Sickness and love: An introduction

Sjaak van der Geest, Sofie Vandamme

01 Jan 2008


Love is a neglected topic in anthropology, for good reasons: it has always resisted scientific definition and analysis. By associating love with sickness seven authors attempt to capture various meanings and experiences of love. Two broad concepts arise: love as sickness and love in response to sickness; the former refers mainly to ‘romantic love’, the latter to love as care and doing / testing love.

“Love is a gypsy child,” sings Carmen in Bizet’s romantic opera. It does not stay in one place, it does not listen to the rules that people have made. “A rebellious bird that nothing can tame,” another line from the same habanera. The elusiveness of love as an emotion extends itself to the concept of love: it resists definition and escapes from the nets of scientists who want to capture it in their studies.

Take anthropologists. They have written extensively about ritual, relationships, and institutions that have been spun around ‘love’, but love itself has been largely avoided. Lindholm (2006: 7), in a special issue on romantic love (Etnofoor 2006), remarks: “… ethnographers have been far more comfortable writing about cannibalism and incest than about romance.” Recently, prompted by the HIV/AIDS epidemic, anthropologists have been producing an increasing number of studies about sex and sexual practices, but not about love.

There are some (early) exceptions, however. In 1929 Malinowski published his study on “the sexual life of savages” that does contain some striking observations on the emotion and practice of love. The author pointed out differences as well as similarities in the experience of love among Europeans and Trobrianders: 

Love is a passion to the Melanesian as to the European, and torments mind and body to a greater or lesser extent; it leads to many an impasse, scandal, or tragedy; more rarely, it illuminates life and makes the heart expand and overflow with joy (Malinowski 1929: 239). 

Husband and wife, he writes, lead a life of close companionship; they work together, share tasks in the house, and spend a large part of the day “in excellent harmony and with mutual appreciation” (p. 93). Their union may last for their entire lives, but there are also striking differences between Trobriand and European relationships, according to the author: 

There is an interesting and, indeed, startling contrast between the free and easy manner which normally obtains between husband and wife, and their rigid propriety in matters of sex, their restraint of any gesture which might suggest the tender relationship between them. When they walk, they never take hands or put their arms about each other in the way, called kaypapa, which is permitted to lovers and to friends of the same sex (Malinowski 1929: 95). 

To Malinowski, love is a looking glass which more than anything else reveals the paradox of culture: startling differences that are reconciled at a deeper level of understanding.

The other early exception is Margaret Mead, who at the age of twenty-three set out to record the differences in the experience of adolescence among Samoan and American youngsters. She had numerous discussions about love with her Samoan age-mates and concluded: 

Romantic love as it occurs in our civilization, inextricably bound up with ideas of monogamy, exclusiveness, jealousy and undeviating fidelity does not occur in Samoa… Even a passionate attachment to one person which lasts for a long period and persists in the face of discouragement but does not bar out other relationships, is rare among the Samoans. Marriage, on the other hand, is regarded as a social and economic arrangement, in which relative wealth, rank and skill of husband and wife, all must be taken into consideration (Mead 1949: 74). 

In Samoa, she writes, romantic faithfulness is counted in days, or weeks at most. Life-long fidelity sounds like a joke, and Mead’s informants listened to the story of Romeo and Juliet with disbelief and disapproval (p. 106).

After Malinowski and Mead, one looks practically in vain for anthropological studies of human sentiments such as love and faithfulness, until the nineties of the previous century. Evans-Pritchard, who in 1974 published a collection of literal texts spoken by Zande people, remarks in his preface that “… anthropologists (include me if you wish) have … dehumanized Africans into systems and structures and lost flesh and blood” (Evans-Pritchard 1974: 9).

It is only quite recently that love, and emotions in general, have again entered into the anthropological focus. Not surprisingly, that rapprochement coincided with a growing reflexivity and deliberate intersubjectivity in anthropological work. The ethnographer’s awareness of his/her own emotional experience in fieldwork made an openness to the emotional world of the Other unavoidable.

Most publications on the anthropology of love that have since appeared focus on ‘romantic love.’ Questions that are raised include: is romantic love a Western / capitalist invention? (No, according to Jankowiak 1995, Jankowiak & Fischer 1992, Lindholm 1995, 2006); does romantic love exist at all? (No, according to Illouz 1997; doubtful, according to Giddens 1992); can romantic love survive in a life-long relationship? (No, according to Mead 1949 and Pershon, quoted in Lindholm 2006); and, can we adequately speak about romantic love? (No, according to Alberoni 1983).

In one of the new anthropological studies of love, Trawick (1990) exploited her own experiences as a ‘tool’ of research and interpretation. She lived with her little son in the house of a South Indian family and used the meetings and conversations between and about her, her son, and the members of the family as a starting point for her ethnography of love. Comparing and contrasting her and their experiences she attempted to grasp what love means in a Tamil family.

Trawick’s approach of shifting between ‘them’ and ‘us’ lies also at the heart of this special issue on sickness and love. By contrasting, comparing, and discussing seemingly different ways of loving we hope to attain a fuller understanding of what it means ‘to love’. Getting to know the love of others, whether this is in ethnography or in literary fiction, creates space to reflect on one’s own experience and concept of love. 

Sickness and love 

This special issue contains seven contributions to a symposium on sickness and love that was held in 2007 in Amsterdam. The authors try to capture experiences and meanings of love in various social and cultural situations by connecting love to sickness. Medical anthropologists have a fairly accurate understanding of sickness: for about forty years they have been discussing the various shades of meaning of sickness. Distinctions between ‘disease’ (medical professional-outsider definition), ‘illness’ (patient’s own experience and description), and ‘sickness’ (social role attached to being sick) became common knowledge within (and outside) medical anthropological discourse and have since been problematised again. Kleinman in particular drew attention to the medicalisation (by physicians) and culturalisation (by anthropologists) of human experiences of ill health and misfortune, and proposed the concept of ‘suffering’ as a less reductionist and more experience-near characterization of health-related human distress (Kleinman & Kleinman 1991; Kleinman 2006). ‘Sickness’ in this introduction and in the entire issue is used in a general sense and does not refer to the specific meaning of sickness in medical-anthropological jargon.

By questioning love within the more familiar terrain of sickness, we hope to reach a better insight into what love is and does in ordinary life situations. The contributions to the present issue undertake two approaches, one metaphoric and one contextual. 

Love as sickness 

The first approach is the exploration of love through the metaphor of sickness. Metaphors help us to grasp what appears ungraspable at first by making it more concrete. A metaphor invites if not seduces us to look at something from a different, usually less abstract, perspective. By using a metaphor we borrow, as it were, the light of one ‘thing’ to illuminate another that is still in darkness. With the help of a known or more familiar concept we explore and appropriate a less-known part of our world. Thus, our understanding moves from inchoate to concrete (cf., Fernandez 1986).

By comparing love to sickness we ascribe some of the most obvious effects of illness to the experience and emotion of love, romantic love in particular. Like sickness, love overcomes us; it is an involuntary event: we fall in love as we fall sick. Love throws us from our feet as sickness does; it changes our view of the world, it confuses. It “torments mind and body,” as Malinowski wrote. It causes pain and raises our temperature, it disturbs our sleep. Love, like sickness, even causes loneliness and despair.

Describing love as a kind of sickness – sometimes pleasant and cherished, sometimes unwelcome – is particularly popular among artists such as poets, novelists and painters (Vandamme 2007). Several contributions do in fact refer to the world of artistic expression where metaphors enjoy high prestige.

It would, however, be a mistake to associate metaphors solely with the living metaphors of artistic creativeness. Most metaphors – and metonyms – are part of daily speech and ordinary life and pass unnoticed. They are called ‘dead metaphors’ because they lack the sparkling brightness of poetic originality, but they are not dead in their effects. Dead metaphors pass unnoticed because they are no longer recognized as metaphors but taken as factual reality. By continuously comparing love to sickness, love gradually becomes a sickness. Metaphors may then produce ‘misplaced concreteness.’ Thus we see that love becomes lovesickness.

A metaphor is not an allegory. We must resist the temptation to extend the work of metaphor beyond its capacity. We must not let ourselves be carried away by the charm of metaphor. A metaphor sheds light, highlights a certain aspect, makes a point, but never says everything. It is not a definition. Most – if not all – metaphors can be countered with another metaphor that throws another light, highlights another facet, makes another point. Thus, love may also be illuminated with the metaphor of health and robustness. It would lead to the revelation of the energy that love produces, to the vitality and regained confidence that is found in the experience of love. To quote Malinowski again: love “… makes the heart expand and overflow with joy.” Both love as sickness and love as vitality are ‘true.’

In a philosophical essay, Fabio Bacchini exploits the sickness metaphor as a conceptual device to explore the properties and effect of love. By using the term ‘symptoms,’ Frans Meulenberg indicates that first love can indeed best be viewed as a sickness, albeit a pleasant and unforgettable one. Mixing personal experiences with literary love stories, he concludes that some people never ‘recover’ from their first love. Anette Wickström takes us away from ‘romantic love’ and focuses on understandings and management of love in rural daily life in north-eastern KwaZulu Natal, South Africa. People see themselves as deeply dependent on one another and love must be maintained through hard work. Love medicines offer another way to strengthen a relationship or win somebody’s love. In the last article in this section, Janus Oomen and Woet L. Gianotten take paintings by Jan Steen as a starting point to explore 17th Century concepts of ‘lovesickness,’ a disease that no longer exists in the medical textbooks of today, to the surprise of the authors. 

Love facing sickness 

The second association between sickness and love is contextual; love in times of sickness. The event of sickness calls for an emotional and practical response. Sickness is a condition which leads to a review of existing relations and commitments. The patient’s loss of autonomy, temporarily or permanently, necessitates the care and support of another person. Easy love is tested and matures; it becomes care, or leads to ‘tough love.’ Or love fails, collapses, and shrivels into nothingness, infidelity, or aversion. Words and feelings must become deeds if love is to survive. In the face of sickness and hardship, romantic love must show its colours.

The experience of HIV/AIDS in Southern Africa is an extreme example of the heavy tax placed on love. The contribution by Corrie du Preez and Anke Niehof focuses on love in the era of AIDS. Love turns into care, a ‘labour of love.’ Using extensive case material of households struck by HIV/AIDS, the authors highlight the gendered nature of love and the intertwinement of emotion and activity in the face of the disease. Catarina Frois describes how love for a sick child makes parents sick as well, and parents that participate in ‘Families Anonymous’ attempt to turn their ‘soft’ love into ‘tough love’ by breaking with their child. Frois’ article sketches the dilemmas of love that has reached its limits in the face of other people’s suffering. Finally, Deanna Trakas presents a ‘love story’ between an elderly couple and their caregivers in an American institution of terminal care. Vignettes illustrate different facets of love, and the story belies the stereotypical image of professional care as coming short of emotional bonding. 


Bringing love and sickness together into one perspective has led to two broad perceptions of love. Some of the authors saw love as a kind of illness, which concretised the romantic view of love as an involuntary event. The emotional effect throws the lover out of balance and robs him/her of a clear understanding of the world. He/she becomes insane and ‘confused.’ These effects may worsen if the love is not requited and the lover literally falls into lovesickness.

Love is put to the test when sickness enters as a misfortune that calls for support and care. Romantic love no longer suffices in that situation. Love becomes a polysemic phenomenon that entails both hard work and deep sentiment. In the face of sickness, love is challenged to maturation. A poem, titled Liefde (Love) by the 19th Century Dutch poet P.A. de Génestet illustrates this test and maturation; the poet asks, in the language of his time, whom he has loved most: the beautiful bride, the tender woman who made his home a home, the mother of his children, or the sick person on whose bedside he sits. His choice falls on the last. 

Die ik het meest heb liefgehad –
’t Was niet de slanke Bruid wie ’k in ’t zoeter leven Mocht dwalen op het duin en droomen in de dreven Wier hand mij leidde op ’t rozenpad.

Het was niet de jonge en teed’re vrouw,
Die, goede genius, mijn hart, mijn huis bewaakte, Die mij het leven, ach, zoo licht en lieflijk maakte, Met al de rijkdom harer trouw!

‘Zoo was ’t de moeder van uw kroost
Die u gelukkige, voor ’t offer veler smarte,
Deed smaken, onvermengd het reinst geluk van ’t harte, Des levens liefelijkste troost?’

Neen! – die ik ’t meest heb liefgehad,
Dat was mijn kranke; ’t was de moede, de uitgeleerde, Van wie ik leven leidde en hopend sterven leerde, Toen ’k weenend aan haar sponde zat. 


Sjaak van der Geest is cultural and medical anthropologist at the University of Amsterdam and editor of this journal. Personal website:; Email:
Sofie Vandamme is research fellow at the Department of Medical Ethics and Philosophy of Medicine, at the Erasmus Medical Centre. She is the author of Koele minnaars. Medische verwoording en literaire verbeelding van ziekte in verhalen, a study on cultural representations of illness and disease in fiction. E-mail:


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