This paper examines the feasibility of developing `material-discursive' approaches suitable for studying the reciprocal interactions between the sociolinguistic and physical aspects of health and illness. The term `discursive' is used in the broadest possible sense, to refer to a mode of description characterized by awareness of the socially constructed and linguistically mediated nature of human experience. Similarly, the term `material' is extended to embrace any non-reductionist account of physical being which appears compatible with a discursive outlook. The obstacles to a material-discursive approach are discussed, with particular reference to the debate between researchers who conduct traditional quantitative and experimental research within the `biopsychosocial' framework and those who advocate a radical anti-realist position and qualitative research. A variety of material-discursive perspectives are explored, ranging from consideration of the physical origins and manifestations of linguistic meaning and socio-cultural processes, to analysis of the consonance between social constructionism, phenomenology and James Gibson's ecological psychology.
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References
1.
Abu-Lughod, L. , & Lutz, C.A. (1990). Introduction: Emotion, discourse and the politics of emotion. In C. A. Lutz & L. Abu-Lughod (Eds.), Language and the politics of emotion (pp. 1-23). Cambridge: Cambridge University Press.
2.
Anderson, R. , & Bury, M. (Eds.). (1988). Living with chronic illness. London: Unwin Hyman.
3.
Armstrong, D. (1987). Theoretical tensions in biopsychosocial medicine. Social Science and Medicine, 25, 1213-1218.
4.
Banister, P. , Burman, E., Parker, I., Taylor, M., & Tindall, C. (1994). Qualitative methods in psychology: A research guide. Buckingham: Open University Press.
5.
Barrett, R.J. (1988). Clinical writing and the documentary construction of schizophrenia. Culture, Medicine and Psychiatry, 12, 265-299.
6.
Berger, P.L. , & Luckmann, T. (1966). The social construction of reality. London: Penguin.
7.
Bhaskar, R. (1989). Reclaiming reality. London: Verso.
8.
Billig, M. , Condor, S., Edwards, D., Gane, M., Middleton, D., & Radley, A. (1988). Ideological dilemmas. New York: Sage.
9.
Blaxter, M. (1993). Why do the victims blame themselves? In A. Radley (Ed.), Worlds of illness. London: Routledge.
10.
Brodwin, P.E. (1992). Symptoms and social performances: The case of Diane Reden. In M.-J. DelVecchio Good, P. E. Brodwin, B. J. Good, & A. Kleinman (Eds.), Pain as human experience (pp. 77-99). Berkeley: University of California Press.
11.
Cioffi, D. (1991). Beyond attentional strategies: A cognitive-perceptual model of somatic interpretation. Psychological Bulletin, 109, 25-41.
12.
Conrad, P. (1990). Qualitative research in chronic illness: A commentary on method and conceptual development. Social Science and Medicine, 30, 1257-1263.
13.
Corbin, J. , & Strauss, A. (1985). Managing chronic illness at home: Three lines of work. Qualitative Sociology, 8, 224-227.
14.
Costall, A. (1995) Socializing affordances. Theory & Psychology, 5, 467-481.
15.
Deleuze, G. , & Guattari, F. (1984). Anti-Oedipus: Capitalism and schizophrenia. London: Athlone. (Original work published 1972.)
16.
DelVecchio Good, M.-J. , Brodwin, P. E., Good B. J., & Kleinman, A. (Eds.). (1992). Pain as human experience. Berkeley: University of California Press.
17.
Derrida, J. (1974). Of grammatology. Baltimore, MD: Johns Hopkins University Press. (Original work published 1967.)
18.
Douglas, M. (1970). Natural symbols. London: Barrie & Jenkins.
19.
Engel, G.L. (1977). The need for a new medical model: A challenge for biomedicine. Science, 196, 129-136.
20.
Engel, G.L. (1982). The biopsychosocial model and medical education. New England Journal of Medicine, 306, 802-805.
21.
Foucault, M. (1989). Birth of the clinic. London: Routledge. (Original work published 1963.)
22.
Fox, N.J. (1993). Postmodernism, sociology and health. Bristol: Open University Press.
23.
Frank, A.W. (1991). For a sociology of the body: An analytical review. In M. Featherstone, M. Hepworth, & B. S. Turner (Eds.), The body: Social process and cultural theory (pp. 36-102). London: Sage.
24.
Frankenberg, R. (1986). Sickness as cultural performance: Drama, trajectory, and pilgrimage root metaphors and the making social of disease. International Journal of Health Services, 16, 603-626.
25.
Gergen, K.J. (1985). The social constructionist movement in modern psychology. American Psychologist, 40, 266-275.
26.
Gibbons, M. , Limoges, C., Nowotny, H., Schwartzman, S., Scott, P., & Trow, M. (1994). The new production of knowledge: The dynamics of science and research in contemporary societies. London: Sage.
27.
Gibson, J.J. (1966). The senses considered as perceptual systems. Prospect Heights, IL: Waveland Press.
28.
Gibson, J.J. (1982). Notes on affordances. In E. Reid & R. Jones (Eds.), Reasons for realism (pp. 401-418). Hillsdale, NJ: Erlbaum.
29.
Gibson, J.J. (1986). The ecological approach to visual perception. Hillsdale, NJ: Erlbaum.
30.
Ginsburg, G.P. (1990). The ecological perception debate: An affordance of the Journal for the Theory of Social Behaviour. Journal for the Theory of Social Behaviour, 20, 347-364.
31.
Gordon, D.R. (1988). Tenacious assumptions in modern medicine. In M. Lock & D. R. Gordon (Eds.), Biomedicine examined (pp. 19-56). Dordrecht: Kluwer Academic.
32.
Guggenbuhl-Craig, A. , & Micklem, N. (1988). No answer to Job: Reflections on the limitations of meaning in illness. In M. Kidel & S. Rowe-Leete (Eds.), The meaning of illness (pp. 141-153). London: Routledge.
33.
Harré, R. (1984). Social elements as mind. British Journal of Medical Psychology, 57, 127-135.
34.
Harré, R. (1991). Physical being. Oxford: Blackwell.
35.
Heft, H. (1989). Affordances and the body: An intentional analysis of Gibson's ecological approach to visual perception. Journal for the Theory of Social Behaviour, 19, 1-30.
36.
Helman, C.G. (1988). Psyche, soma and society: The social construction of psychosomatic disorders. In M. Lock & D. R. Gordon (Eds.), Biomedicine examined (pp. 95-122). Dordrecht: Kluwer Academic.
37.
Henriques, J. , Hollway, W., Urwin, C., Venn, C., & Walkerdine, V. (1984). Changing the subject: Psychology, social regulation and subjectivity. London:Methuen.
38.
Herzlich, C. (1973). Health and illness. London: Academic Press.
39.
Hopkins, A. (1989). The social construction of repetitive strain injury. Australian and New Zealand Journal of Sociology, 25, 239-259.
40.
Ibañez, T. (1994). Constructing a representation or representing a construction? Theory & Psychology, 4, 363-381.
41.
Ingham, R. (1993). Old bodies in older clothes. Health Psychology Update, 14, 18-23.
42.
Ingram, R.E. (1990). Self-focused attention in clinical disorders: Review and a conceptual model. Psychological Bulletin, 107, 156-176.
43.
Jackson, J.E. (1992). `After a while no one believes you': Real and unreal pain. In M.-J. DelVecchio Good, P. E. Brodwin, B. J. Good, & A. Kleinman (Eds.), Pain as human experience (pp. 138-168). Berkeley: University of California Press.
44.
Johnson, M. (1987). The body in mind: The bodily basis of meaning, imagination and reason. Chicago, IL: University of Chicago Press.
45.
Kidel, M. (1988). Illness and meaning. In M. Kidel & S. Rowe-Leete (Eds.), The meaning of illness (pp. 4-21). London: Routledge.
46.
Kirmayer, L.J. (1988). Mind and body as metaphors: Hidden values in biomedicine. In M. Lock & D. R. Gordon (Eds.), Biomedicine examined (pp. 57-93). Dordrecht: Kluwer Academic.
47.
Kirmayer, L.J. (1992). The body's insistence on meaning: Metaphor as presentation and representation in illness experience. Medical Anthropology Quaterly, 6, 323-346.
48.
Kleinman, A. , Brodwin, P.E., Good, B.J., & DelVecchio Good, M.-J. (1992). Pain as human experience: An introduction. In M.-J. DelVecchio Good, P. E. Brodwin, B. J. Good, & A. Kleinman (Eds.), Pain as human experience (pp. 1-28). Berkeley: University of California Press.
49.
Kvale, S. (1992). Psychology and postmodernism. London: Sage.
50.
Lafaille, R. , & Fulder, S. (Eds.). (1993). Towards a new science of health. London: Routledge.
51.
Lakoff, G. (1987). Women, fire and dangerous things. Chicago, IL: University of Chicago Press.
52.
Lakoff, G. , & Johnson, M. (1980). Metaphors we live by. Chicago, IL: University of Chicago Press.
53.
Larsen, R.S. (1992). Neuroticism and selective encoding and recall of symptoms: Evidence from a combined concurrent-retrospective study. Journal of Personality and Social Psychology, 62, 480-488.
54.
Leventhal, H. , & Nerenz, D.R. (1985). The assessment of illness cognition. In P. Karoly (Ed.), Measurement strategies in health psychology (pp. 517-554). New York: Wiley.
55.
Locker, D. (1981). Symptoms and illness: The cognitive organization of disorder. London: Tavistock.
56.
Lyotard, J.-F. (1993). The inhuman. Cambridge: Polity. (Original work published 1988.)
57.
Maturana, H.R. , & Varela, F.J. (1987). The tree of knowledge: The biological roots of human understanding. London: New Science Library.
58.
Mauss, M. (1979). Sociology and psychology essays. London: Routledge. (Original work published 1950.)
59.
McNay, L. (1992). Foucault and feminism: Power, gender and the self. Cambridge: Polity Press.
60.
Merleau-Ponty, M. (1962). Phenomenology of perception (C. Smith, Trans.). London: Routledge.
61.
Michael, M. (1991). Some postmodern reflections on social psychology. Theory & Psychology, 1, 203-221.
62.
Miles, M.B. , & Huberman, A.M. (1984). Qualitative data analysis. Beverly Hills, CA: Sage.
63.
Miller, S.M. (1990). To see or not to see: Cognitive informational styles in the coping process. In M. Rosenbaum (Ed.), Learned resourcefulness (pp. 95-126). New York: Springer.
64.
Mishler, E.G. (1981). Social contexts of health care. In E.G. Mishler, L.R. Amarasingham, S.T. Hauser, S.D. Osherson, N.E. Waxter, & R. Liem, Social contexts of health, illness and patient care (pp. 79-103). Cambridge: Cambridge University Press.
65.
Morse, J. M. , & Johnson, J. L. (Eds.), (1991). The illness experience. London: Sage.
66.
Noble, W. (1993). What kind of approach to language fits Gibson's approach to perception? Theory & Psychology, 3, 57-78.
67.
Noble, W. , & Hétu, R. (1993). An ecological approach to disability and handicap in relation to impaired hearing. Audiology, 33, 117-126.
68.
O'Neill, J. (1985). Five bodies: The human shape of modern society. London: Cornell University Press.
69.
Pierret, J. (1993). Constructing discourses about health and their social determinants. In A. Radley (Ed.), Worlds of illness (pp. 9-26). London: Routledge.
70.
Pollock, K. (1988). On the nature of social stress: Production of a modern mythology. Social Science and Medicine, 26, 381-392.
71.
Pollock, K. (1993). Attitude of mind as a means of resisting illness. In A. Radley (Ed.), Worlds of illness (pp. 49-70). London: Routledge.
72.
Potter, J. , & Wetherell, M. (1987). Discourse and social psychology. London: Sage.
73.
Prigogine, I. , & Stenger, I. (1984). Order out of chaos. London: Heinemann.
74.
Radley, A. (1993). The role of metaphor in adjustment to chronic illness. In A. Radley (Ed.), Worlds of illness (pp. 109-123). London: Routledge.
75.
Radley, A. (1995). The elusory body and social constructionist theory. Body and Society, 1(2), 3-23.
76.
Ricoeur, P. (1970). Freud and philosophy. New Haven, CT: Yale University Press. (Original work published 1965.)
77.
Riessman, C.K. (1993). Narrative analysis. Newbury Park, CA: Sage.
78.
Romanyshyn, R.D. (1989). Technology as symptom and dream. London: Routledge.
79.
Scheper-Hughes, N. , & Lock, M.M. (1987). The mindful body: A prolegomenon to future work in medical anthropology. Medical Anthropology Quarterly, 1, 6-41.
80.
Schwarz, G.E. (1982). Testing the biopsychosocial model: The ultimate challenge facing behavioral medicine? Journal of Consulting and Clinical Psychology, 50, 1040-1053.
81.
Shaw, R.E. , & Hazelett, W.M. (1986). Schemas in cognition. In V. McCabe & G. J. Balzano (Eds.), Event cognition: An ecological perspective (pp. 45-58). Hillsdale, NJ: Erlbaum.
82.
Sheets-Johnstone, M. (1990). The roots of thinking. Philadelphia, PA: Temple University Press.
83.
Shilling, C. (1993). The body and social theory. London: Sage.
84.
Shotter, J. (1983). `Duality of structure' and `intentionality' in an ecological psychology. Journal for the Theory of Social Behaviour, 13, 19-43.
85.
Shotter, J. (1993). Conversational realities: Constructing life through language. London: Sage.
86.
Silverman, D. (1993). Interpreting qualitative data. London: Sage.
87.
Sontag, S. (1991). Illness as metaphor/AIDS and its metaphors. London: Penguin.
88.
Soyland, A.J. (1994). Psychology as metaphor. London: Sage.
89.
Stam, H.J. (1988). The practice of health psychology and behavioral medicine: Whither theory? In W. J. Baker, L. P. Mos, H. V. Rappard, & H. J. Stam (Eds.), Recent trends in theoretical psychology (Vol. 1, pp. 313-325). New York: Springer.
90.
Stiles, W. (1993). Quality control in qualitative research. Clinical Psychology Review, 13, 593-618.
91.
Strauss, A. , & Corbin, J. (1990). Basics of qualitative research. London: Sage.
92.
Taussig, M.T. (1980). Reification and the consciousness of the patient. Social Science and Medicine, 14B, 3-13.
93.
Toombs, S.K. (1992). The meaning of illness. Dordrecht: Kluwer.
94.
Turner, B.S. (1984). The body and society. Oxford: Blackwell.
95.
van den Berg, J.H. (1987). The human body and the significance of human movement. In J. J. Kockelmans (Ed.), Phenomenological psychology: The Dutch school (pp. 55-77). Dordrecht: Martinus Nijhoff.
96.
Ville, I. , Ravaud, J.-F., Diard, C., & Paicheter, H. (1994). Self-representations and physical impairment: A social constructionist approach. Sociology of Health and Illness, 16, 301-321.
97.
Ware, N.C. (1992). Suffering and the social construction of illness: The delegitimation of the illness experience in chronic fatigue syndrome. Medical Anthropology Quarterly, 6, 347-361.
98.
Williams, G. (1993). Chronic illness and the pursuit of virtue in everyday life. In A. Radley (Ed.), Worlds of illness (pp. 92-108). London: Routledge.
99.
Wittgenstein, L. (1953). Philosophical investigations. Oxford: Blackwell.
100.
Wynne, A. (1988). Accounting for accounts of the diagnosis of multiple sclerosis. In S. Woolgar (Ed.), Knowledge and reflexivity: New frontiers in the sociology of knowledge (pp. 101-122). London: Sage.
101.
Yardley, L. (1994). Vertigo and dizziness. London: Routledge.
102.
Yardley, L. (in press). Disorientation in the (post)modern world. In L. Yardley (Ed.), Discourses of health and illness. London: Routledge.
103.
Young, K. (1989). Narrative embodiments: Enclaves of the self in the realm of medicine. In J. Shotter & K. J. Gergen (Eds.), Texts of Identity (pp. 152-165). London: Sage.
