#472 Liminality in Illness AND Health

     While we have youth, good health & abundant energy, it's so easy to take these for granted, and focus our worries on relatively trivial matters. As the many & varied challenges of aging start creeping in, we marvel at young peoples' good fortune - which for us is now "slip-sliding away". When life-threatening illness arrives, we're suddenly thrown for a loop. This is how most of us sleepwalk through life - on autopilot.
     But we're ALL, ALWAYS changing, and everything around us is also CONSTANTLY changing. Stability, of any kind, at any age, is an illusion. Reality has nothing to do with solid permanence - everything is liminal!
     Successful adaptation involves perceiving things clearly, accepting life as it is, improving external circumstances as much as practical, AND adjusting ourselves optimally to situations that cannot be improved (serenity prayer). This is thriving in the real world - the world of liminality. 

     "The concept of liminality stems from the work ... on ritual and rites of passage. Van Gennep suggested ‘the life of an individual in any society is a series of passages from one age to another and from one occupation to another’. Typical rites include life events such as: pregnancy, birth, marriage and death. Rites of passage can be divided into three stages: preliminal rites (rites of separation), liminal rites (rites of transition) and postliminal rites (rites of reincorporation). A rite of passage begins by ‘severing connection’ with a previous social state or position, followed by an ambiguous time where individuals find themselves ‘in-between’ social positions, and ends with ‘re-entry’ or ‘rebirth’ into a new social position.

     Rites of passage are not restricted to movement between ‘ascribed’ statuses such as those associated with birth, marriage and death. They also apply to entry into a ‘new achieved status’, for example, membership of a certain group. Turner was particularly interested in the ‘sociocultural’ properties of the liminal (transition) period, asserting that liminality is an ‘interstructural’ situation where culturally recognized positions, such as being married, single, an infant, etc. no longer apply. Liminal people are structurally ‘invisible’ - they are ‘no longer classified and not yet classified’, and therefore are ‘betwixt and between’ structural classification. As such, they are often described as being on the threshold, or margins. Living in the liminal (or transition) period can therefore lead to feelings of ‘ambiguity and paradox’. Yet, Turner also suggested that transition can be transformative. In fact, Turner described liminality as a ‘stage of reflection’ where ‘the reformulation of old elements in new patterns’ occurs, with liminal people re-entering society at a higher social status."

       Blows E et al. Liminality as a framework for understanding the experience of cancer survivorship: A literature review. J Adv Nurs 2012; 68(10): 2155-64.