Auto/Pathographies: Re-constructing Identity through Representations of Illness – Jolene Pozniak

Courtesy of Angela Ellsworth & Tina Takemoto

Jo Spence. (Tembeck)

Bouchard, Spence, Lammer. (Steinbacher)

Summer exhibition at the Kunstpavillon, Innsbruck Austria. Curated by Tamar Tembeck and presented in conjunction with the International Fellowship Programme for Visual Arts and Theory at Künstlerhaus Büchsenhausen.

The stark white walls of the Kunstpavillon Innsbruck took on a distinctly clinical feel with this summer’s exhibition Auto/pathographies. A multi-media exhibition, Auto/pathographies brought together work by 10 international artists, who explore the complex and multi-faceted nature of illness. Through photography, video and performance, the artists investigate processes of transformation that occur for those affected, directly or indirectly, by disease. As part of a curatorial residency with the Künstlerhaus Büchsenhausen, curator Tamar Tembeck drew from interdisciplinary approaches that address body politics, the politics of sickness and the politics of (self)representation as a means of examining illness and identity as both an affirmation of one’s existence and the acceptance of one’s inevitable mortality.

Inherently autobiographical in nature, autopathographical representations expose illness and suffering — ultimately private and personal experiences — as an assertion of one’s agency in the face of often debilitating circumstances. As such, many of the works function to disrupt viewer expectations of the sick body by revealing the subject’s active construction of identity rather than the passive acceptance of an assumed role. According to Tembeck, “Viewers are typically torn between embracing or refusing empathy towards the image and towards the subject depicted. In this way, autopathographic works raise significant ethical questions that pertain to viewers’ responses and responsibilities in the face of images of suffering” (Tembeck, 2008). Simultaneous processes of living and dying confront viewers in this collection of works, which articulate experiences of physical illness and pathos as poetic, absurd, traumatic, documentary, constructive and destructive.

Exhibited for the first time in Austria, Tembeck’s exhibition featured selected works by contemporary artists based in Canada, the U.S., Britain and Austria. Thanks to the generosity of the Jo Spence Memorial Foundation, the exhibition includes rare work by the late British photographer, who died in 1992 from leukaemia. Besides the UK, Finland and Austria are the only countries so far to exhibit The Final Project series by Jo Spence and Terry Dennett.

After a breast cancer diagnosis in 1982, Spence began to use Camera Therapy as a strategy to process her personal battle with cancer and to create further dialogue around patients’ rights. In work such as Cancer Sisters (1982-83) from The Cancer Series, Spence employed her familiar photographic language, documentary style, and use of tableaux as a tool to process, reflect on, and communicate her experience with breast cancer and her subsequent lumpectomy. Using the clichéd female gender stereotype as her model, the artist created a series of tableaux where she marked and mutilated Barbie-like plastic dolls to address issues of clinical objectification. By marking a doll’s breast with a black ‘X’, shaving off her hair, or cutting off a breast, Spence commented directly on her own encounters as a breast cancer patient and the loss of bodily ownership often experienced during treatment.

Cancer Sisters calls into question gender politics, representations of the female body and the stigma attached to breast cancer surgery, where the consequences are commonly concealed by prosthetics and regrettable silences. This notion is exemplified by Audre Lorde who argues, “the expectation that women will hide their deformity and cover it up with a prosthesis makes it impossible for one-breasted women to identify with each other and come to terms with their new bodies” (quoted in Dykstra,1995). Subsequently, the photographer-activist Matuschka also used her practice as a means to challenge the stigma of illness in her autopathographic work Beauty Out of Damage, published on the cover of the New York Times Magazine in August, 1993 (ibid). The photograph shows Matuschka in a white dress designed to reveal the scar from her mastectomy. By photographing herself in this way, Matuschka, like Spence, makes visible the private, often concealed effects of breast cancer in an attempt to normalize illness and challenge singular notions of female beauty.

However, Spence’s photographic techniques changed dramatically after her diagnosis with terminal leukaemia in 1990. Working together with Terry Dennett, Spence’s series The Final Project marked a departure from a more overtly political aesthetic to a psychological and emotional exploration of her own mortality. Using mirrors and layered images, Spence borrowed techniques from realism, Magic Realism, and fantasy to create PhotoFantasy — a strategy that produced an aesthetic that could better convey her experience of leukaemia in light of the disparity between her self-image, as affected by her illness, and her “healthy” physical appearance (Dennett, 2001).

The Decay Project/15th October, 1984 is a montage of a decaying surface layered onto Spence’s body, photographed for The Cancer Project. Like a headless mug shot, Spence holds a card with the date on it, conjuring up associations with criminal line-ups, or specimens tagged for experiment. The black background highlights her naked figure, which bares the real scars of her lumpectomy surgery and the superimposed scars of decay. The image evokes the discomfort and clinical objectification that often comes with being a patient, whose sick body is repeatedly examined, photographed and labelled. Much of her work from The Final Project, 1991-92 marks a dramatic shift toward directly confronting her mortality. In Decaying Face, for example, the artist layered images on top of an earlier self-portrait, thus echoing the transformation that the artist herself was facing. Spence gazes upward, as if catching a glimpse of death.

As the artist’s conditioned worsened, her work from The Final Project became less about confronting death and more about practicing it (Dennett, 2001). In Embalming, Spence Egyptian and Mummy Doll, Spence borrowed from ancient Mexican and Egyptian funeral rites and traditions to create her own “pre-death fantasy funeral”(ibid). In Mummy Doll, Spence has photographed a number of objects reminiscent of the Mexican Day of the Dead ritual. A distorted image of a glass vase containing traditional symbols of death — a taxidermied bird, dried branches, and a mini coffin equipped with mummy doll sitting erect. As in Spence Egyptian or Untitled from The Final Series, Spence used dolls or images to represent herself in these pre-death fantasy funerals. Here, the mummy doll stands in for the real Spence, and by performing death, Spence affirms her life and autonomy in spite of her imminent mortality (Tembeck, 2009).

While autopathographical works also exist in relation to the viewer’s response — as a means of addressing or problematizing the politics of the body — Tembeck’s curatorial inquiry of representations of illness extend to include relationships between healthy and sick individuals. Christina Lammer’s video installation Empathographies (2009) conveys illness from the Austrian clinician’s perspective by asking the question, “What does it mean to be a patient?” Moving away from the autobiographical perspective of illness, the video explores relational pathography: a relationship between a sick and a healthy person, which in this case exists between the patient and clinician. The viewer stands before two televisions placed side-by-side. On one screen, medical professionals are interviewed individually and given the opportunity to answer Lammer’s question. Each interview takes place in an empty room, the doctor’s presence illuminated against a muted, dark background. Only Lammer’s voice is heard and, like the viewer, she occupies a position of observation. In a slippery reversal of roles, the doctor is now the subject of inquiry — a figure of authority in an uncanny examination situation.

Among Lammer’s subjects are a plastic surgeon, an oncologist, a general practitioner, a radiologist and an ear, nose & throat specialist, all of whom maintain different patient–practitioner relationships — a product of both personality and specialization. For example, the radiologist answered Lammer’s question by simply stating that a patient is a sick person, a response perhaps not so unexpected from a professional trained to target disease in a precise and isolated manner.

While the viewer is in the position to observe and judge the clinicians in their relational pathographic role, their answers reveal more about the scope of the medical system than they provide insight into the clinicians’ capacity for empathy. This becomes evident in the blinking mosaic of white coats and black backgrounds on the second television screen; it is a piecemeal effect of differing viewpoints and experiences, which become more or less indiscernible. These individuals become boxed-into an undifferentiated category called clinician. A mix of undulating voices echoes the sentiments of the Austrian healthcare system, foregrounding the politics of disease, and a tendency to reduce both patient and clinician to singular and over-simplified categories.

Visualizing the patient from the clinician’s perspective raises questions about relational pathography with regard to issues of patient autonomy and the construction of identity, projected or otherwise. At the crux of this installation, however, is an honest curiosity about the politics of medicine, the politics of disease, and the role of patient-clinician relationship in determining the course of both.

The limitations of empathy are explored by different means in the work of American artists Tina Takemoto and Angela Ellsworth, causing the viewer to question the extent that one can participate — as a healthy person — in the experience of illness. After Ellsworth’s diagnosis with Hodgkin’s disease in 1993, the artistic partners began their explorations into the politics of disease with Imag(in)ed Malady.

In an 18-minute video loop comprising three videos, the viewer witnesses moments of pain, frustration, strenuous work and struggle in an attempt to explore the limits of empathy. Arm’s Length (1998, 7 min) documents a performance by Takemoto, where she tapes five matches to her right arm and proceeds to light them. The burns were an attempt to mimic the effects of Ellsworth’s chemotherapy treatments, and as a result, Takemoto sustained 3rd degree burns. In another effort to explore pathos and to approximate the experience of cancer treatments on the body, Takemoto performs a wall-climbing exercise up and down a 25-foot wall, while boiling, slicing and bandaging eggs in reference to wounds on the body. The act is both absurd and endearing, and ultimately fruitless in communicating the physical, emotional and psychological processes of burning, scarring and healing that resulted during Ellsworth’s chemotherapy.

The struggle, hard work, and systematic rigor involved in the process of sickness and healing is also addressed in Caffeine and Carotene (1997). This 6-minute video documents a laborious performance that took place over three days, involving more than 900lbs of carrots. While observing this bizarre act with vegetables, coffee and medical tubing, one hears the mechanical murmuring of an exercise bicycle, which is attached to a juicer. Ellsworth and Takemoto create a spectacle that is part mad-science lab, part circus, part factory-line as they meticulously work away to juice, bag and label their concoctions. Here, the artists are not merely participants, but active agents in the functioning of this system. They are part of the mechanism that circulates the treatment through IV bags of carrot juice and medical tubing. Discarded piles of carrot mulch are bandaged, bagged and stamped with the words “pre-existing condition”. The procedure and treatment regimen is nothing short of exhausting, and despite the absurdity of this performance, a sense of crisis and necessity transforms it into a compelling act about the impossibility of communicating the experience of illness.

Carl Bouchard’s video Mille Excuses (So Sorry/ Es tut mir Leid, 2005) also attests to the limits of empathy in the patient-doctor, artist-viewer relationship. Having undergone five rectal surgeries between 2005-2006, Bouchard questions the degree to which healthcare professionals and gallery visitors can identify and empathize with the pain and vulnerability that is part of the experience of surgery. Lying back in a dental chair, the viewer is invited to witnesses Bouchard’s dental surgery, the closest equivalent to the painful process he experienced during his anal surgeries.

In a textual re-telling of his rectal surgeries, Bouchard describes the procedure, the pain, and the trauma he incurred. By sharing his surgical experience with the reader, Bouchard underscores the loss of control and power experienced within the actual medical context; he allows the reader/viewer access to a situation where his permission was previously disregarded. As Bouchard describes in the accompanying text, “While waiting outside the operating room what should I see, nerves already on edge, but two student nurses. Their nervousness and furtive glances in my direction informed me. Accomplices. They knew I was next, they knew why I was there, and they knew what they would see.”

Staring into the screen, sounds of the equipment accompany a close-up view of Bouchard’s mouth being probed with metal instruments. A dental dam obscures our view of Bouchard, creating the dehumanizing effect of a barrier that separates the problem and the patient, as a private matter becomes a public spectacle. By permitting the viewer’s presence, however, Bouchard reasserts his agency and maintains the autonomy he was denied during his surgeries.

The expectations surrounding patient behaviour are addressed, to different degrees, in Chantal DuPont’s Headstrong All the Way Round (2000, 30 min). In a poetic narrative of physical and emotional transformation, DuPont expresses her experiences as a cancer patient undergoing treatment. After a breast cancer diagnosis in 1999, the artist began radiotherapy treatments, which resulted in the loss of her hair. With the intimacy of a diary, the video is presented as a timeline, but one that avoids a linear narrative. Her journey weaves across past and present, combining imagination, memory, and the weightiness of reality throughout her process of sickness and healing, of hair loss and eventual re-growth.

In an act of defiance, she refuses the role of the patient patient. DuPont sheds her wig and proceeds to pull out her remaining hair, expediting this side effect of the radiotherapy. Closing her eyes, she blows the fluffy tufts of hair to the wind and embarks on her journey.

DuPont’s work is poetic, whimsical and playful to an extent that might even be considered inappropriate given the circumstances, given her role as a patient. But perhaps it is this juxtaposition of the gravity of the situation and the lightness with which she creates that results in such a soulful piece. Floating in between memories, she says, “I have the feeling I’m off to the front with a somewhat bald head for a breast-plate — and why not? — my forehead for a banner. MADAM, YOU’LL PROBABLY LOSE IT ALL, EVEN YOUR EYEBROWS AND EYELASHES. Well then, I’ll be headstrong: in the depths of my gaze, my eyes will stay wide open right to the end of the road.”

Her bald scalp becomes both a canvas and a metaphor for her journey. Using a tiny red wagon to cart various objects — toys, plants, fruits — across her head, she invites the viewer along as she indulges in an exploration of childhood memories, traversing moments of hope, desperation, exhaustion and triumph.

Tembeck’s ambitious curatorial project culminates in a thought-provoking exploration of the politics of medicine and the body, issues of control and agency, and the limits of empathy that exist in the relationship between sick and healthy individuals. The artists in the exhibition rely on their artistic practice to question the politics of illness and to explore the transformations that occur in identity and body.

Auto/pathographies confronts the viewer head-on with illness, posing a challenge to the privileging of the healthy “normal” body, which renders disease invisible. Tembeck’s selection of works collectively disrupts viewer expectations of the patient as victim, underscoring the power of visibility to avow identity and affirm one’s life by evincing one’s mortality.

Image credits

1. Takemoto Tina, Angela Ellsworth, Arm’s Length, 1998, 7m00s (performance document). Courtesy of Angela Ellsworth & Tina Takemoto.

2. Jo Spence, Cancer Sisters, 1982-83 From The Cancer Project, 4 photographs, 10x15cm, Gallery View, Tamar Tembeck.

3. Carl Bouchard, Mille Excuses / So Sorry, 2005 DVD, 20m00s, Jo Spence / Terry Dennett, Portrait Skull, from The Final Project, 1991-92, Lammer, Christina, Empathographies, 2009, Video installation 2 DVDs,5- and 20-min loops, Gallery View, David Steinbacher.


Dennett, Terry. The Wounded Photographer: The Genesis of Jo Spence’s Camera Therapy. Afterimage (Nov/Dec 2001).

Dykstra, Jean. Putting Herself in the Picture: Autobiographical Images of Illness and the
Body. Afterimage (Sept/Oct 1995).

Tembeck, Tamar. Exposed Wounds: The Photographic Autopathographies of Hannah Wilke and Jo Spence. RACAR XXXII, No. 1-2 (2008).

Tembeck, Tamar. Autothanatography and Performance of Survival: Jo Spence’s The Final Project. Unpublished paper (2009).

Jolene Pozniak works as a freelance writer and editor in Canada and Austria. She has written on the contemporary visual arts, film, and cultural theory – specializing on issues of multicultural politics in Canada and abroad. Pozniak was the co-founder and Editor-in-Chief of the magazine Locus Suspectus and a graduate from McGill University’s M.A. program in Art History and Communications.

Submitted by Barbara Hammer (not verified) on Sat, 01/02/2010 – 17:56.

Hello Joelen Pozniak,
I enjoyed reading your review and analysis of the exhibition.
I want to alert you to the First Medical Film Symposium in Philadelphia, Pennsylvania
Jan. 20=23, 2010.

There will be 3 nights of screenings. I curated the Exerimental Medical Films program for the 21rst at International House. Saturday night a surgical film will be rpesented in the historic surgery theater depicted in the paintings of Thomas Eakins. It will be an event!

You can find info on line and in Facebook.

Have you seen my experimental film on surviving ovarian cancer, A Horse Is Not A Metaphor?

All my best,
Barbara Hammer

Submitted by Jolene (not verified) on Sun, 01/10/2010 – 02:15.

Dear Barbara,

Thanks for your comment. I’m glad you enjoyed the article. I haven’t had a chance to see your film yet, but I’ve received your contact info from Tamar Tembeck. It would be great to keep in touch and learn more about your work.

Kind regards,

Jolene Pozniak