Frequent observation: sexualities, self-surveillance, confession and the construction of the active patient.

Abstract

Following Foucault's analyses of the development of the disciplinary power of the medical gaze, this paper describes the themes that are relocating the 'active patient' as the central object of health scrutiny by professionals. A key element in these discourses has been the deployment of power through disciplinary knowledge and techniques of social control through ritual forms of confession, thereby positing the patient/client as the subject of self-surveillance. The individual is also engaged their own sexuality, performativity and 'truths' of sexual experience. These Foucauldian insights have constructed the notion of surveillance medicine, whereby with the assistance of professional technologies, not only the patient's body but also the 'self' can be probed through incitement to confess. However, the actor is not docile; resistances to disciplinary techniques are evident and within the professional practices of the clinic, there is resistance to the power of the erotic. The paper draws on recent research on the social construction of male sexualities in the fields of genitourinary practice, and explores how the ceremonial practices of the clinic engage with the rise of surveillance medicine and the medicalisation of everyday life. The individual actor is exhorted to engage in increased sexual and medical self-surveillance and to be recruited in the project of becoming an 'active patient'. It concludes with an examination of some of the implications this surveillance of self may have for practitioners in terms of power and the professional lens through which the sexualised, symbolic body is viewed.