Emily Courtney on breast cancer, objectification, and health
Dr. Emily P. Courtney is a social psychologist and assistant professor at the University of South Florida. She earned her undergraduate and master’s degrees at Cleveland State University and her Ph.D. at the University of South Florida. Her research program employs an existential perspective on contributors and impediments to health and well-being, with considerations for individual, cultural, and gender-based differences. Primarily, Dr. Courtney uses terror management theory to investigate issues related to deadly disease, breast cancer, and the objectification of women. She is also passionate about undergraduate research mentorship and professional development. Her current research applies the notion that, just like lived experiences, existential threats and concerns may be gendered. Further, Dr. Courtney is working with a population of women diagnosed with or at high risk of breast cancer to investigate mechanisms underlying difficult treatment decisions and individual feelings toward one’s body.
Emily on the web: Faculty Page | Google Scholar | ResearchGate | Twitter | LinkedIn
By Dylan Horner, Minot State University. October 17, 2024.
Left-to-right from top: The Things They Carried by Tim O’Brien; Fight Club by Chuck Palahniuk; The Denial of Death and Escape from Evil by Ernest Becker.
ISSEP: How did you first become aware of and interested in existentialism and the science of existential psychology more broadly?
Emily Courtney: One thing that really started to resonate with me at an early age was understanding the underpinnings of how people grow as individuals, asking questions like, “How do we define ourselves?” and “How do our experiences throughout life influence the way that we perceive the world around us?”
There were two books that stood out as my first foray into those big questions. One was The Things They Carried by Tim O’Brien. It’s a book about the Vietnam War and the idea of bringing home those horrendous experiences with the death of not only close friends but also bystanders, and it deals with questions about the influence of trauma on the way that we feel about our lives. The second book that was really influential for me was Fight Club by Chuck Palahniuk. This book is a satirical commentary on how we adhere to systems and ideologies that may not coalesce well with feelings we have about ourselves. Combining questions and ideas from these books with an awareness that life is finite was a really tough thing to wrap my head around as a teenager.
But when I got to college, that was the moment that the light bulb went off. As a transfer student at Cleveland State University, my very first class was a research methods class with a brand-new professor at the time by the name of Ken Vail. On the first day, Ken introduced himself and talked very briefly about his own research, and I realized this area of work explains those early understandings and questions I had about the world. I was desperate to learn more, so I followed him back to his office and asked him to give me things to read. He gave me The Denial of Death and Escape from Evil by Ernest Becker, and from then on, I was hooked. I also asked to help with his research, as I was always very invested in answering questions and finding new ways to think about things. So, doing research in this area was something I was excited to do.
ISSEP: You’ve been doing some fascinating research in existential psychology lately. Could you tell us more about your work with breast cancer, death awareness, and physical health?
Emily Courtney: Absolutely! I am super excited about all the work that my colleague Jamie Goldenberg and I have done in the realm of breast health. One focus has been on existential barriers to breast health and the extent to which women are willing to approach breast health, like doing breast self-exams or choosing radical treatment options like a mastectomy. The theorizing for this work starts with the creatureliness of the body—as humans, we are finite, physical creatures. Any reminder of this connection with other animals and the fact that animals are eventually going to die sets off this connection where we might think, at least at a subconscious level, “Oh, we are animals—we are going to die.”
Because of the very physical, creaturely nature of the breasts and their connection to things like breastfeeding, pregnancy, and menstruation, they have this additional level or layer of creatureliness. So, when we are trying to approach breast health, this can be dissuading at best—then, at least on a subconscious level, someone might think, “If my breasts are so creaturely and there might be cancer in them that could kill me, why am I going to confront that issue if all it’s going to do is just remind me of my own mortality?” This presents an existential problem or barrier to breast health.
Courtney (2022) found a chain in the data such that family history of breast cancer predicted perceived susceptibility, which predicted death thought association, which predicted breast health importance, which facilitated intentions to engage in breast health behaviors.
But, if we can strip away some of the meaning from a body part like the breasts and view them as just objects that are attached to the body, then they are no longer part of our sense of self. This “adaptive self-objectification” is the mechanism through which the existential barrier to breast health can, at least to some extent, be removed. Once you have a physical, inert thing, the problem of creatureliness and the connection to living, breathing animals is no longer there. So, someone might instead think that breasts are just an inert object that is attached to the body and not necessarily a component of who they are as a person. My research on breast health is really trying to parse out the ways that we can encourage women to view their breasts and their bodies in this way, taking away the existential threat and that connection to creatureliness and instead allowing for more psychological comfort in approaching breast health.
In my recent work (Courtney, 2022), I looked at women with differing levels of family history with breast cancer. This included women who had no familial experience with breast cancer, women whose family members survived their diagnosis, and women whose family members had died over the course of their breast cancer journey and treatment. Results from this work found an interesting chain reaction of variables that can influence women’s intentions to engage in adaptive breast health behavior. Specifically, compared to women with no family history of breast cancer, women with a family history of breast cancer—regardless of whether the family member died or survived—saw their lifetime chance of having breast cancer as high, and in turn, recognized that breast cancer is a severe risk. In other words, they associated breast cancer with death to a greater extent. These high perceptions of both susceptibility and severity predicted how much these women saw breast health behaviors as personally important to them, which in turn facilitated future intentions to engage in breast health behaviors.
What this research tells us is that there’s an optimal pathway to communicate risk levels to people. Familial experiences are tied to risk perception, both in terms of susceptibility and the extent to which women associate breast cancer with death. But importantly, health behaviors themselves need to be intertwined with a sense of meaning or esteem in order for those risk perception factors to facilitate intentions to engage in breast health.
ISSEP: Very interesting! What do you see as important next steps for this research?
Emily Courtney: Public health campaigns aimed at breast cancer awareness have already been separating the breast from the woman by using disembodied types of public health campaigns like “Save the Boobies” and “Save the Tatas.” But these approaches also sanitize the idea of breast cancer in a problematic way—not only should we be “saving the boobies,” but we also need to remind people that “boobies” are things that could kill them, especially for women whose breast cancer risk is elevated due to familial or genetic factors. People need to realize this risk, but also understand that taking care of their bodies is something that can be empowering and a source of self-esteem.
In current cultural perspectives on health, we can really draw from the idea of empowerment. We have a variety of social movements focused on empowering women—such as the body positivity movement, the #MeToo movement, and the Time’s Up movement—and trying to give power to people over their bodies and the way they feel about their bodies. It’s important to make sure that once women are aware of their risk level for breast cancer and understand the death component, there are ways to solidify feelings of individuality, feelings of investment, and feelings of esteem as it relates to breast health behaviors. So, facilitating ways in which the breasts can be seen as not only separated from the body, but also helping women understand their risk level and see breast health behaviors as a source of self-esteem is an important direction and has potential to be very helpful for risk reduction, early detection, and treatment options.
ISSEP: Do you see instances of this research topic and those ideas when you look at arts and culture?
Emily Courtney: If we look at traditional art, even going back to Romanesque marble, we often see women’s bodies without a head. And whether it’s your headless marble Romanesque statue or a beer advertisement with a bottle between boobs, there has been sexual objectification of women in media and art that have persisted over millennia. But there doesn’t need to be this sexual layer to objectification—if we can view breasts as just an object attached to the body, adaptive self-objectification can be helpful.
Luckily, we are seeing some of these shifts. For example, there is a social media movement called #FeelItOnTheFirst, where women give how-to videos on breast self-exams, and it is a monthly reminder to check yourself. There are also interviews with Angelina Jolie, who had a bilateral prophylactic mastectomy in order to reduce her own genetic breast cancer risk. There are also some excellent influencers promoting breast health. One by the name of Paige More, whose non-profit called The Breasties, went on Good Morning America and talked about breast self-exams and how to find out about risk level. Even sororities across the United States, especially Zeta Tau Alpha, partner with organizations like Bright Pink to really promote breast cancer awareness in the month of October. Breast cancer awareness has become so much more than just a pink ribbon now, and I think these types of outlets have had a positive role in helping people grip that traditionally sexualized view of women’s bodies and really influence the way that people see the breasts on a cultural level.
ISSEP: How did you become interested in these topics?
Emily Courtney: There is a lot of conversation within the high-risk breast cancer community and comments like, “My breasts are ticking time bombs” and “I want to get rid of them—they are a threat to my body.” There is a very disembodied tone to all of it. And I have seen this discourse because I am a part of that high-risk group. I was confronted with the idea of mortality at a younger age than I anticipated I would. When I came back from college, I found out about my own genetic risk factors for breast cancer. I opted for some radical prophylactic options for myself, undergoing bilateral mastectomy in 2013. This focused effort at a very young age to address my own health risks really informed my program of research. Had I not gone in for that doctor’s appointment when I was 19, I would have had breast cancer very, very early in life.
I was lucky to catch it early, and other women deserve to be more than just lucky. I also had the opportunity to serve as an education ambassador for a breast cancer non-profit organization called Bright Pink, so I traveled across the country delivering seminars to groups of women who might be at high risk and groups of women who may not know their risk level at all. Health is intertwined with death at a very intrinsic level, so finding ways to help women like me figure out how to best approach their own risk levels is something really near and dear to my heart. For me, it gives me a real sense of fulfillment.
ISSEP: Thank you for sharing. So, you’ve attended and presented research at our Existential Psychology Pre-Conferences. How has your experience been with that?
Emily Courtney: It’s so fun! The pre-conference has not only this educational, really cutting-edge ability to present research and ideas, but it’s also a chance to network and chat about our big ideas and big questions. Having an outlet where we’re not rushed and can share our interest in the science of being and becoming is incredible. I felt lucky to be part of the pre-conference the last few years.
Dr. Courtney and Little Bear
ISSEP: Can you tell us a little about yourself outside the work/research context?
Emily Courtney: I am super into the Legend of Zelda games. The last two have been a really cool reflection of some of the work that we do as existential psychologists, because you get to make decisions yourself and go about this massive open world in a super self-determined kind of way. I also love going to the gym—I like picking up heavy things and putting them back down—and I have started getting into furniture rehabilitation, trying to make old pieces look nice and preserve some of their charm. I also love my dog! He’s a Lab Newfoundland mix, and we call him our little bear.
ISSEP: What is one piece of advice you would give to people who want to follow in your footsteps or contribute in innovative ways to existential psychology?
Emily Courtney: The biggest piece of advice that I can give is to read. The field of existential psychology is expanding so quickly, so it’s critical to know what it is that you care about and figure out if there are people answering those same questions or at least seeking to. And it’s important to not just read scientific, peer-reviewed literature—we’ve got great resources in the work of writers like Ernest Becker and Simone de Beauvoir from which we can draw inspiration. So, if someone has the time and opportunity, just sit down and read as much as possible.
Also, asking big questions can be intimidating. As existential psychologists, it can be daunting and off-putting to some people to be so focused on topics like death. But, although these existential questions can sound scary, I think they serve to highlight the light in the world and give us more purpose.
ISSEP: A lot of us like to listen to music while working or studying, and in general. What are you listening to lately?
Emily Courtney: I usually put on some ambient house music when I’m working. Aphex Twin is usually on the top of my playlist, especially when I am doing data analysis. I’m super into an artist by the name of Fred Again. He recently put out an album with Brian Eno that’s very ethereal.
I’ve also really gotten into solid pop music. So, you’ll find me jamming to Ice Spice and Doja Cat, but also listening to Aphex Twin when doing math—life is about balance! I listen to a lot of different stuff, but I think my favorite album right now is Motomami by Rosalía.