Lecture 2 And 3 Flashcards
Nature of illness from Cassell (1976)
Illness is what we feel when we go to visit a doctor and disease is what we have after we have been to the doctors office and we are now on the way home
Nature of illness from helman (2007)
Illness can be thought of as a type of misfortune which brings on a subjective experience of physical and emotional changes what are generally conformed by other people
Nature of illness form Kleinman (1989)
To bocome temporarily deomorilsed with ones world
“Language of distress”
acts as a bridge
between the subjective experiences of
impaired well being and social
acknowledgment of them.
What does congested illness show
Contested illnesses show the
mul/direc/onal direc/onal flow
of interpre/ve work in ‘doing’
health and illness and it gets
poli/cal – eg you consider
yourself ill but few agree you
have a disease (ie ME)…or…
• Others think that you have a
disease but you yourself
consider you are just one more
varia/on of how to be normal
(ie successfully living with
mental health issues or perhaps
with D/deafness –there are just
so many examples)
A definiPon of pilgrimage (Turner, 1969:4):
“the process
of going to a far place to understand a familiar place
becer”
Personal dimensions of suffereing. - young(1995): the primary experience of suffering is Alienation in 3 phase
- You become alienated from yourself, even hatred (e.g Oliver Sacks A leg to stand on)
- Alienated form the others (rips aside the social self, need to speak, unsure of reception)
- Makes strangers out of those you know well (an insight into foreign territory
What is suffering form cassell 2004
suffering is a state of distress brought about
by an actual or perceived threat to the integrity or continued
existence of the whole person ie body/self which includes
cultural and social dimensions (eg Ca Cx/fertility)
The regaining of voice has 3 phases (for Younger)
• mute suffering
• Expressive suffering (the narrative)
• Finding an authentic voice
Jaye 1998 healing
Healing relates to notions of transformation, restoration,
resolution, being made whole
How does healing work?
Helman (2000): through language, ritual and the
manipulation of powerful cultural symbols
How does healing work : Kleinman (1980:372)
Kleinman (1980:372) healing has 3 stages – labeling
the sickness with a culturally appropriate category,
the label is ritually manipulated to culturally
transform it, this creates a new potent cultural symbol
of ‘well’ that is applied independently of behavioral
or social change
Quest narrative
Whentheexperienceofmakingsenseofillnessisresolvedbyhelping
othersorundertakingapersonallysignificantchallenge
Chaos story
Andthenthishappened,andthenthishappened,andthenthis
happened…
Restituation narratives
Yesterday i was well, today i am sick, but tomorrow i will be perfectly well again
Definition of disease
What you have when you leave the doctors office
Health (from an interpretive medical anthropology perspective)
asetofcommonsenseideaswhichwehaveallbeenlearningsincechildhoodaboutourbodilyprocesses,thewayinwhichwe. monitorthem,andthestandardrhetoricaldeviceswhichwe usetodescribethem.”Kleinman(1988)
Curing
The removal of disease
Suffering
astateofdistressbroughtaboutbyanactualorperceived threattotheintegrityorcontinuedexistenceof thewholepersonie.body/selfwhich includesculturalandsocialdimensions
Two definitions of healing
Ifwecanfindsomewaytoregainourvoice,thisisthebasis ofthemasterypoliticalofsuffering.
Nichter1991:“theperceptionofpositivequalitativechangeintheconditionoftheafflicted”
Csordas1988:“personalandsubjectiveprocessesof transformation”
Comaroff1982:“culturallyspecific,self-consciousattemptstomend
[one’s]physical,emotional,socialbreaches”
Humanities
“Educating‘theemotionsaswellastheintellect,enhanc[ing]compassionaswellascriticalthinking,…encourag[ing]activeengagementinpublicand/orprofessionallife”(Cole,Carlin&Carson,2015:2)
Health (from a political economy perspective)
“accesstoandcontroloverthebasicmaterialand nonmaterialresources
Thatsustainandpromotelifeatahighlevelofsatisfaction”
Baer,SingerandSusser(1997)
Medical humanities
“Aseriesofintersections,exchangesandentanglementsbetweenthe
biomedicalsciences,thearts,thehumanitiesandthesocialsciences”
(Whitehead&Woods,2016:1)
Restitution stories do not consider _____ elements of illness - uses _____ as the hero
The metaphysical elements (changes to yourself, your sense of identity and purpose)
Medicine
What is the active character in restituation stories
The active character in this story is the medication or the treatment modality.
Biomedicine emerges as heroic and triumphan
Chaos stories are from people who…
Have no distance from their illness in their life - instead they are consumed by it
Quest sores are like
Journeys
Testimonial stories
press you to witness and to believe and excluding information that contradicts their key storyline.
- combines elements of all 4
Key differences between the stories
ResPtuPon stories leave out the metaphysical aspects of illness; Chaos stories leave out the possibility of hope and acceptance; Quest stories tend to diminish greatly the suffering involved at least iniPally in a quest…
What does Developing sophistication in interpreting stories do?
helps us understand the context of people’s health experiences – and to recognise that people respond to illness in varied ways - recovery is a process, not an event
Health practitioners and scientists are no more bullet proof than anyone
else to life’s misfortunes – you can be a patient and a professional too.
True and real
Quote by some cunt called Sontag (1978:3)
Illness is the night-side of life, a more onerous
citzenship. Everyone who is born holds dual
citzenship, in the kingdom of the well and the
kingdom of the sick. Although we prefer to use only
the good passport, sooner or later each of us is
obliged, at least for a spell, to identfy ourselves as
citzens of that other place.
What is this…. Who painted it….where did they paint it… when did they paint it…
A digital enhancement of ‘the starry night’ originally painted by Van Gogh while staying in an asylum in saint Remy de Provence in 1889
The metaphor of journey helps express…
this distance we must travel to reach another’s experience of
health and illness ie through assumptions, between
cultural worlds, between people and communities,
across political beliefs…
- no fert
Cassell (1976) definition of illness
llness is what we feel when we go to visit a doctor and disease is what we have after we have been to the doctor’s office and we are on our way back home.
Helman (2007) definition of health
illness can be thought of as a type of misfortune which brings on a subjective experience of physical and emotional changes which are generally confirmed by other people
Kleinman (1989)
to become temporarily demoralised with one’s world
the “language of distress” acts as a bridge between
the subjective experiences of impaired well being and social
acknowledgment of them.
The language of distress and example
Its expression is the resolution of a tight
knot of physiological, psychological and
socio-cultural meanings (including spiritual,
political and environmental knowledges)
EXAMPLE:
ashen faces on the Sepik River, PNG versus
Bogotá Colombia, Southland Farmers, the
Italian ladies from Wollongong
It can be very culturally distinctive ie
‘crawling ants’ in Nigeria, ‘steaming bones’ in
Chinatown in Sydney
Health care pluralism and who suggested it
Kleinman suggests that there are mulPple sources of
experPse/knowledge of health care (health care pluralism)
Kleinman iceberg of hierarchies of resort and health care pluralism and two examples
Kleinman suggests at least 3 sectors of health care – lay, folk
and professional with the professional being the tiny tip of
the iceberg and the other 2 sectors below the surface of our
attentionon most of the time (depending upon who ‘we’ are)
• The layers are porous and the categories are blurred, but
people follow through them in a hierarchy of resort to seek
relief from illness with professionals neither first nor last
EXAMPLES:
- Combat veterans watch as Navajo medicine man Albert Laughter fans a fire in his teepee during ceremonies to care for the soldiers who have PTSD
- Treating aches the traditional way, a healer in Bayt al Faqih, Yemen, makes a series of incisions, then places a heated horn over each to create suction. Finally, through a tiny hole, he draws out blood.
Contested illnesses show the..
multidirectional directional flow of interpretive work in ‘doing’ health and illness and it gets political – eg you consider yourself ill but few agree you have a disease (ie ME)…or…
What is contested illness / diagnosis
Others think that you have a
disease but you yourself
consider you are just one more
variation of how to be normal
(ie successfully living with
mental health issues or perhaps
with D/deafness –there are just
so many examples)
Canguilhem (1991) definition of disease
disease is a departure from the norm established by biomedical authority’ and to which the practice of medicine seeks to return the client
Canguilhem (1991) definition of health
Being healthy means being not only normal in
a given situation … “What characterises health is the possibility of
transcending the norm which defines the momentary normal, the
possibility of tolerating infractions of the habitual norm and
instituting new norms in new situations.” (Canguilhem 1978:115-
116)
Defining health in these more poli6cal journeys…
health is the capacity to become sick and to
recover, is contextually dependant and not at all about becoming ’normal’ –instead it is the capacity to continue living your life in a wide array of different circumstances which become normal to YOU
The CONCEPT of pilgrimage
the parents undertook a
journey in which they achieved self awareness and
insight through a series of great hardships travelling from
disillusionment with biomedical approaches to
D/deafness to relief at finding the bilingual school
approach
• A definiPon of pilgrimage (Turner, 1969:4)
“the process
of going to a far place to understand a familiar place
becer”
An example of a contested illness/diagnosis
medicalized versions of deafness as deficit and ‘tragic’ thus in need of fixing vs Deaf as a cultural identity with its own
Distinctive language of signing and completely ordinary.
