Even when she was playing dressing-up games for the camera, the late Jo Spence's photography was raw as a scraped shin. In some works, she flirts with sexual cliches, posing with a vacuum cleaner pipe curled around her fishnet-clad legs, like a phallic ball and chain.
Mostly though, it's gritty stuff. Acting the hollowed-out mother, she fixes us with a glazed stare, nude but for a floral pinny and holding up a dish that says "Love" in felt-tip pen. Even more unsettling is seeing her crying, naked and clutching a grubby teddy like a little girl.
Throughout the 1970s and 80s, Spence sought to expose photographic stereotypes of family life, sex and class. Our picture perfect fantasy of ourselves was something she knew well. Born to London factory workers in 1932, she was sent to secretarial college at 13 before she landed a job as a bookkeeper and typist with a photographer in the 1950s. After taking a Kodak training course, she opened her own studio in the 1960s to do actors' portraits, wedding and passport photos.
By 1978, Spence had left commercial photography behind and was upending traditional shots of smiling couples and radiant new mothers with Beyond The Family Album. Posing as browbeaten housewives or traumatised children, she explored a domestic reality punctuated not by the get-togethers photos normally recorded, but by abuse, rows and workaday grind. In the intervening decade, she had focused on documentary photos with a socialist, feminist bent, founding projects such as the wonderfully named Hackney Flashers – a collective of women taking the camera back from photography's boy's club.
Spence was a true innovator: she was one of the first artists to explore identity politics through role-play and photography; Cindy Sherman and Gillian Wearing would adopt similar strategies. Undoubtedly, her most heroic work was The Picture of Health, in 1982, which she began after being diagnosed with breast cancer. This series of self-portraits is both alternative therapy and a critical response to modern medicine, with Spence regaining ownership of her body by documenting her treatment.
In all of her work, Spence confronted us with the things society tries to conceal – not least women's unconventional physiques. In The Picture of Health she upped the ante, bringing disease into the frame. In one bare-chested photo, she stands before a mammogram, her breast laid out between its slabs like a separate entity. Later, she poses in a biker's helmet, holding up her arms to reveal battle scars.
Spence survived breast cancer, preferring Chinese medicine to more aggressive treatment. It's incredibly sad that she then died of leukaemia in 1992, though she continued creating her playful, defiant photos until the end.
Why we like her: For the quiet beauty of Return to Nature. Created shortly before Spence's death, it pictures her floating in an endless pool of blue.
Medicine woman: Spence pioneered photo-therapy, embracing the camera's ability to capture our self-image and using it to heal.
Where can I see her? At Studio Voltaire, London, until 11 August.