The active citizen works hard: Living with chronic heart failure

Among the range of possibilities in which the body can develop, health appears to be a particularly sought end. Acknowledgement that the responsibility for health is attributed to the individual has led to a rethinking of the forces that shape behaviour and an awareness of the processes by which the individual, the body and the self are shaped throughout the life course. Attention to health is given high moral value, as maintaining the healthy body demonstrates a commitment to maintaining one’s self-identity. The healthy supple body is viewed not only as a controlled body but one that reflects idealized attitudes in the self (Williams and Bendelow 1998). Changes in the presentation of the body reflect alterations in life experiences as well as being shaped by social and cultural processes. A prominent example of this occurs during chronic illness when the self can be threatened by the resulting loss of control and disruption to identity. Individuals then make considerable effort to maintain their sense of normalcy and continuity by incorporating the meaning of the illness into their sense of self (Bury 1997).