details. John Green, author of Religion and Culture Wars in an article for PBS Frontline,26 lists four cardinal views that Evangelicals tend to hold:

1. The Bible is inerrant; it was and is without error in all of its claims. 2. The only way to salvation is through the Lord and Savior Jesus Christ. 3. Individuals must be converted or also known as being born-again accepting salvation for themselves; no sprinkles or dabs of water will do. 4. They must proselytize according to their fundamentalist views.

As rhetoricians, we know that denotation and etymology are only a part of the meaning words carry. Connotations are the suggested or implied meanings of a word or phrase derived over time that come to be associated with people, places, and actions beyond its literal meaning. It is precisely the connotative meaning of the words Evangelical Christian Right that carries a particular tone, a tone that evokes a specific religiopolitical ideologic narrative. That of conservativism and anti-liberation.

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It was in the 1970s in response to the Civil Rights Movement that this particular brand of Christian Evangelicalism, also known as the Christian Right/ Religious Right, came into existence in the United States. The Religious Right founded and ratified its mission of segregation and oppression during this period.27 The Christian Right or the Religious Right are Christian political factions that are characterized by their strong support of socially conservative policies. Christian conservatives seek to influence politics and public policy with their interpretation of the teachings of Christianity. White Evangelicals, who are a large part of President Donald Trump’s political base, continue to glorify the privilege of the fundamentalist doctrine of manifest destiny that underlies this mission.28 Ironically, some Evangelical Christians have differences with the current conservative right-leaning political climate. However, they remain silent or are complacent for the sake of white solidarity and maintaining the white, capitalist, patriarchal power structure. Preservation of whiteness, the founding myth of white nationalism,29 is the priority reminis- cent of times past. The relationship between politics and religion in the United States is long-standing and contentious, dating back to the founding of the nation. The explication of it is beyond the scope and space of this chapter. Briefly, however, Christian nationalism is religion, and the separation of church and state is preached one way but practiced another, which is illustrated by the political influence that some religious groups and organizations hold in the current U.S. political process. This merging of the sacred and secular is called by some theopolitical a power espoused by Evangelical Christians and salient in these turbulent times.

DISSENTING CHRISTIAN VOICES

There are Christians who work alongside non-Christians in support of social justice and equality for the Black community and other minority groups. All have a role to play in advocating for parents and families at school board meetings, fair housing, health equity, and jobs. The dissenting voices take on many formal and informal forms of action. Highly visible civil unrest through protests, establishing and affirming equity in a professional or educational environment, and speaking up when others engage in disparaging comments and microaggressions are on the continuum of how an individual can be a dissenting voice. White Evangelicals can be a dissenting voice for inclusion, social justice, and equity.

In the spring of 1785, an itinerant Methodist preached against slavery in the Virginia countryside near Norfolk. It was a momentous occasion, pitting British

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native and newly minted Methodist bishop Dr. Thomas Coke against a group of lay Virginians gathered to hear the Gospel. Coke condemned slave holdings as unchristian and urged his audience to manumit30 their slaves. Many stalked out of Brother Martin’s barn, vowing to “flog” Coke as soon as he emerged. “A high-lady” egged them on, Coke reported, promising “fifty pounds, if they would give the little Doctor one hundred lashes.” The threat to humiliate Coke with a punishment meant to inflict shame as well as pain on slaves came to naught finally, but the danger was palpable. The crowd dispersed only after Martin, who was the local justice of the peace as well as a Methodist convert, cornered the ringleader and talked him down.31

Since two-term president Barak Obama occupied the White House, some Christians and non-Christians alike have become very vocal against issues of social equity along racial, political, and religious lines. There is a fear of “socialism,” access to finite resources, and the loss of privilege. A study done by McCarthy, Garand, and Olson indicates that “religion ranks among the more powerful forces driving American political polarization, sitting alongside social media, class distinctions, racial tensions,” and a variety of other factors.32 There are Christian denominations that lean a bit left and have openly voiced and affirmed their support of the Black Lives Matter movement, espouse an antiracism agenda, and espouse social justice as part of their organizational mission statements.33

• United Church of Christ34 • Presbyterian Church (USA)35 • American Baptist Churches

These churches are voicing ideological differences related to health care, education, income equity, and various issues of social justice and inequality— differences that make some Evangelical Christians uncomfortable as there is a cognitive dissonance that White Evangelicals must overcome to be that dissenting voice. According to Andre E. Johnson’s Twitter comments in response to the White Evangelicals response to the Black Lives Matter protests:

It is hard for those who only know white evangelical theology to talk about race or understand racism. There is nothing in their theological understanding that prepares them to deal with race. Many of them still believe in the inferiority of non-white people.36

Johnson continues:

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For instance, to even affirm Black Lives Matter, many have to leave their faith traditions behind or begin the work or expand their theological frameworks. Because the theology/faith they have is not compatible with affirming Black Life at all.37

CONCLUSION: WOMANIST VOICE DISRUPTING THE NARRATIVE

As a womanist, I am concerned about and committed to the survival of an entire people.38 The womanist tradition captures the lived experience and vocation of Black women in a variety of intersecting contexts. From mothers, entrepreneurs, educators, social workers, preachers, evangelists (in the original sense of the word), medical professionals, corporate executives, sisters, wives, to daughters, you get the point and understand that many of these roles run concurrently. Black women, African American women situate historically and contemporarily in hostile spaces in the United States of America and around the world, hostile areas that have a traumatic impact on her life and livelihood. It is the womanist tradition (an action that existed before it was named) that influences many to speak up for themselves and others. To speak out on behalf of their communities. Womanism is a tradition that seeks to force a change in the narrative on behalf of oppressed people. The advent of social media has provided alternatives for Black people and other communities of color to disseminate news and events pertaining to their communities, which can pose a challenge to traditional mainstream media even if social media is included as part of their broader communication strategy. Individuals are citizen journalists with the eyes, ears, and cell phone that have the ability to report what is happening in real time. Katie Geneva Cannon and Ida B. Wells Barnett are two prominent women who played vital roles in disrupting the narrative of the status quo. Both were Black women living and working in hostile spaces. Both women challenged dominant power structures of oppression for the liberation of women and men. There is a community component to their work and, using the vernacular of Wells Barnett’s time, “uplifting of the race.” Both were the Black womanist voice in hostile spaces; for Cannon, it was during her theological education and work with the Presbyterian church, and for Wells-Barnett, it was society at large and her work as a journalist. This antioppressionist voice will consciously and continuously speak and act out a theology of liberation that is inclusive of all humanity in a womanist tradition. If you see something, say something or do something. Womanism is for everybody.

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NOTES

1. See Beverly Guy-Sheftall, Words of Fire: An Anthology of African-American Feminist Thought (New York: The New York Press, 1995), 23. 2. Chimamanda Ngozi Adichie. “The Danger of a Single Story” TEDGlobal July 2009 https :/ /ww w .ted .com/ talks /chim amand a _ngo zi _ad ichie _the_ dange r _of_ a _sin gle _s tory? langu age =e n. 3. Jeffrey Gottfried, et al. “Trusting the News Media in the Trump Era: Partisan Dynamics Overshadow Other Factors in Americans Evaluations of the News Media.” https :/ /ww w .jou rnali sm .or g /201 9 /12/ 12 /tr ustin g -the -news -medi a -i n- the -t rump- era/. 4. Jerry Fallwell, Jr. Op Ed Piece in the Washington Times. https :/ /ww w .was hingt ontim es.co m /new s /202 0/apr /28 /l ibera l -med ia -sm ears- again st -li berty -univ ersit y -sh/ . 5. Aljazeera, https :/ /ww w .alj azeer a .com /prog ramme s /lis tenin gpost /2018 /11 /c hosen -trum p -chr istia n -bro adcas ting- netwo r k -18 11030 72226 078 .h tml. 6. Layli Phillips discusses the first use of the termwomanism by Walker in the introduction of her anthology The Womanist Reader. 7. Layli Phillips discusses origins of the term womanism. Ogunyemi and Hudson- Weems are considered to be two of the early progenators of the term along with Walker. See The Womanist Reader p. XX. 8. Ibid. 9. Ibid. 10. Annette D. Madlock. Listening for the Call: A Reflective Essay I think I Got it Right. Listening/Journal of Communication, Ethics, Religion, and Culture (in press). 11. Theology of Work Project. (2013). Calling a biblical perspective. https :/ / ww w .the ology ofwor k .org /uplo ads /g enera l /Cal ling_ A _Bib lical _Pers pecti ve _by _the_ Theol ogy _o f _Wor k _Pro ject_ 2017. pdf. 12. Sherman, A. (2014 ). The Basics of a Biblical Theology of Work. Accessed from: https :/ /ww w .the gospe lcoal ition .org/ artic le /th e -bas ics -o f -a -b iblic al -t h eolog y -of- work/ . 13. Janet Woodlock, Vocational Discernment and Female Experience of Pastoral Ministry Call [online]. Zadok Papers, No. 231/232, Spring 2018: 8–16. Availabili ty: < https :/ /se arch. infor mit .c om .au /docu mentS ummar y ;dn= 03199 85164 669 16 ;res= IELHS S> IS SN: 1322-0705. [cited 27 Apr 19]. 14. Emnile M. Townes, Womanist Justice, Womanist Hope (Atlanta, GA: Scholars Press, 1993), 176. 15. Toniesha L. Taylor, Womanism, Encyclopedia of Identity, PDF, p. 5. “Womansit ethics speaks directly to the images, discourses, and actions, upheld by normative ethics, that support a racist ideology against Africana women. Womanist ethics is grounded in the daily practices and talk of women who, in their lived experiences, speak back to normative ethics that seek to discount them. 16. Katie G. Cannon. Katie’s Cannon: Womanism and the Soul of the Black Community (New York: Continuum, 1995), 23, 56.

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17. Autumn A. Arnette. Shaping the Narrative, Powered by the Black Press. National Association of Black Journalists, Journal, Winter 2017, pp. 19, 26. at www .nabj .org. 18. Black Press, community news, The Milwaukee Courier was established in 1964. https://www.loc .gov /item /sn78005245/ 19. Black Press, community news, The Milwaukee Community Journal was regis- tered in 1975. https://www.loc .gov /item /sn84025860/ 20. It is important to note that media sources for news consumption differs by generation. 21. Pew Research, Jeffrey Gottfried and Michael Barthel https :/ /ww w .pew resea rch .o rg /fa ct -ta nk /20 20 /06 /25 /b lack- hispa nic -a nd -wh ite -a dults -feel -the- news- media -misu nders tand- them- but -f or -ve ry -di ffere nt -re asons /, June 25, 2020. 22. https :/ /ww w .alj azeer a .com /prog ramme s /lis tenin gpost /2018 /11 /c hosen -trum p -chr istia n -bro adcas ting- netwo r k -18 11030 72226 078 .h tml. Contributors to this piece include: Gordon Robertson—CEO, Christian Broadcasting Network, Terry Heaton— Former executive producer, The 700 Club and author of The Gospel of Self: How Jesus Joined the GOP, Sarah Posner—Reporting fellow, The Investigative Fund and author of God’s Profits: Faith, Fraud, and the Republican Crusade for Values Voters, and Nicole Hemmer—assistant professor in presidential studies, University of Virginia and author of Messengers of the Right. 23. Ibid. 24. https :/ /ww w .pew forum .org/ relig ious- lands cape - study /. There is an interactive reporting tool available for data analysis. 25. Pew Research 26. Frontline the Jesus Factor. https:/ /ww w .pbs .org/ wgbh/ pages /fron tline /show s/ jes us /ev angel icals /evma in .ht ml. April 29, 2004. 27. Tom Head. “The Religious Right.” ThoughtCo. https:/ /ww w .tho ughtc o .com / the- relig ious- rig ht -7216 31 (accessed March 31, 2020). 28. Gregory A. Smith. “Among White Evangelicals Regular Churchgoers Are the Most Supportive of Trump.” Pew Research. https :/ /ww w .pew resea rch .o rg /fa ct -ta nk /20 17 /04 /26 /a mong- white -evan gelic als -r egula r -chu rchgo ers -a re -th e -mos t -sup porti ve -of -trum p/. Philip Schwadel and Gregory A. Smith. “Evangelical Approval of Trump Remains High but other Religious Groups Are Less Supportive.” Pew Research. https :/ /ww w .pew resea rch .o rg /fa ct -ta nk /20 19 /03 /18 /e vange lical -appr oval- of -tr ump -r emain s -hig h -but -othe r-rel igiou s -gro ups -a re -le ss -su pport ive/. 29. Andrew L. Seidel. The Founding Myth: Why Christian Nationalism Is Un-American. (New York: Sterling, 2019). 30. Means Emancipate. 31. Extracts of the Journals of the Rev. Dr. Coke’s Five Visits to America (London, 1793), 35. As cited in Sarah Barrington Gordon’s The First Wall of Separation Between Church and State: Slavery and Disestablishment in Late-Eighteenth Century Virginia. The Journal of Southern History, 85, no. 1. (2019). file: ///D: /Reli gious %20Ri ght%2 0Evan gelic als/T he_Fi rst_W all_o f_Sep arati on_b. PDF

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32. Angela F. McCarthy, et al. (2019), “Religious Right, Religious Left, Both, or Neither? Understanding Religio‐Political Identification.” Journal for the Scientific Study of Religion, 58: 547–569. doi: 10.1111/jssr.12618. 33. Mark Oppenheimer, New York Times, accessed June 18, 2020 https:/ /ww w .nyt imes. com /2 016 /0 1 /23/ us /so me -ev angel icals -stru ggle- with- black -live s -m at ter -m oveme nt .ht ml. (2016) 34. https :/ /ww w .ucc .org/ justi ce _ra cism_ black _liv e s _mat ter 35. Presbyterian Church USA Advocacy and Social Justice, Accessed June 18, 2020. https :/ /ww w .pre sbyte rianm issio n .org /what -we -d o /adv ocacy -soc i al -ju stice /. PCUSA work on such issues as the environment, hunger and food, child advocacy, human rights, responsible investing, world peace, disaster assistance, development and grants, domestic/international public witness and social welfare. 36. Andre Johnson Twitter post 11:12 PM June 17, 2020. Twitter for IPhone. 37. Ibid Twitter post June 17, 2020. 11:25 PM Twitter or iPad. 38. Dianna L. Hayes. Standing in the Shoes My Mother Made. p. 56 in Stacey M. Floyd Thomas, Editor, Deeper Shades of Purple: Womanism in Religion and Society.

BIBLIOGRAPHY

Adichie, Chimamanda Ngozi. “The Danger of a Single Story.” TEDGlobal video, filmed. 2009. https :/ /ww w .ted .com/ talks /chim amand a _ngo zi _ad ichie _the_ dange r _of_ a _sin gle _s tory/ recom men da tions /1770 23 /sh are (accessed April 5, 2020). Adney, Karley. “Womanist Theology.” In Encyclopedia of Women in Today’s World: The Multimedia Encyclopedia of Women in Today’s World, edited by Mary Z. Stange, Carol K. Oyster, and Jane E. SloanFirst, 1561–1562. Thousand Oaks, CA: SAGE Publications, Inc., 2011. doi: 10.4135/9781412995962.n912. Aljazeera. 2018. https :/ /ww w .alj azeer a .com /prog ramme s /lis tenin gpost /2018 /11 /c hosen -trum p -chr istia n -bro adcas ting- netwo rk -18 11030 72226 078 .h tml. Arnett, Autumn. Shaping the Narrative. Powered by the Black Press. National Association of Black Journalists Journal. Winter (2017):19,26. https:/ /cd n .yma ws .co m /www .nabj .org/ resou rce /r esmgr /Jour nal _w inter 2017/ NABJj ourna l -win ter20 17 -V2 .pdf. Benson, John M. “The Polls: A Rebirth of Religion?” Public Opinion Quarterly 45, no. 4 (1981): 576. doi: 10.1086/268692. Bosmajian, Haig. “The ‘Wall of Separation’ Metaphor in Supreme Court Church- State Decisions.” Religious Communication Today 8 (September 1985): 1–7. https :/ /se arch- ebsco host- com .e zprox y .lib erty. edu /l ogin. aspx? direc t =tru e &db= ufh &A N =141 41058 &site = ehos t -liv e &sco pe =si te. Braunstein, Ruth, and Malaena Taylor. “Is the Tea Party a ‘Religious’ Movement? Religiosity in the Tea Party versus the Religious Right.” Sociology of Religion 78, no. 1 (Spring, 2017): 33–59. http: / /ezp roxy. liber ty .ed u /log in ?ur l =htt ps:/ /se arch- proqu est -c om .ez proxy .libe rty .e du /do cview /2266 34449 2 ?acc ounti d =120 85.

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Byron, Gay L., and Vanessay Lovelace, eds. Womanist Interpretations of the Bible: Expanding the Discourse. Williston: Society of Biblical Literature. 2016. Accessed May 19, 2020. ProQuest Ebook Central. Cannon, Katie G. “Hitting a Straight Lick with a Crooked Stick: The Womanist Dilemma in the Development of a Black Liberation Ethic.” The Annual of the Society of Christian Ethics 7 (1987): 165–177. Accessed May 19, 2020. www .jstor .org /stable /23559475. Cannon, Katie G., Alison P. Gise Johnson, and Angela D. Sims. “Womanist Works in Word.” Journal of Feminist Studies in Religion 21, no. 2 (2005): 135+. Gale General OneFile (accessed May 19, 2020). https :/ /li nk -ga le -co m .ezp roxy. liber ty .ed u /app s /doc /A138 81233 4 /ITO F ?u =v ic _li berty & sid= ITOF& xid =a 9b5fe ea. Dorrien, Gary. Economy, Difference, Empire: Social Ethics for Social Justice. New York: Columbia University Press. Accessed May 19, 2020. doi:10.7312/ dorr14984. Dreisbach, Daniel L. “Micah 6:8 in the Literature of the American Founding Era: A Note on Religion and Rhetoric.” Rhetoric & Public Affairs 12, no. 1 (2009): 91–105. doi: 10.1353/rap.0.0072. Floyd-Thomas, Stacey M. 2006. Deeper Shades of Purple: Womanism in Religion and Society. New York, NY: New York University Press. Frontline The Jesus Factor. https :/ /ww w .pbs .org/ wgbh/ pages /fron tline /show s /jes us / ev angel icals /evma in .ht ml. Gordon, Sarah Barringer. “The First Wall of Separation between Church and State: Slavery and Disestablishment in Late-Eighteenth-Century Virginia.” Journal of Southern History 85, no. 1 (2019): 61. Gale Academic OneFile (accessed April 7, 2020). https :/ /li nk -ga le -co m .ezp roxy. liber ty .ed u /app s /doc /A575 90216 0 /AON E ?u =v ic _li berty & sid= AONE& xid =9 1bd82 ba. Gottfried, Jeffrey, and Michael Barthel. Black, Hispanic, and White Adults Feel the News Media Misunderstands Them, but for Very Different Reasons. Pew Research Fact Tank News in the Numbers. 2020. https :/ /ww w .pew resea rch .o rg /fa ct -ta nk /20 20 /06 /25 /b lack- hispa nic -a nd -wh ite -a dults -feel -the- news- media -misu nders tand- them- but -f or -ve ry -di ffere nt -re asons /. Hardesty, Jared. An Angry God in the Hands of Sinners: Enslaved Africans and the Uses of Protestant Christianity in Pre-Revolutionary Boston. Slavery & Abolition, 35 no. 1 (2014): 66–83. doi : 10. 1080/ 01440 39X.2 013.7 80459 . Harris, Tina M., and Rebecca J. Steiner. “Beyond the Veil: A Critique of White Christian Rhetoric and Racism in the Age of Trump.” Journal of Communication & Religion 41, no. 1 (Spring 2018): 33–45. https:/ /se arch- ebsco host- com .e zprox y .lib erty. edu /l ogin. aspx? direc t =tru e &db= cax &A N =129 77911 1 &sit e =eho st -li ve &sc ope =s ite. Hartmann, Douglas, Xuefeng Zhang, and William Wischstadt. 2005. “One (Multicultural) Nation under God? Changing Uses and Meanings of the Term ‘Judeo-Christian’ in the American Media.” Journal of Media & Religion 4 (4): 207–234. doi: 10.1207/s15328415jmr0404_1. Head, Tom. “The Religious Right.” ThoughtCo. https :/ /ww w .tho ughtc o .com /the- relig ious- right -7216 31 (accessed March 31, 2020).

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Huckins, Kyle D. “Communication in Religious Lobbying: Making Meaning, Creating Power.” Journal of Media & Religion 1, no. 2 (2002): 121. doi: 10.1207/ S15328415JMR0102_3. Hughes, Ceri. “The God Card: Strategic Employment of Religious Language in U.S. Presidential Discourse.” International Journal of Communication (19328036) 13 (January, 2019): 528–549. https :/ /se arch- ebsco host- com.e zprox y .lib erty. edu /l ogin. aspx? direc t =tru e &db= ufh &A N =139 17171 4 &sit e =eho st -li ve &sc ope =s ite. Jackson, Ronald L., and Michael A. Hogg. “Womanism.” In Encyclopedia of Identity, edited by Ronald L. Jackson and Michael A. Hogg, 889–893. Thousand Oaks, CA: SAGE Publications, Inc., 2010. doi: 10.4135/9781412979306.n285. Karenga, Tiamoyo, and Chimbuko Tembo. “Kawaida Womanism: African Ways of being Woman in the World.” Western Journal of Black Studies 36, no. 1 (Spring, 2010): 33–47. http: / /ezp roxy. liber ty .ed u /log in ?ur l =htt ps:/ /se arch- proqu est -c om .ez proxy .libe rty .e du /do cview /1018 07446 2 ?acc ounti d =120 85. Kendall, Mikki. Hood Feminism Notes from the Women that a Movement Forgot. New York, NY: Viking, 2020. Lunceford, Brett. “Rhetoric and Religion in Contemporary Politics.” Journal of Contemporary Rhetoric 2, no. 2 (2012): 19–29. https:/ /se arch- ebsco host- com .e zprox y .lib erty. edu /l ogin. aspx? direc t =tru e &db= ufh &A N =799 20828 &site = ehos t -liv e &sco pe =si te. Mannon, Bethany. Xvangelical: The Rhetorical Work of Personal Narratives in Contemporary Religious Discourse. Rhetoric Society Quarterly, 49, no. 2 (2019): 142–162. doi: 10.1080/02773945.2018.1547418. Masci, David. https :/ /ww w .pew resea rch .o rg /fa ct -ta nk /20 18 /04 /23 /b lack- ameri cans- are -m ore -l ikely -than -over all -p ublic -t o -b e -chr istia n -pro testa nt/ (accessed August 13, 2020). McCarthy, Angela F., Olson, L. R. and Garand, J. C. Religious Right, Religious Left, Both, or Neither? Understanding Religio‐Political Identification. Journal for the Scientific Study of Religion, 58 (2019): 547–569. doi: 10.1111/jssr.12618. Medhurst, Martin J. “Forging a Civil-Religious Construct for the 21st Century: Should Hart’s ‘Contract’ Be Renewed?” Journal of Communication & Religion 25, no. 1 (2002): 86–101. https :/ /se arch- ebsco host- com .e zprox y .lib erty. edu /l ogin. aspx? direc t =tru e &db= ufh &A N =141 68163 &site = ehos t -liv e &sco pe =si te. Nelson, Thomas E., Rosalee A. Clawson, and Zoe M. Oxley. “Media Framing of a Civil Liberties Conflict and Its Effect on Tolerance.” The American Political Science Review 91, no. 3 (1997): 567–583. ProQuest. Web. 8 May 2020. Nix-Stevenson, Dara. “Womanism.” In Encyclopedia of Women in Today’s World The Multimedia Encyclopedia of Women in Today’s World, edited by Mary Z. Stange, Carol K. Oyster, and Jane E. Sloan. Thousand Oaks, CA: Sage Publications 2011. Oast, Jennifer. ““The Worst Kind of Slavery”: Slave-Owning Presbyterian Churches in Prince Edward County, Virginia.” The Journal of Southern History 76, no. 4 (2010): 867–900. Accessed April 7, 2020. www.jstor .org /stable /27919282.

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Oyster and Jane E. Sloan, First ed., 1559–1560. Thousand Oaks, CA: SAGE Publications, Inc., 2011. doi: 10.4135/9781412995962.n911. Pew Research Center. Political Polarization in the American Public. 2014. Available at . ———. America’s Changing Religious Landscape. 2015. Available at . https :/ /ww w .pew forum .org/ 2015/ 05 /12 /chap ter -3 -demo graph ic -pr ofile s -of- relig ious- group s/ ———. Religion in Public Life. 2016. Available at http: / /www .pewf orum. org /2 016 /0 1 /27/ 3 -rel igion -in -p ublic -life /. _____. Religious Landscape Study. 2014. Available at https :/ /ww w .pew forum .org/ relig ious- lands cape- study/. ———. Since Trump’s Election, Increased Attention to Politics—Especially among Women. 2017. Available at . Rodgers, Selena T. Womanism and Afrocentricity: Understanding the Intersection, Journal of Human Behavior in the Social Environment, 27, no. 1–2 (2017): 36–47. doi: 10.1080/10911359.2016.1259927. Ross, Rosetta E. “Katie Geneva Cannon and the Soul of Womanism.” Journal of Feminist Studies in Religion, 35, no. 2 (Fall 2019): 141–143. http:/ /ezp roxy. liber ty .ed u /log in ?ur l =htt ps:/ /se arch- proqu est -c om .ez proxy .libe rty .e du /do cview /2359 96244 1 ?acc ounti d =120 85. Schwadel, Philip, and Gregory A. Smith. “Evangelical Approval of Trump Remains High, but Other Religious Groups Are Less Supportive.” 2019. https :/ /ww w .pew resea rch .o rg /fa ct -ta nk /20 19 /03 /18 /e vange lical -appr oval- of -tr ump -r emain s -hig h -but -othe r -rel igiou s -gro ups -a re -le ss -su pport ive/. Seidel, Andrew L. The Founding Myth: Why Christian Nationalism is Un-American. New York, NY: Sterling, 2019. Taylor, Toniesha, L. Womanism in Ronald L. Jackson II and Michael A. Hogg Encyclopedia of Identity. Thousand Oakes: C.A., 2010, 889–893. Tewkesbury, Paul. “Keeping the Dream Alive: Meridian as Alice Walker’s Homage to Martin Luther King and the Beloved Community.” Religion and the Arts, 15, no. 5 (2011). Thomas, Linda E. “KATIE CANNON: Premier Womanist Ethicist, Mentor, and Big Sister.” Journal of Feminist Studies in Religion 35, no. 2 (Fall 2019): 145–146. http: / /ezp roxy. liber ty .ed u /log in ?ur l =htt ps:/ /se arch- proqu est -c om .ez proxy .libe rty .e du /do cview /2359 96345 9 ?acc ounti d =120 85. Townes, Emilie M., Katie Geneva Cannon, and Kristine A. Culp. “Appropriation and Reciprocity in the Doing of Feminist and Womanist Ethics.” The Annual of the Society of Christian Ethics13 (1993): 187–203. Accessed May 19, 2020. www .jstor .org /stable /23559561. Wilsey, John D. “‘Our Country Is Destined to Be the Great Nation of Futurity’: John L. O’Sullivan’s Manifest Destiny and Christian Nationalism,” 1837-1846.” Religions

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8, no. 4 (2017): 68. http: / /ezp roxy. liber ty .ed u /log in ?ur l =htt ps:/ /se arch- proqu est -c om .ez proxy .libe rty .e du /do cview /1899 74803 0 ?acc ounti d =120 85. Wünch, Hans-Georg. “Learning from African Theologians and Their Hermeneutics: Some Reflections from a German Evangelical Theologian.” Verbum Et Ecclesia 36, no. 1 (2015): 1–9. http:/ /ezp roxy. liber ty .ed u /log in ?ur l =htt ps:/ /se arch- proqu est -c om .ez proxy .libe rty .e du /do cview /1737 51374 4 ?acc ounti d =120 85.

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Gatison and Glenn_9781793613554.indb 16 13-11-2020 11:40:07 Robert S. Littlefield, Deanna D. Sellnow, and Timothy L. Sellnow, “Situating Culture and Integrated Marketing in Risk and Crisis Communication” in Integrated Marketing Communications in Risk and Crisis Contexts: A Culture-Centered Approach (Lanham, MD: Lexington Books, 2021), 7–25. Series: Integrated Marketing Communication. All Rights Reserved.

Chapter 1

Situating Culture and Integrated Marketing in Risk and Crisis Communication

The concept of culture is complex, even for anthropologists who study culture from every conceivable dimension. Johoda (1984) considered culture an elusive term, suggesting that the number of books devoted to this topic would fill many library shelves. Over time, others have concurred. But, when culture is introduced into the mix with IMC, and risk and crisis communication, the result is, figuratively speaking, the construction of a multi-lane expressway, with multiple entrances and exit ramps leading to myriad destinations ready for voracious exploration. Quite simply, the complexity and impact of culture on how informative and persuasive risk and crisis messages are created, disseminated, and received cannot be overstated. Here is where we begin our examination, situating culture and integrated marketing within the domain of risk and crisis communication. Then, we offer a review of communication theory, spokesperson models, and interacting arguments to illustrate how culture both affects and reflects the senders and receivers of crisis messages in the IMC context.

CULTURE AND INTEGRATED MARKETING COMMUNICATIONS

To situate culture within IMC, both must be defined and briefly explained to provide context for what is to follow and to demonstrate how cultural perspectives influence the way organizations and spokespeople view themselves and stakeholders. Culture is characterized by its nonmaterial and material dimensions. Culture is reflected in society through its nonmaterial cultural dimensions (e.g., beliefs, values, symbols, and language), as well as by its material culture (e.g., physical objects, technology, and forms of dress).

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IMC, a major communication development in the late twentieth century, is a process whereby all communication messages used in a campaign are linked to maximize communication effectiveness with stakeholders. The marketing elements included in IMC are advertising, sales promotion, direct marketing, marketing public relations, sponsorship, the internet, and World Wide Web (Kitchen & De Pelsmacker, 2004).

The Effects of Culture on Communication While the number of cultural factors affecting communication is stagger- ing, Sarbaugh (1979) identified four general categories of a taxonomy that organize the discussion of culture’s effects on communication, particularly when applied to messages communicated to diverse publics. These categories include code systems, perceptions about relationships and intent, knowing and accepting normative beliefs and values, and worldview. Code systems, or language variations, present a major challenge for effective communication. Within cultures, distinctive language features (e.g., rules of grammar and common usage) make it difficult to even suggest that a single culture has a common language. By extension, the “arbitrariness, abstractness, meaning-centeredness, and creativity” of language makes communication across cultures a complex undertaking (Ting-Toomey & Chung, 2005, p. 141). Because language affects how people think, speak, and interact, the presence of first language and second language usage further complicates the communication process. The verbal style used by spokespeople also influences how messages are perceived. For example, Gudykunst and Ting-Toomey (1988) explained four variations of verbal communication styles that affect levels of understanding (e.g., direct versus indirect, elaborate versus succinct, personal versus contextual, and instrumental versus affective). Other scholars have provided insight into code systems and language choices more specific to specific cultures (Klopf, 2000; Neuliep, 2003). These various perspectives pertaining to differing language styles and code systems serve as guidelines for individuals engaged as spokespersons to follow. The way individuals view their relationship with members of cultures, as well as the corresponding intent demonstrated by these communicators, can affect how messages are received. Hofstede (1991) identified four broad cultural patterns that influence how individuals perceive each other and respond to intercultural communication (e.g., power distance, other-orientation, uncertainty avoidance, and gender-identity). The effect of this variable is evident by the degree to which the spokesperson establishes a relationship based upon authority and power. For example, if a spokesperson fails to consider the cultural perspectives of the publics, this CN position may alienate the

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spokesperson from the communities and reduce the probability that they will respond positively to the message. Another aspect of intercultural communication involves the receptivity of the communicators to know and accept each other’s beliefs and values. When the beliefs and values are known and accepted, positive intercultural communication is the result. If beliefs and values are not known or not accepted, misunderstanding and distrust occur. Thus, the manner of communication may be directly influenced. For example, in a high-context culture, beliefs and values are understood and accepted without explicit explanation. In a low-context culture, explicit information about the beliefs and values must be shared if there is to be knowledge and acceptance (Hall, 1976). Ting-Toomey and Chung (2005) classified these high- and low-context communication patterns by how they affect levels of connection and understanding between the senders and receivers. As every characteristic of a culture has the potential to influence as it reflects beliefs and values, the need for attention to this area of cultural variability is paramount. Communication between cultures is complicated further by the various ways people perceive and act in the world around them. How people experience their reality (nature of life), focus their attention (purpose of life), and use their agency to affect change (place in the cosmos) contributes to an individual’s worldview (Sarbaugh, 1979). For example, humans may be subjugated to nature, equal with nature, or attempt to dominate nature. From another perspective, individuals may feel controlled by, effectively manage, or want to control a situation. Ishii et al. (2006) discussed this in the context of fatalism versus agency. Religious orientations that reference sacred writings, authority figures, rituals, speculation, and ethical perspectives also contribute to how people identify and understand messages related to their well-being (Samovar et al., 2014). Some scholars suggest that value orientations contribute to worldview and have a powerful influence on the way members of a culture perceive and respond to communication (Kluckhohn & Strodtbeck, 1961). Klopf (2000) goes on to suggest that the way members of a culture perceive, think, and speak is influenced by the manner in which they view the world around them. Thus, how individuals view their values in relation to other values reflects their value priorities (Schwartz, 1992). The complexity of culture as characterized in this taxonomy reflects the challenges facing decision-makers using IMC to promote products or ideas, and risk and crisis communicators intent on saving lives. The language or code system used to convey the message must account for the ability of the receivers to understand and respond as desired. How groups perceive the intent of the sender as helpful, hurtful, or neutral toward them and their needs will affect how they respond to messages. How groups handle tolerance for

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ambiguity will also affect their reactions. To clarify, while some cultures may be more holistic in their response to a stimulus, others may respond better to direct and sequential messages to follow instructions about how to proceed. Senders should not ignore the cultural beliefs, values, and assumptions of their customers, stakeholders, or publics. While decision-makers may know some elements of their publics’ cultural values, without input from the groups to provide context for those values, the decision-makers’ messages may not be perceived as they were intended. Even more importantly, differing worldviews may complicate communication between senders and receivers. Not all groups have the agency to make changes or take charge of the situation. Some groups may be fatalistic and unable to respond due to religious perspectives that the crisis is god’s plan. Whether through differences in language, relational intent, tolerance for ambiguity, knowledge and acceptance of values, or through worldview, the complexity of culture can make effective IMC or risk and crisis communication a challenging endeavor. In the area of communication, how groups present and represent themselves through their culture demonstrates what they value. Cultural variables shape not only how messages are created, but their dissemination and reception, as well. Studies abound with results supporting the conclusion that the cultural backgrounds of senders and receivers of messages influences how effectively those groups communicate with each other. When senders do not account for the cultural perspectives of those receiving their messages, they are—in effect—CN, or what is also referred to as culturally insensitive. When the sender makes an effort to tailor the message in ways that acknowledge norms and values of the receiving culture, it is an improvement. But, when senders use the cultural preferences of the receivers as they construct and disseminate messages integrating members of the cultural group, this CC approach creates the greatest opportunity for success in achieving the intended outcome. In addition, these cultural variables affect the ability of people from different groups to know and accept each other in the process of developing relationships. The audience-focused attention to culture can be applied to approaches used in marketing. IMC is a relatively new marketing approach used to build relationships between a company and its consumers. By definition, “[IMC] is the coordination and integration of all marketing communications tools, avenues, and sources within a company into a seamless program that maximizes the impact on consumer and other end users at a minimal cost” (Clow & Baack, 2007, p. 8). As IMC has evolved, its elements have remained focused on advertising, sales promotion, personal selling, direct response marketing, and public relations. The need for IMC grew as the availability of social media exploded around the world. As user access to media increased, media outlets expanded

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to provide alternative channels for reaching current and potential consumers. With the expansion and fragmentation of the media, marketing became exceedingly difficult. Because consumers received so much information from marketers, to build customer loyalty, companies needed a strategy dependent upon consistent messages that could be placed on the media platforms across the spectrum. In this way, through consistent and coordinated messaging, businesses could build strong bonds with consumers by tying together and reinforcing the images and messages using integrated marketing (Kotler, 2005). The intersection of culture and IMC with risk and crisis communication is the central focus of this book because both IMC and risk and crisis communication are audience-centered concepts. McKendree (2016) explains that because IMC demands that organizations communicate with “consistency, coherence, clarity, and continuity within and across formal organizational boundaries,” following an IMC approach can diminish or remove the “risk and uncertainty associated with crisis events” (p. 131). Within the audience- centered context, culture must be a primary variable in message creation because developing and deciding how and when and by whom messages should be disseminated makes a difference in how these messages are received by publics. Because IMC relies on a coordinated approach to promoting a product, decision-makers must account for multiple stakeholders and carry the consistent brand over multiple channels. One standard message may not have the same effect on all customers, but elements of the message that are consistently disseminated across a range of platforms will draw the publics to the product. Similarly, when crises occur, decision-makers are challenged to provide consistent messages to multiple publics with differing cultural perspectives, particularly in the pre-crisis stage when the credibility of the spokesperson may be a factor. Persuit (2013) sees IMC as an enabling consideration of multiple perspectives in responding to crises and thereby engaging multiple audiences in “productive discourse” (p. 87). To meet this potential, vital information must be conveyed, with sensitivity toward the cultural perspectives of the publics, to achieve intended results. Whether in the promotional mix used to reach potential customers (in the case of IMC) or in messages designed to provide life-saving information to distressed publics (in the case of risk or crisis), decision-makers ought to account for the cultural perspectives of receivers to achieve their goals. If not, they risk losing potential customers or losing lives of victims needing critical instructions for self-protection.

The Process of Integrated Marketing Communications For the public relations practitioner, IMC means that all the promotional tools available will be linked and function harmoniously in the creation and

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dissemination of a message. In this integration, every point of contact is a communication opportunity as elements are combined, integrated, and syner- gized in the promotional mix so to consumers, all messages look, sound, and feel alike. Practice tells us that when all tools are used together, they are more effective than if the tools are employed in a haphazard or uncoordinated way. Schultz and Kitchen (2000) were among the first to identify the stages of IMC development in an organization. These stages move sequentially (figure 1.1) . In stage 1—tactical coordination of marketing communication—a high degree of interpersonal and cross-functional communication is needed both internally and externally. This stage is led by the business or organization, not by external agencies. For IMC to be implemented at stage 1, no real attempt is made to understand the consumer, customer, and prospect dynamics (Kitchen & De Pelsmacher, 2004). Additionally, no investment has been expended to build databases or apply information technology. Essentially, for businesses who anchor in this stage, IMC may be nothing more than ensuring that the promotional mix of elements is consistent. Most stage 1 businesses eventually move to stage 2—redefining the scope of marketing communication—where extensive information about their customers is gathered from external sources and evaluated. In this stage, the business aligns with external agencies to redefine the scope of the marketing communication based upon the available data that are collected. In stage 3—application of

Figure 1.1 Stages of Integrated Marketing Communications.

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information technology—databanks are built and maintained to segment publics. Data about different publics are converted into customer knowledge, ultimately affecting communication planning and implementation. To reach stage 4—financial and strategic integration—the business leader(s) constantly must monitor performance from a return on investment perspective. Information linked to each of the publics is analyzed on a global scale and used in the decision-making process when adapting to market forces or customer demand. Businesses that move through all four stages are using a comprehensive IMC approach. By the end of the twentieth century, IMC was being adopted widely by public relations practitioners and businesses due to the explosion of all forms of media and the growth and development of niche and single media markets. As multinational and global entities expanded their influence over economic and political systems, digital technology played a major role in diffusing information and building corporate identities. With the growth of information technology, access to and use of large consumer databases became a tool for marketing programs of all types. As access increased, IMC strategies to build consumer loyalty for the organization’s brand expanded. Early proponents of IMC promoted its utility for others seeking to develop more effective relations with their publics. The components needed for IMC to function included consistency, interactivity, and mission. Consistency helps information to fit together to create an impression with publics. Although messages may be tailored for different audiences, a thread exists to link messages together and contributes to the collective brand. Another component is interactivity, whereby businesses use databases to identify publics who are given the opportunity to initiate communication and provide feedback. Providing for publics to engage with the company builds loyalty and strengthens the connection with their mission or stated purpose. In particular, just as all communication messages must be linked for a promotional campaign to be success; in crisis situations, all of the messages must be coordinated and work in harmony in order to reach the publics with the information they need to mitigate the crisis and avoid personal harm. For example, governmental agencies must work with local community govern- ments; emergency management efforts must be communicated with local community groups; health, environment, and education systems in a community must share information to bring needed resources to members of the community who need them. To be effective, risk and crisis communication must involve constant review and coordination during the pre- and post-crisis contexts. IMC involves different levels of integration to reach targeted populations. These integration levels strengthen the effectiveness of the communication

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because their shared goal is the adoption or acceptance of the product or idea by consumers and stakeholders (MMC Learning, 2019). In IMC, horizontal integration occurs when marketing crosses multiple departments in determining what actions must be taken and how messages are sent to stakeholders. In risk and crisis contexts, horizontal integration describes inter-agency coordination, one of the best practices necessary to ensure that relevant information being shared with the publics is consistent and immediate (Seeger, 2006). Data integration in IMC involves different departments collecting and sharing information collaboratively to effectively and consistently integrate all the promotional tools used to promote a message. For risk and crisis, data integration involves entities sharing relevant information to minimize conflicting messages coming from different levels of crisis management. Vertical integration suggests that IMC is consistent with higher-level objectives within the corporate structure and supports the mission. For example, if an organization supports corporate social responsibility (CSR), vertical integration focuses on making sure all messages from every level of the organization support that mission. In the case of crisis messaging, when applying IMC principles, one would expect to find consistency between corporate objectives and what organizational leaders were communicating through their messages. IMC requires all staff to be informed and motivated to promote new product developments, new service standards, or new partnerships. Hence, everyone is responsible for knowing what is happening to fully market new ideas or outcomes; consistent internal communication is essential. For crisis situations, effective intra-agency communication is essential to functionally operate with a consistent message. Intra-agency communication enables an organization to retain its credibility by maintaining consistency about what is happening to mitigate the effects of the crisis on the publics. Finally, IMC requires external integration to attain the goal of cohesive and integrated communication with outside entities. In this context, when multiple agencies are involved, there is a need to work together to deliver a seamless solution. For risk and crisis communicators, this goal becomes controlling the narrative. When multiple voices are presenting critical information in advance of or during a crisis, members of the publics need to know that their source of information is providing the complete message they need to survive.

Advantages of IMC IMC offers many benefits to organizations when promoting their products or services. These include, for instance, being customer-centered, producing

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a consistent and credible message, controlling the narrative, responding to timelines, and being cost- and time-effective. Customer-centered communications is at the heart of integrated marketing, guiding the customers through the buying or acceptance process. The customer-centered approach mirrors what Dutta (2008) termed the CC approach, whereby the perspective of those receiving the information guides the decision-makers when they create and disseminate their risk and crisis messages. When relationships are culture-centered, images and relevant information will have been identified from the intended publics. By using these images and information, risk and crisis communicators will know precisely what the publics need to know, when they need to know it, and from whom they should be getting it. As IMC helps an organization build loyalty with its customers, it also opens spaces to help publics sort through conflicting risk and crisis messages, focusing on those that emanate from the most trusted and credible sources. The consistent and credible messages that are characteristic of IMC are more effective in cutting through the noise from other messages and keep the customers unified in their support of the organization. Creating one consistent and credible message is the goal of IMC because it has more impact with multiple messages that may or may not have persuasive elements appealing to a broad population. This characteristic is consistent with the best practice of risk and crisis communication that calls for controlling the narrative through a single source (Seeger, 2006). When life or death is hanging in the balance, the publics want to know that the message they receive is the one to which they should be paying attention. If disjointed messages are presented in the face of crisis situations, the publics may become confused, frustrated, or anx- ious. The development of consistent messages presented in the face of a crisis sends a message of reassurance and order to the publics. Customers are typically influenced more when shared messages are unified. Message consistency is enhanced in IMC by using images across different communication tools and modes of distribution to create more avenues for customers to be exposed to the product and decide about purchasing the product or idea. This is evident when a logo or image is used across multiple platforms and packaging options. Similarly, message consistency is a critical component of risk and crisis communication because, like IMC, having multiple agencies referencing the same information in the same or similar way is advantageous and is reaching multiple publics preferring different sources or modes of delivery. As one might expect, as messages become more consistent, their credibility in the buyer’s mind is enhanced. IMC seeks to reduce uncertainty about risks associated with the product or idea being promoted. Controlling the narrative and being credible are equally important for organizations disseminating

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information in risk and crisis situations. As the spokespeople present their messages, reliance on credible sources will enable them to appear more consistent and a source that people can trust to provide them with accurate information. When IMC is implemented, messages are linked and sequenced to provide reminders to the customers about updated information and special offers to guide them to the buying process. The timeliness of these messages serves to direct the customers to keep moving toward the completion of a transaction. In risk and crisis situations, the timeliness of the warnings and updates is equally critical in the process of informing the publics affected by the crisis about steps they should take to get out of harm’s way or mitigate the impact of the situation on their lives and livelihoods. As a final consideration, IMC eliminates duplication of effort because all elements of the promotion are shared across the organization. These elements find their way into all advertising, exhibits, and sales literature, to name a few. A single department being responsible for IMC saves money for the organization through a reduction of duplication (e.g., advertising, time spent in meetings, creative sessions, and workload). Similarly, in risk and crisis situations, saving time and effort is critical when lives are at stake. Risk and crisis communication are enhanced when all aspects of the communication messages are being coordinated and disseminated by an identified spokesperson and strategic team.

Barriers to IMC IMC has several barriers that limit an organization’s ability to successfully communicate with target audiences, including what have been called functional silos within the organization. Silos are artificial walls or obstacles that stifle creativity, produce conflicts, and challenge decision-makers. Within some organizational structures, departments exist with managers who have as a primary goal the protection of their turf, including both budgets and staff. Because multiple departments are involved when IMC is implemented, if information is not shared across departments, efficiency and cost savings may not be realized. In addition, managers often do not communicate with each other to avoid giving the appearance of being influenced by someone from another department. Public relations departments may not report to marketing; while sales departments may meet with advertising staff about new promotional offers. Instead of generating creative ideas to be used across IMC, departmental staff refrain from adopting or developing ideas generated by other units for fear of appearing to lack creativity themselves. This limitation is not unique to IMC because in risk and crisis situations, similar turf wars exist between agencies seeking to mitigate the harms of the

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situation. Multiple entities are involved in crisis situations, including different levels of elected government, non-profit organizations, emergency management entities, communication specialists, news agencies, health and safety offices, environmental agencies, and community action groups, to name a few. The same silos that exist in IMC can prevent crisis responders from sharing information and result in less efficiency and cost overruns. Multiple agencies make it possible for crisis managers to avoid communicating regularly or completely with each other. Without a central command to bring the involved parties to the table to develop a comprehensive strategic crisis plan of action, the impact of their collective efforts will be limited. IMC can have the effect of stifling creativity because once the coordinated marketing plan has been agreed upon and is in place, spontaneous creativity is eliminated. Making creative adjustments to IMC limits its effectiveness because of the coordination required to convey the adjustments across the organization. For example, the spontaneity of responding to declining consumer purchases with a new promotion to boost sales would be unlikely if an overall IMC did not allow for such modification. For risk and crisis communicators, the example of an organization developing its crisis plan and then failing to use it during a crisis runs parallel with IMC. For example, just as the dynamics of consumer response may prompt a change of strategy, the dynamics of crisis situations make constant adjustments a necessity. If the crisis managers are not agile and creative in their responses to changing dynamics during a crisis, they may limit their ability to respond in ways that will have a greater impact on reducing the threats to lives and livelihoods. Finally, a threat to the effective implementation of IMC is the lack of familiarity among managers to the concepts of coordinated marketing. Because most public relations agencies are single discipline in their focus, they lack experience across the marketing disciplines and lack commitment to implementing a way of promotion that limits their individual influence in favor of a more collective decision-making strategy. Similarly, in risk and crisis situations, individuals bring their own training and expertise into their decision-making regarding how to reach the affected publics. Communications specialists may focus on the development of the message and how it is disseminated, while emergency managers may assume that their plans will be carried out without concern for how those plans are conveyed to the publics. Developing a CC, collaborative communication and management approach to risk and crisis communication is a goal worthy of pursuing.

Implementing Integrated Marketing Communications As with any marketing system, there are challenges to implementing IMC effectively. Similarly, risk and crisis messages to be effective must also build

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upon strengths while overcoming the challenges. These best practices in both contexts focus on management, organizational climate, communication strategy, budget, and customer orientation. For IMC to succeed, senior management must believe the benefits outweigh the drawbacks. IMC requires leadership from the top that is integrated at different levels throughout the organization. Discussing integration at every meeting, whether vertically or horizontally, as well as internally or externally, the focus must be on developing a consistent message and ensuring that all groups within the organization convey the message. As crises occur, they also require decision-makers with authority to use an overarching strategy that acknowledges the tensions associated with developing and disseminating a message that can be maintained consistently within the organization at all levels, and eternally from the organization across different populations (Littlefield, 2020b). The organizational climate for IMC to succeed must be inclusive of all units. Information must be shared across departments so that all can benefit and use it successfully. Artwork and other media must be developed together and shared in all mailings, exhibitions, press releases, websites, and even holiday cards. The brand book and design manual should be used to maintain common visual standards across all promotional materials, and internal marketing of the promotional campaign must be carefully planned and consistently reinforced. In crisis situations, all entities responding to the crisis must exhibit the trait of shared authority and cooperation to make sure that brands and information are shared to provide consistent and recognizable messages. Images and designs must be consistently used and appropriate to the publics who view them. Developing a marketing strategy involves having clear communication objectives and position statements. The vertical integration of the corporate vision must transcend levels in the organization. Linking the core values into every message will strengthen the impact of the campaign on the publics who experience them. Controlling the narrative is an essential task that risk and crisis decision-makers must complete to assure the publics that the goal of saving lives and mitigating the crisis takes top priority. Without such a strategy, the objectives of the crisis decision-maker are unclear, and the vision is inconsistently acknowledged. In IMC, the budgeting process for organizations always begins from a zero base because the marketing is developed for the client. Thus, with each objective comes the budget needed to accomplish the intended objectives. An awareness of the preferences of intended customers also impacts the budget to develop uniquely tailored strategies designed to gain compliance or adoption. Similarly, developing a crisis plan is necessary for the decision- maker because budget estimates can be made that are built upon achieving objectives. If disseminating information to residents in an area requires multiple modes of distribution, providing budget authority for those distribution

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expenses will enable an organization or community to make plans prior to a crisis to have funds when needed. Making CC decisions in IMC keeps the customers first. By considering the stages a customer goes through before, during and after a purchase, the appropriate communication tools can be selected for each stage. The sequence of communication will guide the consumer through each stage of the purchase or adoption process. Within the risk and crisis phases, the pre-crisis phase provides warnings and instructional messages appropriate to preparing for the crisis. When the crisis presents itself, a different series of messages must be used to help publics deal with the realities of the crisis and take action to save their lives or livelihoods. Once the crisis passes, in the post-crisis phase, messages of recovery and learning provide insight into actions the publics should take to avoid experiencing similar crises in the future. The CC risk and crisis messages developed for multiple publics provide a broad range of strategies with a broad range of appeal.

Establishing a Theoretical Baseline Understanding how organizations communicate with their publics to market their products, promote ideas, or provide information about how to prevent harm or mitigate a crisis is essential. Using relational dialectics theory (Baxter, 2006; Baxter & Montgomery, 1996), Littlefield (2020b) argued that the prioritization by decision-makers of strategic responses to perceived tensions associated with a crisis influences how messages intended to maintain positive relationships with their publics are created and disseminated. Despite the different contexts in which such relational messaging occurs, the elements in the communication model are consistent. The sender of the message must conceive, develop, and disseminate the information via available channels to receivers who identify, understand, and respond immediately through feedback to the source of the message. While this process is underway, distrac- tions may create noise for the receiver that blocks or impedes some of the message from being conveyed successfully. If the sender understands the audiences’ needs and is aware of how cultural elements may influence the audiences’ receptivity, the message will likely be perceived as relevant and, thus, more persuasive. For example, knowing when to promote a product with more overt or more subtle messages may help the sender to craft a message that is more likely to be acted upon by the receiver (Sellnow & Sellnow, 2019). If the spokesperson knows how to interpret the feedback, the message may be modified, or additional strategies may be employed to entice the receiver to act as instructed. There are several IMC approaches used to diffuse information or products into a social system. Sellnow et al. (2009) discussed and evaluated

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the effectiveness of these spokesperson models. The single-step model is very direct and proceeds from the sender to the receiver. This model can be face-to-face or involve social media, as evidenced by Twitter and Instagram enabling senders to market in real time directly to consumers. When more than one person is involved in the process, the multiple-step message may be transmitted via an opinion leader, or someone who is trusted by the receiver. The sender and the opinion leader have an established relationship that enables the message to move more directly than through some other form of media. In addition to using an opinion leader, IMC relies on multiphase communications to market comprehensively through mass media. When publics process information, they select from a variety of communication channels over time, necessitating that marketers provide information at every stage of the diffusion process across the spectrum of choices. IMC draws its advantage from coordinating the promotion of the message horizontally and vertically as earlier discussed. In the case of securing buy-in from the customer, knowledge or familiarity with the product or idea is necessary. Once the consumer is aware, the persuasion phase incorporates both interpersonal and forms of mass communication to move toward the decision to respond as the sender instructs. The decision is not made in a vacuum, as the consumer must confirm it over time as conflicting messages or experiences challenge the original decision. The implementation of the decision enables to consumer to bring the diffusion process to its conclusion (Rogers, 2003). While this process appears to be linear; in reality, consumers often loop back and forth between the stages based upon how they perceive the relative advantage of the product or course of action. Knowing when and how to use communication strategies is necessary for marketers to be successful. The use of specific strategies may be more effective in different situations based upon whether raising awareness or gaining acceptance is the goal. For example, an advertisement may provide the information uniformly to all consumers, but providing a sample may be more effective in ultimately securing the adoption of the product or idea by the consumer. In crisis situations, communication may come in the pre-crisis stage as warnings about the crisis; during the crisis stage in the form of instructional communication about how to mitigate or avoid harm, or in the post-crisis stage to share information that assesses the damage, determines levels of effectiveness; and plans for future crises.

The Role of the Spokesperson Culturally identifying with a spokesperson helps the publics connect with the need or crisis event and contributes positively to the dissemination of crisis information. Weick (1988) wrote, “[I]nitial responses do more than set the

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tone; they determine the trajectory of the crisis. Since people know what they have done, only after they do it, people and their actions rapidly become part of the crisis” (p. 309). We argue that relationships must be built in advance during the pre-crisis phases with members of disparate populations to avoid the miscommunications that can arise. The position of using a spokesperson affiliated with the ethnicity of the population is supported in the literature. Littlefield and Thweatt (2004) extended the work of Arpan (2002) and found that publics felt more com- fortable receiving information from a cultural agent or spokesperson when discussing information related to their health or safety. Arpan initially argued that the ethnic identity of an audience should be considered before selecting a spokesperson to maximize receptivity. The assumption behind the single spokesperson model (figure 1.2) is that one person presenting one message will be more effective in communicating information about how to respond to a crisis. This speaker-centered approach draws strength from what Klopf (2000) termed “projective cognitive simi- larity,” or the belief that “the person with whom we are talking perceives, judges, thinks, and reasons the same way we do” (p. 223). This perspective provides some assurance that the public will receive a consistent message in times of crisis, which is essential for success (Rogers, 2003). While this theoretical position seems logical, in reality, it is not practical because there is not just one universal public receiving a crisis message. Instead, there are multiple publics represented by a wide range of ethnic and cultural groups who are asked to receive the cross-cultural message uniformly and respond accordingly (Perelman & Olbrechts-Tyteca, 1958/1971). Unfortunately, due to sociocultural variables, the publics’ responses are often far from uniform. Scholars in intercultural communication recognize the diversity of the multiple publics and have identified factors that affect how culturally diverse groups send and receive messages (Abramson & Moran, 2018). These factors range from macro to micro in scope, but all can change the way a crisis message is received. Since each individual culture has specific elements associated with language, the use of one crisis message transmitted across cultures is an ineffective way to motivate individuals to respond appropriately to the crisis. Language differences and styles of communication are likely to increase misunderstanding or result in

Figure 1.2 Single Spokesperson Model of Crisis Communication.

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non-compliance when crisis messages are transmitted unless these variables are considered. With only the single spokesperson presenting one message cross-culturally, individuals in the different cultural groups are unlikely to respond as directed. Samovar et al. (2014) suggested that to communicate effectively with people from diverse cultural backgrounds, an individual must have knowledge about the people from other cultures and respect for their diversity. This said, the need to rethink the single-spokesperson model of crisis communication seems apparent. Under the established model (figure 1.2), the single spokesperson presents the message to the public. Because the public is seen as a homogenous group, the single spokesperson is confident that the crisis message will be received as it is intended. The reality of multiple publics complicates this model because of the cultural variables that may influence how the crisis message is perceived and acted upon by the publics. In figure 1.3, during the pre-crisis phase, relationships should be established with cultural agents drawn from the diverse publics who will be part of the message transmission if the risk becomes a crisis and a response is needed. The single spokesperson can still be at the center of the crisis and will likely serve as the contact person for the cultural agents who are ultimately responsible for presenting the crisis message in a meaningful way to members of their respective cultural groups. This alternative approach is audience-centered and responds to the needs of people to get information from those who seem more closely affiliated with them. We propose that when communicating with diverse publics, using multiple spokespeople who represent and speak in patterns associated with the intended audiences, and

Figure 1.3 Multiple Spokesperson Model of Crisis Communication.

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using language representative of these groups, will enhance the receptivity of those who receive the messages.

Interacting Arguments While multiple spokespeople can have a positive impact when seeking to reach different groups within a social system, with more voices comes the potential for different, conflicting views. These differences may result in oppositional perspectives or arguments that must be evaluated by audiences who may not share the same level of technical expertise to recognize the merit of the information being presented. Accounting for the publics’ understanding of the interacting arguments necessitates an audience-centered approach, whether through IMC or in risk or crisis messaging. Perelman and Olbrechts-Tyteca (1958/1971) introduced the concept of interacting arguments affecting universal and particular audiences and described a means by which audiences might evaluate them. In their treatise, differentiated forms of interaction were identified, as follows: interaction occurring between arguments (e.g., X is a better solution than Y); interaction between arguments and the overall situation (e.g., X is a better solution than Y, given the current situation); interaction between arguments and their conclusion (e.g., X will achieve the preferred result more quickly than Y or other alternatives); and interaction between the arguments in the discourse with those about the discourse (e.g., X may be better solution than Y, but neither address the systemic cause of the problem). They suggested that when arguments interact, audiences or stakeholders make judgments based upon the strengths of the different arguments (e.g., source of the information, the strength of the claims, and their value). Because opposing arguments are dynamic and shift as the argumentation proceeds, Sellnow et al. (2009) portrayed competing arguments as interacting through convergence, congruence, mutually exclusivity, or dominance. As claims are presented in the ongoing argumentation, the publics may find some merit in each of the competing arguments and be unsure about which claim is the best option. With the addition of multiple sources of information, convergence is the primary objective for organizations seeking to bring competing arguments to a single conclusion that is recognized by the publics as making sense. The convergence of competing perspectives into a coherent and cohesive argument intersects the assumptions underlying IMC. To move toward a context where potential customers collect and contemplate multiple messages about a product or idea, conflicting perspectives must converge into a single conclusion. Similarly, once that conclusion is reached, it becomes a part of the broader interaction between multiple groups who may or may not share that perspective.

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Considering Culture in Crisis Stages When decision-makers are confronted with a crisis and must decide how to respond, or businesses seek to promote a product or idea using IMC, developing a coherent message to influence publics or secure customers requires an awareness of the communication process. Messages are created and disseminated; receivers hear, interpret, and respond accordingly. The goal is to gain compliance or acceptance. When crises strike, keeping culture at the center of the decision-making process is essential because, with an audience focus, the decision-maker or communicator will tailor responses in such a way that the intender receivers of the message are willing to accept. In the pre-crisis stage, communicators invite members of cultural groups to be part of the discussion. In this stage, there is time to develop trust and learn what the groups want or need to know, how they prefer to receive the information, and from whom. Enlisting the support of cultural agents who are already trusted by the group can enable senders to understand how messages should be presented for greatest impact. In this stage, multiple arguments are introduced, and the effective communicator will seek convergence to find the most effective means to market the information. In the crisis stage, there is no time for trust building because messages must be presented directly, consistently, and credibly to save lives and mitigate the harms emanating from the immediacy of the crisis. Using knowledge gained during the pre-crisis stage, communicators use the trusted spokespeople and opinion leaders to convey the important information in a way that will be culturally synchronous with the preferred ways of communicating. The goal is to make sure the critical information is shared with the affected publics in such a way that they will respond and act according to what is suggested. In the post-crisis stage, listening and responding to the cultural groups affected by the crisis is essential if organizations are going to learn how to do a better job of communicating when the next crisis occurs. Bringing members of the cultural groups or community into the decision-making process within an organization will build trust and establish credibility. Ultimately, cultural groups will be more likely to demonstrate loyalty to the organization if they believe the focus of interest for the organization is genuinely on them, rather than on itself.

SUMMARY

This chapter has revealed how dimensions of culture are reflected in the communication process and the study of IMC, as it intersects with risk and

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crisis communication and benefits from the inclusion of culture in the conception, dissemination, and reception of informative and persuasive risk and crisis messages. A review of related communication theories, spokesperson models, and interacting arguments provided the conceptual framework for the inclusion of culture and IMC in the advancement of effective risk and crisis communication. Our discussion of pre-crisis, crisis, and post-crisis stages supports the need to include elements of culture in the crafting and transmission of messages, as well as an understanding of cultural beliefs, values, and practices affecting the way crisis messages are received. In chapter 2, we propose our rationale for using culture to enhance the best practices of risk and crisis communication, along with a discussion of how differing worldviews may serve to mitigate the realization of strategic planning designed to save lives and livelihoods.

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Littlefield_9781793618771.indb 25 1/20/2021 2:36:32 PM Vinita Agarwal, “The Wholeness Project” in Medical Humanism, Chronic Illness, and the Body in Pain (Lanham, MD: Lexington Books, 2020). 1–31. Series: Lexington Studies in Health Communication. All Rights Reserved.

Chapter One

The Wholeness Project

To begin a book on wholeness is to face a large expanse of sky and wonder where to begin to grasp it in order to describe its width and breadth. The project is as elusive as it is huge. It is also a reminder of the power of scale. To look up is to be aware of the individual self in a self-reflexive relationship contemplating a larger entity, of a here in relationship with a there, and of a dialogic connection that speaks to the shared positionality of both perspectives. It’s an awareness of an embodied self in engagement with an other. Understood, as an act of agency, one’s contemplation of the first step appears as an engagement of dialogic communication with a vast enterprise. The enterprise will evoke the imagination as much as the discursive body, the intangible reality of the embodied self as much as the materiality and inscription of our hopes and fears, our joys and pain, our goals and our constraints, on the construction of our discursive bodies. In the act of looking up at the sky, we look within as we look outward, engaged in sense-making with all that we have, realizing that it is a self-reflexive exercise in grasping all that we are. The act of looking up at the sky could well be an illustration for the act of contemplation of our outward actions and the intentionality that guides them, an act that can be substituted by any other action and that might yet well implicate all the above questions. Medical Humanism, Chronic Illness, and the Body in Pain: An Ecology of Wholeness is a postmodernist, social constructionist treatise on wholeness. It approaches the construction of wholeness as a journey to the enterprise of a lifetime of living with a chronic condition as it intersects with the thicket of the vast forest of medico-social scientific knowledge and human progress. The ever-deepening expanse of scientific research and technological sophistication takes us further into the space of medico-pharmaceutical, health care, public health, mediated-socio-cultural-communicative, neuroscientific, and biological

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universes, affording us ever greater predictive precision and power of repli- cability that can examine the minute spaces of our DNA within the skin that encases our lived bodies. Present medical knowledge gives us the benefit of knowledge predict our risk of specific diseases and conditions, their anteced- ents and outcomes, our pasts and our anticipated futures, and all the conditions of their materialization, with impressive and ever-increasing precision. Within this dynamic and growing universe, the book raises a call to consider the relationality of the individual in dialogic engagement with the whole, of the individual’s own awareness of the self in relationship with the body on one hand and the planet of its material existence on the other, and all the many micro- and macro-interactions, contexts, and spaces that we inhabit, and that in turn constitute us, in between. The book takes as its center the chronic condition experience, caused largely by lifestyles, that are preventive in nature, amenable to health promotion, and in many cases, to the benefits of curative treatment that promise long-term survivorship. Chronic conditions and those living with them can well be the poster child for the advances in disease prevention and health promotion efforts of centuries of progress characterizing the evolution of human civilization. Yet, as this book argues, the complex and multi-perspectival global burden of chronic conditions advances deeper and further than ever before. It seems the advances in the medico-scientific-public health centered socio-cultural- mediated-communicative effort miss a gap in providing a sense of quality- of-life in the care of patients and individuals living with long-term conditions. The ecological model of wholeness developed in the book proposes to integrate current advancements in an integrative framework that (re)orients us to the relationality and dialogic engagement with ourselves and our lived contexts in a way that centers and balances to create a sense of wholeness. Given all the current advancements, the book asks, why has the meaning of health and treatment, health outcomes and long lives, cures and long-term survivorship, not resulted in individuals who are in engagement with the fulfill- ment of their highest goals, as current definitions of health and wellness will posit? Why would chronic conditions place an ever-increasing global burden on health care systems, national economies, and social capital, when survivorship and cure ensured by medico-science should be the precursor to much easier, non-scientific, humanistic question of living fulfilled lives? Our communities are characterized by disparities and disadvantage, fissures of racial, national, cultural, and medico-religious-social differences, and filled with anxi- ety over changing lifestyles, the relationship with the earth’s natural resources, the loss of species and ecological diversity, and consumption and excess. These are questions and challenges raised in the experiences of the individuals I’ve spoken with during the course of my research on comple-

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mentary and alternative medicine providers and their patients—individuals living with chronic pain, who are supporting their biomedical treatment with other forms of care to address side effects of depression or drowsiness feel they have forgotten what it means to live a meaningful life. These are questions raised when we combine multiple, intersecting approaches to ideas of treatment, healing, and cure, and in order to do so successfully, need to be aware of what healing and health means to us by way of providing a cure. They are also raised when we, as social scientists, researchers, educators, and practitioners, recall definitions by leading world bodies and authoritar- ian global institutions in medical and health care research that are predicated on wholeness. They are relevant to concerns of delivering meaningful patient-centered care that makes a difference in the lives of patients and in our larger communities. The underlying premise of the book focuses on the nature of wholeness and how it can be conceptualized to be integrated in the lives of individuals with chronic conditions and in conceptualizing patient-centered care. In raising the question of wholeness, the book is concerned not so much with the philosophical, phenomenological inquiry into the nature of meaning and human existence, but with the central premise of proposing an integrative vision of medicine, humanities, and the human expression of wellness in/as healing communication. My goal in engaging in this endeavor, from the vantage point of an individual facing these challenges, is to engage with these concerns in an integrative call for an ecological model of wholeness. The ecological model of wholeness is applied, in this book, to the chronic condition self-management domain, as an illustrative instance, and as a device to exemplify the model’s applicability to a range of definitions of wholeness. The social constructionist approach employed in the model en- capsulates the invitation for multiple meaning-creation intersections, on the basis of context and individual positionality in the framework. This book is, therefore, a proposition to center the question of wholeness in the dialogic relationship of the individual within the whole. To be whole is to be aware, open, and integrated in our relationship with the self and others, and with diverse human cultures, plant and animal species, and geological ecosystems that construct our lived spaces and our planet Earth. As a state, the project of wholeness presented in this book envisages being open to revising the fundamental definitions of humanism, to rethinking how we position the self in dialogic ways with the body, and to recognize alternative ways of organizing knowledge, human experience, and relationships. For the chronic illness patient, the chronic condition domain is characterized by discontinuities and fragmented narratives, ruptured identities, and struggles in meaning-making of the daily experience of their illness. The project on

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wholeness is particularly relevant to addressing challenges in human health and healing, particularly in patient-centered care in the domain of chronic illness management, where clinician-patient communication in disease management can make an especially impactful contribution to patient outcomes (Street et al., 2009). A social constructionist, humanist approach experience to understanding the constitution of the chronic illness experience can contribute to enhancing not only objective and measurable health-related quality of life indicators, but also, as the book argues, costruct an embodied, reflexive awareness of the discursive and material body/self independent of the disease. Chronic conditions are disruptive, but also preventable, and can be supported by self-management in long-term contexts. They connect with our lifestyles and with our ecological challenges and resonate at a time when we are faced with increasing evidence connecting the health of planetary environmental and geological systems, human biological and social systems, and the individual body’s dialogic and regulatory mechanisms. Stressors, dys- functionality, and misalignment between these, evidence reveals, are closely related with the production of body mass pathologies that underlie chronic conditions (e.g., obesity, cardiovascular risk factors; Tsigos et al., 2016). Living with a chronic illness in the long term is to understand the condition as an experience. Mattingly and Lawlor describe an experience as a fleeting, ambiguous, unique, memory-making exercise that lends itself to potentially a multitude of meanings with time; remaking meaning with the future, and the future remaking the meaning set in the past (2001). The long-term, situated nature of chronic illness is characterized by its negotiation in the patient’s lived context as a story or a narrative that helps them make sense of their life and its challenges in the context of their evolving symptoms. This exercise, conducted in collaborative partnership with the physician, entails patient reorganization of their experiences to engage in interpretive construction with physicians, their care givers, allied health care professionals, and others (Murphy et al., 2001). The ecology of wholeness centers how we can (re) create individual empowerment and what it means to be human in ways that envision meaningful experiences of healing while foregrounding prevention and management of long-term chronic conditions. We live in an ever-complex, globally interdependent planet, one characterized by a search for balance between progress, ecosocial stresses, and their attendant impacts on the health and well-being of its inhabitants. The book approaches wholeness as a communicative act–one that constantly revisits, reas- sesses, and contemplates its engagement with the body/self relationship. In this book, I define communication as an engagement that supports mutual dialogic constitution between relational interactants. Within the larger domain of communication, I define healing communication as communication that supports

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awareness, intentionality, or actionability of the relational integration of the body/self understood in a situated context. In laying out a whole-person, medical humanistic framework of healing for chronic condition contexts grounded within the practice of medicine and health, the chapters in this book construct an ecological understanding of wholeness through a social constructionist lens. Although the arguments developing wholeness presented in this book enhance everyday lived experiences of healthfulness and healing, due to the pervasiveness, preventive nature, and long-term self-management potential of chronic conditions, they resonate especially with the chronic (or alternatively, noncommunicable diseases, NCD) experience of the individuals, and that of the caregivers, providers, allied health care professionals, and community members involved in their care. Furthermore, as differentiated from acute care contexts, chronic conditions are often long-term, lifestyle- and genetics-based, incremental in their fragmentation of the body/self-identity, and socially invisible in nature. These factors support the social constructionist emphasis on relational, dialogic, and contextual orientation with a related concern with self-identity and situated nature of experiences.

AN ECOLOGY OF WHOLENESS

In this book, I propose an ecological model of wholeness centering the body/ self in a dialogic engagement with itself and the contextual layers. I construct the model using a medical humanistic perspective centered in a relational social constructionist approach and employ it in the book to address the challenge of prevention and long-term management of chronic conditions. A medical humanistic approach allows me to emphasize an integrative lens of social justice, locally situated cultural values, and traditional medicine, and through this ecological framework, to suggest ways to cultivate wholeness in the prevention and long-term management of chronic conditions. The social constructionist approach allows me to construct an interdisciplinary and theoretically open dialogic space to articulate, in each chapter, applied practices such as reflection, visualization and art, narrative engagement with our bodies, solitude and meditation, positive lived environments, journaling and telling stories, creating healing spaces, and building an authentic relationship with our food that can help envision and sustain wholeness in our lives and lived contexts. Medical Humanism, Chronic Illness, and the Body in Pain: An Ecology of Wholeness invites us to (re)consider being whole as an individual, relational, and dialogic premise, one vital for the construction of the paradigms upon which our ideas of collective growth, progress, and change are envisioned.

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The chapters on wholeness presented in this book provide a medical humanistic perspective employing a social constructionist epistemological framework for understanding the experience of chronic conditions with healing in the context of a global world with economic flows, technological advances, and cultural connections on the one hand, yet one where the divide between people, resources, nature, and the environment is growing larger than ever before. In this chapter, “The Wholeness Project,” I lay the groundwork for the conceptual understanding of wholeness, situating it in the global challenge of chronic condition management and its ethical dimensions, as explicated through the need for integrative and collaborative perspectives. I then situate the medical humanistic perspective, attending to the employment of the expanded chronic care model, and the parameters of self-management and self- care. Finally, I share a few words on the impetus for the book and the methodological approach employed in the conceptualization and development of the model. I conclude the chapter with a look at the ecology of wholeness model situated within the conceptual layout of the chapters presented in the book. The proposal for a wholeness approach is particularly relevant to the management of chronic conditions. At a time when an increasing number of individuals globally live with chronic and NCDs, it is important to position the conversation around wholeness and chronic conditions not as polarities with health and disease, but in ways that carefully fill out their meanings and experiences in non-adversarial, integrative ways. More importantly, the book argues, such experiences should be grounded in empowering and fulfilling choices that achieve measurable but personally constructed outcomes of health and disease. Although I will go into the case of chronic conditions in more detail in the second half of this chapter, here at the outset, I will provide a few salient reasons explaining why chronic condition management constitutes an appropriate case for examination in this book. The book’s focus on the case of chronic condition prevention and management is based on a few salient factors. Even as life expectancies increase, increasing numbers of people are living with chronic conditions than ever before. Chronic diseases are the leading causes of death and disability globally, with about two thirds of the deaths attributed to chronic and NCDs occurring in developing countries. In the United States, about two thirds of all the deaths are attributed to one of five chronic disorders of cancer, chronic obstructive pulmonary disease, diabetes, heart disease, and stroke. Newly classified conditions such as obesity alone cost the US health care system about USD 147 billion a year (Centers for Disease Prevention and Control, CDC, 2019). Like- wise, CDC statistics show that about 1 in 4 adults in the United States lives with arthritis, making it a leading cause of disability and a common cause of chronic pain. A humanistic approach to conceptualizing health and disease in

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Figure 1.1. A medical humanist, social constructionist approach to wholeness. Figure created by author.

the domain of chronic conditions has the potential to guide how prevention and treatment of disease progressions that are often characterized by long-term management of pain, debilitation, or disability can be reframed in meaningful ways to further an integrative human vision of wholeness.

THE ARGUMENT FOR A MEDICAL HUMANISTIC APPROACH

By taking a medical humanistic approach, the book argues for a praxis informed by reflection and insight into the experience of connecting the human condition with the relational and ecosocial from a dialogic and mutually constitutive perspective (figure 1.1). These intersectionalities invite us to look

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at religion and philosophy as much as they invite us to re-examine the intersections of multiple epistemologies and definitions of science and medicine. Modern science and medicine have led to the eradication of many diseases, brought health, and long life, and furthered the ability to conquer formidable assaults from viruses, microbes, the environment, accidents, and the body’s own genes with dependability and reliability. A distinctive feature of the intellectual history of twentieth-century medicine is its alignment with science, guided by objectivity, hyper-specialization, bureaucratization, technology, and the pursuit of knowledge for its own sake. Although it is not the goal of this book to position humanism and science as basic polarities, a deeper look at this relationship is warranted if an effort to balance the practice of medicine with humanism has to be fully understood as reflecting distinctive approaches to comprehending human existence. As Pel- legrino argues, the practice of medicine fundamentally lies between the practice of science and its humanistic principles, and the domination of any one over the other is bound to compromise the authenticity and ethicality of the knowledge and practice of both (1981). The enduring prevalence of chronic conditions is a call to address the challenge of (re)conceptualizing difference to understand disparities and social organization in ways that support what is vital in our individual lifestyles, traditions, communities, and cultures. Keeping differences alive and nurturing their uniqueness within a global landscape is central to the project of achieving health and mitigating the ruptures caused by lifelong chronic conditions. The arguments in this book present a framework illustrating how the project of medical humanism is central to the endeavor of accomplishing individual and social wholeness. In part, a starting point for this project of wholeness lies in revisiting the processes of training and education of those who work toward cultivating health in our society. Several thinkers have called for a revision in medical education and curricula to include the human and the social alongside the objective and the medical. Spivak (2003), for instance, calls for an enabling vision of humanism through language-based humanities and teaching, a humanism that can cultivate a capacity to produce a qualitatively different, pluralistic form of pedagogies. What will make such forms of pedagogies vital is their validation of both humanistic ethics and human rights principles with equity and humil- ity, an openness to being “intended toward the other,” not merely through rationality and reason, nor of an unnamed otherness, or, as Spivak puts it, as a derivative of an “alterity” that is unnamed (pp. 72–73). Such moves call for more than an addition of educational programs promoting an awareness of the other. What is needed is a fundamental understanding of such identifications and integrations as they operate within a living framework of difference and otherness, to construct a dialogic engagement that promotes a critical and

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continuing work toward the alignment of the individual and the universal, the objective and the subjective, the traditional and the contemporary, and the humanistic and the objective. Such integrations are possible but made challenging in the absence of the basic supports of global equity and justice. Our present circumstances are characterized by an increasing global divide in economics and the attendant disparities in access, availability, and engagement with fundamental health services and advances. The statistics from the international non-governmental agencies and national centers are striking and only too familiar. I will take a moment to highlight a few here to lay out the ways in which a deeper examination for the call of wholeness as a way of thinking about human health can be re-examined and, indeed, should be carefully investigated, developed, and explicated. More than 80 percent of the world’s population lives in developing countries and approximately half the world’s population cannot access essential health services. Even as the number of people able to obtain essential life- saving services like immunizations, family planning, antiretroviral treatment for the human immunodeficiency virus (HIV), or insecticide-treated bed nets for preventing malaria has increased in the twenty-first century, gaps in availability of services in certain regions of the world, such as in Sub-Saharan Africa and South Asia, have become especially acute. At the same time, the proportion of gross national product (GNP) spent on health care has increased sharply in industrialized countries. According to the Centers for Medicare and Medicaid Services (CMS), the United States alone spends about 50 percent (USD 1.2 trillion) of the total health care expendi- ture in the world on 5 percent of the world’s population. The national health spending in the United States is projected to reach approximately USD 6 trillion in 2027 (CMS). These global ruptures in access and equity, further ac- centuated by loss of public trust in the medical profession, have undermined the larger social structure and threatened the equitable delivery of essential health and social services foundational for supporting a basic quality of life.

(Re)thinking Wholeness in a Fractured Self/World Taking a relational, dialogic view of wholeness is central to guiding the achievements of modern science and technology ethically and deliberatively. They are key to accomplishing an integrative relationship of the individual within the multiple cultural logics underlying lifestyle-based conditions and the competing medical worldviews of our present landscape. A relational perspective emphasizes connections and an integrative approach. It positions the self, the individual, within a larger whole and provides the individual the tools to reflect upon the self from within this network of relationships. Moreover,

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the ecological model of wholeness proposed in the book goes beyond articulating a relational approach to equip the individual to envision how each part affects the other in dynamic ways. Doing so can help move us toward making a difference in the many chronic health conditions premised on the problems of access and inequity on the one hand, and the crises of modernity and its market-driven excesses on the other (Gergen & Gergen, 2004). Alongside these postmodernist and structural-economic factors, others have emphasized the social constructionist shaping of disease, as through the use of metaphors that add to suffering and exacerbate fear of certain conditions such as cancer (Sontag, 2001). The relational perspective emphasizes the integrative aspect of language and lived experience, the construction of chronic illness as a disease, and the patient’s reflexive and embodied experience through the discursive and material body in ways that can reshape the illness experience. These connections are pervasive in their effects while being diffuse in their relationship with the structural causes of global inequity. Critics note that growing global inequity is fed by Third World debt and governance challenges and complicated by structural adjustment policies of intranational agencies such as the International Monetary Fund (IMF) and the World Bank (WB), prolonged social and national conflict, and increasing consumerism (Benatar et al., 2003). Benatar et al. argue that the individual determinants of health are increasingly dependent upon addressing these factors in the context of eroding social norms and traditional practices that provide a protective buf- fer guiding moral and social progress. Such profound interdependence of the individual and the global is acutely felt in the domain of preventable lifestyle conditions that underlie chronic diseases such as diabetes, rheumatoid arthritis, and chronic obstructive pulmonary disease (COPD) than ever before. The call for global health ethics to guide policymaking in the health care arena targets the negative impact of climate change, loss of species diversity, and destruction of environmental capital to create a framework of international collaboration and trust to sustain equity, peace, freedom, and justice (Benatar et al., 2003). The connections between climate change and structural-economic policies speaks to the larger issues of disparities and inequity in general. NCDs kill about 41 million people, accounting for about 71 percent of all deaths globally every year, with more than three quarters of global NCD deaths occurring in low- and middle-income countries (WHO, 2019). The four main groups of diseases include cardiovascular diseases (e.g., heart attacks, strokes), cancers, respiratory diseases (e.g., chronic obstructive pulmonary disease, asthma), and diabetes. Their primary drivers are related to rapid unplanned urbanization and the globalization of unhealthy lifestyles, including poor diet and lack of physical activity that result in metabolic risk factors such as raised blood

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pressure, blood glucose, blood lipids, and obesity. Economically and socially disadvantaged groups are especially vulnerable to NCDs and their negative impacts such as through loss of household income and through vulnerability to poverty. Primary health care services that emphasize early detection and treatment can lessen the impact of NCDs on individuals and society (WHO, 2019). In addressing the health challenges of NCDs, we need to situate understandings of wholeness with access to traditional lifestyle and medicine alongside biomedical screening and treatment approaches. Wholeness has been discussed in many ways by international agencies, wellness advocates, and sustainability experts, mostly by way of general references to a connection of mind, body, and spirit. However, these general- ized references to connecting mind, body, and spirit in care suggest a need for greater explication and development in order to be conceptually, theoretically, and pragmatically helpful for those struggling with chronic diseases on a day-to-day basis and their providers and caregivers. This book makes a unique contribution by developing a conceptual framework for an ecology of wholeness through the lens of social constructionism. The emphasis on relationality and dialogic engagement laid out in this book proposes the bringing together of the philosophical orientations of interdisciplinary approaches from humanities and sciences to address the ontological orientations of the indigenous and the other while including forms of knowledges that may appear irrational, primitive, or prehistoric. Such an ecological model of wholeness involves constructing a critique of the larger project of humanism, health, and medicine as a starting point to connect with diverse cultural logics and contexts of their enactment. By connecting diverse practices in medicine and health with a reflection on the self and the body, these chapters on wholeness articulate a social constructionist perspective on an integrative understanding to reshape the chronic disease experience. The chapters take an integrative and medical humanistic approach to bring together disciplinary insights from geography, anthropology, art, and health economics among others with health and medicine to propose a framework for understanding change in the body and self through a relational lens for those living with chronic conditions. Health and disease have shaped the course of civilizations in the past. Historic evidence indicates the emergence of infectious diseases has been associated with shifts in socioeconomic and cultural practices (Wallace et al., 2019). Advances in the etiology of diseases and their relationship with planetary ecology have deepened our understandings of the connections between human health and our planet. Evolutionary biology, focusing on connections between the homo sapiens sapiens (Latin for “wise man”) over the last 10,000 years as they evolved from hunter-gatherers to technologically

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advanced, longer-living beings, has the potential to better understand autoim- mune diseases and psychiatric disorders. In its exploration of factors ranging from our evolving symbiotic relationship with bacteria to the employment of vaccination for public health, evolutionary biology sees the body as an adaptive organism comprising a hundred trillion individual cells each following a strategy of differentiating to maximize not health but reproductive efficiencies. This view displaces the previous structural paradigm of diseases and highlights how evolutionary thinking can illuminate unexpected facets for medical practice (Dybas, 2007; Stearns et al., 2010). Understanding how cellular and genetic pathways play an important role in adaptive responses and evolutionary processes has, in turn, helped explain many aspects of the etiology of human genetic diseases and, ultimately, shed light on less well understood aspects of the body’s healing mechanisms. For instance, science has begun to understand how the epigenetic state is altered with environmental and lifestyle factors in many diseases, and this understanding is leading the way to greater insights in the fields of lifestyle- related chronic conditions related with nutrition, behavior, stress, physical activity, and working activity (Algeria-Torres et al., 2013; Ishino et al., 2013). Insights connecting biology, genetics, and the environment are reshaping biomedical approaches. By forcing us to rethink their deterministic assumptions, these newer arguments connecting evolutionary biology, epigenetics, and chronic diseases make a strong case for taking into account factors such as lifestyle and nutrition and their connection with globalization and neoliberal policies to better understand their impact on NCDs (Wallace et al., 2019). These findings reinforce the implications of increased global interdependence and the need to situate reflective, dialogical, and ethical approaches to address emergent challenges to individual, community, and public health. The increased attention on marginalization, social disparities, neoliberal philosophies, and their relationship with paternalistic and deterministic models of health care with respect to individual and community-level health outcomes is emblematic of the foregrounding of concerns pertaining to economic disparity, social justice, and global health ethics (Dutta-Bergman, 2007). The disparities evidenced in the numbers is revealing. For instance, in the second decade of the twenty-first century, the richest 10 percent have up to 40 percent of global income whereas the poorest 10 percent earn only between 2 to 7 percent (United Nations Development Program, UNDP, 2019). Scholars have drawn attention to the implications of the neoliberal doctrine of development and progress on a multitude of factors including positioning natural resources as commodity exports and an over-dominance of cultivated, agricultural land (60 percent) in proportion to Earth’s ice-free land surface (40 percent; Wallace et al., 2019).

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Statistics illustrating a similar imbalance can be found for a range of other environmental impacts such as the overwhelming percentage of livestock as representing the vertebrate biomass on Earth today. These imbalances also play out in individual terms, particularly in regions where people survive on USD 1.90 or less a day. Out-of-pocket health expenses have pushed more households globally into extreme poverty (WHO, 2019). Scholars have warned that globalization will negatively affect the public health of those in the developing world by eroding the knowledge and practice of indigenous or traditional medicine, while doing little to make Western medicine economically or geographically accessible (Aginam, 2000). The increasing prevalence of chronic conditions means that the impacts on individual health of global imbalances are being felt everywhere—from the more developed, industrialized nations to the low- and middle-income nations.

Ethical Parameters and Social Justice The realities reflected by such statistics bring to the fore the ethical parameters of individual and community health, environment, and progress. Health care ethics traditionally emphasizes the four basic principles comprising autonomy, justice, beneficence, and non-maleficence. Their application to public health goals has given importance to the multiple connections and considerations of social, economic, and environmental factors. The public health focus within this landscape characterized by the tensions of multilateralism and destabilization is faced with debates on how to address the burden of NCDs and the social determinants of health (including income, community resources, and structural racism; Jennings et al., 1988; Institute of Medicine, IOM, 2005). In addition to individual autonomy, the IOM considers a commitment to social justice, a prevention orientation, and providing adequate social support essential to discussions of individual health promotion in the chronic care domain (2005). The arguments surrounding these perspectives are consistent with the viewpoint that individual health is intimately linked with issues of human rights, economic opportunities, law, policy, governance, and peaceful co- existence with sustainable development and environmental protections in a complex and interdependent world (Benatar et al., 2003). Social justice, comprising the values of fairness and equity, particularly with respect to the need of marginalized communities and individuals, is considered a core principle of the mission of public health. In guiding our decisions on the direction of the policy and application of medicine in society and for the benefit of individuals, bioethics has been an important support to medical humanities. The field of bioethics, with its attention to developments in science, technology,

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medicine, and care from an interdisciplinary perspective, and drawing upon theology, religion, philosophy, and law, among other disciplines, has contributed to understanding the ethical principles undergirding the practice of medicine and allocation of health care resources. Bioethics can support the dialogue needed to provide direction guiding the role of medical technology in our experience of health care, meanings of health and disease, and how we seek to achieve these. Bioethicists recognize the need to take an inclusive view of the relationships and partnerships necessary for fostering the dialogues centering around a critical examination of their role and influence on human development and progress. These conversations are central to guiding the ethical practice of medicine in many contexts, such as, in providing a voice to disadvantaged or vulnerable populations, those who are chronically ill, or those in palliative care. To contextual- ize the integrative nature of these discussions, I’ll provide an overview of two initiatives here to illustrate their main parameters.

Integration and Collaboration The first, the One Health Initiative, acknowledges these imperatives, adopting a “collaborative, multisectoral, and transdisciplinary approach—working at the local, regional, national, and global levels—with the goal of achieving optimal health outcomes recognizing the interconnection between people, animals, plants, and their shared environment” (CDC, 2019). The philosophy of the One Health Initiative draws upon the recognition that planetary environmental health will affect human and animal health through contamination, pollution, climate change, and the emergence of new infectious agents. The second move is the recognition of traditional, indigenous, and local systems of knowledge and how their alternative logics can be integrated with the more objective basis of biomedical research to optimize health care access, delivery, and outcomes. The main philosophical arguments driving the One Health Initiative draw upon the ecosystemic theory. Recent global trends in emerging infectious diseases and their economic and public health impacts have drawn attention to the correlations between environmental impacts, planetary ecology, and socio-economic trends with human health. In the last half of the twentieth century and the first decades of the twenty-first, emerging infectious diseases have ranged from the HIV pandemic, SARS (severe acute respiratory virus), Ebola, and Zika, to name a few. Their emergence highlights the impacts of urbanization on livelihoods, risk exposures, disparities, and chronic and de- generative diseases. The One Health approach adopts a relational, ecological emphasis, drawing upon the ecosystemic theory that states that the health

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of organisms in the field is relational and that animals and pathogens are embedded in webs of interaction across populations and species. Its mission statement recognizes that human health, animal health, and the health of the ecosystem are inextricably linked. Thus, to achieve health from a whole person approach, the Initiative seeks to “promote, improve, and defend the health and well-being of all species by enhancing cooperation and collaboration between physicians, veterinarians, other scientific health and environmental professionals and by promoting strengths in leadership and management to achieve these goals” (One Health Initiative, 2019). These initiatives seek to achieve greater prevention of infectious and chronic diseases; promote information sharing related to disease detection, diagnosis, education, and research; set up interdisciplinary programs in education, training, research, and policy; and facilitate development of new therapies and approaches to treatments in ethical ways (One Health Commission, 2019). Although it has been critiqued for a deterministic bias, the initiative still goes a long way toward recognizing in actionable ways the connectivity and interdependence that are salient to human health. The second example considers the move to recognize alternative, culturally situated logics in how health care initiatives are implemented, how their outcomes assessed, and how we articulate the practice of medicine more explicitly in furthering the ethical principle of fairness and equity in medicine. These considerations are especially relevant to the increasing numbers of individuals living with chronic conditions whose preventable nature and lifestyle orientation make them particularly well-situated to making a meaningful difference, particularly as the marginalized and vulnerable populations are most susceptible to their negative outcomes. WHO’s goal for universal health coverage emphasizes the social justice principle of fairness by ensuring all people have access to health promotion, disease prevention, treatment, and rehabilitation in an affordable manner (2013). This has meant acknowledging that traditional medicine (TM) is the primary source of health care where availability and access of allopathic services is limited. In certain regions of Africa, for instance, the ratio of traditional healers to population far exceeds the ratio of allopathic doctors to the population. These imbalances provide a compelling rationale for considering how complementary and alternative medicine (CAM) systems that are culturally appropriate and readily available in local contexts should be included in appropriate ways with biomedicine as a support to individual health in different regions of the world. This is the imperative of national bodies in the United States such as the National Center for Complementary and Integrative Health (NCCIH), whose focus centers on supporting basic research for identifying and addressing important regulatory, safety, and implementation mechanisms to achieve

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safe and efficacious integration between different knowledge systems. The vast scale of work needed to be done to explore the knowledge base of the different traditional systems globally emphasizes the many hurdles that need to be overcome in this direction and recognizes that more work is needed to develop a truly integrative system. The challenges of poor product and mechanistic research, poor communication between health care professionals and patients, and poor documentation and follow-through of side effects have hampered the integration process (WHO, 2013). Yet, the move is important in bringing health care in culturally meaningful ways to individuals from different philosophical orientations and to do so in an ethical manner that emphasizes equity and access and protects the family structure and social fabric of communities. By recognizing the challenges of providing allopathic care in underserved areas equitably to all communities across the globe, initiatives that work toward finding ways of supporting traditional and complementary medicine (T&CM) systems at the primary and preventive level are important for addressing chronic conditions in ways that can make a meaningful difference. Such initiatives open to integrating traditional health care systems can further the ability to increase access to complementary and alternative models of health care (WHO, 2013). T&CM modalities are globally accessible and contribute to ensuring access to care that is close to homes, culturally acceptable, trusted, and affordable, while helping meet the quality-of-life needs of those living with chronic care conditions. The inclusivity of different health care systems has been categorized by WHO across a continuum by the range of approaches taken across global regions. For instance, national areas/regions where CAM is officially incorporated at all levels (e.g., from primary clin- ics to research, implementation, and regulation at national policy level) are categorized as an integrative system; regions where CAM is recognized, but not fully integrated (e.g., quality control or implementation concerns are still being addressed) are categorized as an inclusive system; and regions where the allopathic system is recognized and supported by the state legally are categorized as a tolerant system. These initiatives are important for chronic condition management because of the preventable nature of chronic conditions and their origin in lifestyle-based factors, which are closely connected with culture and particularly amenable to the preventive focus of many traditional medicine contexts. Some broad considerations will help illustrate the cautionary facets of CAM integration. First, the use of CAM approaches is not uniform by chronic condition type globally. The use of T&CM approaches has been found to vary by the prevalence of specific types of chronic conditions in different national contexts. For instance, trends show that those with chronic musculoskeletal

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conditions and multiple sclerosis patients were more likely to use T&CM in the United States; those with cerebrovascular accidents, intervertebral disc displacements, hemorrhoids, ischemic heart disease, and essential hyperten- sion were more likely to use T&CM in China; and bone, joint, and muscle system disorders, dyspepsia, osteoarthritis of the knee, and facial service disorders were relevant predictors of T&CM use in the Republic of Korea. Second, while lifestyle approaches and local preventive CAM modalities can, with proper regulation, oversight, and research, contribute to promoting equity and access to health, wellness, and people-centered care, their implementation has to be guided with caution (Patwardhan, 2005). For instance, while traditional pharmacological preparations make greater use of local resources for local needs in their formulation, their overuse risks the health and diversity of herbal resources in these ecosystems. Thus, it is important that regulations to protect the natural resources of the ecological systems from which the raw materials for traditional medicine (TM) are extracted are in place alongside guidelines for integration (Li et al., 2015). The next section presents the scope and depth of chronic conditions and NCDs globally and within the United States. By situating the preceding discussion toward understanding the challenges presented by chronic conditions and highlighting the depth and urgency with which we need to examine the discourses of alternative and mainstream medicine practices, subjective and objective knowledge, integrative and complementary approaches, and scientific and traditional ontologies, the book seeks to envisage their pragmatic impacts and praxis in constituting wholeness for individuals in empowering and self-directed ways. As this discussion illustrates, the multiplicity of links between the environment, markets, natural resources, and lifestyle and culture complicate the interdependence underlying global disparities. These interconnections are particularly well illustrated in the domain of chronic health conditions. Recent scholarly work has helped draw attention to these connections. The export of processed food (as a Western market artifact), for example, has been critiqued as changing dietary conditions globally and perhaps fueling a global obesity pandemic (Aginam, 2000, p. 612). If the obesity pandemic is attributed as a metabolic correlate of a neoliberal model of development (Wallace et al., 2019), the need for recognizing how social practices and institutional policies support or discourage particular social norms, beliefs, and values becomes relevant in ethical considerations of lifestyle practices. Lifestyle practices draw upon local norms and bridge the social and the global in impactful ways in the realm of prevalence and treatment of chronic conditions. In the next section I present a brief overview of medical humanities as it furthers an ethical, relational, and dialogic way of approaching medicine, health, and healing in the context of chronic diseases globally.

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MEDICAL HUMANISM IN CHRONIC DISEASE MANAGEMENT

The culture of medicine and medical practice is intertwined with the culture of the age in which it is enacted and that of the local and individual contexts of its practitioners. To be practiced ethically, these need to be in alignment with their way of being enacted in thought, action, and practice, in the local contexts in which health is understood and contextualized. To translate ethical reasoning into ethical practice, Kong (2015) argues for the creation of an ethics community that nurtures and supports professionals, provides moral resources and a moral imagination, and helps reflection in engagement with the four principles of social justice such as fairness, equity, access, and autonomy. While medical education today emphasizes competency-based outcomes such as those backed by assessment-driven learning and a free-market model of an education system, human values, cultural norms, and local ethical frameworks can emphasize its connection with living, diverse communities. This integration can be made possible through a framework of medical humanism. Those arguing for the greater insertion of a liberal education in medical education, have advocated for the need to cultivate room for non- technical information that is not directly relevant to the practical, technical parameters of medicine (Pellegrino, 1981). The liberal arts and humanities provide the vocabulary and the logics to critique biomedical practice from a meta-analytic perspective in ways that can then serve as a guiding force for its practical application. For instance, critiquing biomedicine as a product of the Euro-centric framework of humanism is to open the possibility of examining the practice of medicine as situated within the hegemonic space of universal- ization, liberal humanist discourses on rights, and the politics of difference that place the Western subject as the ideal subject figure of all histories and societies. This vocabulary and meta-analytic glance opens the space to nego- tiate other ways of being human that are empowering of the minorities and indigenous cultures without being adversarial or antithetical to the project of euro-humanism (Pawar, 2011). Considering healing, health, and medicine from a framework of cultural diversity, hegemony, and universalism opens possibilities to critique the normativity of the homo euopaeus in this landscape, according an equitable space of self-determination to the indigenous other (Pawar, 2011). Such a critique is particularly relevant to the field of medicine if we understand health and healing as a human right and center the social justice framework of equity and access in making care available in ways that are efficacious but also culturally meaningful. In chronic condition management, the absence of care that connects with human values, health, and healing and privileges only an outcomes-driven

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and adverse-event focused measurement emphasis runs the danger of depen- dence on pharmacological treatment at the cost of an emphasis on quality of life. Drawing upon the postcolonial critique of the humanistic subject and the other, Bhabha argues that minority cultural rights stand in the liminal spaces between individual needs and obligations, and collective claims and choices, in a hybrid cultural milieu (2000). This book provides a medical humanist approach to centering wholeness in chronic condition management by foregrounding the human and the cultural in the space of how we approach prevention of lifestyle-based conditions. In the practice of medicine for chronic disease management, this hybrid space is occupied by immigrants, refugees, and diasporic populations who are within yet distinctive forms of national cultures, and who, as this book argues, are caught between navigating the liminal spaces of cultural health practices and local values at the intersection of normative universal modes of disease management. To situate the medical humanistic approach to chronic disease management as an element of the postmodernist framework presented in this book, I’ll provide an illustrative example. African liberative ethics, for example, reflect and embody the history of, and are an “outcome of communal and individual reflections on the meaning of life and how to achieve freedom in the face of oppressive systems” (Chitando, 2013, p. 31). In grappling with HIV/AIDS (acquired immunodeficiency syndrome), violence, land rights, and epidem- ics, African ethics emphasize harmonious relationships within communities as opposed to individualism (illustrated by the concept of ubuntu, the humanist perspective describing correct communal behavior, or spirit of connected- ness), promoting the values of personal growth within the community, and thus situating community and solidarity as central to the process of ethical decision making in guiding individual lifestyle choices. In this context, the HIV/AIDS epidemic is closely connected with ethical considerations of healing at a communal level, including a focus on questions of access that illuminate the intersections of land, environmental conservatism, reconciliation, dispossession (culturally, politically, and economically), violence, and displacement as fundamental to healing alongside pharmacological treatment. The emphasis on the ethics of resistance, discrimination, and transformation to challenge some of the oppressive themes and support empowerment then becomes a relevant project to curbing spread of HIV/AIDS and supporting reintegration of individuals in the management of HIV/AIDS disease progres- sion and post-treatment journey. Medical humanism can provide meaningful support to the practice of medicine in the case of chronic disease management emphasizing prevention and long-term disease management to bring health in ways that also empower and make the patient whole. Centering medical health ethics emphasizes

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compassion, empathy, and identification with psychosocial considerations, and on the cultural, social, and educational implications of medicine as a profession. Informing medicine, with its technocentric, practical, material, and objective paradigms, with the values, culture, and the idiosyncratic individual has often begun to define the parameters of what it means to think about health, medicine, and decision making within these realms. The humanities offer a unique insight into the practice of medicine through their ability to capture and comprehend the human experiences of happi- ness, hope, and despair in the experience of health and disease. Long-term management of chronic conditions involves making decisions that lie at the intersection of personal life choices and social norms, community structures, and family roles. It can be argued that the humanities bring to a biomedical approach to understanding chronic condition management a sensitivity and nuance that is culturally grounded and respectful of individual empowerment. For instance, literature simulates many illness experiences to induce empathy; history locates the health care professional within a landscape along with the patient and society, in a moment of time and a frame of geography and culture; while philosophy helps weigh the essential nature of acts performed under medicine (Pellegrino, 1981). These provide vital insight to insert the humanities in the practice of medicine, while acknowledging the integrity of their distinctive positions toward a shared goal.

Chronic and Noncommunicable Diseases Most chronic health conditions are driven by lifestyle factors that are easily preventable or manageable in nonpharmacological ways through behavior and lifestyle modifications. The challenge of health care systems is to improve quality of life, and healthy life expectancy, and reduce health care costs across the life span. Addressing such conditions involves initiatives that reduce the leading causes of infant death and illness, strengthen healthy communities, support child care programs and schools, help adults lead active lives and increase use of preventive screening services, and promote quality of life and independence for people as they age. Achieving these goals requires a multipronged approach that understands the prevalence of chronic diseases and their risk factors to improve our lived environments so that it is easier for people to make healthy choices. These healthy choices include both behavioral and structural facets such as creating environments that promote exercising, strengthening health care systems to deliver prevention services that keep people well and diagnose diseases early, and connecting clinical services to community programs that help people prevent and manage their own chronic conditions.

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The expanded chronic care model (Expanded CCM, Barr et al., 2003) envisions an integration of the CCM with population health promotion. In this way, it seeks to move beyond reducing the burden of chronic disease to integrating disease prevention by guiding action that addresses the role of social determinants of health in supporting healthy people and communities. The ECCM includes a focus of practice to work toward health outcomes for individual care alongside communities and populations. The ECCM envisions an exchange of ideas, resources, and people between the formal health systems and the community, and their relationship with the four areas of focus: self-management support, decision support, delivery system design, and information systems. The self management/ develop personal skills focus references self-management support such as health literacy initiatives in coping, development of personal skills for health and wellness for the individual, communities, and the health system. The delivery system design/re-orient health services criteria refers to encouraging health care professionals to not only provide clinical and curative services but also to fulfill the population health promotion imperative to support individuals and communities in a more holistic way. The focus here is to shift the emphasis on connecting health with socio-politco-economical and physical environment conditions and foreground the emphasis on health promotion. As Barr et al. (2003) describe it, in the action area of decision support, the emphasis is on supporting professionals and individuals to address disease impact and decision making in ways that support health and well-being. In the action area of information systems, clinical informatics could emphasize new programs, evaluate established ones, and support new ways of knowing. In building healthy public policy, the development and implementation of population health policies for organizational and governmental policy and legislation fosters equitable, safe, and healthy environments (Barr et al., 2003). In creating healthy environments, the focus is on going beyond social supports for health and quality of life to create supportive environments that entail working to generate tailored and optimum living conditions. It advocates for going beyond protection of natural and biophysical environment to include strategies to support conditions for optimal levels of health in social and community environments. In strengthening community action, the ECCM action area advocates collaboration with community groups to achieve priorities and goals that enhance community health, encourage effective public participation, and support individuals to find their own ways for managing health and community (Barr et al., 2003). As the traditional paternalistic model of health care, where the patient was a passive recipient of care from expert providers (e.g., physicians), shifts toward more equitable, collaborative partnerships, such models provide a collaborative

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framework based on an equal partnership to achieve health care goals. The shift from paternalistic models envisions the patient as an actively involved participant in their care (Epstein & Street, 2011). Living with chronic conditions requires day-to-day monitoring of physical and psychosocial problems and their self-management by the individual over their life span. It also requires individuals to have knowledge of the condition and its treatment, performance of condition management activities, and application of necessary skills to maintain adequate psychosocial functioning. The collaborative orientation shifts the responsibility of day-to-day management to the patient from health care professionals, thus positioning the patient as the “expert,” able to access information relevant to their health care needs and to design and carry out the self-management tasks needed for their condition at a given point in time. This shift has prioritized notions such as “self-care” and “self-management.” As discussed later in this chapter, self-care has been interpreted as a preventative strategy, a task performed by healthy people, often in home-based settings (Clark et al., 1991). Self-management, in contrast, is understood as “the day- to-day tasks an individual must undertake to control or reduce the impact of disease on physical health status. At-home management tasks and strategies are undertaken with the collaboration and guidance of the individual’s physician and other health care providers” (Clark et al., 1991). Keeping in mind the complexity of tasks that the individual must undertake to self-manage their condition, Barlow et al. (2002, p. 178) define self- management of chronic conditions as a “dynamic and continuous process of self-regulation,” one that encompasses “the ability to monitor one’s condition and to effect the cognitive, behavioral, and emotional responses necessary to maintain a satisfactory quality of life.” Several components of self-management have been identified in research and scholarly literature. These range from the ability to obtain information about the condition and its treatment to managing symptoms (pain management, fatigue management, sleep management, self-monitoring), psychosocial consequences (anger management, depression, disease acceptance, emotion and stress management), lifestyle (exercise, leisure, nutrition, smoking), social support (family, friends, peer and work groups), and communication (assertiveness and ability to communicate effectively with doctors). In their research examining the relationship between communication and healing outcomes, Street et al. (20) identify the pathways of access to care, patient knowledge and shared understanding, therapeutic relationship, patients’ ability to manage emotions, social support, patient empowerment and agency, and evidence- and values-based decision making as being central to achieving optimal health outcomes through clinical encounters.

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As human beings, it can be argued that we don’t instinctively yearn for health, we don’t always consciously strive for a healthful existence, we have no overriding primal desire to stay or become healthy at all costs. Indeed, many of us often don’t think about health and healing at all, except in its absence in our lives, families, or communities. We may believe that we value our health, but this condition is true to the extent that we value our health only as a consequence of a rational fear of our human condition if we lose the attributes of good health. We do not, really, care much about health or healing in the absence of such a fear. More importantly, we don’t usually think about the nature of health and its positionality in our lives until we are faced with an acute or chronic health condition that pushes health-related outcomes, positive or negative, at the forefront of our awareness. Indeed, it may be more accurate and reasonable to assert that we recognize the impulse of hunger more acutely and primally from the moment of our conception. Our bodies are discursively and materially tuned to respond to hunger, to procure food and resources, and to survive against the possibility of hunger than they are to instinctively protect our health from the moment of our birth. It would be more appropriate to state that our education system and social conditioning makes us aware that health and healing are means to an end. With good health, we are free to ignore our bodies so we may do the things we like to do, and unless we explicitly recognize this, we often do ignore the healthy body. Within this paradigm, health and healing are mechanisms for living a whole life, an essential pre-condition to achieving our goals during our lifetimes, to be able to avoid bodily discomfort, and to not be distracted by pain or symptoms that remind us of our frail human bodies. WHO defines health in the preamble to the Constitution of the WHO as adopted by the In- ternational Health Conference, New York, June 19–July 22, 1946, and signed on July 22, 1946 by the representatives of 61 states (records of WHO, no. 2, p. 100) and entered into force on April 7, 1948: “Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” Medical Humanism, Chronic Illness, and the Body in Pain: An Ecology of Wholeness is a book that invites us to ask what we would like to understand by health and wholeness as individuals work toward healing and health. Like health, the term wholeness is conceptually vast, connecting domains from religion to health, to bodily injury, and relationships. As a testimony to its conceptual vastness, wholeness is evoked with the congregation in a church by the priest and with the patient in a hospital by the nurse. To think about healing in relationship with wholeness, for instance, might arguably evoke health, but although health and healing are closely related, and health is a central concept that supports healing in important ways, they are, nevertheless, conceptually distinct terms. This book undertakes an

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examination of wholeness and its relationship with health and healing through centering the body. Through the lens of the body, it invites us to investigate, from our own perspectives, the multiple layered meanings of healing. Thus, it invites us to create an infinite set of possibilities that are as unique as they are universally applicable to the lived conditions and the larger dimension of existence. The multiplicity of meanings of wholeness arises from the many contexts where health and healing are enacted and constructed, and the specific needs communicated through those settings. Although a hospital may be a distinct environment in terms of the rules, regulations, and practices enacted therein from the church or the site of religious rituals and discourses, wholeness references a common ground of motivations in chronic condition self-management that draws its participants, willingly or unwillingly, within that discursive space. This book is about those practices, their meanings, and the motivations that propel the notion of wholeness to the center stage of so many conversations centered on long-term chronic disease management in the contemporary age. It proposes an ecology of wholeness as a way to advance the interdisciplinary understandings that can help construct the relationships and processes of healing. The domain of chronic conditions and NCDs is distinguished by its close relationship with lifestyle factors and thus, the agency of the individual in preventing the condition or promoting their health. Given the relevance of this point, at this juncture, I will take a few moments to clarify the intersection of chronic diseases with self-care and self-management, and explicate the differences between the two terms themselves.

Self-Management and Self-Care Self-care draws upon the basis that the individual is in the best position to take care of themselves as they know what they are going through. It draws upon the patient-centered turn in the practice of health care, which starts with the assumption that in order to be effective, health care should place the patient that it treats at the center and begin to design its treatment approach and interventions keeping in mind the patient’s experiences and conditions (Ep- stein & Street, 2011). Most research findings suggest that providers can support patient self-care if they are trained to implement a few evidence-based practices (Wagner et al., 1996). These include engaging in collaborative problem definition involving patients and care providers (Suarez Vazquez et al., 2017). Research findings suggest that this is achieved through targeting patient issues and encouraging patient goal setting, emotion management, defining and addressing uncertainty, active and sustained follow-up, and designing education and training components that support individual level behavior change (McCormack et al., 2011).

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Such practices involve the patient’s ability to define and identify what practices make them feel better and what practices make them feel worse with respect to the treatment. It involves helping patients identify how to structure and implement behaviors that promote the goals of their health care plans (Alpay et al., 2011), while decreasing and eliminating behaviors that impede or reverse the parameters of their health care treatment plans. Self-care is an important support to patient outcomes. Drawing upon notions of patient empowerment, it seeks to provide the patient themselves the tools for their own health outcomes, such as by enhancing health literacy (Schulz & Nakamoto, 2013). Using multiple sources, such as the electronic health record (EHR), the patient’s own information, and physician recommendations on a web/mobile based platform (EMPOWER) that supports self-management activities of patients and providers has been shown to have important practice implications in diabetes management for both patients and the physician as well as for the patient-provider relationship (Mantwill et al., 2015). As a collaborative, co- constructed relationship, the patient is in the driver’s seat, and the provider is in the passenger’s seat, next to the driver, watching where they are going, and perhaps monitoring for any unnoticed obstacles, but letting the patient lead the way in implementing their mutually agreed-upon plan in their lives. Self-care has been documented to prevent burnout, compassion fatigue, and vicarious traumatization in behavioral medicine, psychotherapy, and counseling. It has been documented that self-care affects health outcomes through several pathways including adhering to treatment regimes, maintaining good physical health through lifestyle choices, monitoring symptoms to inform treatment and self-care decisions, monitoring and managing stress and/or emotional consequences of illness, interacting effectively with health professionals to ensure that patients’ needs are expressed and addressed, and using social support networks to help to achieve the above (Greaves & Campbell, 2007). It is generally understood that self-care is something that patients do all the time and that, in most cases, the majority of care received by patients with long-term conditions is self-care. There is considerable scope for improving self-care. As well as being a crucial element of illness management, self-care in the form of day-to-day lifestyle behaviors is also the basis of preventative care. The drive to prevent more illness by promoting healthy behaviors increases the need for effective systems of self-management.

Self-Management Closely related to self-care, the construct of self-management emphasizes structured guidance through patient-provider consultations, ongoing follow- ups, and provision of self-help materials. It alludes to a more guided approach,

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one which privileges the health care interaction and institutional settings more than self-care. A large body of communication research has examined variables in chronic illness that support self-management behaviors such as self-efficacy (Willis, 2016), social networks (Roblin, 2011), health literacy (Shaw et al., 2012; Waverjin et al., 2016), culture and talk (Cooke-Jackson, 2011), and language and linguistics (Perera et al., 2012). In this case, medication adherence and management of side effects through nursing support for a multiple sclerosis patient would be a good example of self-management, where taking daily walks and avoiding sugar might be a major component of self-care discussions for a pre-diabetic individual. A smaller branch of communication research in the chronic disease management domain has examined provider variables such as physician certainty and curiosity (Shields et al., 2013), message framing and patient compliance (Zhao et al., 2012), and communication over different channels such as online and web-based information seeking and literacy (Stellefson et al., 2018). Much of the emphasis in communication research on patient self- management has been in the direction of understanding decision making and the factors that impact it such as culture and the patient’s health literacy. To support self-management, communication research suggests that provider communication should emphasize patient needs (Friedman et al., 2012), and employ combinations of strategies to improve a patient’s disease or treatment knowledge (e.g., health literacy, Press et al., 2013), access to services (Mead et al., 2019), or independent monitoring of symptoms (Gambling & Long, 2010). The patient empowerment paradigm has included communication scholarship examining collaborative decision making (Kaminsky & Finlay, 2019), concordance based on culture in provider-patient interaction (Alden et al., 2010), epistemic expertise (Mikesell et al., 2016), and patient education (Scherr et al., 2017), among other variables. This emphasis has yielded valu- able research findings establishing the contribution of various factors in the doctor-patient communication and relationship context that lead to improved patient empowerment outcomes such as medication adherence, asking questions, or active patient involvement in the chronic condition domain. The investigations in such research have leaned on health behavior change theories to understand the cognitive and affective bases of patient empowerment. Health behavior change theories (e.g., theory of planned behavior) and models such as Siminoff and Step’s communication model of shared decision making have been adapted for use in patient empowerment when making decisions. Researchers Quick et al. (2018) employ the extended parallel processes model to investigate fear control processes while Greene employs the theory of active involvement (2013) in adolescents’ message planning behaviors. The theory of active planning, for instance, conceptualizes arousal as

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involvement, skill production or knowledge gains as outcomes, and reflection as perceived discrepancy along with related cognitions such as expectations, norms, and intentions in producing behavior change. Gaps in the empowerment paradigm from patient perception include communication that elicits questions, presents all treatment choices, and encourages patients to take responsibility without placing blame such as in diabetes, for instances of poor glycemic control (Wan, 2012). The emphasis is on supporting the patient’s independent decision making skills through improving communication- related factors during the provider-patient encounter.

Self-Care and Self-Management Both self-care and self-management are patient-centered and empowering approaches that have the potential for providing a pathway to achieve health and receive treatment without living and being treated as a patient without power or control over their situation. Both offer choices in the provider’s ability to tailor a treatment to the patient and for the patient to be able to collaborate with their health care provider in understanding and determining the choice of treatment that should guide their care. Both self-care and self-management illuminate the challenges facing our health care professionals. The burden of providing care that addresses the needs of our current social structures—both in human, and in institutional and economic terms—is immense. On the one hand, self-care and self-management initiatives seek to bridge this gap with the need to provide care in human, empowering ways. On the other hand, providers too, as recent research findings have increasingly recognized, are over-burdened and over- stretched, facing burnout and stress at alarmingly higher rates. A key basis for both self-care and self-management initiatives is the ability of the provider and the patient toward working collaboratively to make shared decisions. For the dialogue to be successful, it requires the ability of the individual and the provider to be self-aware of what they seek to achieve and how it can best be achieved. Current training and education has attended to the factors influencing how the first of these conditions can be met, while remaining largely ignoring the equally critical second half of this equation. Recent findings have taken note of the shared trauma felt by health care providers and recognized that the most well-intentioned dialogues, implemented with the best of education and training in collaborative decision making, will come to naught if either the provider or the patient is not sufficiently self-aware, or equipped to be self-aware, of what they want through the treatment, and how they’d like to see it achieved beyond its pharmacological mechanisms. Considerations of how we cultivate self-awareness and recognition of the many dimensions involving the experience of disease through our mind and

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bodies working together, when discussed, have fallen upon medical philoso- phers, nurses, social workers, psychologists, and other supportive, frontline, or allied health professionals, while remaining largely outside the purview of the practicing medical professional. While these are worthy avenues for such discussions, the circle is not complete until we don’t recognize, implement, and educate professionals through the touchpoints of the medical system from the patient to the medical provider. These are central to how the practice of medicine approaches care of the patient and long-term well-being of the health care provider, and key to how the institutional structures comprising the health care system manages implementation and delivery of patient care.

THE IMPETUS FOR THE BOOK

The book is grounded on processes that are inspired from my cultural backdrop supported by formal continuing studies in the Indian traditional whole system approach of Ayurveda and its preventative, lifestyle focus on health and chronic disease management alongside my training in Vipassana meditation, which takes its Buddhist roots from ancient Indian philosophy. Bringing together my formal academic credentials in communication, and research in patient-centered communication, the chapters in the book construct the emphasis on the self, the body, and the relationship between the two in articulating its ecological model wholeness. The model incorporates time, solitude, nature, and nourishment as salient dimensions based on an integration of both Ayurvedic medical science and Buddhist meditation philosophies, in combi- nation with the patient-centered research findings from my recent research on chronic pain patients and CAM treatments. In integrating the vastly different ontological approaches, the traditional whole system medical philosophy of Ayurveda, and findings from contemporary Western biomedical sciences and emerging research, the book is, at its heart, an integrative project, constructed in the spirit of wholeness, bringing together the contrasting approaches and worldviews in a relational, dialogic engagement with each other. The first half of the book lays out the conceptualization of the individual as the reflexive self, the embodied self, the discursive body, and the material body. In the second half, the book traces the relationship of the self with the ecological elements of nature of time, solitude, and nature as dimensions that give the human condition its flow and structure. The final epilogue chapter aligns the human condition and its quest for structure and flow through an integrative lens of continuity and dualisms that increases awareness of a whole-ness framework. Each chapter is organized thus: the first half builds the central argument by drawing upon extant and emergent research find-

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ings, followed by its application to chronic disease management, and finally, concluding by laying out pragmatic implications for addressing the challenge of chronic illness. The proposed ecology of wholeness introduced in this chapter suggests empowering ways of aligning the body in pain with meaningful experiences that support wholeness in long-term chronic disease self-management.The conceptual layout of the book will preview in brief the theoretical assumptions employed in crafting each chapter.

Conceptual Layout of the Book The book articulates an ecological framework for wholeness in chronic disease management through conceptualizing communication, language, and re- lating in a multi-layered framework based on a medical humanistic approach and the ethical principles of social justice. As a meta-analytic, integrative project, it conceptualizes the experience of chronic illness as a process of meaning-making that empowers the individual and enriches a holistic understanding of the individual self. By grounding the ecological model of wholeness upon medical humanities as a foundational principle and a backdrop of whole-system philosophies of traditional medical systems as a relational frame, the book suggests strategies, activities, and engagements that individuals, caregivers, and providers can use to promote wholeness in preventing and managing chronic disease (figure 1.2).

Integrating the Reflexive/Embodied and Discursive/Material Theoretically, the book is organized in three main sections. The first two chapters that comprise the first section describe the wholeness project with its focus on the medical humanist ethical framework as applied to the global health challenge of chronic condition management and the social constructionist epistemological framework. Together, the first two chapters lay the conceptual and theoretical foundations for the model. The social constructionist approach emphasizes the relational, dialogic, and situated nature of experience in lived settings. The second section centers the experiencing individual as the frame of reference. It comprises four chapters, each of which describes one element of the core body/self axis that anchors the model. The four chapters in this section are organized around the relationship between the self and the body. They explicate the central idea of wholeness and integrity intertwined with the progressive awareness of the human self/body relationship. Medical Hu- manism, Chronic Illness, and the Body in Pain begins its journey in the first chapter with an examination of the reflexive self as the core of our efforts

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to be self-aware, and continues in the next chapter to the embodied self, as beginning to experience our self and the world interface through our bodies. The following chapter on the discursive body examines the bond that defines how we communicate, connect, relate, and experience our body and the self. It contends this bond is one of deliberative openness as vulnerability to the construction of the self complete with contradictions, complexities, tensions, and harmony. It presents an argument for understanding the multiple, often contradictory discursive constructions of the self as an act of deliberative openness, without striving to accept or reject, legitimize or resist, any discursive construction to constitute balance and strength from acceptance and control. In the next chapter in this section, titled, “The Material Body,” the idea of the tangible, attitude-intention-behavior centered body is situated within the communicative context of its mediated construction alongside its depiction in the biophysiological domain of public health and medical science imperatives of primary, secondary, and tertiary prevention and promotion. The third section comprises the outer contextual layers of the model which provide the relational body/self anchor a dialogic context for its construction and engagement to constitute wholeness. The three layers are discussed in order in the chapters from the innermost, or the one closest to the body/self axis to the outermost, or the one closest to the larger environment for the expres-

Figure 1.2. The ecological model of wholeness. Figure created by author.

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sion of the body/self. The first layer, presented in the chapter “Time, Change, and Illness Intrusion,” develops the idea of temporality as an a-linear concept that grounds the body/self in the notion of subjective change relationship with self-concept and self-identity. This chapter centers the experience of subjective change as a defining element of the chronic condition experience and explicates it through subjective time in the experience of chronic illness to envision it as an experience of wholeness. The next chapter, “Traditional Health Systems,” presents the second outer layer that addresses the grounding of our experiences in the mind/body axis as constructed through the context of each of our individual ontological frameworks. It develops the idea of solitude, silence, and presence and the practices that can be employed to cultivate these in a manner that integrates the three layers and the body/self axis. These practices include, for instance, the construction of healing spaces like healing gardens in health care institutions and community settings, wilderness experiences, meditative reading, and narrative restructuring through journaling. The third layer is presented in the final chapter in the book, “Food, Na- ture, and Body/Self Integration,” which articulates the idea of cultivating the self-reflexive, embodied awareness of the relationship of the self with the discursive and material body and its contextual layers through the connections between food and nature as resource and nourishment. It constructs an awareness of each of our eco-social secular-medico-cultural roots positioned in the heterodox religious and socio-cultural systems that give them meaning to tie in the idea of food and nourishment with its goal of connecting us with our individual purpose and its enactment in life. Through a self-reflexive, embodied awareness of these connections, the chapter argues, the biomedical treatments and long-term lifestyle programs, public health initiatives, and the health care continuum can be positioned in a meaning-making framework that give them relevance and integrate the fractured experience of the body in pain in a sense of balance and harmony with purpose that constitutes wholeness as the conceptualization and actualization of human health and healing goals.

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